01/07/2004
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New Hanover County Health Department
Revenue and Expenditure Summary
November 2003
Cumulative: 41.66% Month 5 of 12
Revenues
Current Year Prior Year
Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remalnln Amount Earned Remalnln
Federal & State $ 1,691,857 $ 925,234 $ 766,623 $1,322,579 339,566 $ 983,013 25,67%
nimal Control $ 570,161 $ 264,573 $ 305,588 $ 587,944 230,447 $ 357,497 39.20%
Medicaid $ 1,046,080 $ 82,424 $ 963,656 $1,035,386 264,575 $ 770,811 25,55% t
Medicaid Max $ 273,333 $ $
EH Fees $ 300,212 $ 83,503 $ $ 312,900
Health Fees $ 111,850 $ 65,128 $ 482,700
Other $ 2,336,580 $ 1,052,202 $1,670,644
Expenditures
Typa of
Ex ndlture
Current Yea,
Expended
Amount
%
Prlo, Yea,
Expanded
Amount
Budgeted
Amount
Balance
Remalnln
%
Budgeted
Amount
Balance
Remalnln
9,938,494 $ 3,339,266
1,532,820 $ 541,731
335 863 $ 68,834
9,184,41 $3,257,197 $5,927,216 35,46%
1,917,481 $ 678,122 $1,239,359 35,37%
183 746 $ 8,862 $174,884 4,82%
Summary
Budgeted Actual %
FY 03-04 FY 03-04
Expenditures:
Salaries & Fringe $9,938,494 $3,339,266
Operating Expenses $1,532,820 $541,731
Capital Outlay $335,863 $68,834
Total Expenditures $11,807,177 $3,949,831 33.45%
Revenue: $6,330,073 $2,473,064 39.07%
e Net County $$ $5,477,104 $1,476,767 26.96% -
Revenue and Expenditure Summary
Fiscal Year 04
As of November 30, 2003
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NHCHD BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 03-04
Date (BOH) Grant Reauested Pendlna Received' Denied
12/312003 No activity to report for December 2003.
Cape Fear Memorial Foundation- Funds needed to
cover dental services for needy children 8S identified by
11/512003 School Heatth Nurses. $3,000 $3,000
NC Medical Foundation - Through the Good
Shephard Mlnl.tne. for nursing services to the
population frequenting the .hetter. $25,000 $25,000
Duke University- To provide 10 hours of nursing
services for TB Outreach. $10,388 $10,388
NC T abaeto and Control Branch, OHHS- &f:tfJB j..'fvkJ.
Continuation of Tobacco Prevention Program. $100,000 $100,000
10/112003 No activity to report for October 2003. "
New Hanover County Safe Schools- Uniting for
Youth "U4Youth"(funding will be received over a
91312003 3 year grant period) $49,000 $49,000
Safe Kids Coalltlon- Fire Prevention (Please note
this grant was pulled- coalition not able to meet
deadline for request) $2,500 $2,500
8/612003 NC DHHS- OPH Preparedness and Response $82,350 $31,950 $50,400
Smart Start- Partnership for Children (Grant
7/312003 Increase for Part Time Nurse Position) $5,523 $5,523
Cape Fear Memorial Foundation - Diabetes
Today (two-year request; $42,740 annually)
(Received $25,00 year 1 and $20,000 year 2) $85,480 $45,000 $40,480
Duke University Nicholas School of the
Environment-Geographic Information Systems
Grant (Env Health) $10,000 $10,000
Safe Kids Coalltion- Safe Kids Mobile Car Seat
Check up Van $50,000 $50,000
Safe Kids Coalition- Risk Watch Champian
6/412003 Team $10,000 $12,500
Smart Start- Partnership for Children: Child
5n 12003 Care Nursing Program (Preliminary Approval) $171,977 $172.500
Smart Start- Partnership for Children: Health
Check (Preliminary Approval) $41,035 $41,747
UNC-CH: Child Care Health Consultant $62,849 $64,495
Cape Fear Memorial Foundation (through
Partnership for Children): Naviaator Program $178,707 $180,000
4/3/2003 No activity to report for April 2003.
3/512003 No activity to report for March 2003.
2/5/2003 No activity to report for February 2003.
1/812003 NC DHHS- OPH Preparedness and Response $115,950 $33,600 $82,350
12/4/2002 No activity to report for December 2002.
NC Health and Wellness Trust Fund-Teen
Tobacco Use Prevention & Cessation Program
11/612002 ($100,000 per year for 3 years) $100,000 $100,000
Safe Kids Buckle Up Program-North Carolina
101212002 Safe Kids $5,000 $5,000
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A. of 12/1612003
. N<?TE: Notification received since last report.
NHCHD BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 03-04
Developing Geographic Information Systems
(GIS) Capacity In Local Health Department In
Eastern North Carolina-Duke University
Nicholas School ofthe Environment and Earth
Sciences (NSEES) $18,000 $18,000
1",4"UU' No actiVity to report lor september 2002.
No activity to report lor August 2002.
No activity to report for July 'UU4.
I Totals $1,126,759 $187,388 $614,792 $331,253
16.63%
29.40%
54.56%
Pending Grants 5 25%
Funded Total Request 8 40%
Partially Funded 3 t5%
Denied Total Request 4 20%
Numbers of Grants Applied For 20 tOO%
As of 12/1612003
. NOTE: Notification received since last report.
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NEW HANOVER COUNTY
HEALTH DEPARTMENT
2029 SOUTH 17TH STREET
WILMINGTON. NC 28401-4946
TELEPHONE (910) 343-6500 FAX (910) 341-4146
December 10, 2003
TO: New Hanover County Board of Health
FROM: David E. Rice, Health Director ,
SUBJECT: Reclassifications
Attached please find the proposed reclassifications for:
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Incumbent From To
Nancy Nail Public Health Division Nutrition Services
Manaaer - MG07 SUDervisor - PT09
Janet McCumbee Public Health Division Personal Health Services
Manaoer - MG07 Manaoer - MG09
Jean McNeil Public Health Division Animal Control Manager
Manaaer - MG07 - MG07
Dianne Harvell Public Health Division Environmental Health
Manaