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Home My WebLink About08/02/2000 BOH Minutes & Agenda Packet fJr.Je~ (hNd' 1$ J.I( ~udl~ ?-trft ;td-' ~ m1-IJEJt1 -'('I "",~?d'J.- ~ ~ ~~~~ I,?Ok /./ -~ ~~-w-i~~' &r:J i~ · - NEW HANOVER COUNTY BOARD OF HEALTH . Dr. Thomas Fanning Wood Memorial Conference Room New Hanover County Health Department AGENDA Date: August 2, 2000 Time: 8:00 A.M. Dr. Thomas Fanning Wood Memorial Conference Room New Hanover County Health Department Presiding: Mr. William T Steuer, Chairman ~ edf W--i>'O PII-'EZ5 Invocation: Wilson O'Kelly Jewell, DDS ./ ,,/. L. /' .L fp/lvll ClJII.ItBIPS: pr. Joe /fNpBr'-ltoPI/'f' rtlfJJIf' JI'-jr91!J t -1 Minutes~ July 12,2000 Place: Recognitions: e(S~~~ Years of Service - Mr. William T Steuer Chairman 25 Years Susan O'Brien, Laboratory Director, Laboratory Personnel New Emolovees Joan Hulette, Clerical Specialist I, Communicable Disease Maureen Lamphere, Public Health Nurse I, Communicable Disease Lenora Kay Lunceford, Clerical Specialist I, Communicable Disease Harvey Eugene Young, Environmental Health Specialist, Environmental Health - Department Focal: WIC Outreach Ms. Nancy Nail Nutrition Director - If) - /{ Monthly Financial Report: June 2000 Ms. Cindy Hewett BuYin!ss Ojficer NHCBH Agenda August 2, 2000 - Page 2 - Committee Reports: Executive Committee (listed under New Business) - Mr. William T. Steuer Personal Health Committee (listed under New Business) - Mr. Hank V. Estep, Chairman Unfinished Business: - Mr. William T. Steuer (P/1OKff -1kt~1i) GeneratorslHookups at Emergency Shelters WPtr1!t::r~) New Business: - Mr. William T Steuer Smart Start Applying for Cape Fear Memorial Foundation Grant - Maternity Outreach Workers ($52,000) '"ILl _~q~OGrant Application - Z. Smith Reynolds Foundation, Inc. _0<7/ ~Enhanced Counseling Program ($48,000) 30 - 3'~DGrant Application - Z. Smith Reynolds Foundation, Inc. I,\Teen AIDS Prevention ($59,000) IJ- ---/3 lif'" ~J ~~ Grant Status Update Strategic Planning Process c:.~~ f/tC~E-r _ t~~'~ <c@~!:b: ~ PJ4.L-.BH- tJ~ ~ QI..&J/5Mt?C' ~ 3' .., 'I School Health Nurses Health Director - Mr David E. Rice 1@j,d1oD Meeting with State Health Director (~Xf"!~;fJkJ 8utlr/ ~ ~5tI~c...~/T1!5 0'1 ,,~DO ':.E~o~=OO;t~~5~~~f:':)"" e Other Business: - Mr. William T. Steuer Adjourn: - Mr. William T Steuer I I I 160 Mr. William T. Steuer, Chairman, called the regular business meeting of the New Hanover County Board of Health to order at 8:00 a.m. on Wednesday, August 2,2000. Members Present: William T. Steuer, Chairman Wilson O'Kelly Jewell, DDS, Vice-Chairman Henry V. Estep, RHU Michael E. Goins, 00 Gela M. Hunter, RN Mr. Robert G. Greer Anne Braswell Rowe Estelle G. Whitted, RN Members Absent: W. Edwin Link, Jr., RPH Philip P. Smith, Sr., MD Melody C. Speck, DVM Others Present: Mr. David E. Rice Frances De Vane, Recording Secretary Invocation: Dr. Wilson Jewell gave the invocation. Minutes: Mr. Steuer asked for corrections to the minutes of the July 12, 2000 New Hanover County Board of Health meeting. The Board of Health approved the minutes of the July 12, 2000 Board of Health meeting. Public Comment: Proposed Rel!ulation for the Use of Mobile Telephones While Operatinf: a Motor Vehicle Dr. Joseph Hooper, former Board of Health Chair and New Hanover County Commissioner, thanked the Board of Health for the opportunity to appear before the Board to present a proposed regulation to prohibit the use of hand-held cell phones while driving an automobile. He expressed hand-held mobile phones are a threat to the safety, cause injuries and automobile accidents, and are a health hazard to New Hanover County citizens. Dr. Hooper advised other states have pending mobile phone usage regulation and some municipalities and other countries have banned the use of cell phones. He chose to submit the Proposed Regulation for the Use of Mobile Telephones While Operating a Motor Vehicle to the Board of Health, because under North Carolina General Statue 130-A-l.l the Board has the authority to promote and make public health and safety regulations. 1 161 Ms. Rowe asked if the proposed cell phone regulation would infringe on individual rights. Dr. Hooper I responded cell phones need to be regulated for safety reasons, and the proposed regulation has nothing to do with the freedom of speech. Mr. Steuer asked if the Board should wait for the state or federal governments to restrict cell phone usage while driving a motor vehicle. Dr. Hooper encouraged the Board of Health to consider the recommendation as presented. Mr. Steuer thanked Dr. Hooper for presentation to the Board. The Proposed Regulation for the Use of Mobile Telephones While Operating a Motor Vehicle will be presented to the Executive Committee of the Board of Health for their consideration. Recognitions: Service Awards Susan O'Brien - 25 Years Mr. Rice recognized and congratulated Ms. Susan O'Brien, Laboratory Director, as a recipient of a New Hanover County Service Award. He acknowledged Ms. O'Brien is a cornerstone of the Health Department, and he commended her for 25 years of dedicated public health service. Personnel Joan Hulette, Clerical Specialist I, Communicable Disease Maureen Lamphere, Public Health Nurse I, Communicable Disease Lenora Kay Lunceford, Clerical Specialist I, Communicable Disease Harvey Eugene Young, Environmental Health Specialist, Environmental Health I New Emplovees Department Focal: WIC Outreach Ms. Nancy Nail, Nutrition Director, presented a department focal on WIC Outreach. She explained the New Hanover County Health Department received a WIC Outreach Grant ($10,000) that provided an outreach worker from mid-May through June. The objective of the WIC Outreach Grant was to recover the caseload lost as a result of Hurricane Floyd. Outreach campaigns included storefront set-ups, radio spots and public service announcements, newspaper articles, and community visits. WIC informational booths were set up at Wal-Mart, K-Mart, and Roses from 10:00 a.m. to 4:00 p.m. on high volume shopping days. Public service announcements were aired in English and Spanish on W AA V & WMYT/WDVV. An article entitled Women, Infants, and Children Program Improves Health of Low- Income Children was featured in the Wilmington Journal. To reach the target population outreach workers were made to doctor's office, WIC vendors, Childcare Centers, housing authorities, churches, and Headstart Center to encourage new and former clients to participate in the WIC Program. As a result of these efforts, 17 additional appointments were scheduled for new WIC participants. Mr. Steuer thanked Ms. Nail for her presentation. I 2 I I I 162 Monthly Financial Report - June 2000: Ms. Cindy Hewett, Business Officer, presented the June Health Department Financial Summary Monthly Revenue and Expenditure Report that reflects an earned revenue remaining balance of $224,914 (94.74%), an expenditure remaining balance $974,896 (89.95%), and a cumulative percent of 100%. Ms. Hewett advised revenue and expenditure balances are basically on schedule and in line compared to last year. She explained most of the Capital Outlay remaining balance $237,640 (69.46%) is to be carried forward to FY Budget 2001 for the Medical Records renovation. Ms. Hewett referred the Board to an earned revenue remaining balance of $76,836 (85.13%) that is an increase of earned revenue of approximately $60,000. She reported Animal Control Services earned more revenue this year as a result of the installation of the new computer system. Additional Medicaid monies will be posted later. Ms. Hewett explained this financial report is not the final yearend report from the county. The revised report could be as late as September. Committee Reports: Executive Committee Mr. Steuer reported the Executive Committee met at 6:00 p.m. on Tuesday, July 25, 2000. Items are listed under New Business on the Board of Health Agenda. Environmental Health Committee Mr. Link, Chairman, Environmental Health Committee, reported the Executive Committee met at 6:00 p.m. on July 15, 2000. Items are listed under New Business on the Board of Health Agenda. Personal Health Committee Mr. Estep reported the Personal Health Committee met at 6:00 p.m. on July18, 2000. Items are listed under New Business on the Board of Health Agenda. Unfinished Business: Generators/Hookups at Emerl!encv Shelters Mr. Rice referred the Board to a memo from Dennis Ihnat, School Retrofit Projects, New Hanover County Emergency Services, containing an Update on Generators and Manual Electrical Transfer Switches for Schools Used as Emergency Shelters. On April 18, 2000, the county signed a contract with Watson Electric Company to install manual switches with a required completion date of July 22. The contract price is $211,851. Manual electrical transfer switches are installed at the Central Office Freezer, Dorothy B. Johnson, Eaton, Noble, and Trask Schools. Plans are to install an additional generator switch at Codington School in August 2000. 3 163 Motion: Motion passed to remove the Generators/Hookups at Emergency Shelters under Unfinished I Business from the monthly New Hanover County Board of Health Agenda. Upon vote, the MOTION CARRIED UNANIMOUSLY. On behalf of the Health Department staff, Mr. Rice expressed appreciation to Mr. Steuer, Ms. Hunter, and to the Board of Health members for addressing the need to install generators/hookups and to improve conditions at the disaster shelters. He praised Mr. Steuer for his leadership and tenacity and thanked Ms. Hunter for first presenting the evacuation shelter issues to the Board of Health. Mr. Steuer thanked Mr. Greer, Vice-Chairman, New Hanover County Commissioners, and the County Commissioners for their support of this project. New Business: Grant Status Update Ms. Hewett presented a Grant Status Report from March 3, 1999 through July l2, 2000. The Health Department submitted 29 grant applications ($1,075,62) and received 11 grants ($291,284). Five grant proposals ($182,500) are pending. Eleven (11) grant applications ($555,742) were denied. Ms. Hewett advised the 4 grants approved by the Board of Health in June and July are indicated as pending grants and will be submitted to the New Hanover County Board of Commissioners at their August 7 meeting. Mr. Steuer reported the Executive Committee decided the Grant Status Report should be completed on a fiscal year basis and will be retroactive from July 1,999. Smart Start Applvinl! for Cape Fear Memorial Foundation Grant - Maternity Outreach Workers ($52.000) Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and approve a budget amendment of $52,000 if Smart Start receives the Cape Fear Memorial Foundation Granf to fund the salary of two Health Department Maternity Outreach Workers and operating expenses. Ms. Lynda F. Smith, Assistant Health Director, clarified if Smart Start is awarded the $52,000 grant from the Cape Fear Memorial Foundation, the Health Department will hire and supervise the MOW positions and will receive $52,000 funding. She advised after Smart Start receives the grant, a budget amendment will be submitted to the County Commissioners. The purpose of the Smart Start Cape Fear Memorial Foundation Grant Application is to provide services to high risk pregnant women during pregnancy and to provide services to the child for the first year life. . Motion: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve a budget amendment of $52,000 if Smart Start receives the Cape Fear Memorial Foundation Grant to fund the salary of two (2) Health Department Maternity Outreach Workers and operating expenses. Upon vote, the MOTION CARRIED UNANIMOUSLY. I I 4 I I I 164 Grant Application - Z. Smith Revnolds Foundation. Inc.. Enhanced Counselinl! Prol!ram ($48.000) Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and approve a Grant Application for an Enhanced Counseling Program for $48,000 from the Z. Smith Reynolds Foundation, Inc. The purpose of the grant is to provide enhanced counseling services to newly diagnosed HIV -infected individuals and high-risk Sexually Transmitted Disease (STD) clinic clients. The budget includes a Masters level Social Worker Position ($45,503) and operating expenses ($2,497) to implement the program with total in-kind support of$12,849. Motion: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve a Grant Application for an Enhanced Counseling Program for $48,000 from the Z. Smith Reynolds Foundation, Inc, and to submit the grant application to the New Hanover County Commissioners for their consideration. Upon vote, the MOTION CARRIED UNANIMOUSLY. Grant Application - Z. Smith Reynolds Foundation. Inc. Teen AIDS Prevention ($59.000) Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and approve a Grant Application for Teen AIDS Prevention (TAP) for $59,000 from the Z. Smith Reynolds Foundation, Inc. The purpose of the Teen AIDS Prevention Grant is to continue the TAP peer education program. The grant application is in addition to the Cape Fear Memorial Foundation TAP Grant Application ($55,000). If the Health Departments receives both grants from the two funding sources, the TAP Program is to be enhanced and expanded. Motion: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve a Grant Application for Teen AIDS Prevention (TAP) for $59,000 from the Z. Smith Reynolds Foundation, Inc, and to submit the grant application to the New Hanover County Commissioners for their consideration. Upon vote, the MOTION CARRIED UNAMIOUSL Y. Fundinf: for School Health Nurse Positions ($192.520) Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and approve five (5) new School Health Nurse positions to be funded by the New Hanover County Board of Education. The $192,520 budget includes Salaries/Fringes, Operating Expenses, and Capital Outlay for FY2000- 2001. Health Department staff will hire and supervise the additional ten-month School Health Nurse positions. Motion: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve five (5) new School Health Nurse positions to be funded by the New Hanover County Board of Education and to submit the budget request ($192,520) to the New Hanover County Commissioners for their consideration. Upon vote, the MOTION CARRIED UNAMIOUSL Y. Stratef:ic Planninl! Process Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and approve a List of Key Stakeholders and Community Leaders, the forms for Interview for Key Stakeholders and Community Leaders, the Department/Divisional Survey, and the Expectations from Planning Process for the Health Department Strategic Planning Process. 5 165 Mr. Estep, Chairman, Personal Health Committee, reported the List of Key Stakeholders and Community Leaders and Strategic Planning questionnaires were reviewed by the Personal Health and Executive I Committees. Each Board member and retreat participant will be requested to interview three (3) community leaders and to complete the interview and participant questionnaire forms by August 25, 2000. Mr. Rice distributed to the Board a Strategic Planning Process packet including a list and three questionnaires (a List of Key Stakeholders and Community Leaders, the Interview for Key Stakeholders and Community Leaders form, the Department/Divisional Survey, and the Expectations from Planning Process for the Health Department Strategic Planning Process). He advised on August 9 a letter will be mailed to community leaders (including a copy of the Interview for Key Stakeholders and Community Leaders form) prior to their interview by a Strategic Planning Retreat participant. Mr. Rice gave a computer presentation on the completion of the planning process forms. The three interview forms and questionnaires due to Mr. Rice by August 25 may be entered on computer diskettes or handwritten. If possible, retreat participants should personally interview their designated community leaders. Dr. Goins clarified the Health Department Strategic Planning Process should be proactive not reactive, should perceive and identify problems in advance. Mr. Rice explained the Health Department Mission Statement is included on the interview forms to assist the selected community leaders. The original List of Key Stakeholders and Community Leaders included 278 people and the Executive Committee's revised list includes 78 people. Mr. Rice reported Mr. William T. Herzog, facilitator of the Strategic Planning Retreat, will review the vital statistics and summary reports prior to the retreat on October 6 I and 7, 2000. Mr. Rice plans to prepare the pre-retreat Strategic Planning informational packet and distribute it to retreat participants by September 22,2000. Motion: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve a List of Key Stakeholders and Community Leaders and forms for the Interview for Key Stakeholders and Community Leaders, the Department/Divisional Survey, and the Expectations from the Planning Process for the Health Department Strategic Planning Process. Upon vote, the MOTION CARRIED UNAMIOUSL Y. Comments: Board of Health Members Ms. Whitted stated it is reassuring to know if needed generators/hookups are available in the emergency evacuation shelters. On behalf of the Personal Health Committee, Mr. Estep thanked the Board of Health for their support with the Health Department Strategic Planning Process. Ms. Rowe advised the Board Dr. Hooper requested public comment before the Board of Health regarding his concern about the use of mobile telephones while driving. She emphasized it is a public I health and safety issue that needs to be addressed. , 6 I I I 166 Mr. Estep suggested this issue be referred to the Personal Health Committee. Mr. Steuer recommended and the Board of Health concurred to refer the mobile telephone usage while driving a motor vehicle recommendation to the Executive Committee and then possibly to the Personal Health Committee. Health Director Meetinl! with State Health Director Mr. Rice reported he was honored to meet with Dr. A. Dennis McBride, State Health Director, and other selected Regional Health Directors, on July 18,2000. The group discussed the State Expansion Budget and made plans to meet quarterly to address Public Health issues. N. C. Association of Local Health Directors (NCALHD) Mr. Rice attended the NCALHD meeting held on July 26-27, 2000. He reported for two years, the Information Technology Committee has researched the feasibility of implementing and developing a statewide computer system for local health departments. The current state system is the Health Services Information System (HSIS ) and our local Health Department computer system is QS. Medicaid Maximization funds ($3,000,000) were appropriated for this new computer system. Mr. Rice advised the NCALHD is developing Legislative Priorities for the next legislative session. He referred the Board to a copy of A Legislative Summary of the General Assembly Short Session adjourned on July 13. AEIOU Update Mr. Rice reported the AEIOU (Assessing, Evaluating, Improving, Our Opportunities are Unlimited Team met on July 17,2000. The Team completed the analysis of 50 of 75 strengths identified though the Organizational Capacity Survey. In 1998, the AEIOU Team identified 60 strengths. Upon completion of the analysis of strengths, the team will analyze opportunities to improve. Information for Board of Health Mr. Rice referred the Board to supplementary information in their folders including a letter of appreciation on behalf of the Board of Health and Health Department Staff to Mr. William A. Caster, Chair, and to the Board of County Commissioners and letters from Mr. William K. Atkinson, President and CEO, New Hanover Health Network, from two concerned citizens regarding drainage problems; a Legislative Summary of Short Session Highlights; and an issue of the NALBOH NewsBrief Other Business: Ms. Smith announced the new generator for the Health Department pharmacy is being installed. The Medical Records Renovation is nearing completion. 7 167 Adjournment: Mr. Steuer adjourned the regular meeting ofthe New Hanover County Board of Health at 9:05 a.m. dJ/L,/M~- William T. Steuer, PE/RLS, Chairman New Hanover County Board of Health David E. Rice, M.P.H.,M.A., Health Director New Hanover County Health Department Approved: September 6, 2000 I I I 8 e Mr William T Steuer, Chairman, called the regular business meeting of the New Hanover County Board of Health to order at 8:00 a.m. on Wednesday, July 12, 2000. Members Present: William T Steuer, Chairman Wilson O'Kelly Jewell, DDS, Vice-Chairman Henry V Estep, RHU Michael E. Goins, OD Gela M. Hunter, RN Mr Robert G. Greer W Edwin Link, Jr., RPH Philip P Smith, Sr., MD Melody C. Speck, DVM Estelle G. Whitted, RN Members Absent: Anne Braswell Rowe Others Present: Mr David E. Rice Frances De Vane, Recording Secretary Invocation: Ms. Gela N. Hunter gave the invocation. e Minutes: Mr Steuer asked for corrections to the minutes of the June 7, 2000 New Hanover County Board of Health meeting. The Board of Health approved the minutes of the June 7, 2000 Board of Health meeting. Recognitions: N. C. DeDartment of Labor Award _10th Consecutive Year Mr David E. Rice, Health Director, displayed the Safety A ward presented to the New Hanover County Health Department for the tenth consecutive year from the N. C. Department of Labor He commended the staff for their outstanding injury prevention and safety record. SUDer Staff Award Mr David E. Rice presented Ms. Ruth Roethlinger, X-ray Technician, and Communicable Disease, recipient of the Semi Annual Super Staff A ward. Ms. Roethlinger received the award in recognition of her dedicated service to the Tuberculosis Program. She was nominated by her peers and selected by the Board of Health Executive Committee. Personnel e Service Awards Mr Rice recognized and congratulated the following New Hanover Count Service Award recepients: 1 Ie e e Years of Service 5 Years Deborah Lovett, Clerical Specialist, Environmental Health 10 Years Jean McNeil, Animal Control Services Director, Animal Control Services 20 Years Tom Stich, Environmental Health Supervisor, Environmental Health Mr Rice introduced the following new Health Department employees: , New EmDlovees Vivian Anderson, Public Health Nurse !, Community Health/Jail Lucretia Cox, Medical Laboratory, Assistant I Laboratory Shenita Josey, Public Health Nurse II, Community Health Summer 2000 Hurricane Recoverv Corns Mr. Rice introduced the college/university interns from the Hurricane Floyd Recovery Corps placed in the Health Department by the Department of Health and Human Services to perform public health outreach services and to assist with a backlog of work due to the hurricane. They are as follows: Meredith Bank, University of North Carolina @ Wilmington Ashley Brewster, University of North Carolina@ Chapel Hill Kristen Collins, University of North Carolina @ Wilmington Michael Greenwood, University of North Carolina@ Wilmington Jessica Hulick, University of North Carolina @ Wilmington Karen Miller, University of North Carolina@ Chapel Hill Antonio Montgomery, Elizabeth City State University Tracy Pena, University of North Carolina @ Wilmington Mandy Thurston, University of North Carolina @ Chapel Hill Mr. Rice advised the ten interns are adding capacity to our organization and serving our community He thanked the interns for their assistance. Department Focal: Friends in Deeds Ms. Betty Creech, Community Health Director, presented a department focal entitled Friends in Deeds. She stated that today is a special day to say thanks to and to recognize our professional friends for their volunteer services rendered to health department clients and clinics. She emphasized these people are truly Friends in Deeds who for years have given their time and services to the Wilmington Rotary Orthopedic Clinic, Neurology Clinic, and New Hanover County Schools. On behalf ofthe New Hanover County Health Department, Mr Rice presented plaques to the following in appreciation for their outstanding and dedicated volunteer services: 2 _ _ _ James D Hundley, M. D., Wilmington Rotary Orthopedic Clinic Medical Director, and On Behalf of Students in New Hanover County Schools Thomas Craven,M.D., Wilmington Rotary Orthopedic Clinic & New Hanover County Jail Health David S. Bachman, M.D., Neurology Clinic Medical Director Michael E. Goins, O.D., On Behalf of Students in New Hanover County Schools F Michael Floyd, C.P.O., Wilmington Rotary Orthopedic Clinic Wilmington Orthopaedic Group, 45 -Years Volunteer Service To The Community Wilmington Health Associates Neurology Division, Volunteer Service To The Community New Hanover Healtb Network Update Dr William K. Atkinson, President and CEO, made a presentation on the status of the New Hanover Health Network. He informed the Board New Hanover Health Network like other hospitals nationwide is facing budgetary cuts in reimbursement from federal health insurance programs. The budget reductions are forcing some hospitals into bankruptcy. Many hospitals have laid off employees to cope with cuts in federal reimbursements and managed-care payments. Dr Atkinson stressed the importance of caring for sick people. He stated health care is involved in every element of things that happen to people and that health services left undone mean an unhealthy population. Dr Atkinson advised hospital officials are trying to figure out how to keep the essential services. With modem technology, science and population growth our regional hospital demands and costs have increased. New Hanover County is involved in four areas of health care including Public Health, Mental Health, Emergency Medical Services, and hospital services. Dr. Atkinson gave a brief history of the 30-year-old regional hospital. He advised New Hanover County citizens voted to construct the hospital but did not fund for hospital expenses and facility upkeep. Dr Atkinson emphasized the budget crunch is here with reduced reimbursement from the federal government for existing services. He advised New Hanover Regional Home Health is in serious financial trouble. Beginning October I, 2000, Home Health will not receive enough federal reimbursement to operate, and it will probably be sold. The Health Department ran the Home Health Program until January 1995 when New Hanover Regional Medical Center acquired the program. Mr. Rice advised it is unlikely that the Health Department will consider taking the program again because the reimbursement rate would be similar the hospitals. Reimbursements for Home Health are based on the number of visits. Dr. Atkinson expressed the hope is the federal government probably eventually will realize that nationwide hospitals are in financial trouble, will probably have to provide resources, and will probably designate available health care services. Both federal resources and permanent solutions are needed to make health services work for citizens. The duplication of agency services will need to be eliminated. Mr. Estep inquired regarding the breakdown of revenue for the hospital. Dr Atkinson stated funding includes approximately 50% Medicare, 20% Medicaid, and less than I % full insurance coverage. The current reimbursement is 35 cents on I-dollar of costs. Dr Smith asked if there is any likelihood of the Coastal Diabetes Center being reopened. Dr. Atkinson advised the Coastal Diabetes Center would not be revived unless $300,000 funding is provided to operate the Diabetes Center Mr Rice expressed his appreciation to Mr. Atkinson and the hospital staff for their health care services, for their open communication, and for working with the Health Department staff in a cooperative manner Mr. Atkinson expressed the New Hanover Network is regional and works with multi-programs and activities to make a difference in the health of people in our community and region. He stated the hospital is committed to working with the Board of Health and the Health Department in health care issues. 3 e e e Mr. Steuer thanked Mr Atkinson for his presentation. Montbly Financial Report: Mav 2000 Montblv Financial Report Mr. Steuer reported the Executive Committee reviewed the May Financial Health Department Financial Summary Report Ms. Cindy Hewett, Business Officer, presented the May Health Department Financial Summary Monthly Revenue and Expenditure Report that reflects an earned revenue remaining balance of $517,788 (87.90%), an expenditure remaining balance $1,702,875 (82.45%), and a cumulative percent of 91.67%. Ms. Hewett advised revenue and expenditure balances are basically on schedule and in line compared to last year. She indicated Animal Control budgeted revenue is $516, 453 and revenue earned is $384,709 For the prior year the revenue projected was $493,100 and revenue earned was $340, 062. Committee Reports: Executive Committee Mr Steuer reported the Executive Committee met at 6:00 p.m. on Tuesday, June 27, 2000. Items are listed under New Business on the Board of Health Agenda. Budl!et Committee - FY 20001 Budl!et Update Ms. Lynda Smith, Assistant Health Director, presented the following summary of the Requested and Approved New Hanover County Health Department FY2000-2001 Budget: Requested Approved Salary and Fringe Operating Expenses Capital Outlay $7,904,40 I $1,731,565 $ 591.334 $10,227,300 $7,532,967 $1,553,934 $ 291.851 Total $9,378,752 Ms. Smith explained the Total FY 2000 Approved Budget was $9,701,833 and is $9,378,752 for FY 2001 which is a decrease of $330,000. She reported the County Commissioners approved a 3.5% market increase for county employees (based on performance) and approved increasing the Health Department Salary Lag to $300,000 (current budgeted amount $225.000). The FY 2001 Budget is effective July I, 2000. The New Positions request was for 20 New Positions and (I) increase from a part-time to a full-time position. The Approved FY 2001 Budget includes 3 New Positions: I Environmental Health Specialist and I ClericallEnvironmental Health funded by Water Sample Revenue, I Partnership for Children Clerical PT-FT grant funded, and I Jail Health Licensed Practical Nurse. Ms. Smith reported on June 30, 2000, we received information from the State Mosquito Control Program that we will not receive any of the $20,000 State Grant for Mosquito Control which was projected in the FY 2000 revenue projection for Vector Control. She also announced we will not receive approximately $20,000 of the $111,572 revenue projected for FY2000 from the Corps of Engineers. 4 e e e On behalf of the Board of Health and Health Department Staff, Dr Goins recommended and requested Mr Rice prepare a letter of appreciation to the New Hanover County Commissioners thanking the Commissioners for their budgetary efforts and for the approved 3.5% market increase for county employees (based on performance). Dr Goins stated this year the budget process has exceptionally difficult, and the County Commissioners should be commended for their dedicated services to New Hanover County Environmental Health Committee Mr Link, Chairman, Environmental Health Committee, reported the Executive Committee met at 6:00 p.m. on June 14, 2000. Items are listed under New Business on the Board of Health Agenda. Personal Health Committee Mr Estep reported the Personal Health Committee met at 6:00 p.m. on June 20, 2000. Items are listed under New Business on the Board of Health Agenda. Unfinished Business: Generator Hookups at Emefl!encv Shelters Mr Rice referred the Board to a memo from Dennis Ihnat, School Retrofit Projects, New Hanover County Emergency Services, containing an Update on Generators and Manual Electrical Transfer Switches for Schools Used as Emergency Shelters. On April 18, 2000, the county signed a contract with Watson Electric Company to install manual switches with a required completion date of July 22. The contract price is $211,851 Mr. Rice reported manual electrical transfer switches are installed at the Central Office Freezer, Dorothy B. Johnson, Eaton, Noble, and Trask Schools. Plans are to install an additional generator switch at Codington School in August 2000. Dr Speck inquired about the availability of personnel to operate the generators in the evacuation centers. Mr Rice responded personnel would be available for the operation of electrical service generators, and a New Hanover County Emergency Shelters Standard Operating Guide Manual has been developed by the Emergency Shelter Planning Group. New Business: March Toward Tuberculosis ITB) Elimination Grant Application ($10,000) Mr Steuer recommended from the Executive Committee for the Board of Health to approve a March Toward Tuberculosis (TB) Elimination Grant Application in the amount of $10,000 from the Tuberculosis Control Program, Division of Public Health, North Carolina Department of Health and Human Services (DHHS). The purpose of the grant is to improve the local Tuberculosis Control Program and to implement - demonstration projects for replication in other areas of North Carolina. Funding is requested to purchase a portable sputum induction device and supplies, to implement and computerize surveillance information, to produce a patient testimony video, to provide travel kits for incarcerated individuals upon release from the Jail, to develop a Communicable Disease Web page, to purchase two television video-phones for patient/staff communication and follow-up, and to furnish other educational materials to the public. 5 e e e Motion: Mr Steuer moved from the Executive Committee for the Board of Health to accept and approve a March Toward Tuberculosis (TB) Elimination Grant Application in the amount of $10,000 from the Tuberculosis Control Program, Division of Public Health, North Carolina Department of Health and Human Services and to submit the grant application to the New Hanover County Commissioners for their consideration. Upon vote, the MOTION CARRIED UNAMIOUSL Y. Cape Fear Memorial Foundation Grant Application (S55.000) Mr Steuer recommended from the Executive Committee for the Board of Health to approve a grant request to reapply for the Teen AIDS Prevention (TAP) for $110,000 from the Cape Fear Memorial Foundation with funding at $55,000 each year for FY 2001 and 2002. The purpose of the grant is to continue the TAP peer education program. The goals are to promote an environment where personal health, safety, and positive life skills are more desirable than healthy alternatives IE unsafe sexual practices and drug/alcohol abuse, to empower adolescents to make a difference in their lives through education, and to facilitate open communication between TAP-trained teens and their peers. Motion: Mr Steuer moved from the Executive Committee for the Board of Health to accept and approve a Grant Reapplication for Teen AIDs Prevention (TAP) for $110,000 (2 year funding at $55,000 FY's 2001 and 2002) from the Cape Fear Memorial Foundation and to submit the grant renewal application to the New Hanover County Commissioners for their consideration. Upon vote, the MOTION CARRIED UNAMIOUSLY. DIABETES TODAY GRANT APPLICATION (SIO.000) Mr Steuer recommended from the Executive Committee for the Board of Health to accept and approve a DIABETES TODAYIDIABETES COALITON Second Year Grant Application for $10,000 funding from Diabetes Today Community Implementation Funds through the Diabetes Prevention and Control Unit, Division of Public Health, DHHS. The second year grant proposal includes two broad goals to reduce the burden of Diabetes in New Hanover County. Educating Patients and Communicating with Physicians. The budget ($10,000) includes the services of a Coordinator and a Program Assistant @160 hours each and operating expenses. Motion: Mr Steuer moved from the Executive Committee for the Board of Health to accept and approve the Diabetes Today Second Year Grant Application for $10,000 from the Diabetes Prevention and Control Unit, Division of Public Health, North Carolina Department of Health and Human Services and to submit the grant application to the County Commissioners for their consideration. Upon vote, the MOTION CARRIED UNAMIOUSLY. Proposed Rnles Governinl! Fencinl! and Operation of Private Swimminl! Pools Mr Steuer recommended from the Executive Committee for the Board of Health to approve for the Environmental Health Committee and staff to pursue obtaining more information related to the Proposed Rules Governing Fencing and Operation of Private Swimming Pool. Mr Link, Chairman, Environmental Health Committee, advised the existing swimming pool rules passed in June 1992 do not include above ground pools. A four (4) foot fence is required around four (4) sides ofthe swimming pool. He referred the Board to the draft ofthe Proposed Rules Governing Fencing and Operation of Private Swimming Pools. 6 e e e Mr. Link explained the proposed rules include in-ground and above ground swimming pools, wading pools, and spas capable of holding 24-inches of water. Water gardens and water fountains are exempt. These rules state all private swimming pools shall be enclosed by a fence or a permanent barrier designed to minimize the possibility of unauthorized or unwary persons entering the pool area. Private swimming pool enclosures shall be completely installed within thirty (30) day of the pool completion. Private pools must be maintained in a clean and sanitary condition so as not to create a nuisance or a hazard to others and to prevent a breeding site for pests such as mosquitoes. Private swimming pools constructed prior to the effective date of this regulation must be brought into compliance at the earliest possible date, but in no case longer than one (I ) year of the regulation date. Mr Link clarified Ms. Dianne Harvell, Environmental Health Director, and Mr Robert Keenan, Environmental Health Specialist, are working on the proposed pool regulations and are seeking the Board of Health's and more public input. Dr. Goins endorsed the Proposed Rules Governing Fencing and Operation of Private Pools prior to a possible tragic injury or death. Ms. Hunter inquired if Section I 4 Non-conforminl! Private Swimminl! Pools regarding pools constructed prior to the effective date of this regulation is going to be left at one year Mr. Keenan responded the committee is considering requiring pools must be brought into compliance no longer than six months. Mr Keenan reported the Environmental Health staff receives many citizen inquires regarding the lack of fence requirements and the neglect and sanitation of swimming pools. Mr Steuer expressed concern about the proposed pool regulations and fencing requirements being an encroachment of individual liberties. He stressed the importance of education and responsible pool owners. Ms. Dianne Harvell, Environmental Health Director, explained the intent of the proposal is more educational than for regulatory purposes. Ms. Harvell advised before the Board of Health approves the revised swimming pool rules, more information is needed from the public and from swimming pool vendors. Mr Estep reiterated the regulations are needed to promote safety, to prevent loss of life, and to address pool sanitation problems to prevent nuisances. He stated children have the right to be protected from swimming pool drowning and near-drowning incidents. Fences are now required for private inground pools, and the proposed swimming pool rules would incorporate above ground swimming pools in the regulations. Motion: Mr Steuer moved from the Executive Committee for the Board of Health to approve for the Environmental Health Committee and staff to pursue obtaining more information related to the Proposed Rules Governing Fencing and Operation of Private Swimming Pool. Upon vote, the MOTION CARRIED UNAMIOUSLY. Stratel!ic Planninl! Process Mr Steuer recommended from the Executive Committee for the Board of Health to accept and approve the Strategic Planning Process with Mr William T Herzog, MPH, as facilitator; a two-day Strategic Planning Retreat on October 6 and 7, 2000, (located off the Health Department site); and with the participants composed of the full Board of Health, Assistant County Manager, Health Director, Assistant Health Director, Health Department Division Directors, Budget Officer, and Administrative Assistant. Mr Estep, Chairman, Personal Health Committee, advised the Personal Health Committee met to discuss and to formulate the development of the Strategic Planning Process for the Health Department. He reported Mr. Rice, Health Director, recommends Mr William T. Herzog as facilitator for the planning effort. The University of North Carolina School of Public Health, UNC @Chapel Hill, North Carolina, is to fund the expenses for Mr. Herzog. Mr Estep referred the Board to Mr Herzog's professional biography and a proposal for Strategic Planning for New Hanover Health Department. Mr Estep 7 explained the advance work and information gathering process is to be completed by Health Department staff. The Board of Health is to be involved in the interviewing of key stakeholders. e Mr Rice stated he plans to distribute a Key Community Leaders and StakeHolders List and Strategic Planning Process forms to the Board of Health. The next meeting of Personal Health Committee is on July 19,2000. Motion: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve Strategic Planning Process with Mr. William T Herzog, MPH, as facilitator; a two-day Strategic Planning Retreat on October 6 and 7, 2000, (located off the Health Department site); and with the participants composed of the full Board of Health, Assistant County Manager, Health Director, Assistant Health Director, Health Department Division Directors, Budget Officer, and Administration's Administrative Assistant III. Upon vote, the MOTION CARRIED UNAMIOUSLY. Comments: Board of Health Members Mr Steuer asked for comments from the Board of Health. There were no additional issues. Health Director e National Association of Local Boards of Health 8th Annual Conference - Julv 26-29.2000 Mr Rice reminded the Board the 8th Annual Conference of the NALBH is to be held on July 26-29, 2000, at the Sheraton Capitol Center, in Raleigh, North Carolina. Registration is due for the conference. Summer 2000 Hurricane Recoverv Corns (Interns) Mr. Rice reiterated the Hurricane Recovery Corps intems are providing added outreach, administrative and clerical capacity to our organization. New Hanover Countv Blood Drive - Julv 11. 2000 Mr. Rice invited Board members to participate in the New Hanover County Blood Drive on July II, 2000 at the Health Department Blood donors are being accepted at the Red Cross Center two weeks prior to and after the County Blood Drive. Three Letters Rel!ardinl! Mercurv in Ocean Fish e Mr Rice referred the Board to three letters regarding the collection and frequency of samples for the detection of mercury in ocean fish. The Division of Marine Fisheries plans to resample 30 to 40-inch mackerel within two years. Mr Greer, Ms. Hunter, and Mr Steuer expressed a need for more frequent, consistent testing and statistical data on king mackerel. 8 e e - Information for Board of Health Mr Rice referred the Board to supplementary information in their folders including a letter from Congressman Mike McIntyre, Future of Children Article, a Dangerous Dog Report (April - January 2000), and a Food Talk/Serving Safe Food Class Other Business: There was no other business presented to the Board of Health. Adjournment: Mr Steuer adjourned the regular meeting of the New Hanover County Board of Health at 10:00 a.m. William T Steuer, PE/RLS, Chairman New Hanover County Board of Health David E. Rice, M.P.H.,M.A., Health Director New Hanover County Health Department Approved: 9 e e e New Hanover County Health Department FY 99 - 00 MONTHLY REVENUE REPORT As of June 30, 2000 Sununary for the New Hanover County Health Department Cumulative % 100.00% Month Reported Man 12 01 12 Jun-DO Current Year Prior Year Type of Budgeted Revenue Balance % Budgeted Revenue Balance % Revenue Amount Earned Remaining Amount Earned Remaining Federal & State 1,394,968 1,276,431 118,537 91.50% 1,377,269 1,354,279 22,990 98.33% AC Fees 516,453 439,969 76,484 85.19% 493,100 381,906 111,194 77 45% Medicaid 801,504 708,113 93,391 68.35% 824,754 723,773 100,961 87.76% Medicaid Max 366,891 368,891 100.00% 401,769 209,467 192,302 52.14% EH Fees 312,900 304,821 97 42% 243,100 299,857 (56,757) 123.35% Health Fees 109,515 134,092 122.44% 98,065 101,178 (3,113) 103.17% Other 776,172 823,172 106.06% 572,457 628,832 (56,375) 109.85% Note: County Appropriation is not calculated above. The County appropriation is the difference between the total amounts on the program expenditure report and the totals on the program revenue report. The budgeted amount for County Appropriation for FY 99 - 00 is ($9,703,333 - $4,278,403) = $5,424,930. The expended amount for County Appropriation lor this FY (year-ta-date) is ($8,728,438 - $4,053,489) = $4,674,949. 10 Revenue Summary For Month of JUNE 2000 . e e - New Hanover County Health Department FY 99 - 00 MONTHLY EXPENDITURE REPORT As of JUNE 30, 2000 Summary for the New Hanover County Health Department Cumulative % 100.00% Month Reported Man 120112 Jun-QO Current Year Prior Year Type of Budgeted Expended Balance % Budgeted Expended Balance % ExpendRure Amount Amount Remaining Amount Amount Remainin 7,208,638 6,524,977 Expenditure Summary For Month of JUNE 2000 11 e e e NEW HANOVER COUNTY HEALTH DEPARTMENT BOARD OF HEALTH (BOH) APPROVED GRANT APPLICATION STATUS Date (BOH) Grant ReQuested Pendlna Received Denied March Toward TB Ellmlnatlon- NC Dept of 7/12/00 Health and Human Services (DHHS) $10,000 $10,000 Cape Fear Memorial Foundation (TAP Program)2 vear reauest $55,000 per vear $55,000 $55,000 Diabetes Today - DHHS Division of Public Health $10,000 $10,000 Servlclos Para Nlnos-Rahab Therapy 617/00 Foundation $50,000 $50,000 Family Planning Outreach Inltlatlve-NC Division of Public Health- WPH Unit (Year One $21,538 and Year Two: $22,615) $21,538 $21,538 Healthy Homes Inltlatlve-NC Childhood Lead Poisonina Prevention Proaram $20,000 $12,448 Project Assist-American Legacy Foundation 5/3/00 Grant ($57,500 for each of 3 years) $57,500 $57,500 MOW Services (Infant Mortallty)-NC Healthy Start Grant Application (2yr Grant: 4/5/00 $85,000 yr 1 and $43,845 vr 2\ $128,845 $128,845 Skin Cancer Screenlng- NC Advisory Committee on Cancer Coordiantion and Control $1,500 $1,500 WIC Outreach- NC Dept of Health and 3/1 /00 Human Services $5,590 $5,590 No actlvltv to reDOrt for Jan and Feb 2000 Child Health Consultant Grant- UNC Dept of Maternal and Child Health- Contract with NC Dept of Health and Human Services, 12/1/99 Division of Women and Children's Health $48,210 $29,275 Healthy Carolinians Task Force- NC Office 11/3/99 of Healthy Carolinians (FROZEN) $10,000 $10,000 Operation Reach Women- Susan G. Komen, Breast Cancer Foundation $19,822 $19,822 North Carolina Chllhood Asthma Initiative NC Dept of Health and Human Services, Women and Children's Health Section I'FROZENl $7,500 $7,500 No .COvltv to 18""" lor 0cl1999. 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 Aoreement $54,730 $54,730 As of 7/19/00 1 12 NEW HANOVER COUNTY HEALTH DEPARTMENT BOARD OF HEALTH (BOH) APPROVED GRANT APPLICATION STATUS e DateIBOH\ Grant Reouested Pending Received Denied 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 Initlative-NC Dept of Health and Human Services - Diabetes Prevention and Control Unit $10,000 $10,000 No actlvltv to renort tor Au"1999. Healthy Women Flrst- Community Health 717/99 Imnrovement Proaram $24,692 $24,692 Teen Aids Prevention-Cape Fear Foundation Grant $50,700 $35,000 Healthy Homes State Grant- NC Dept of Health and Human Services Childhood Lead 6/2/99 POisonina Prevention Proaram $20,000 $16,111 Skin Cancer Health Education Project- NC Dept of Health and Human Services, Division of Community Health- Cancer Control Proaram $10,000 $10,000 Safe Communities Grant Proposal- 5/12/99 Governor's Hiahwav Safetv Proaram $10,000 $10,000 Intensive Home Visiting Program - Office of Juvenile Justice $100,000 $100,000 RECOGNITION, REWARD, AND RENEWAL GRANT PROGRAM- North Carolina Center For Nursina $5,000 $5,000 Community Dental Health -Cammunity 417/99 Health Imnrovement Prooram $20,000 $20,000 HIV Preventlon- Kate B. Reynolds 3/3/99 Charitable Trust Health Care Division $190,000 $190,000 Intensive Home Visiting Program-Smart Start $100,000 $100,000 HISDanlc Prenatal Prolect- Smart Start $12,700 $12,700 Totals $1,075,602 $182,500 $291,284 $555,742 e e As of 7/19/00 13 e e e HEALIH NEW HANOVER COUNTY BOARD or REQUEST FOR BOARD ACTION Meeting Date: . 08{ o:J.f 00 ~~!~';~~'~::"~~ :::.';..;;.. Department: Health Presenter: Betty Jo McCorkle, Women's Health Director Contact: Betty Jo McCorkle SUBJECT: Smart Start Grant Application to CAPE FEAR MEMORIAL FOUNDATION for $52,000 to fund Health Department Maternity Outreach Workers (MOWs) BRIEF SUMMARY: Smart Start is applying for a $52,000 grant from the CAPE FEAR MEMORIAL FOUNDATION to provide the Health Department with salary and operating expense funding for 2 Maternity Outreach Workers this FY 2001 In June, 2000, the Partnership for Children (Smart Start) Executive Director and other Partnership board rnembers met with board members from the CAPE FEAR MEMORIAL FOUNDATION about a grant, and the Foundation encouraged Smart Start to apply for a grant to fund the 2 MOW positions. This $52,000 would provide salary and operating expenses for 2 MOWs for FY 2001 During the first year after orientation, training, and developing a caseload of pregnant women, we will begin billing Medicaid for services provided by the MOWs. This will generate revenue through Medicaid (XIX) to cover salary and operating expenses for this program in FY 2002. Under the supervision of nurses and social workers, the MOWs (paraprofessionals) will provide services to high risk pregnant women during their pregnancy (Maternity Care Coordination-MCC) and for the first year of the child's life (Child Services Coordination-CSC). MOWs will carry a caseload of 25 clients, making home visits to the most needy clients to accomplish goals negotiated with the nurse and social worker The most needy clients would be chosen from the present MCC caseload of approximately 1000 women. See the attached CAPE FEAR MEMORIAL FOUNDATION grant application form of 7 pages for more specifics including budget information. RECOMMENDED MOTION AND REOUESTED ACTIONS: Approve acceptance and budgeting of $52,000 in the health department budget if grant awarded to Smart Start. FUNDING SOURCE: Smart Start through a CAPE FEAR MEMORIAL FOUNDATION GRANT ATTACHMENTS: Yes (8 pages including a memo and 7 page grant application 14 NEW HANOVER COUNTY INTER-OFFICE ~MEMO f, _ p,,:s ct'6 . C"'1! tAc- To: 'Fb lc,,€~JJZ:: lcb From: Janet McCumbee<f: ~ Betty Jo McCorkle'tif Date: 7/18/00 Subj: Grant Application for Maternity Outreach Workers -- $52,000.00 e We are presenting for your approval a copy of a Cape Fear Foundation (CFF) Grant put together and submitted by Smart Start this month. The Partnership for Children (Smart Start) Executive Director, Janet Nelson and Janet McCumbee met with Gary Garris and some CFF Board Members about the grant in June. They encouraged Smart Start to apply for the money to fund our first year start up for Maternity Outreach Workers (MOWs). Mr. Garris liked the idea of working with Smart Start and providing the funding through them to us, if approved by our BOH and the Foundation. This grant for $52,000.00 would provide the salary and operating expenses for 2 Maternity Outreach Workers in the 00-01 fiscal year. This would give us time to get them oriented and trained, develop a caseload of pregnant women, and begin billing Medicaid for their services. MOWs generate their salary through home visiting Medicaid revenue and will become self sufficient for 01-02. They provide services to Maternity Care Coordination clients under the direction of the nurses and social workers and then until the child is one year old under the direction of Child Services Coordination. cc: David Rice, Lynda Smith e 15 e e e Revised: 4/30/99 CAPE FEAR MEMORIAL FOUNDA TION GRANT APPLICA nON FORM I PART I: YOUR ORGANIZATION Name: New Hanover County partnership for Children Street Address: 100-A Eastwood Road, Suite 18 City, State & Zip Code Wilmington, NC 28403 Name of Key Contact Person: Janet H. Nelson Title: Executive Director Telephone#: 910-792-6160 Fax#: 910-792-6044 Fiscal YearEnd June 30, 2001 Federal Tax 10# 56-1951952 1 Is your organization a nonprofit, tax-exempt organization under IRS Code Section 501 (c) (3) or a governmental unit? If not, you do not qualify for a grant. If your organization is a 501 @ (3), please attach a copy of your current IRS tax- exemption letter with this Application. YES 2. Is your organization a private, nonoperating foundation? If Yes, you do not qualify for a grant. NO 3. Would a grant from Cape Fear Memorial Foundation in the amount being requested jeopardize your tax-exempt status? NO 4 Will any of these funds be used to pay a nationally affiliated organization? please explain. If yes, NO 5. Does your organization now, or does it plan in the future, to engage in any way in the promotion or advancement of political causes? If yes, please explain. NO 1 16 CAPE FEAR MEMORIAL FOUNDATION e GRANT APPLICATION FORM 6. Summarize your organization's background, goals and current programs. Discuss your assets in personnel, services, and programs which could be buih upon by the Foundation's help. The New Hanover County Partnership for Children is a part of the Smart Start Early Childhood Initiative created by the North Carolina General Assembly Through public and private support, it is dedicated to building collaborative partnerships in the community and assembling existing resources to ensure that children, age 0-5, receive the health, family support and early childhood learning experiences that they need in order to arrive at school prepared to learn. The New Hanover County Partnership for Children currently funds twenty programs through various agencies within the community, such as the New Hanover County Heahh Department, the Department of Social Services, the American Red Cross, and the New Hanover Public Library Among the many services these programs provide are health and safety training for child care workers, parenting skill training, scholarships for child care so that parents can work, vision screening, and public nurses at child care centers. The Partnership was incorporated in 1995 and has been admini!ltering funds in the community since January 1997 The proposal described below would compliment activities that are currently funded by Smart Start at the NHC. Health Department and with other agencies. e 7 Describe your organization's structure and attach a list of your officers and directors. The New Hanover County Partnership for Children is a non-profit 50 1 C(3)organization. Our agency operates under an administrative staff of five. In-house contractors include a Child Care QuaIity Enhancement staff of eight, a Program ManagerlEvaIuator, a Community Outreach and Education Coordinator. The Partnership. is governed by a volunteer Board of Directors. The Board of the partnership is mandated to include the heads of local governments and non-profit agencies working with young children and families, parents and representatives of the faith and business communities. I PART n: PROJECTIPROGRAM (Please qoantify whenever possible.) 1. Describe the problem/need that the program/project will address. The needs to be addressed are smoking cessation, spacing of pregnancies, nutrition, and access to health care, to improve pregnancy outcomes. Other needs to be addressed include: use of community resources, parenting skills, prevention of child abuse and neglect, ttansportation services, promotion ofbreast f-tlillg. and health/developmental/safety education. New Hanover County has poorer outcomes than the State as a whole in the following areas: e 2 17 I . e e e New Hanover County Risk Factors(97-98) Smokers Non-white Smokers Short Birth Intervals Non-white Short Birth lntervaIs<23 months Very Low Birth Weight Babies Low Birth WeightlMaternaI Age-15-19 Inadequate Prenatal Care Ages 15-19 Pregnant Moms Smoked Moms 15-19 Smoked 1754 children under reported as suspected Child AbuselNeglect State Statistics 15.2% 14.2% 157% 14.9% 11.2% 131% 13.8% 13 7"10 90% 8.8% 14.2% 10.6% 36.1% 16.4% 21.5% 30.3% 151% 18.6% NHC second in the state for out-of-home placements. The Maternity Outreach Worker Program is a state public health initiative already present in many counties to address these needs. The Maternity Outreach Workers(MOWs) work with high risk pregnant women during their pregnancy and for the first year of the child's life. Money is needed to pay salaries and operating expenses for 2 MOWs during the start up of the program. After orientation and training, the MOWs would have a caseload of 25 clients to make home visits, which are Medicaid reimbUrsable. MOWs are paraprofessionals who work under nurses and social workers in the Maternity Care Coordination and Child Services Coordination Programs. These nurses and social workers have caseloads of 60-100 clients and cannot address many of their needs. The MOWs compliment these programs by working with the most needy clients to accomplish goals negotiated with the nurse or social worker. The most needy clients would be chosen from the present MCC caseload of approximately 1000 women. 18 I e e e CAPE FEAR MEMORIAL FOUNDATION GRANT APPLICATION FORM 2. Describe the objective of the project/program and indicate how individual lives of the recipients will be changed and what benefits are expected to result. The objective of the MOW program is to enhance our New Hanover County Maternity Care Coordination and Child Care Services Coordination Programs through New Hanover County Health Departments. The intense needs of our Medicaid Pregnant women are not being met with the high caseloads ofMCCs and CSCs. The women who participate in the MOW program will be assured that all their resources are in place to do everything possible to have a healthy baby and become a good parent. Many of these low income Moms have no support or modeling from their families to teach good parenting. They will have a MOW to assist them with getting transportation, financial assistance, health care, etc. If they desire to return to work, the MOW will refer them to appropriate agencies for assistance in employment, finding Child Care going back to school, budgeting money, etc. Special assistance will be available for breast feeding, smoking cessation, and birth control methods. The ultimate goal for the participants will be to help them become self sufficient, good parents for the long haul. 3 Describe the strategies you will develop to accomplish the objective. The money obtained from the Cape Fear Foundation would be used in the 00-01 fiscal year to start up the MOW program. The two MOWs would be hired by the New Hanover County Health Department, contracted through Smart Start, as soon as possible after the grant is approved. Over the first 2-3 months of their employment, they would attend local orientation and state training to learn their program. They would also visit other Health Departments to see how the program is carried out in other counties. The MOWs would then begin taking clients and making home visits and would be closely supervised by the MCC and CSC staff. Medicaid billing by the Health Department would be instituted as soon as feasible so that the program will become self-sufficient. The Health Department already has a good working relationship with all agencies in New Hanover County and would coordinate all services as needed so that no duplication occurs. 4 State how, when and who will conduct an evaluation to measure how well the program is meeting objectives. The New Hanover County Partnership for Children (Smart Start) has a Program ManagerlEvaluator and an evaluation process in place to monitor all grants administered through their agency If the grant is received, the Program. ManagerlEvaluator will work with the NBC Health Department to establish specific measurable outcomes and outputs to evaluate at the end of the grant period. The initial 9 month period will get the program up and running smoothly, and establish our objectives in changing the statistics in question 1. By June 2001, we project the 2 MOWs will be trained and have developed a caseload of25 each. AB services are no longer needed or wanted, new referrals will be accepted. 3 19 e e e Revised: 4/30/99 CAPE FEAR MEMORIAL FOUNDATION GRANT APPLICATION FORM I PART 11/: FINANCIAL INFORMATION 1 Amount requested from Cape Fear Memorial Foundation. $52,000 2. Develop a complete project/program budget, including income and expenses, for the period you are requesting funds (see attached format). Also, please attach a copy of your most recent audit or financial statement with this application. Black Booklet 3. List the names of organizations, both public and private, to which you have applied for support for this specific project/program. Also show the amount requested and the status (pending, approved or disapproved). Oraanization Amount Status None Other Total 4 20 e e e CAPE FEAR MEMORIAL FOUNDATION GRANT APPLICATION FORM 4 Describe how your project/program will become self-sufficient within three years. Maternity Outreach Workers provide a service which is Medicaid reimbursable to Health Departments. Their visits are reimbursed as follows: MOW Brief Visit $20 MOW Standard $55 MOW Extended $85 After the first grant year, the MOWs should be able to generate their salary and operating expenses to keep the program going. The grant year will allow the Partnership for Children (Smart Start) to contract with the New Hanover County Health Department and lend administrative support to this home visiting service. 5 If the funds are to be used for construction or equipment acquisition, explain the bidding process. 5 21 e e e Revised: 4130199 CAPE FEAR MEMORIAL FOUNDATION GRANT APPLICATION FORM I PART IV: REPORTING REQUIREMENTS Do you agree to fumish to Cape Fear Memorial Foundation, in a timely manner, periodic progress reports informing the Foundation of the progress made by your project/program? If Progress Report forms are enclosed for projects previously funded for which an annual report has not yet been made, please complete the forms and retum with this Application. SUBMITTED BY: Janet Nelson Typed Name of Chief Executive Officer of Requesting Organization 7-/3- 00 Date New Hanover County Partnership for Children (Smart Start) Title Royce Angel Typed Name of Chairman of the Board of Directors &~)( ~ Sign tu of Chairman the Board of Directors 7~ IlJ ~~ Date Signature of Chief Executive Officer and Board Chairman is required for Application to be viewed as complete. Completed Application must be received in the Office of Cape Fear Memorial Foundation by 5:00 p.m. on the cutoff date for each grant cycle. The cutoff dates are January 15 and July 15 annually. 6 22 e e e . . I Part III: Question 2 Attachment, Project/program Information Develop a complete project/program budget, including income and expenses for the period you are requesting funds as shown below' Project Budget: From 10-1-00 To 6-3-01 Expenses (By Category) Income (By Sources) Annual Base Salary MOWs (2) $21,753 x 2=$43,506 Prorated for 9 months= $32,630 Fringe Benefits MOWs (2) $6331 x 2=$12,662 Prorated for 9 months=$9497 Total salary and fringe, 9 months $42,127 Operating Expenses Contracted services (Smoking cessation classes, transportation, and services not covered by Medicaid) $1033 Telephone installation x 2 $120 Cell phones for field x 2 (2 x $20/month x 8 months) $320 Printing patient literature, brochure $500 Departmental Supplies (Videos and patient ed materials, tvlver, office supplies, office furniture, Computer supplies - printer, software, incentives) $3500 Employee Reimbursement - mileage at .325/mile $1000 Uniforms (Public Health requirement) $5oo/year x 2 $1000 Training and travel (Registration, hotel, food) $1200 Total= $8673 Capital Computer $1200 Total Salary/Operating/Capital $52,000 Income may be generated this year by Medicaid billing once a case10ad is established. An estimate would be $5000 for the year If this Medicaid money is generated by the Health Department, they would need to get their budget and finance office to approve spending that revenue on additional services or supplies after the money is earned. Total Expenses: Total Income: 7 23 Ie e e ~EALTH NEW HANOVER COUNTY BOARD OF !!I 10RatS REQUEST FOR BOARD ACTION Meeting Date: 08/02/00 Department: Health Presenter: Beth Jones, Communicable Disease Di rector Contact: Beth Jones, 343.6648 SUBJECT: Grant Application to Z. SMITH REYNOLDS FOUNDATION, INC. for $48,000 to fund an Enhanced Counseling Program BRIEF SUMMARY: We are requesting approval of a grant application to Z. Smith Reynolds Foundation, INC. for $48,000 to start an Enhanced Counseling Program, which will include a new fulltime Masters level Social Worker to implement the program. We will provide enhanced counseling services to newly diagnosed HIV.infected individuals and high risk Sexually Transmitted Disease (STD) clinic users. We will offer multiple counseling sessions to two types of clients seen at the health department: 1 Individuals infected with HIV or other STDs 2. Individuals at high risk for acquiring STDs The Enhanced Counseling Program will assist these individuals in preventing the transmission of their disease to others and in accessing the resources that will help them cope with their diagnosis. It is time to stop focusing solely on treatment; we must put more of our efforts into prevention. Enhanced counseling aims to prevent infected individuals from transmitting their disease to others and to prevent all clients from acquiring any additional STDs or HIV We can achieve this through intense counseling sessions that focus both on behavioral change interventions and on linking individuals to long.term resources, such as case management; substance abuse treatment; mental health counseling; domestic violence shelters; and health care. See attached 6 page grant application which includes budget information. RECOMMENDED MOTION AND REQUESTED ACTIONS: Approve grant application for $48,000 for submission to Board of County Commissioners and approval of budget amendment for $48,000 if grant awarded. FUNDING SOURCE: Z. Smith Reynolds Foundation, Inc. Grant ATTACHMENTS: Yes.S page grant proposal. 24 PROPOSALSU~Y ITIDS SECTION MUST BE COMPLETED USING THIS FORM) .e of Petitioning Organization: New Hanover County Health Department _ of Project: Enhanced Counseling Program Amount Being Requested: $ 48.000 Summarize below the pwpose for which funds are being requested from the ZSRF (a separate proposal giving a more detailed description of the project must also be submitted). New Hanover County Health Department would like to start a new program to provide enhanced counseling services to newly diagnosed HIV-infected individuals and high risk STD clinic users. The program will offer multiple counseling sessions to two types of clients seen at the health department: individuals infected with HIV or other Sexually Transmitted Diseases (STDs) and individuals at high risk of acquiring STDS, as determined during the initial interview at the clinic. The purpose of the enhanced counseling program is to assist these individuals in preventing the transmission of their disease to others, avoiding the acquisition of additional STDs, and accessing the resources that will help them cope with their diagnosis and other relevant issues, such as substance abuse or mental health services. The program will target the marginalized groups that are disproportionately affected by HIV and other STDs, such as low-income individuals, young people, members of ethnic/racial minorities, and people who abuse drugs and alcohol. The program will provide transitional support services to individuals newly diagnosed with HIV or other STDs in the period immediately following the diagnosis. It is during this vulnerable time that newly diagnosed individuals are most in need of information and support. Through self-esteem work, assertiveness training, role plays, and education, newly diagnosed individuals will be encouraged to adopt safe behaviors so that they do not spread their infection to.others or acquire additional STDs. HIV-infected individuals will additionally be linked to one of the three HIV case managers in New Hanover County, who will assist them with long term medical, psychological, and psychosocial needs. The program will also provide enhanced client-centered counseling services ~o individuals at high risk of acquiring HIV/STDs who visit the STD clinic. These individuals include the following visitors to the STD clinic: teenagers under the age of 17, individuals who visit the clinic three or more times per year, teenagers brought to the clinic from the Juvenile Detention Center, and individuals engaging in high risk behavior, as determined during the initial interview. The purpose of the enhanced counseling is to empower these clients to take control of their health and prevent themselves from acquiring STDs. The enhanced counseling sessions will offer th~e individuals the tools, such as education, assertiveness and behavioral skills, to help them adopt safer behaviors. According to the STD Clinic Nurse Coordinator at New Hanover County Health Department, approximately 40\ of STD clinic users are repeat clients: they come to the clinic for treatment, but once a specific infection is treated, they continue to engage in the same risky behaviors until they end up in the clinic again. CUrrently, clinical testing and treatment services do not allow time for client-centered counseling with follow-up visits specifically designed to reduce risky behaviors. It is time to stop focusing solely on treatment; we must put more of our efforts into prevention. The enhanced counseling program aims to prevent infected individuals from transmitting their disease to others, and to prevent all clients from acquiring any additional STDs or HIV. This goal is achievable through intense counseling sessions that focus both on behavioral change interventions and on linking individuals to long-term resources, such as case management, substance abuse treatment, mental health counseling, domestic~olerce shelters, and health care. The more comprehensive approach will facilitate behavioral change to adopt a healthier lifestyle. The salary money will be ased to hire a full-time Master's level social worker to implement program services. (DO NOT EXCEED THIS SPACE) Z. SMITH REYNOLDS FOUNDATION, INC. APPLICATION FORM, I - - I (Rev 19991 25 e e e NEW HANOVER COUNTY HEALTH DEPARTMENT 2029 SOUTH I1D1 STREET WILMINGTON, NC 28401-4946 TELEPHONE (910) 343-6500, FAX (910) 341-4146 ......... _. .-. DAVID E. RICE, M.P.H., M.A. LYNDA F. SMITH, M.P.A. Health Director Assistant Health Director New Hanover County Health Department would like to start a new program to provide enhanced counseling services to newly diagnosed HlV -infected individuals and high risk SID clinic users. The program will offer multiple counseling sessions to two types of clients seen at the health department: individuals infected with HlV or other Sexually Transmitted Diseases (SIDs) and individuals at high risk of acquiring SIDs, as determined during the initial clinic interview. The purpose of the enhanced counseling program is to assist these individuals in preventing the transmission of their disease to others, avoiding the acquisition of additional SIDs, and accessing the resources that will help them cope with their diagnosis and other relevant issues, such as substance abuse or mental health services. The specific amount being requested is $48,000. This new program will address a gap in services for individuals in this community. Heightened efforts must be made to serve people who are transmitting diseases to others. The focus is maintenance and restoration ofhealth and HlV ISID Prevention. The target population consists of people who are infected with HlV ISIDs or who are at high risk for infection, which are primari1y young people, people of color, women, and men who have sex with men. New Hanover County Health Department (NHCHD) offers SID screening, treatment, education, and H1V counseling and testing services. A client-centered counseling model is utilized, but a single risk- reduction session is not sufficient to effect change in those at greatest risk. Quite often, infected individuals are wrestling with issues that complicate their ability to make behavioral changes, such as substance abuse, domestic violence, denial, and mental health problems. Resources to overcome these difficulties have either not been available or not utilized by these individuals. Services including case management, substance abuse treatment, mental health counseling, and health care exist in our community to benefit HlV+ individuals, and are offered to them during their one post-test counseling session al NHCHD. However, this post-test counseling session, in which test results are given, is not the ideal time to address all the ramifications of the diagnosis and develop a treatment plan. According to the case manager for the HlV Care Team at New Hanover Health Network, approximately 30% of these newly diagnosed HlV+ clients do not follow up to seek additional services. The CDC reports a one to five year delay between HlV -infected youth learning their test resuhs and seeking treatment. By offering individuals increased awareness of and accessibility to available resources, along with enhanced client- centered counseling to confront the under1ying issues, the new program can both empower individuals to take care of their health and protect others by preventing the transmission ofHlV and other SIDs. A January, 2000 article in the American Journal of Public Health (Diamond C, Buskin S. Continued risky behavior in HlV -infected youth) asserts that HlV -infected individuals continue to exhibit risky behaviors, including unsafe sex and needle sharing, after learning their HlV diagnosis. The study found that 66% ofHlV -infected young women, 46% of infected aduh women, 28% of infected young men, and 16% of infected aduh men exhibited evidence of risky behaviors after they learned their diagnosis. Several studies document that SID incidence rates in HlV -infected women do not significantly differ from those among women who do not have H1V. These studies demonstrate the need to focus prevention efforts on HlV+ people. Traditionally, prevention and treatment services have been separate when, in filet, these two interventions must coincide to lower the rates ofIDV and SrD N ~ -::i(r.,/H _ ~ ~~,." 26 e e e infection. The project proposed by NHCHD will unite these two formally disparate interventions. The plan is to provide transitional support services to individuals newly diagnosed with HlV or other SIDs in the period immediately following diagnosis. The program will accept referrals from private providers as well in order to offer transitional support services to all newly diagnosed H1V+ individuals in the community. The new program will also offer client-centered counseling services to individuals at high risk of acquiring HlV ISIDs who visit the SID clinic, including teens under the age of 17, individuals who visit the clinic three or more times per year, teens brought from the Juvenile Detention Center, and individuals engaging in high risk behavior, as determined in the initial interview. The program will serve approximately 700 individuals during a one year period. In 1999, 50 cases ofHlV or AIDS were diagnosed in New Hanover County, either through NHCHD or through a private provider; as of June, 2000, 23 cases ofHIV/AlDS have been diagnosed in the county in the year 2000. Taking these figures into account, approximately 40-60 newly diagnosed H1V+ individuals will be referred to the enhanced counseling program during its first year, and approximately 650 individuals who either have an SID other than H1V or are at high risk will be referred to the program. The specific goals and objectives of the program, the ways in which they will be achieved, and the method and criteria for evaluation of the proiect are described in the followiruz chart: Goal #1: Empower newly diagnosed individuals and individuals at high risk for H1V ISIDs by teaching them about HlV I SIDs and how to effectively navigate the system of resources available to them. Objectives 1. 85% of participants score at least a 30% increase on a pre-post knowledge instrument that measures knowledge about transmission, prevention, and similar issues. 2. 85% of participants score at least a 20% increase on a pre-post instrument that assesses knowledge of available resources in community. 3. 50% of those clinic users who are referred to program attend at least 4 of the 6 counseling sessions. Activities 1. Provide H1V - and SID-infected individuals and other high-risk clients with up to 6 visits with a trained MSW therapist. 2. Collaborate with the 3 H1V case managers in the county. Encourage H1V+ clients to select a case manager and make an appointment with them as soon as possible. 3. IdentifY referrals for psychological support, including mental health or substance abuse services. 4. Make referrals to other needed services as iodicated. Outcomes InitioJ 1. Clients are knowledgeable about their infection and ways to take care of their health. 2. Clients learn about resources available to meet medical, psychological, and psychosocial needs. 3. Clients learn how to prevent the spread ofHlV/STDs to others. Intermediate 1. Clients will contact the resources available to them, as indicated. 2. Clients will practice behavioral skills learned in one-on-one sessions. Longterm 1. Clients will access the needed resources to treat their medical or psychosocial issues. 2. H1V - and SID-infected individuals will utilize learned behaviors to reduce transmission to others. 27 . e e e Goal #2: Prevent HIY-infected individuals, SID-infected individuals, and other SID clinic clients from transmitting or contracting SIDs. Objeetives 1. 75% of participants do not receive a diagnosis for a new SID for a one year period following the end of their counseling sessions. 2. 85% ofHIY-infected participants remain in contact with their chosen case manager at least 6 months after their first appointment. 3. 85% of participants score at least a 30% increase on a pre-post instrument that measures behavioral change and intention to change behavior. Activities 1. Provide 6 client-centered counseling sessions that assess readiness for behavioral change and teach behavioral change techniques for adopting safer behaviors. 2. IdentifY and explore obstacles that client has encountered in adopting safe behaviors. , 3. Foster self-efficacy of individuals to follow through with behavioral change through self-esteem work, assertiveness training, and role plays. 4. Ensure HIV+ clients are compliant with control measures listed in N.C. Administrative Code. 5. Practice ways that HIV+ clients will notifY future sex/needle sharing partners ofHIY status. Outcomes InitioJ 1. Participants are knowledgeable about safer sex behaviors. 2. Participants possess skills that will lower their risk of acquiring SIDs or transmitting STDs to others. 3. HIY+ clients leam how to notifY future partners ofHIY status. Intermediate 1. Participants follow safe sex and/or needle sharing practices necessary to avoid getting or giving SIDs. 2. Participants gain assertiveness and self-esteem skills necessary to implement behavioral change. Longterm 1. Participants do not acquire additional SIDs. 2. HIY - and SID-infected participants do not spread their disease to other individuals. 3. Partici s achieve sitive behavioral c e, as measured the behavioral instrument. For the evaluation, the behavioral change instrument is a modified version of an evaluation tool developed by The Measurement Group and the HRSAIHAB's SPNS Cooperative Agreement Steering Committee. The knowledge and resource evaluation instruments were developed by NHCHD staff. The total funds required for the project are $48,000. NHCHD funds in the amount of$505,500 are allocated to provide staff and operating expenses in support ofHIY ISID counseling and clinical services. In addition to this grant application, NHCHD will submit a grant application to the Ehon John AIDS Foundation. NHCHD has additionally sent a letter of inquiry to the A.I. Fletcher Foundation, and is waiting for a response from them. New Hanover County Health Department is a local public health department serving the citizens of New Hanover and surrounding counties. The mission of the organization is to protect the public health and environment, promote healthy living, and optimize the quality oflife through preventive, restorative, environmental and educational services. The Communicable Disease Division ofNHCHD provides medical and educational services to screen, treat, and prevent the spread of communicable diseases. Please see the Appendix for more details about the petitioning organization. David E. Rice, M.P.H., M.A. Heahh Director 28 e e e Enhanced Counseling & Testing Program Budget Project Budget: From October 1. 2000 To September 30. 2001 Expenses (by Category) SalarieslWages. . . . $37,193 Fringe Benefits . . 8,310 Total. . . . . . . . . . . . . . . . . . .. $45,503 Income (by Sources) Z Smith Reynolds Foundation . $48,000 Operating Expenses Printing . . . . . . . . .. $200 Dept. Supplies 647 Employee Mileage 800 TraininglTravel . 850 Total Operating Expenses ... $2,497 NHCHD In-Kind Support..... $12,849 TOTAL ................... $48,000 NHCHD In-Kind Support Management Support 2 hrslwk x 52 wks x $12/hr Fringe (25%) Administration 1 hrlwk x 52 wks x $25/hr . Fringe (25%) . Professional Staff Support . 3 hrslwk x 52 wks x $25/hr plus 40 hours initial training Fringe . Space (36 sq ft x $7/sq ft x 12 mol 3,024 Telephone 200 Utilities . 600 Copier Services. 300 Employee Mileage 165 Dept. Supplies. . . . 500 Totalln-Klnd ............. $12,849 . 1,248 312 1,300 325 3,900 975 Total Expenses (including in-kind) . . . . . . . . . $60,849 Total Budget: $60.849 29 e e e ~E'f\111.\ NEW HANOVER COUNTY BOARD OF' .~IYlI ),IIJUtRS REQUEST FOR BOARD ACTION Meeting Date: 08/02/00 Department: Health Presenter: Beth Jones, Communicable Disease Director Contact: Beth Jones, 343.6648 SUBJECT: Grant Application to Z. SMITH REYNOLDS FOUNDATION, INC. for $59,000 to fund our Teen AIDS Prevention (TAP) Program for FY 200l. BRIEF SUMMARY: We are applying to Z. SMITH REYNOLDS FOUNDATION, INC. for grant funding to continue our Teen AIDS Prevention Program. We began the TAP peer education program in January, 1999 with $32,000 from the HIV /STD Prevention and Care Section of the North Carolina Department of Health and Human Services, with initial funding for six months to pilot a peer education program for teenagers. A health educator was hired, a curriculum manual developed, recruitment and training of teen peer educators completed, and successful programs were facilitated by the peer educators. TAP was then refunded through a $35,000 (original request from CAPE FEAR MEMORIAL FOUNDATION was for $50,200) grant from the CAPE FEAR MEMORIAL FOUNDATION for FY2000. We have reapplied to the CAPE FEAR MEMORIAL FOUNDATION for 2 years funding, but since we do not know if that grant will be awarded, we are now applying for a grant for $59,000 from Z. SMITH REYNOLDS FOUNDATION, INC. to increase our chances of being funded. With continued funding, the health educator position and the TAP program can continue to access the hard.to.reach adolescent population. See attached grant narrative for specifics. We have already included and you (the Board of Health) have approved the $55,000 expenditure and revenue projection for TAP in our FY2001 budget request. We are submitting this application and if awarded, it will be the source of revenue for the TAP program (if the $59,000 is awarded, we will submit a budget amendment to put the additional $4,000 in the budget for FY 2001) RECOMMENDED MOTION AND REOUESTED ACTIONS: Approve grant application for $59,000 to be submitted to the Board of County Commissioners and approve budget amendment if grant awarded. FUNDING SOURCE: Z. SMITH REYNOLDS FOUNDATION, INC. ATTACHMENTS: Yes.6 page grant application 30 PROPOSAL SUMMARY (THIS SECTION MUST BE COMPLETED USING THIS FORM) Name of Petitioning Organization: New Hanover County Health Department eOfPrOject: Teen AIDS Prevention Program Amount Being Requcsted:$ 59,000 Summarize below the pUI]lose for which funds arc being requested from the ZSRF (a separate proposal giving a more detailed description of the project must also be submitted). New Hanover County Health Department is requesting funds.for an adolescent peer education program that focuses on HIV prevention, entitled TAP (TRen AIDS Prevention). Five young people worldwide contract HIV/AIDS every minute of every day. Through a community peer-led approach, TAP aims to decrease the number of teenagers infected with HIV. Centers for Disease Control research recommends that the most effective method of educating adolescents about HIV risk reduction is through peer education programs. utilizing this recommendation, TAP trains adolescents to become HIV prevention peer educators. In order to reduce the incidence of HIV and STDs among New Hanover County adolescents in the long term, the primary goal of TAP is to promote an environment in Wilmington and the surrounding areas where personal health, safety, and positive 1i~e skills are more socially and personally desirable to young people than unhealthy alternatives such as unsafe sexual practices and drug/alcohol abuse. In this way, adolescents will choose to engage in safe behaviors rather than risky behaviors. The second goal is to empower adolescents to make a positive difference in their own and other teenagers' lives through education, leadership, and being a role model for other teenagers. The third goal is to facilitate the exchange of ideas and open communication between TAP-trained teens and their peers, and provide opportunities for question and answer sessions. TAP peer educators provide educational sessions to adolescents in church youth groups, after-school programs, and other agencies. Although the focus of presentations is HIV revention, TAP peer educators present on a wide range of topics including self-esteem and elf-respect, HIV/AIDS facts, assertiveness training, effects of drugs and alcohol on ecision making, awareness of personal values, problem-solving skills, sensitivity to stereotypes and diversity issues, dealing with peer pressure, healthy relationships, and communication skills. Through these presentations, TAP peer leaders offer other teenagers the skills and knowledge to make wise decisions for themselves. The phi10spp!1y of TAP is one of empowerment: the program empowers the peer educa~rs to become leaders in their communities, and empowers program participants to gain knowledge and take better care of their health. TAP gives teens a message that their community values them, and that they can make a difference in their own and other teenagers' lives. When TAP peer educators give presentations to community groups, they often invite audience members to write questions on index cards, and then anonymously pass them up front to be answered. TAP peer educators are typically flooded with questions during these presentations; teenagers are filled with questions about sexuality, re1ationshipe, and similar issues. TAP gives these teenagers the opportunity to receive answers to their questions from their peers, assisted by the TAP coordinator who can provide them with referral and resource information. These question and answer sessions can serve to replace the misinformation and misguidance that permeates the social environments of junior high and high school s~udents. TAP targets adolescents who are at high risk for infection of HIV or other STDs, which are primarily adolescents of color, low income adolescents, and adolescents with substance abuse problems. In order to reach these teens, TAP trains peer educators that come from these backgrounds in order to serve as role models for their peers. TAP facilitates the majority of its presentations in locations that attract high risk adolescents, such as the public housing projects, substance abuse treatment centers, and the Juvenile Detention Center. TAP's purpose is to reach the teens who are most at risk for acquiring these infections, offering them the knowledge and skills that will help them adopt safe, live- preserving behavior. (DO NOT EXCEED THIS SPACE) Z. SMITH REYNOLDS FOUNDATION, INC. APPLiCATION FORM, PAj 31 v 19991 e e e NEW HANOVER COUNTY HEALm DEPARTMENT 2029 SOUTH 17D1 STREET WILMINGTON, NC 28401-4946 TELEPHONE (910) 343-6500, FAX (910) 341-4146 __.s_. DAVID E. RICE, M.P.H., M,A. Health Director LYNDA F. SMITH, M.P.A. Assistant Health Director New HanDver County Heahh Department (NHCHD) is requesting funding to continue an adolescent peer education program that focuses on mv prevention, entitled TAP (Teen AIDS Prevention). The purpose of TAP is to give adolescents the opportunity to send positive messages to their peers to counteract all of the negative pressures that continuously bombard them, and for teenagers to be able to learn the skills, information, and support from peers that will help them to avoid engaging in risky behaviors. By providing information, teaching personal risk reduction strategies, and serving as role models for their peers, TAP peer educators help to foster a social climate where it is comfortable and acceptable for adolescents to avoid risky behavior. The TAP program educates teenagers that the risk- taking behaviors that expose them to mv and other SIDs also compromise their potential for heahhy and productive adult lives. The TAP program offers adolescents the information, skills, and self-esteem building exercises that lead to increased self-confidence, improved health, and attainment of life goals. The specific amount being requested is $59,000. NHCHD began the TAP peer education program in January, 1999. Please see the Appendix for a separate page on previous accomplishments of TAP. The program began in order to address a growing problem observed among youth both in North Carolina and in New Hanover County. Teens account for 3% of all reported AIDS cases within North Carolina, which is more than three times greater than the cumulative percentage for the United States. New Hanover County has an SID infection rate that is more than two times higher than the state average. Since 1995, one-fifth to one-fourth of all NHCHD SID clinic patients have consistently been under the age of20. By their very presence in the SID clinic, these teenagers are acknowledging that they are engaging in risky behaviors. In April, 1999, the Search Institute published a report on New Hanover County adolescents in grades 6 through 12 entitled "Developmental Assets: A Profile of Your Youth." According to the survey, 33% of students have had sexual intercourse one or more times, and an alarming 22% of students. have had sexual intercourse three or more times in their life. The Centers for Disease Control has conducted research to determine effective strategies to reduce the risky behaviors of adolescents. Based on current data, the most effective prevention strategy to reduce high risk behaviors among adolescents is to train peer leaders to provide prevention messages to at-risk youth. The TAP program is a response to this research-based evidence and is taking heed of the survey results descn'bing the risk-taking behavior of New Hanover County adolescents. TAP espouses three main goals- these goals, as well as the objectives, activities, outputs, and outcomes that arise out of these goals, are found in more detail in the Appendix. The primary goal is to promote an environment in WUmington anCl the surrounding areas where personal health, safety, and positive life skills are more socially and personally desirable to young people than nnhealthy alternatives such as unsafe sexual practices and drug/alcohol abuse. Two objectives fiill under this goal: to ensure that 85% of program participants score at least a 30% reduction in risky behaviors on the post-test portion of a pre- and post-test behavioral instrument; and to ensure that 80% of program participants report choosing abstinence or safer sexual practices 95% of the time, as measured by the fDllow-up survey administered to each program participant three months after they attend a TAP presentation. N~ ~r/H-d..~~" 32 e e e The second goal is to empower adolescents to make a positive difference in their own and other teenagers' lives through education, leadership and being a role model for other teenagers. In order to achieve this goal, TAP program staffhave developed two objectives: to ensure that 95% ofpeer health educators report practicing abstinence or safer sexual practices, as measured by a behavioral questionnaire administered every 3 months; and to ensure that 95% of peer heahh educators score 95% or higher on a knowledge test after a 40 hour training period. The third goal is to facilitate the exchange of ideas and open cOlIUDunication between TAP-trained teens and their peers, and provide opportunities for question and answer sessions. The following objectives will measure this goal: ensuring that 85% of evaluations of presentations filled out by adolescent audiences give a score of "excellent" for the overall rating of the presentation; and receiving requests to return for additional presentations from 80% of organizations visited. TAP currently consists of twenty peer educators who have received intensive training in mv /SID information and presentation skills. The TAP peer educators are a diverse group of adolescents: ranging in age from 14 to 21, they come from African-American, Caucasian, and Latino backgrounds. One of the peer educators is mv -infected, and acquired mv perinatally. The peer educators were interviewed and carefully selected by the TAP program coordinator, and share three main attn'butes: they demonstrate a zeal for helping their peers, they are dedicated to alleviating the problems faced by adolescents, and they come from colIUDunities and demographic groups that have been targeted as "at-risk" for mv and other STDs. In order to make a difference in the COlIUDunity, it was essential for TAP to select peer educators who are the true peers of teenagers at risk of acquiring mv or other SIDs, and not simply teenagers with active leadership roles in the schools. The subgroup of teens targeted for TAP training falls in the category of financially needy and medically underserved. Some of the TAP peer educators come from single parent homes and some lack an adult mentor The TAP coordinator serves as an adult mentor for them, helping them through crises and periods of doubt in themselves. TAP provides an opportunity for teenagers to develop a higher sense of self-esteem. Research shows that teenagers who have a higher self-esteem, as well as a supportive aduh mentor, are less likely than other teenagers to engage in behaviors that put them at risk for mv and other SIDs. If refunded, TAP program staffplan to train a minimum of eight additional peer educators in the following year. The educators use four methods to reach the target population: a series of smaIl group programs, colIUDunity outreach, a play, and one-on-one outreach. Although the focus of presentations is mv prevention, TAP peer educators present on a wide range of topics including self-respect, lllV/AlDS facts, assertiveness training, effects of drugs and alcohol on decision making, awareness of personal values, problem-solving skills, sensitivity to stereotypes, dealing with peer pressure, heahhy relationships, and colIUDunication skills. For maximum effectiveness and retention of information, TAP staff prefer to give a series of three to six weekly presentations for each group of adolescents. Nevertheless, TAP's scheduling fleXl'bility allows it to adapt easily to the needs of collaborating organizations. Currently, TAP gives approximately 3-5 presentations per week, and TAP receives daily requests for presentations. TAP presentations have enabled hundreds of teenagers to discuss issues of concern to them in an environment where they receive both correct information and respect for their opinions. The TAP program collaborates with a wide array of cOlIUDunity groups. For example, TAP peer educators give a presentation every Wednesday morning to adolescents at the Juvenile Detention Center. TAP peer educators also give presentations every Thursday after schoo~ during the school year, for teenage residents of the Nesbitt Courts housing project. TAP travels beyond Wilmington's city limits in order to reach teenagers. In addition to New Hanover County, TAP has traveled to the more rural Duplin, Brunswick, Pender, and Columbus Counties to give presentations. With funding, TAP aims to 33 e e e give a minimum of 50 presentations to at least 25 community groups during the coming year. The second method of reaching adolescents is through outreach activities. TAP peer educators set up booths in places where they can reach other adolescents: in the ~ at schools, and in other locations in the community. If funded, TAP plans to continue to participate in health fairs and other outreach activities in the community. With funding, TAP aims to reach at least 1,000 more youth through presentations and community outreach in the next year. The third method of reaching adolescents is through drama. Two TAP peer educators wrote a thirty minute play about peer pressure, stereotypes, sexuality, relationships, and alcohol abuse. The peer educators have presented the play for two community groups; ifT AP is refunded, they will continue to perform the play around Wilmington and hope to present the play in the New Hanover County schools. The fourth method of educating adolescents is through one-on-one street outreach. TAP peer educators are encouraged to provide one-on-one informal education to their peers, sharing mv and STD prevention education with other teenagers. Peer educators are also trained to provide their peers with support and referrals for teen issues such as depression, pregnancy, and substance abuse. With additional funding, TAP aims to provide 200 more one-on-one sessions in the next year. TAP staffwill administer a standardized pre- and post-test behavioral questionnaire to all program participants. NHCHD will contract with a PhD Epidemiologist in order to ana1yze data The questionnaire is a modified version of the Prevention Minimum Evaluation Data Set developed by the Sociometrics Corporation. The post test will be administered to all program participants three months after their attendance at a TAP presentation. TAP peer educators will be required to complete the pre-test behavioral questionnaire before they begin their training. They will then complete the post-test every three months. In addition, pre- and post-test instruments that measure increase in knowledge have been designed by TAP stafffor use by peer educators before and after they complete 40 hours of training. Program participants complete an evaluation form after presentations, so that peer educators can assess skills that need improvement. The TAP coordinator collects program data using forms to document the number of education sessions conducted, the type of activity performed, the location of the activity, the number of participants or contacts, the characteristics of groups of individuals receiving the information, and referrals made. The total funds required for the project are $59,000. In addition to the Z. Smith Reynolds Foundation, Inc., the TAP program will submit grant proposals to the Cape Fear Memorial Foundation and MetLife Foundation. TAP program staff are waiting to hear a reply from a letter of inquiry sent to the Design Industries Foundation Fighting AIDS. NHCHD is a local public heahh department serving the citizens of New Hanover and surrounding counties. The mission of the organization is to protect the public health and environment, promote healthy living, and optimize the quality of life through preventive, restorative, environmental and educational services. NHCHD has eleven divisions that offer programs for the prevention of disease and the promotion of health. The Communicable Disease Division (CDD) provides medical and educational services to screen, treat, and prevent the spread of communicable diseases. Although TAP is not a new program, it has been in existence for only a year and a half. TAPis a long term investment in our teenagers. It takes years to change attitudes and behaviors in a society full of negative messages. That does not deter TAP but rather magnifies the necessity for efforts to continue TAP in this community. David E. Rice, M.P.H., MA Health Director ,34 I i e e e Teen AIDS Prevention Program Budget Project Budget: From October 1. 2000 To September 30. 2001 Expenses (by Category) Income (by Sources) SalarieslWages . . . . $30,032 Fringe Benefits . . . 8,455 Total. . . . . . . . . . . . . . . . . . " $38,487 Z Smith Reynolds Foundation $59,000 TAP Peer Educator Fundraising Activities . ...... 3,000 Operating Expenses Contracted Services .. . $4,000 Postage. . . .......... ... $300 Printing ... .. . . 500 Dept. Supplies . . 13,685 Employee Mileage . 878 TrainingfTravel . . 3,750 Cellular Expense ..... . . .. 400 Total Operating Expenses .. $23,513 Total Income .............. $62,000 NHCHD In-Kind Support. . . .. $20,974 TOTAL. . . '" . . . . . .. . . .. .. $62,000 NHCHD In-Kind Support Management Support 2 hrslwk x 52 wks x $12/hr . 1,248 Fringe (25%) ... ..... .. 312 Administration 5 hrslwk x 52 wks x $25/hr ... 6,500 Fringe (25%) . ........ .1,625 Professional Staff Support .. .. 5,200 4 hrslwk x 52 wks x $25/hr Fringe ... .. . . .... 1,300 Space (36 sq ft x $7/sq ft x 12 mo) .. 3,024 Telephone. . .. ........ 200 Utilities. ...... 600 Copier Services ....... ......300 Employee Mileage ... 165 Dept. Supplies.... ...... 500 Totalln-Kind ............. $20,974 Total Expenses (including in-kind) . . . . . . . .. $82,974 Total Budget: $82.974 Collaborating agencies will contribute in-kind space and staff for programs. 35 e e e ~e~~H~ili~~~~to Lynda Smith, Assistant Health Director From: Betty B. Creech /5 ~ Subject: New Public Health Nurse Positions-School Health Date: July 20, 2000 The Board of Education has requested and will fund five (5) additional ten (10) month Public Health Nurse positions. Funding includes salaries, FICA, retirement, insurance for 12 months, operating expenses and capital outlay(for work stations). The requested history of the program is: In 1990 or 1991 the Health Department began contracting with the Board of Education to assume responsibility for the School Health Program. Prior to that time the Health Department provided nurses in the elementary schools and the Board of Education provided the nurses in the middle and high schools. The issue came up due to the fact that the school nurses had no nursing supervision. The Health Department could solve this problem and enhance School Health services. Due to increased student health needs, the School Health Program has realized almost continuous growth since that time. Please request as soon as possible, approval to establish and fill these positions. We need the staff as near the start of school as we can get them. Thank you.. 36 07/20/2000 17:11 9102544352 SUSAN PAGE 01 Ie MEMORANDUM TO: FROM: RE: DATE: Betty Creech AI LerchoJ..... Additional Nursing Positions 10: July 21, 2000 FY991#77 e New Hanover County Schools will be funding five (5) additional nurses' positions and related services for 2000-2001 school year. These nurse positions are being added to ensure half-time service in each elementary school. Please include this request in your new contract. If you have any questions, please feel free to contact me at 254-4207. C: John Morris Norm Shearin Tony Lopatka Justine Lerch e 37 07/20/2000 17:11 Ie 9102544352 SUSAN PAGE 02 CONTRACT New Hanover County S~hoabJ 18028.1l1'" Street Wilmington. Ne 21401 AND New Ha_ County ""Ith Department 2029 8. 17'" Street Wilmington, Ne 21401 This conll8Ct win begin on July 1. 2000 and end on June 30, 2001 between New HanoYer County Schools and New Hanover County Health Department. Both partl.. do mutuelly "Il"'. to the follawlng: A. New HenllVel' County Schools will: 1. Pay $574,348.00 ($51,434.90per month) for serviI:eS. 2. Provide anleppmprtateIy equipped room fer the nUf8ll when she Is warking at her deslgneted echooI. B. New H..._ County Health DepaItnIent WUr. SUpeMse nurse (VIdarIB Wheeless, R. N.), employed by \he New HeftllYer County Schools. Develop end melntaln First Aid guidelines and nutSlng pratoooIelo be used In all schools. Provide a full.tirne nurse to New HaftllYSr High School, lllney High School and Roland Grise Middle SChool. 1. 2. 3. 4. 5. e e. 7. 8. 9. PrvYIcIe three t11lH1m. nu...... to be $JlIIt W. ~.n the six mldclle .._. lIIICI one full.... n_ farthe.....lIIiW.-ooI flit "'" lIddIIIaIlIIIM.lgnmente - n UI.-y. Provtde sIX fuJl_ nurses for elementary echoclIs. Provide supplies for SchOOl Medlc&l Services. Heve nurses vtsft their esslgned school. weekly. Provide .ervice. In eccordanoo with the North carotIne Nurse PreclIce Act "nd the guidelines estebllshed by the New Hanover County Health OeplIrtmenl. Provide nursing oupervlslon through the Public Health Nurse DIrector. This cxmtrecI ClII\not be amlll\Cled, rnodllled Of ellered exaept by egreement, In writing, by duly eu\hollDd oIIIcllIIs for both petIIes. Either party may terminate !hll CIDIlIracI after gMng ethlrt)'-dey notice. In wrmng, ~ Intent to do 110. In witness whereof the pertiee lICting through tIIeir duly 8Ulhor1zed ofIlctaIs have executed this oonInICt. NHCS DATE This Instrument hes been lIIIdlled In the Menn. l8qulred by the School Budget And FIsceI ConlIoI /Id. 1a14o.06&-311 2~140-695-311 o$1eo.ooo.oo 0$414,348.00 cONTRACTOR DATE DATE NHCS FINANCE OFFICER e 38 e e e Expenditures School Health Budget 2000-2001 Additional Funding Revenue Salaries. . . . . . . . . . . . .. $133,208 Contributions/School. . . $192,520 FICA .................. 10,190 Retirement ........ ...... 6,527 Insurance ............... 23,405 Hea1th/Dental .. $23,010 Disability ......... 395 Insurance paid for full year Telephone. . . . . . . . . . . . . . . . . . 500 Employee Reimbursement. .. 5,586 Mileage ....... $3,500 Uniforms . . . . . 2,086 Training and Travel. . . . 1,500 Capital Outlay (work stations) . .. 11,604 Total .................... $192,520 Total .................... $192,520 a:schbudgadd 39 e e e New Position Or Increase/Decrease Hours Fiscal Year: 2000 - 2001 Department: Health Division: School Health Contact Person: Kim, Marcy Contact Phone Nbr.: 6522,6649 Fund: 110 Agency: 510 Orgn: 5169 o I Am Not Requesting New Positon Or Increase/Decrease Hours Check The Requested Action: . New Position 0 Increase/Decrease Hours A newly completed Position Description (PD) form must accompany a request for a New Position. The Supervisor should complete the form. New Position Number Requested: 5 Requested Positon Classification Title: Public Health Nurse I Requested Pay Grade: 119. OOA, $26,642 - $38,133 Proposed Effective Date Of Requested Action: August, 2000 Check one: ~ Full-Time 0 Part-Time 050% 075% 080% Justification For Requested Action 10 months/year position. Due to the increase in the number of medically-fragile students and the medications/treatments necessary to manage these students, Board of Education has requested and funded additional school nurses. Additional nursing staff will promote safe management of these students and enable the school system to comply with laws governing meeting student health needs. How Will The Requested Action Benefit The County? Student health problems will be efficiently and effectively managed. This should reduce absenteeism and improve school performance. Liability to the schools will be reduced. The schools can comply with laws requiring that student health needs be met. Home schooling can be reduced. 40 Are There Any Employees Currently Performing The Same Duties And Responsibilities As Described In The Attached PD? e . Yes 0 No If "Yes", Identify By Name, Position Classification Title And Unit. Patty Hochwalt Public Health Nurse I Community Hlth/School Hlth Candice Sancilio Public Health Nurse I Community Hlth/School Hlth Mania Swart Public Health Nurse I Community Hlth/School Hlth Ellen Harrison Public Health Nurse III Community Hlth/Personal Hlth Gloria Umstetter Public Health Nurse I Community Hlth/School Hlth Rose Bauerlein Public Health Nurse I Community Hlth/School Hlth Dorothy Ashbaugh Public Health Nurse I Community Hlth/School Hlth Teresa Stanley Public Health Nurse II Community Hlth/Personal Hlth Frankie Mincey Public Health Nurse I Community Hlth/Personal Hlth Evelyn Bowden Public Health Nurse II Community Hlth/Personal Hlth Charlotte Norris Public Health Nurse I Community Hlth/School Hlth Leslie Yusko Public Health Nurse I Community Hlth/School Hlth Pat McSwain Public Health Nurse II Community Hlth/Personal Hlth Shenita Josey Public Health Nurse II Community Hlth/Personal Hlth Mary Jo Newton Public Health Nurse II Community Hlth/Personal Hlth Beverly Fussell Public Health Nurse II Community Hlth/Personal Hlth e If "Yes", What Impact Would The Requested Action Have On The Position(s) Listed? They would be able to provide more comprehensive, timely services to the schools. They would be responsible for fewer students; liability related to service delivery would be reduced. What Will Be The Impact If The Requested Action Is Not Taken? Schools will be unable to meet requirements for student health services. More at-risk care will be provided. School personnel will have to neglect their duties to provide health care. How Will The Position Be Funded? New Hanover County Schools If position requires any equipment (uniform, computer, vehicle, etc.) please list the equipment and approximately cost below. Uniforms. $2,086 Telephone installation. $500 e Mileage. $3,500 Training/Travel. $1,500 Workstations. $11,604 41 ".'-- e TO THE EMPLO'PrhiS written information is of great value In understanding and evaluating the duties and responsibilities of your job. These questions should assist you in describing your work and clearly explaining your duties. POSITION DESCRIPTION Read the questions carefully and try to answer so that anyone who does not know the job can understand what you do. Think and write In terms of what you do and how and why you do It. Feel free to attach any additional information you feel would be helpful in describing your job. Also you may attach additional pages if you need additional space for your answers to any of these questions. Name Last Public Health Nurse I Official Position Title School Health Nurse Working Title N/A How long have you been In this Job? N/A How long In this agency/department? Betty B. Creech. Community Health Director NamelTltle of Immediate Supervisor First Middle Health Agency or Department Community Health Division or Section 2029 S. 17"' SI. Work Address 910-343-0500 Telephone Number 8:00 a.m. - 4:30 p.m. Regular Hours of Work 1/2 hour Length of Meal Break 1. PURPOSE OF JOB: What Is the primary purpose and objective of your job? (Why does your position exist?) To provide skilled nursin9 services to students In New Hanover County Schools 2. GENERAL DESCRIPTION: (How would you describe your job to someone who has never done It?) Work with students, parents/guardians, school personnel, health and other human service providers to eliminate or manage student health problems. Work with school personnel and students to promote healthy lifestyles and prevent disease/disability 3. REQUIRED DUTIES AND TASKS: Please read these Instructions carefully. DUTIES AND TASKS UST: In the space provided on page 3, list the duties and tasks involved in the perlonnance of your job. Describe each task in a dear, concise statement. Begin each statement with an action verb (e.g., drives, conducts, repairs. files, types, _swers, summarizes, prepares, etc.) Avoid words like coordinates, handles, participates. Continue on additional sheets if necessary. After carefully reviewing each dutyltask you have listed, mark each column using the following guidelines: PERCENTAGE OF TIME: In the small column to the left, indicate the percent of time you spend in each task listed. The total of percentages cannot exceed 100%. 42 fREQUENC.Y' How often do you perform the task? Mark this column: D (daily) or W (weekly) or M (monthly) or I (irregular intervals) or A (annually) IMPORTANCE: Rank the importance of tasks in accomplishing the objectives of your position with "1" being the most important. e: The most important tasks are not necessarily the ones on which you spend the glllatest amount of time. 4. PHYSICAL DEMANDS: For each task, supply ALL applicable codes in each category - Activities, Effort, and Visual. " ACTIVITIES: Does this task involve any of these activities? List ALL that apply in the Activities column beside the task. EFFORTS: Does this task require that weight be lifted or carried or force be exerted to push or pull? If so, how much? ~ Activitv A B C D E F G H I Stand Walk Sit Talk Use hands to finger, handle, feel or grasp Climb or balance StOOl>, kneel, crouch or crawl Reach with hands and arms Taste or smell ~ 10 25 50 100 100+ ~ VISUAL: Does this task have any special visual requirements? Visual reouirement 1 2 3 . 6 7 Phvsical effort to lift carry. oull or oush Up to 10 pounds Up to 25 pounds Up to 50 pounds Up to 100 lX!unds More than 100 pounds Close vision (clear vision at 20 inches or less) Distance vision (clear vision at 20 feet or more) Color vision (ability to identify and distinguish colors) Peripheral vision (ability to observe areas that can be seen up and down or to the left and right while eyes are fixed on a given point) Depth perception (three-dimensional vision, ability to judge distances and spatial relationships) Ability to adjust focus (ability to adjust the eye to bring an object into sharp focus) No special visual requirements 5. WORK ENVIRONMENT: For each task, supply ALL applicable codes in each category - Conditions, Noise, Exposure to Blood and Other Infectious Materials. CONDITIONS: Does this task require regular exposure to any of the following conditions? NOISE: What is the typical noise level for the work environment while performing the task? ~ A B C D E F G H I J K L Conditions Wet, humid conditions (non-weather) Work near moving mechanical parts Work in high, precarious places Fumes or alrbome particles Toxic or caustic chemicals Outdoor weather conditions Extreme cold (non-weather) Extreme heat (non-weather) Risk of electrical shock Work with explosives Risk of radiation Vibration ~ VQ Q M Noise level Very quiet (examples: forest trail, isolation booth for hearing test) Quiet (examples: library, private office) Moderate noise (examples: large business office with typewriters and/or computer printers, light traffic, pumps, compressors, conveyors) Loud noise (examples: metal can manufacturing, large earth-moving equipment) Very loud noise (examples: jack hammer work, front row at concert) eXPOSURE TO BLOOD: Put a check mark in this column if performing this task puts you in contact with blood or other potentially infectious materials (fluids, needles, etc.) LN VLN 43 ,~ ;~j1;) ... woe . .. . ". " .....-.--......... ,........-....... ....~NYDi..... .. .... li'li~/ ..... " .....---.--..,.. ............" ". ...,........".,. ..-.-........__.,...................,-. ........, " ...,-, .....,-.-..-...-......._..__... ........----,-...-..-. .... ......... ........-'_.........................--,-. . ..'................ 8 ---..... ..,..... .........--........ :1 "!'it,'" . .,'. '.<11 I ......... ..... ; Ii .',. . . ':..ll:r': S ill! I ""t;, , , i , :t.l.' ,jQh.. Q i I ,~( ,J:i. II i \1\ = ::::~::::::: '4.t: , , E 25 Do student physical assessments D I A, B, D, E, 10, 1,2, F M X G, H 3 E 5 Conduct mass screenings for particular health problems (i.e. scoliosis, 3x1 A, B, D, E, 25 1,2, F M visioD) yr G ,H 3 E 20 Provide other health care at school (i.e. first-aid) A, B, C, D, 50 F M X E, F, H, I E 15 Consult with parents, school personnel, students, health care providers, D 3 A, B, C, D 10 1,2 F M and other human service providers to access services; follow-up as needed E 10 Develop plans of care for studeots with chronic health problems D 2 C, D 10 I F M, Q E 10 Counsel students, school personnel and parents regarding health care D 4 A, B, C, D 10 1,2 F M and healthy lifestyles E 4 Counsel parents and school personnel regarding community resources D A, B, C, D, 10 1,2 F M * I Collect data and assist with strategy developments related to school M A, B, C, D 10 1,2 F M health services 3 Deliver and maintain school health supplies W 5 A, B, C, D, 25 1,2 F M E, F, G, H E I Assist school personnel and pareots with compliance with immunization W A, B, C, D 10 laws E I Conduct communicable disease investigations I A, B, C, D 10 I D, M X F E 2 Establish and maintain health services records D C, D, E 10 I F M, G E I Atteod job related meetings and workshops M A, B ,C, D 10 I F M E <I Other duties as assigned I <I Provide disaster health services I A-I 25 1-6 A, L,N X D,F G, H, K Include comments ~ot covered in the list above, describe any unusual and/or difficult conditions you encounter in your job. .ut the physical surroundings, unavoidable hazards and/or physical hann to which you are exposed, etc. Considerable amount oftime spent in heavy traffic. Must work in high crime areas at times. 44 8. MElfiAL DEMANDS: Describe the degree of mental stress and pressure that is required in the perfonnance of your job. (Examples: Are there frequent deadlines; extended periods of concentration; close, exacting work analytical work; frequent interruptions; public contact; tight work spaces; crises; etc.?) " _collect accurate data to develop nursing diagnosis meet daily and weekly deadlines regarding service delivery ing with families with limited education and resources very stressful Handling medical emergencies very stressful 7. MINIMUM REQUIREMENTS: (What is required to perfonn the essential functions of your job?) What education, training or certification is necessary for your position? Bachelor's Degree in Nursing and one (1) year nursing experience. Ucensed to practice as a Registered Nurse in North Carolina. Valid NC driver's license. List any required skills (typing or computer skills, blueprint reading, etc.) Operation of diagnostic and treatment equipment used to perfonn nursing diagnosisltreatment Operation of office equipment required to perfonn nursing duties e What other special knowledge, skills or abilities are necessary to perform this job? Knowledge of community resources, current record keeping requirements, confidentiality, and current standards of care; ability to work effectively with others; ability to communicate c1eariy and effectively orally and in writing; skill in the safe operation of motor vehicle. How much prior job-related work experience do you think Is the minimum needed to adequately perform your job? One (1) year 8. SUPERVISORY RESPONSIBILITIES: Do you have supervisory responsibility (i.e., for perfonnance appraisals, disciplinary action, etc.)? If not, write "NONE" below and go directly to #9. If you are a lead worker, do not complete this section, but be sure you have included lead worker duties in the preceding task list on page 3. If you do have supervisor responsibilities, give the name of employee and job title for each position reporting to you (filled and vacant). Indicate whether each, in tum, supervises other positions by putting the number of positions or "0" in the space provided. Name of Emolovee None Job Title # Suoervlses e # of employees reporting directly to you: _ # of employees reporting Indirectly to you: _ 45 9. DECISIONS AND ACTIONS, METHODS AND GUIDELINES: What types of decisions (other than "prioritizing work") do you normally have to make In your work each daylweek? . A.ing diagnosis W;t community resources to access Oetennine needs for assistance Give examples of the types of significant errors a person In your position might make and describe how difficult It would be for others to catch your errors. What would be the likely consequences of such errors? Inappropriate nursing assessment could lead to severe medical problems for students. Could sometimes be caught if student accessed care elsewhere. Incorrect or incomplete recording could allow problems to become more severe. How does your Immediate supervisor assign your work? Work as assigned verbally and/or in writing Job description defines specific duties How does your supervisor review your work? How often? Work is reviewed by observation, conferences, consultation with school personnel and team leader Fonnal job pertonnance appraisal completed yeariy What manuals, guidelines, rules, or pOlicies do you use In your work? Arth Carolina Nurse Practice Act; School Health Manual; current practice guidelines; federal, state, county agency policies and 'cedures; physician orders. Which of your duties do you consider the most difficult and why? Working with families with limited education and resources - it is hard to meet the student's health needs in this type of situation. Prioritizing work when there is so much that needs to be done. Describe problems that arise during the course of your work and the manner In which you respond to them. Anxiety of school personnel in handling health problems - teaching them how to pertonn specific procedures, trying to be available for consultation. Unable to meet health needs of students - ~earch for community resources to meet these needs; consult with team leader, supervisor. 10. CONTROL OF ASSETS: Do you have responsibility for the preparation and control of a budget? _Yes X No If yes, Indicate current dollar amount of budget: Do you handle money? _Yes ~ No How much annually? 11. EQUIPMENT AND TOOLS: What machines, equipment or tools do you use, operate, maintain, or repair In the course of your work? Examples Include mechanic's tools, shovel, truck, mower, computer, adding machine, telephone, and drafting tools. Include the percentage of time spent In the operation, maintenance, use or repair of each. The total of percentages cannot exceed 100%. e Otoscope 3 % Car 10 % Scales 2 % Audiovisual aids 2 % Sphygmotonometer 1 % Thermometer 1 % Stethoscope 1 % Telephone 5 % 46 ~ 2. oRE-CORDS AND REPORTS: Does your position require responsibility for any records or reports? ~ Yes _ No If yes, describe the types of records and reports for which you have responsibility and Include how your are Involved in them (filing out forms, checking, validating, verifying, proofreading, filing &rd health care provided on school health records; prepare monthly statistical reports; interpret medical reports for parents and school personnel; develop and record instructions for care. , 13. SAFETY: Does your position have responsibility for the safety or health of others (other than your subordinates or for the enforcement of laws and standards of public safety or health? ..lL- Yes _ No If yes, describe your responsibilities. If you were careless In your work, could others be hurt? How seriously? Responsible for patient assessment, teaching and treatment. A major error could be fatal or put patient at risk for disease or disability Must instruct schools when children not in compliance with communicable disease laws. Must report neglect and abuse. 14. CONTACTS: Indicate persons or organizations Inside and outside your section with which you deal directly In the course of your normal duties. Also describe the purpose and frequency (dally, weekly, monthly) of such contacts. Do not Include your supervisor. TITLE OF CONTACT AGENCY PURPOSE FREQUENCY Medical Care Providers Medical community Access health care Daily Human Resource Providers Access/coordinate services Daily _hOOI Personnel NHC county schools Promote heallh Daily mmunlty Health Director NHC Health Dept. Consultation, instruction, 2-3 times/wk evaluation Other Public Health Nurses NHC Health Dept. Coordinate/assist 2 times/wk The above responses are my own and are correct to the best of my knowledge. EMPLOYEE'S SIGNATURE DATE TO THE SUPERVISOR: Review the answers of the employee for completeness and accuracy. Use this space to e/aborate on or clarify any answers that you think need It Do NOT change any answers. "you disagree with an answer the employee has given, give your opinion and Identify clearly the points of disagreement I have reviewed and determined that this job description accurately reflects the position. I have reviewed and determined that this job description accurately reflects the position with the following clarification or modification. Go to the Task List on page 3. In the smallleft.hand column Identified as 'EF' (for 'essential function'), put an "E" in the space beside each dutyltask that you consider to be an essential function of the position. By 'essential', we mean At task required to achieve the primary Objective an desired results of the position. Please refer to the 'Guide to ~etermlne Essential Functions of a Job' In making these determinations. SUPERVISOR'S SIGNATURE DATE 47 e e e . Dennis Ihnat 07/311200005:12 PM # '.,,' / To: David E Rice/NHC@NHC cc: Lynda Smith/NHC@NHC, Betty Creech/NHC@NHC, Dan Summers/NHC@NHC, Allen Q'NeaI/NHC@NHC, David Weaver/NHC@NHC, Pat Melvin/NHC@NHC, Brenda Coffey/NHC@NHC, Debbie Reed/NHC@NHC, Wyatt Blanchard/NHC@NHC, Greg Thompson/NHC@NHC, Max Maxwell/NHC@NHC, alanj@watsonelec.com, Bobby_Lam b@nhcs.kI2.nc.us Subject: Re: Generators/Hookups at Emergency Shelters Here's an update on the status of the Manual Electrical Iransfer Switches (MTS) Project. . Contract with Watson Electric Co. for at 5 school properties (Central Office Freezer, Johnson, Noble, Eaton and Trask) was signed by the county on April 18th. Notice to proceed was given on April 20th., with required completion date of July 22nd. (90 days). Contract price is $211,851 . Change Order to install MTS at Codington was approved by NHC on 7/10/00, for an amount of $39,325.00. Project completion date extended to August 11 tho to complete Codington. . All Installations are substantially complete, with only labeling, final inspections and site clean-up pending. . Replaced 6 defective circuit breakers in main panel at Trask, at a cost of $9,951.00 (in addition to original contract sum, but per unit price quote in original bid. (During last hurricane season, some breakers failed to open properly) . A work change directive issued on 7120/00 to add normal power indicator lights on each of the MTS panels pends. This will not interfere with the opration of the units, but will improve safety for the electricians connecting/disconnecting the rental generators. . Noble MTS installed 7/29. Delay due to parts availability Final inspection pends installation of bollards to protect the MTS and Main Breaker cabinets from the dumpsters sited immediately adjacent to the cabinets. Bobby Lamb (NHC Schools Maintenance (Electrical) plans to install the bollards this week. . We are considering issuing a change order to add cam-Iock fittings for each MTS, pending a price proposal from Watson Electrical. This will reduce the time required to hook up the rental generators (from estimated 2 - 3 hours to less than 1 hour per site), and improve safety when making the connections. . Contract value (school properties) currently $262,652.00 (including base contract, Trask breakers, Codington, support mods and indicator lights). Please do not hesitate to call if you have any further questions. Sincerely, Dennis Ihnat New Hanover County Department of Emergency Management Hazard Mitigation Planner & Project Manager Phone: 341.4587 e e e DRAFT A REGULATION OF THE NEW HANOVER COUNTY BOARD OF HEALTH WHEREAS, the New Hanover County Board of Health is charged pursuant to North Carolina General Statute 130A-1.I with promoting and contributing to the public health of the citizens of New Hanover County; and WHEREAS, the Board of Health believes that the operation of a motor vehicle on the public roadways while using a telephone may cause the operator to maintain less than full attention to the operation of said motor vehicle; and WHEREAS, the Board of Health finds that the regulation of the use of mobile telephone while operating a motor vehicle in the County will enhance the safety of those persons operating motor vehicles and other persons using the roadways; NOW, THEREFORE, BE IT ORDAINED BY THE NEW HANOVER COUNTY BOARD OF HEAL m that a regulation be adopted to read as follows: Section 1.0 Definitions: As used in this Ordinance: (I) "Mobile Telephone" means, including but not limited to cellular, analog, wireless and digital telephones. (2) "Use" means to use a mobile telephone in: (A) Dialing (8) Answering (C) Talking (0) Listening (3) "Park" means for an automatic transmission vehicle that the vehicle is in the Park gear; for a standard transmission vehicle that the vehicle is in the neutral gear and the brake is being utilized or otherwise stationary. Section I I Use; Restrictions: (I) No person shall operate a motor vehicle on any street or highway while engaging in any conQuct defined as the "Use" of a mobile telephone unless the operator maintains both'hands on the applicable steering device. Division (I) of this section does not apply to a person who is using the mobile telephone: (a) To contact public safety forces, or (b) While maintaining the vehicle in the Park position either on public !... ',' . (2) , . . . . . e (c) or private property, or With a "hands-free device" which allows the operator to maintain both hands on the vehicle while using the mobile telephone. 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'~!H ~~'mti .-J!.~I~; z"" "(I) C1hbIJ :~,..d'O~'- '-- ..(/)..6 s...."t:l ' . I"'~ ~]'~i ~ ]~l] 'U ~ ab a ~ urn ~~ ~~!i Ij ,. ~ = ~.lOli~~~~.~~~.~ ~~~15'" ]~~~jl.'r~] ~:ln >- ~:1 us lSiil-;: '" ., ofi '0 e'O 13 B ",.8 ~ 0 ~ 8. . ".," ;li!' ~ '=:"~ m. 0 '101 "'-a"';€J ~~ 8,,] . 8 ~ ~~ ~.e-8. ~. ,,,,:1l~""_:".tl8ofil :E'~~ .-I .' .~ J8~.~ ]~th:~ ~:'~'sig IS ~.~~~.B~:~'8~~ ~lh':S :$""'- I:: "'~B~ ....""6:,1A:t!i =ftI'O"USU" ... ~'" :s '0 OJ _.13 o C,J 101 -a.~ .,ofif8 ~ ~".,8:l!,ii';:,] ~'~ g-~.<;i:; g~~'3 ~':';~~:[;1 A. 0 E .,~~ il "'U!l ..~:E ~... ....13 i:51;l, '0'" ",,0 "'" '" ~ :,sZQl-lj:.6 O .' -.Jl ..2;..;:';~~:-h" e~!l.8.i:~fa"8"; "-~.-=i~~.,S~.-' ...ol'.,8.,.1! ;E "... '0 .. ""....- '" 0 c "" iIl::t: .... . " ., ..., -.,.... 13 0'" D:: ~ III '" ~." "a ., 0 " 0,0 ., - O::t: ... u ~ a a'l ... ~ gJ '" -l:l:= o. ",'" , A.. . . 111>- 'I;: "" "il 8 ., f;l: fa'~ ~. ~,g <:; A ."1~ l€i -Q~ IS :ci':~..e,~ ~ jg 1il ~ ~ jg:!l~~ cjJ " '0:_ ::t: '0 .. ...... fa Cl ~,g Z E:E -a ~ -a~ ofi g'~l! ~ ~ 8iJl;:'i ~~ ",,' l:l ~.~~, ~a~ =.oCn .s J:::: ~~~ . ~i e " . . . ,.. WIC Outreach Grant lii:J ~~; Encompassing the Whole Community Objective . To recover the caseload lost as a rcsult of Hunicane Floyd . This allowed us to do outreach campaigns to locate fonner and newly eligible WIC participants to encourage them to participate in the program. 1 . I. . ~ Methods of Outreach . Store-fronl setups . Radio Spots & Public Service Announcements . Newspaper Article . Childcare Center,Church/Ministry, Housing Authority, Vendor, & Doctor's Office Visits . McDonald's Tray Liner Campaign . Headstart Store-front Set-ups . Objective: To sel up a WIC informalional booth in fronl of departmenl slores - WaI-Mart - K.Mart - Roses . Sel-up from approximalely IO:OOam- 4:00pm on high volume shopping days Radio Spots & PSA's ~ . Objective was to run radio ads on popular radio station (Coast 97.3) throughout June 2000 . Successfully ran 60 second radio spot from May 26-June 30 . Total # of spots = 100 2 e e e .'>. -~ Public Service Announcements . W AA V & WMYTrwDVV aired WlC public announcemenl in Spanish once per day through June 30, 2000 . PSA was free Newspaper Article [iJ Objective: To publish WIC anicle in a ncwspaper that dim:t1yreachedtbctarsct population Chose The Wilmington Journal Article "Women, Infants, and Children Program improves health of low- income Children" by DiM SIIITO was published June 8, 2000 Community Visits Doctor's Office - 22 . WlC Vendors - 9 . Childcare Centers - 17 . Housing Authorilies - to . ChurchlMinistry - 26 . Miscellaneous Visits - 22 3 . e e - . rI1 McDonald's Tray Liner Campaign We designed a tray liner to be used at all of the McDonald's restaurants in New Hanover County for one week. Included WIC Program phone numbers for 3 neighboring counties . 22.000 black & white liners printed for 9 restalU1Ults . Tray liners were used about 8 week starting June 20,2000 Headstart . Set-up iii-fold poster at Headstarl Center . Targeted those mothers whose children were not on WIC . Successfully made 17 additional appointments for potential WIC participation 4 e e e NEW HANOVER COUNTY HEALTH DEPARTMENT 2029 SOUTH 17IH STREET WILMINGTON, NC 28401-4946 TELEPHONE (910) 343-6500, FAX (910) 341-4146 E__.E_. DAVID E. RICE, MoP.a., M.A. Health Director LYNDA F. SMITH, MoP.A. Assistant Health Director July 14, 2000 Commissioner William A. Caster New Hanover County Board of Commissioners 320 Chestnut Street Wilmington, NC 28401-4093 Dear Commissioner Caster: The New Hanover County Board of Health and the staff of the New Hanover County Health Department wish to express our gratitude for the loyalty and dedication the New Hanover County Board of Commissioners provides to our residents and visitors. We want to personally thank you for your efforts in processing the Fiscal Year 2000-01 Budget. We admire the Commissioners and County Staffs untiring efforts in working through very difficult decisions. Your support of the Health Department is genuinely appreciated. Your willingness to address the needs of our staff by your support of the market adjustment and the pay and classification study will enhance the future of our workforce. Again, on behalf of our entire organization, a heartfelt thank you. Not only does the Health Department appreciate your efforts, but also the thousands of recipients of New Hanover County services are indebted to people like you. Thank you for a job well done! Sincerely, 4i!~St~:iE New Hanover County Board of Heath ~ David E. Rice Health Director Cc: Allen O'Neal, County Manager N~ ~~,g~_~~" William K. Atkinson. Ph.D. President & CEO .. DD New Hanover Regional Medical Center Cape Fear Hospital Pender Memorial Hospital (oastal Rehabilitation Hospital The Oaks Behavioral Sciences Hospital Medical Center Foundation New Hanover Home Health New Hanover Regional EMS Pender Home Health Coastal Carolinas Health Care Resources, llC a.onsumer ~brary Vitaline 24-hour health information service Vitalink Critical Care Tran5port In affiliation with: Coastal Area Health Education Center (CAHEC) Coastal Carolinas Health Alliance Hospital Hospitality House Lower Cape Fear Hospice July 13, 2000 David E. Rice, M.P.H., M.A. Health Director New Hanover County Health Department 2029 S. 17m Street Wilmington, NC 28401-4946 Dear David: Thank you for allowing Judy O'Neal and me to visit with your Board yesterday morning. Please also pass along our appreciation to your Board members. Weare committed to working with you and the Health Department in every way possible to continue to provide the best in health care to our community With this in mind, we appreciate the great work you and your team do at the Health Department. Again, David, thanks. Please do not hesitate to let us know if we may ever be of assistance. R"'M' William K. Atkinson, Ph.D President and CEO WKA:kbldl--..do01ll(0) 2131 South 17th Street .ox 9000 gton, NC 28402-9000 9 . 43.7040 Fax 910.815.5819 e e , .- f' RECEIVED JUl I 7 2008 e N. H. co. HEALTH DEPT. ........-..-..-. 1 I ~. . e Ie e I:rU pO fP/Vorr . h01f.J: -;ffJ>l1PJ To Whom It May Concern, ~U..;/ I thought signing the petition for sewer hookups in the ~~~ Kings Grant extention and attending the meeting of the county commitioners on 1/3/00, when this matter was heard, would be sufficient after being told at the meeting the situation was being studied by the Health Department and that we should be on line within 3 years. July 10, 2000 Now I have been informed you are waiting to hear from the residents of the Kings Grant extention of their interest and need in this matter. There are 3 of us living at this residence and we have had to curtail taking more than one bath each per week. We can no longer use our washer or dishwasher, or flush our toilets after each use. I would say this is a health hazard. This house is in a low lying area and when it rains the water is standing on top the ground, as high as 8" deep. Some of the houses around us are on higher ground and we get the run off from their yards. Raising our yard is not the answer as the water then would flood the house. If we had sewer the water could run off into it, instead of keeping our cess pool full. We need your help in this matter. Re:Z::d ~~ ~4 Middlesex Rd. Wilmington, Ne. 28405 (910)793-4366 In IE: 'I' GO . \,, re "', :10) r~ \I, re Ii \if :~.I;-i U~i JUL 1 D 2IlI1l I!L 1"- ----_! NEW HANO'IEA ce. HEALTH D"P" ...~.~~Y!RONf.;_E:'.jrAt "';f:/;/",: . " e July 10, 2000 Ie e To Whom It May eoncern; I thought signing the petition for sewer hookups in the Kings Grant extent ion and attending the meeting of the county commitioners on 1/3/00, when this matter was heard, would be sufficient after being told at the meeting the situation was being studied by the Health Department and that we should be on line within 3 years. Now I have been informed you are waiting to hear from the residents of the Kings Grant extention of their interest and need in this matter. There are 3 of us living at this residence and we have had to curtail taking more than one bath each per week. We can no longer use our washer or dishwasher, or flush our toilets after each use. I would say this is a health hazard. This house is in a low lying area and when it rains the water is standing on top the ground, as high as 8" deep. Some of the houses around us are on higher ground and we get the run off from their yards. Raising our yard is not the answer as the water then would flood the house. If we had sewer the water could run off into it, instead of keeping our cess pool full. We need your help in this matter. Respectfully, ~~i/J6~ 4514 Middlesex Rd. Wilmington, Ne. 28405 (910)793-4366 i!n\ rc: <<' If; ~ ~" i<; In' !!9j~~ ,-) Ie. " W ~ I~!: ilnl: JUL 1 0 2000 110: ," U1 I I I NEW HANOVER CO, HEALTH DE?T. ENVIRONMEi'fT.~ HEALTH -~-_._----_.._-_. .4It ~\~ p)~ e e ;;; pJ/co Leldslative Summary-Short Session Hil!hlil!hts-adjourned July 13 Health Trust Fund Bill (HI431) -passes After one and one half years of discussion. the Health (and Tobacco) Trust Fund bill passed giving $40M every year to improve health and wellness for the people of North Carolina. (This will be $IB over 25 years). For the first 25 years of operation, the fund will set aside 50% of money received to build up the fund reserve and only spend the interest on that reserve. The other 50% will be spent each year. The Governor, the Speaker of the House and the President of the Senate will each appoint 6 individuals to serve as members of the commission that approves grants given by the fund. The language in this bilL addresses the health needs for the vulnerable and underserved populations. SII84 SpaylNeuter Bill-presented to the Governor 7/12 "To establish a voluntarily funded statewide spay/neuter program to provide the benefits of spaying and neutering pets and to provide the financial assistance to cities offering low-income persons reduced cost spay/neuter services for dogs and cats" SI234 Long-term Care Residents/Immunizations-signed by the Governor 7/14 Requires that adult care homes and nursing homes ensure that residents and employees are immunized against influenza virus and that the residents are also immunized against pneumococcal disease. HI519 Mental Health System Reform-presented to the Governor 7/05 An act to establish the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities and Substance Abuse Services, and to direct the oversight Committee to develop a plan to reform the State system for mental Health, developmental disabilities and substance abuse services. HI506 Food Estab/Sanitation Requirements-signed by the Governor 7/05 An act to require establishments that prepare or serve food to a certain number of regular boarders or permanent houseguests comply with State food sanitation requirements. Upon Federal approval, NC HHS may provide Medicaid coverage for family planning services to both men and women of childbearing age with family incomes equal to or less than 185% of the federal poverty level. Approved Funding: Healthy Carolinians-$IM Asthma Program- $250KCentralized Internal Training $1 OOK National Association of Local Boards of Health ( Publishedfor Members of Local Boards of Health May/June 2000 President's Message By Vaughn Upshaw, EdD, DrPH UWhat is your plan?" was what my father always asked me. Although it was a fustrating question to answer as an adolescent and young adult, in time I've come to understand the importance of knowing not only where you want to go, but also how you plan to get there. As the President of NALBOH this year, I put the C 'Jestion to the board and staff at our April board meeting. Nha!'s our planf' I wanted to know We had begun a discussion in the fall of 1999 about NALBOH's accomplishments to date and its current activities. An impressive list was generated, but this process also helped us to see what was missing. We all knew that NALBOH's board members and staff were doing a lot of good work, but we could see from our list that we were beginning to spread out in a number of different directions. We sensed that if we were to continue on this path, then we would risk losing our focus and fail to accomplish things that had been important when NALBOH was formed. Concerned that we would end up with a staff and board stretched to their limits but unclear of their priorities and direction, we took time out of our March 2000 board meeting to develop a strategic plan for NALBOH. Over the next three years, NALBOH will use the strategic plan to guide its activites and initiatives, communicate its priorities, monitor its accomplishments, and evaluate its progress. We plan to revisit our strategic plan every two to three years to assure that we continue to move in the direction(s) we intend. You may obtain a copy of NALBOH's strategic plan from the NALBOH office by calling 419-353-7714, from oUl web site at vvww.nalboh.org, or at OUT annual conference in Raleigh, North (' .rolina, July 27-29, 2000. The board and staff welcome your " ,noughts and suggestions about our strategic goals and objectives. If you have an interest in participating in any of (Continued on page 2) The FDA Draft National Retail Food Regulatory Program Standards By Pat Bohan As a health board member, have you ever wondered if the food protection program in your community is effective? How does the public know if the food protection program is similar .among jurisdictions? Are restaurant owners in one jurisdiction held to a different standard than another jurisdiction? What are the guiding principles or foundatIOn for food protection programs? These questions have been heard by the FDA and will be addressed during NALBOH's annual meeting. National uniformity in regulating food safety has long been important to consumers, regulators and industry Adoption of the FDA Food Code by state and local programs has been an important part of achieving that uniformity However, a missing piece has been an agreed upon national standard or foundation for regulatory programs that administer the Food Code. In 1996, the PDA developed two basic principles to build a new foundation for the retail food program; 1. Active managerial control of the CDC-identified risk factors that are known to cause food-borne illness; and 2. Establishment of a recommended retail food program framework within which the active managerial control of the risk factors can be realized. This led to the development of draft program standards that involve voluntary participation by the regulatory agencies. The draft standards were developed after significant input from all stakeholders. The draft standards have been submitted for further review through the Conference for Food Protection (CFP). The CFP meets every two years and is comprised of regulatory and industry representatives who propose recommendations to the FDA for improvements to the food safety system. The FDA believes these draft standards will; serve as a FDA benchmark to retail food regulatory program managers in the design and management of a retail food program; provide a means of recognition for those programs meeting the standards; promote uniformity in retail food programs to reduce the risk factors known to contribute to food-borne illness; provide a foundation for the retail regulatory program that is focused on risk factors and other issues that may (Continued on page 2) May 2000 NALBOH NewsBrief Presidellt's Message (Continuedfrom page 1) these activites or want to provide feedback on where NALBOH is heading in the next few years, you may call me directly at 919 966-9982, e-mail me at vupshaw@Sph.unc.edu or contact the NALBOH office. I look forward to seeing you this summer at our annual meeting! ~ FDA Food Program Standords (Conlinuedfrompage I) contribute to food-borne illness; and, promote, through the management of a retail food regulatory program, the active managerial control in the retail establishment of all the factors that may contribute to food-borne illness. The FDA has proposed the following nine standards: 1. Regulatory foundation 2. Trained regulatory staff 3. Inspection program based on Hazard Analysis and Critical Control Point principles 4. Uniform inspection program 5. Food-borne illness response 6. Compliance and enforcement 7 Industry recognition 8. Program resources 9 Program assessment The idea of program standards for local retail food regulatory programs has a lot of potential. It can provide health board members with information they need to inquire about the ability of their food protection program to protect the public's health. For more information, be sure to attend the FDA Food Program session at NALBOH's annual meeting on this topic. Betty Hardin from the FDA will speak about the recommened program standards and answer your questions. For additional information, please go directly to the FDA website at: http://vm.cfsan.fda.gov / -dms/ ret-toc.htmJ I Ii!] Q) A Look at the Membership Eau Claire Passes Smoke-Free Restaurant Ordinances By Jim Ryder, Director, Eau Claire Oty-COIDIty Health D<partrnmt Clean Air 2000 was a grass roots initiative of several hundred citizens who wanted to address the health issues related to environmental tobacco smoke. The Eau Oaire, Wisconsin City-County Health Department worked with Clean Air 2000 to enact a smoke-free restaurant ordinance in the city of Eau Claire. Two City Council members, Lynne Young and Terry Sheri- dan, introduced a public health ordinance entitled "Smoking Prohibited in Indoor Areas of Restaurants." The City-County Board of Health passed a resolution supporting the Clean Air 2000 initiative at its regular December 1999 meeting. The City Council held a public hearing on the ordinance that attracted over 100 citizens. Forty persons spoke; their testimony was split about fifty/fifty on this emotional issue. The next day, February 8th, the City Council members voted 8-2 in favor of the ordinance. A copy of the ordinance can be obtained from the NALBOH website at: www.nalboh.orgj tobacco_control_efforts.htrn The City of Eau Claire licenses 231 restaurants. The ordinance requires restaurants that derive 50% or less of their gross re- ceipts from the sale of alcoholic products to be entirely smoke- free. Approximately 131 restaurants were partially or totallYQ) smoke-free prior to the ordinance. Thirty eight taverns or bars that had alcohol sales exceeding 50% of their establishment's gross receipts were excluded from the requirements of the or- dinance. The remaining 62 restaurants are now entirely smoke-free. The City-County Health Department was charged with ad- ministration and enforcement of the smoke-free restaurant ordinance. The NALBOH NewsBrief IS published by the National Association of Local Boards of Health 1840 East Gypsy Lane Road Bowling Green, OH 43402 Phone: 419-353-7714 Fa" 419-352-6278 E-mail: nalboh@nalboh.org Website: www.nalboh.org The production and diltribution of Ihi. publiution arc supporIcd by funds from Ibc CCNCfI for DiK.uc Control md J>rc\.oaJtion. President President-Elect Sccretaryrrreasum Past Presidcnt NALROH Officers Vaughn Upshaw, EdD, DrPH (NC) Harvey Wallace, PhO (MI) Stq>hon Popcnbug (N!) Grace: Duncan, RN, BSN (OH) NALBOH Staff Executive Director Director of Liaison and Governmental Relations Project Director-Tobacco Project Director-Training Administrative Assistant N~BOH Trustees Marie M. Fallon, BS Edwin "Ted"Pratt, Jr., MPA Rebecca Edwards., MPH Suah Chant. MA Grace Serrato North Atlantic Mid Atlantic Southeast East Great Lakes West Great Lakes Midwest W,,, State Affiliate State Affiliat.e Ricbard Xanoff (MA) Johne. ~ti(NJ) J. Frederick Agel (GA) Jim Rccx:hio (OH) Ken Hartke(lL) Diane Wartgow (CO) Connie Tatton (lIT) Phil Lyons (lIT) Ned E. Baker (OH) '~ -.J !Page 2 NALBOH NewsBrief May 2000 Report from Washington By Edwin "Ted'" Pratt, Jr. Director of LUzison and Governmental RElations c The winter and early spring is appropriation time here in Washington. The many subcommittees start their work right after the President delivers the "State of the Union" address. Anyone and everyone with an interest in federal programs is lining up to testify, writing letters, making calls and sending e-maiIs.Itis busy and exciting. For the first time, loeal boards of health are playing a part in educating and informing Congress as to the needs and concerns of the public health community at the loeal level. With all the special interests represented here inside the beltway, and the enormous amounts of money that business and other groups are prepared to spend to influence legislation, it may seem there is little our new and seemingly small voice can do to be heard. But let me tell you, when I explain just what NALBOH is and who its members are, there is real interest on the part of congressional assistants and staff from other associations. There is a real desire to hear from loeal follcs, and we need to make sure that happens! NALBOH has been actively supporting a number of items in the President's budget. Most particularly, we have urged full funding of the request for $130 million to support the CDCs Office of Smoking and Health (OSH), up from $96 million this year. We feel this is particularly important in light of the recent Supreme Court decision that removed FDA authority over tobacco products (see below). We have also supported O full funding of the CDC Health Alert Program at $40 million, providing much needed funds to states and loealities for training, communications, and infrastructure development to allow for improved responses to public health emergencies. We have also opposed any actions on the part of Congress to limit the Department of Justice suit against the tob~cco companies, including writing a letter to Senator Stevens (R-AK), Chairman of the Senate Appropriations Committee. NALBOH has also been actively supporting the Norwood (R-GA)-Dingell (D-IL) Bill that provides for a "Patient 8ill of Rights." This bill is tied up in the House-Senate Conference Committee at the moment and is facing real difficulty Any members who are interested in more information on this can contact Rep. Norwood's website at: www.house.gov/norwood As 1 mentioned above, the recent Supreme Court decision stripping the FDA of its power to regulate tobacco has been a major concern. However, the Court also unanimously found that tobacco represented the nation's most serious public health threat and made it clear that the obligation to protect the public from tobacco falls squarely on Congress. NALBOH has been supporting bills introduced by Representatives Ganske (R-IA), Waxman (D-CA) and Dingell (D-IL). These bills enjoy growing bipartisan support, and as of April 14th, have 18 Republicans and 14 Demoerat co-sponsors. These bills seek to restore FDA authority to regulate tobacco. r "-. (Continued on page 4) L___ _______________ _____ Dr. C. William Keck Delivers the Baker Lecture on Public Health Partnerships By Fleming Fallon, MD, DrPH, Bowling Green State University On April 7, 2000, the first Ned E. Baker Lecture in Public Health at Bowling Green State University was delivered by Dr. C. William Keck. The title of Dr. Keck's talk was Multi- ple Partnerships: Endless Opportunities. He discussed the importance of partnerships for communities in general and loeal boards of health in particular. The lecture was avail- able by satellite broadcast to loeal boards of health through- out the country Recognizing the importance of this topic, videotapes of the lecture will be mailed to aU NALBOH members as a membership benefit. Copies can also be ob- tained from the NALBOH office. The Ned E. 8aker Lectureship was established to honor one of NALBOH's founders and its first President. The annual event is co-sponsored by the College of Health and Human Services at 80wling Green State University, the Cove Chari- table Trust of Boston, all eleven state assoeiations of loeal boards of health and NALBOH. Each year, an individual who has made significant contributions to the field of public health is honored as the Ned E. Baker Lecturer. Dr. Keck is the Medical Director for the Akron Health De- partment. He is a past President of the American and Ohio Public Health Assoeiations. Dr. Keck has written many arti- cles pertaining to the fields of public health. He co-authored Principles of Public Health Practice and has helped to establish an MPH degree program that involves five institutions in northeast Ohio. One of Dr. Keck's current projects is imple- menting the public health performance standards. He is also an active participant in the Council on Linkages. Nominations for the 2001 Ned E. Baker Lecturer are pres- ently being accepted. These can be e-mailed to Dr. Fleming Fallon, Chair of the Baker Lecture Advisory Committee at ffallon@bgnet.bgsu.edu, or mailed to 234 College of Health and Human Services, Bowling Green State University, Bowl- ing Green, OH 43403. Page 3 r I I I May 2000 Reportfrom Washington (Continuedfrompage3) All this represents new activity on behalf of local boards of health by NALBOH. Soon, we will be contacting members in key congressional districts to seek support in our effort to inform and educate members of Congress about the needs and concerns of local public health agencies. When we contact you, we hope you will take an active role in this effort. Also, we very much want to hear your views about what NALBOH should be doing on your behalf here in Washington, so please call 202-898-5600 or e-mail me at nalbohdc@olg.com any time. Finally, we have been continuing our work with CDC's Public Health Practice Program Office on the National Public Health Performance Standards Program (NPHPSP). In the next few months, the three assessment tools-state, local, and governance-will be field tested in Minnesota, Hawaii, and Mississippi, with more states to come. We are planning to hold a meeting at the APHA Conference in Boston, MA (November 12-16) for local boards of health (New Hampshire, Massachusetts, Connecticut, and New Jersey). We hope members from those states will mark their calendars and try to join us. We need your advice and guidance on how to implement the NPHPSP effectively in your states. We will be sending more detailed information soon. Writiol!: Elected Leaders By Fleming Fallon, MD, DrPH, Bowling Green State University When proposed public health funding appropriations were reduced by the Governor, the Rockdale County (GA) Board of Health wrote a single succinct letter. The Rockdale Board out- lined the successes of past public health expenditures. It then showed how citizens had become dependent on state funding in public health matters-disaster preparedness, immunizations and the like. The impact of appropriation reductions was pro- jected. Finally, the positive political impact for the Governor was suggested. The letter was successful. The Governor restored the pro- posed budget reductions and funded programs remained in operation. There are important lessons from this example: . Be succinct, polite and truthful . Document past successes . Demonstrate a need . Help the identified opportunities for elected officials to demonstrate his commitment to the community's health The written word remains one of the most powerful tools available to citizens. Properly crafted, written documents can have enormous influence and lead to impressive results. I Page 4 NALBOH NewsBriaf NALBOH Activites o NALBOH AT WORK IN INDIANA NALBOH's Executive Director, Marie Fallon and Ned Baker, State Affiliate Trustee, attended the Indiana Public Health Association (IPHA) Annual Meeting and participated in a Board of Health dialogue session on April 18th. Jerry King, Executive Director of lPHA, chaired the session to discuss interest among local boards of health in networking with other boards, in ongoing public health education and training, and in forming a state association of Indiana local boards of health. In the future, lPHA will be contacting local boards of health for their input into offering training events and into the development of an Indiana state forum or association of boards of health. For more information, please contact Jerry King at the lPHA, P.O. Box 1705, Indianapolis, IN 46206. Phone: 317-221-2392; Fax: 317-221-3006. NALBOH IN NORTH DAKOTA Southeast Regional Trustee, J. Frederick Agel (GA) addressed the North Dakota Health Department staff and board mem- bers at their March Ill'" meeting. His presentation reviewed the National Public Health Performance Standards (NPHPSp) 0, and their role in using this tool to improve quality, account- ability, and provide a scientific basis for better decision- making. The meeting was well-attended and participants were enthusiastic about the upcoming availability of this much needed tool becoming available. If you would like more information about the NPHPSP, visit www.phppo.cdc.gov/ dphs or contact Rebecca Edwards at the NALBOH office, 419- 353-7714 or e-mail rebecca@nalboh.org. TRAVELS WITH HARVEY Dr. Harvey Wallace, NALBOH President-Elect, was your rep- resentative at the Surgeon General's Conference on Children and Oral Health: The Face of'a Child (June 12-13). Harvey spoke on the role of governing bodies in assuring the provi- sion of dental services by local health departments. He also attended the National Environmental Health Associa- tion Conference in Denver (June 17-18). Harvey served on a panel to discuss the Environmental Health Primer that NALBOH is helping to produce. -/ 1 , -------' NALBOH NewsBrief May 2000 NALBOH Activites c Environmental Health Competency Project By Ned E. Baker, MPH NALBOH, along with 13 other national public health organizations, is participating in a panel to develop Environmental Health Competencies. This panel is being led by the American Public Health Association (APHA) with the support of the Center for Disease Control and Prevention's (COC) Center for Environmental Health. The project seeks to develop a set of core competencies for environmental health practitioners working in local public health agencies. The project proposes to build upon the technical competencies identified by the National Environmental Health Association. The primary goal of the project is to identify, in non-technical terms, the competencies needed to address current and emerging environmental challenges in local public health. Local environmental health practitioners are at the front line in this effort to prevent many new and re-emerging environmental health related diseases. It is important to have an environmental health workforce prepared to address these challenges. I am NALBOH's representative to the panel. The final product will assist local boards of health in understanding the importance of environmental health workforce competencies in order to provide effective environmental health ser- vices. o NALBOH Membership By Ned E. Baker, MPH Membership in NALBOH continues to grow As of May 3{)<h, there were a total of 631 members broken down in the following categories: 579 Institutional (Boards of Health) 9 Affiliate (State Associations) 31 Associate (Individuals) 6 Retired 6 Lifetime Because most of NALBOH's members are local boards, approximately 3,720 individuals are encompassed in NALBOH's roster of members. This is about a 13% increase over our tcital1999 membership. We are approaching our goal of 800 members by the end of year 2000. If you have not yet joined NALBOH, it's not too late. jOin now and benefit from the many activities of NALBOH, including: . Copies of the NALBOH NewsBrieffor each and every board of health member . Discounts to NALBOH Annual Education Conference. the only national conference specifically addressing the interests of local boards of health . Use of NALBOH's resource library and videos for board of health education and training . Input to developing national policies such as the National Public Health Performance Standards . Participate as a member of a NALBOH committee . Apply to receive a NALBOH leadership scholarship or tobacco fellowship Send in your application today (See back page) cC Page 5 I May 2000 NALBOH NewsBrief National Association of Local Boards of Health ANNOUNCES a ASSURING CRITICAL CAPACITIES IN PUBLIC HEALTH. The Role of Local Boards of Health in Building Infrastructure NALBOH's 8th ANNUAL CONFERENCE For more i'!formation on the 8th Annual Conference visit www.nalboh.org July 26-29, 2000 Sheraton Capitol Center Hotel Raleigh, North Carolina Visit www.sheratoncapital.comfor hotel information Bioterrorism Emergency Response - Hurricane Floyd Healthy People 2010 Initiatives MAPP (formerly APEXCPH) Plenary Sessions & Keynote Speakers Poster Session Scholarship Opportunities Violence in the Community Workshops: Back to Basics Environmental Health Primer (NALBOH '---.~ ( .~.~ o CONFERENCE HIGHLIGHTS: National Association of Local Boards of Heaijh For more information contact: - - - NAl.BOH 1840 East Gypsy Lane Road Bowling Green, Ohio 43402 Phone: 419-353-7714 Fax: 419-352-6278 E-mail: nalboh@nalboh.org - In Cooperation with the Association of North Carolina Board of Health .-... J I Page 6 ------, co (' "-- I NALBOH NewsBrief May 2000 Call for Local Board of Health Members' Participation ~c Public Health Leadership Training Opportunities NAlBOH is working together with the National Public Health leadership Network to get local board of health members involved in state and regional leadership programs. Since 1991, the Centers for Disease Control and Prevention, Public Health Practice Program Office began to provide technical assistance and support to these state and negional based leadership programs. These programs were formed through academic and practice collaborations among Schools of Public Heaijh and State Health Departments. The programs are dedicated to meeting local grassroots needs by developing and enhancing individual and organizational leadership and management for improving and promoting the health of communities through the Essential Public Health Services. Applications from board of health members are now being accepted in the following states: Arizona Colorado Florida Illinois Indiana Iowa Maine Michigan South Carolina South Dakota Tennessee Utah Vermont Virginia West Virginia Wisconsin New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Pennsylvania Contact NAlBOH for further information - Marie Fallon 419-353-7714 or e-mail: marie@nalboh.org Public Health Leadership Training Opportunity The Southeast Public Health leadership Institute would like to extend a special invitation to NAlBOH members in North Carolina, South Carolina, Tennessee, Virginia, and West Virginia to apply and to en- courage their senior local public health employees to model the way to leadership by applying to the Institute for the year 2000-2001 local public health employees' tuition is sponsored in full by the participating states, CDC, and the Claude Worthington Benedum Foundation. Tuition for all others, including local board of health members, is partially covered and the applicant's organization contributes a tuition of $3,000. The leadership Institute is geared to ex- perienced public health professionals with leadership backgrounds. Individuals with less than one year in their cur- rent position and less than five years of public health experience would be advised to apply once they meet those qualifications. Application deadline is August 15, 2000. Access the scholar application thru the website WWW.unc. sph.eduiphli or contact the scholar selection committee at 919-966-3309 or leadership.lnstitute@sph.unc.edu TrainingFinder.org The Public Health Foundation (PHF) has launched a new online distance learning clearing house, TrainingFinder. 019. In one central website, public health professionals of all disciplines can search the most comprehensive database of distance learning course listings in public health. This service is free to both users and submitters. To search, browse, or submit public health distance learning course listings, visit: www.TrainingFinder.org Back to Basics WorkshoD At NALBOH's stb Annual Conference It is not too late to register for this one-day workshop on clean indoor air policies and regulations. local board of health members will learn the nuts and bolts of a winning clean air policy initiative. Registration forms can be ob- tained on the NAlBOH website, or by contacting the Bowling Green NAlBOH office at 419-353-7714. ~~~----- Page 7 ~ I ----.--.-.---.-..-.---.- - -- .---.---- L~!Y~~~______o_ 0_ _._ __ 00. __ ... TOBACCO FREE USA Tobacco Industry Targets Boards of Health By American Nonsmokers' Rights Foundation In many places, state and local boards of health are allowed to operate independently from legislatures or local councils. In addition, these boards are often vested with powers that allow them to enact rules to protect the public health-including smok- ing restrictions. Moreover, boards of health tend to be com- prised of people who are knowledgeable about, and sympa- thetic to the topic of public health. An educated and motivated board of health can, then, with a fair amount of ease and rapid- ity, make sweeping changes in public smoking rules to protect public health. Their autonomy, power and dedication to health makes them responsive to the need for this, and that sends up red flags in the tobacco industry In recent years, the tobacco industry has been trying to pass measures at the state level to preempt this power, so that local boards of health will be rendered powerless to enact such re- strictions. The following memo from the Tobacco Institute shows the industry's alarm over the power of local boards of health to enact smoking restrictions: "Tobacco Institute Headquarters has advised us of a possible action by the New York State Public Health Council that could set an alarming precedent. This agency is considering adoption of a smoking regula- tion that would ban or severely restrict smoking virtually everyu'here in the state. Affected would be retail stares, restaurants, places of work and even baTS and bar areas. Aside from the proposal's severity, the Council would impose adminis- tratively...the type of smoking restriction that the New York Legisla- ture has refused to enact into law. Please evaluate the nature of the powers of the Public Health Council, board of health or similar administratil'e body in your state and advise me accordingly. This, of course, is to identify any state that may have non-legislative opportunities for obtaining smoking restriction laws." Preemption Preemption is a provision in state (or federal) law which elimi- nates the power of local (or state and local) governments to regulate tobacco. Preempting local tobacco control with weaker state or federal laws is the tobacco industry's number one legis- lative goal. Preemption is a serious threat to effective tobacco control. There are two broad categories of preemption. One is explicit (or ex- press) preemption, in which preemptive language is expressly written into the law The other is implicit preemption, which is implied rather than explicitly stated in the law Implicit pre- emption occurs when Congress or a state legislature adopts comprehensive regulations on a subject which are later inter~ preted by the courts to "occupy the field" being regulated, and therefore preclude inconsistent local (or state) regulation. Addi- tionally, the tobacco industry has been experimenting with leg- , Page B L ----..- - - - - - --..-.-..-....-.-..--, NALBOH NewsBrief islation which does not deny local control over tobacco but has the effect of eliminating it. Why Local Control Is Important Ease of enactment: Local legislation remains far easier to pass than state or federal initiatives. In most instances, local legis- lation passes despite the tobacco industry's considerable op- position. Ease of enforcement and compliance: Local enforcement agen- cies are an easily accessible enforcement mechanism.. particu- larly when compared to often distant enforcement agencies for state laws. Furthermore, because residents have a higher level of awareness of local ordinances than state statutes, compli- ance rates tend to be higher for local ordinances. Synergism: The most important reason we need to protect lo- cal control is to support our larger goal: societal rejection of tobacco use. A powerful educational process unfolds as a lo- cal community considers a smoking control ordinance. Letters to the editor, newspaper and television coverage, town hall meetings and public hearings all ensue. In the process, the community is left not only with a strong, enforceable law bol- stered by public support, but with an increased understanding of tobacco issues. All this helps change social norms and atti- tudes, bringing us closer to our ultimate goal of a smoke-free society Why Is Preemption The Tobacco Industry's Chief Legislative Goal? The tobacco industry's push for preemption is a measure of our success at the local level. Over 1200 local jurisdictions have now enacted local tobacco control ordinances. Of these, 820 contain meaningful clean indoor air provisions, including 247 smoke-free ordinances which completely eliminate smok- ing in enclosed workplaces and/or public places (including restaurants). Big Tobacco finds it nearly impossible to shut down local policy campaigns, so they try to close the door to local ordinances via preemption at the state level. The tobacco industry is keenly aware that it is at a complete disadvantage on a local level. Walker Merryman of the To- bacco Institute said in 1991 "It's barely controlled chaos [at the local level]. We can't be everywhere at once." Victor Craw- ford, a former Maryland state legislator and lobbyist for the Tobacco Institute, explains the tobacco industry's strategy of taking the fight to the state level, away from local control: "We could never win at the local level. The reason is, all the health advocates, the ones that unfortunately I used to call 'health Nazis: they're all local activists who run the little po- litical organizations. They may live next door to the mayor, or the city councilman, and they say 'Who's this big-time lobby- ist coming here to tell us what to do?' When they've got their friends and neighbors out there in the audience who want his bill, we get killed. So the Tobacco Institute and tobacco com- panies' first priority has always been to preempt the field, preferably to put it all on the federal level, but if they can't do that, at least on the state level, because the health advocates can't compete with me on a state level." o o '\\\ j) i NALBOH NewsBrief ~-~ NEW NALBOH PUBLICATION \0 The National Association of Local Boards of Health (NALBOH) has just completed the first-ever compilation of the legal authority for the tobacco control in the United States. The state specific reports identify who legally has the authority to pass tobacco control ordinances on issues rang. ing from clean indoor air to youth access, licensing tobacco product retailers and more. Obtaining this information is a crucial step that should be made prior to any tobacco control effort in order to avoid wasting valuable resources. NAL- BOH members will receive a complimentary copy of the document as a benefit of membership. For more information, please contact Rebecca Edwards at: 419-3S3-7714 or e-mail at rebecca@nalboh.org. Quick Summary of the FDA Decision & What It Means co On March 21, 2000 the U.5 Su preme Court ruled 5-4 that the U.5. Food and Drug Administration (FDA) does not have ju- risdiction to regulate tobacco products or cigarette company marketing practices under existing law The Supreme Court's ruling renders invalid the FDA's 1996 Regulations Restricting the Sale and Distribution of Cigarettes and Smokeless Tobacco to Protect Children and Adolescents (the FDA's 1996 Tobacco Regulations). Those portions of the FDA's 1996 Tobacco Regulations are no longer in effect. These were the provisions that set 18 as the nationwide minimum legal sale age for to- bacco and required that retailers check photo identification before selling cigarettes to persons who appear younger than 27 years of age. This decision brings a halt to FDA-based compliance checks, but does not affect the ability of cities, towns, and health boards to conduct compliance checks under the cover of state and local laws. New Tobacco Control List Serve The National Association of Local Boards of Health and the National Association of County and City Health Officials have begun development of an interactive list serve for local board of health members and local health officials. The list serve will allow constituents of both organizations to interact on issues relating to tobacco control and to receive information from the national level in a timely manner. Please send your e-mail address to rebecca@nalboh.org. We will sign you up for a great opportunity to interact with peers on an informal basis. ( " I' i 'I Ii , I May 2000 NALBOH Testifies on World Health Organization Tobacco Proposal NALBOH joined with other major public health organizations in testifying in support of the core principles to be contained in a proposed World Health Organization Framework Con- vention on Tobacco Control. The Framework Convention is a type of international treaty designed to promote and coordinate an international response to the deadly tobacco epidemic. While the details are to be negotiated, the 191 member states of the World Health Or- ganization, including 5 permanent members of the United Na- tions Security Council, unanimously endorsed the start of the negotiations for this Framework Convention. NALBOH will continue to represent the interests of our members to the United States negotiating team and keep you informed of pro- gress. WEBSITES TO VISIT: American Legacy Foundation http://www.americanlegacy.org American Nonsmoker's Rights Foundation http://www.no-smoke. org Campaign for Tobacco Free Kids http://www.tobaccofreekids.org CDe's Tobacco Resources http://www.cdc.gov/tobacco Food and Drug Administration Compliance Checker http://wwwfda.gov/tobacco Massachusetts Department of Public Health http://getoutraged.com National Association of Attorneys General http:.llwww.naag.org/tob2.htm MODEL TOBACCO CONTROL ORDINANCES Model Tobacco Control Ordinances are available for interested board of health members by contacting Rebecca at the NALBOH office at 419-353-7714 or bye-mail (rebecca@nalboh.org) or by connecting to the Americans for Nonsmokers' Rights website at: www.no-smoke.org. 1 Page g ~ [~~______-===-___-=__ _ __________________NA~~OH NewsBrief I COMING s(x)N! ~ Community Health Status Indicators Project: Providing Information for Improving Commumty Health By Michael R. Fraser, PhD , J Do you ever wonder how to obtain county-specific data on a number of different health and social indicators for your health agency's jurisdiction? Would you like to compare your community's health status to other communities like yours nationwide? Have you shared a recent picture of your community's health with community members, policy makers, and state and local legis- lators' Since 1996, the National Association of County and City Health Officials (NACCHO) has worked with the Public Health Foundation, the Association of State and Territorial Health Officials (ASTHO), and the U.5. Department of Health and Human Services, Health Resources and Services Administration (project funder), to address these and other needs for local health data. The result of this effort is the Community Health Status Indicator (CHSl) report, a local health status report created for every county in the United States that will be released in July 2000. 0' The CHSI report contains information on the demographic characteristics of your county's population, as well as data on "peer communities" nationwide: counties matched with yours on the basis of population size and other selected characteristics. Each CHSl report includes sununary measures of health such as average life expectancy and self-rated health status, local data on na- tionalleading causes of death, birth and death measures for your county, peer counties and the nation as a whole. Other data in the report includes environmental health indicators, use of preventive services, and measures of access to care. Accompanying each report is a companion document of data sources, definitions, and on-line resources for interpreting the report. While this first iteration of the CHSl report is specific to counties, future plans include developing city or district specific reports for areas where counties are not relevant health jurisdictions. NACCHO wi\l be coordinating the dissemination of the CHSl report via mail to every local and state health agency In addition, CHSI reports for every county will be available on the World Wide Web via links from the NACCHO web site and partner organi- zations' web pages. A task force of local and state health officials, chaired by Fran deFlorio (Brattleboro District Health Depart- ment, Vermont), will oversee the CHSl release and recommend appropriate release strategies to project staff. This task force has suggested that local health officials have a "preview period" to review their reports prior to public release, and that materials ac- companying the report include a press-release and other information on how to use the CHSl report with community groups. The project team anticipates public release of the CHSI reports, including the project web site, at the NACCHO-ASTHO Annual Con- ference in Los Angeles, California, July 19th through 22nd. Look for your Community Health Status Indicators report this sum- mer! Recall Round-Up 2000 By Charlene Roundtree o We need your help in reducing serious injuries and deaths among children. The U.5. Consumer Product Safety Commission (CPSC) is conducting a Recall Round-Up to get hazardous products out of consumers' homes. In the past three years, Recall Round-Up campaigns generated tremendous interest and media attention nationwide and resulted in CPSC's single-most success- ful federal-state-local partnership program. CPSC coordinates approximately 300 recalls of defective or dangerous products each year. Removing recalled products from the distribution chain is usually not difficult, but getting consumers to give them up can be. Despite recall notices and public warn- ings, many old hazardous products are still in homes, flea markets, second-hand stores, and at garage and yard sales. The results? Deaths and serious injuries to children caused by -recalled products still occur, and parents lament, uIf only we'd known.. ., What can you do? Provide this information in your newsletter, at programs, during media interviews. Information on getting dangerous products out of consumers' homes is vital and what better time than springtime. Springtime is when we clean out the garage, attic and basement. Let's be sure we are not getting dangerous products out of our homes and putting them into someone else's home. Know what has been recalled and protect yourself and others by' . Promoting community awareness: Distribute CPSC's list of recall products to neighbors, childcare providers, and to local community and homeowner associations that publish local newsletters or sponsor yard sales. . Organizing community round-ups: Work with local safety, health, consumer agencies, schools or other community organi- zations for the central collection and disposal of hazardous products that can't be repaired. . Promoting media awareness: Inform local media in advance; organize a local news conference; issue a local news release; conduct television and radio interviews. lf you would like more information on Recall Round-Up 2000 and a list of the recalled products, please contact me at croundtree@cpsc.gov or 800-638-2772. ~ ---..E Page 10 - -....-..- , _____J I NALBOH NewsBrief May 2000 I I cl CALENDAR OF EVENTS 2000 ASTHO/NACCHO Annual Conference July 19-22, 2000 Los Angeles, CA Spotlight on Teamwork: A Vision for Public Health in the New Century Contact Corinna Estep at 202-371-9090 ext. 213 (ASTHO) Contact Sarah Schenk 202-783-5550 ext. 218 or e-mail sschenck@naccho.org ASSURING CRITICAL CAPACITIES IN PUBLIC HEALTH: The Role of Local Boards of Health in Building Infrastructure NALBOH's 8th ANNUAL CONFERENCE July 26-29, 2000 Sheraton Capitol Center Raleigh, North Carolina For more information, contact NAlBOH at 419-353-7714 or by e-mail at nalboh@nalboh.org o 11th World Conference on Tobacco OR Health August 6- 11, 2000 Visit www wctoh.org for more information. Michigan Association for Local Public Health Annual Conference August 22-24, 2000 For more information, contact MALPH at 517-485-0660 or e-mail info@malph.org 2nd National Symposium on Medical and Public Health Response to Bioterrorism November 28-29, 2000 Washington, DC For more information, call Andrea Lapp aI410-347-3227 or visit www.hopkins-biodefense.org The 15th National Conference on Chronic Disease Prevention and Control Living Healthier, Living Longer' The Will and the Way November 29-December 1, 2000 Washington Hilton and Towers Washington, DC For more information, call Estella Lazenby at 301-588-6000 or visit www.cdc.gov/nccdphp or www.astcdpd.org c I' I 'I Ii , Page 11 I ~---------------------------------------------------------------------------~ I I I I !o. I . ApPLICATION FOR MEMBERSHIP Date Membership Year 2000 Board of Health or Organization Address City Telephone Fax Contact Person Type of Membership Slate Zip Code E-mail Title . Institutional (Dues $100, or $75 if you belong to a Stale Association of Local Boards of Health that is an Affiliale Member of NALBOH) Local board of health or other governing body that oversees local public health ServIces or programs . Affiliate (Dues $250) State association oflocal boards of health . Associate (Dues $50) Individual . Retired Board of Health Member (Dues $10) . Sponsor (Nonprofit $50; For-Profit $250) Organization, agency or corporation Mail Ibis form, with payment of dues to: NALBOH, 1840 East Gypsy Lane Road, Bowling Green, OH 43402 National Association of Local Boards of Health 1840 East Gypsy Lane Road Bowling Green, OH 43402 NONPROFIT ORG. U. S. Postage PAID Bowling Green, OH Permit No. 47 r~~ \ NALBOH$ ~ .o.."-:::;",,~ ~ '--'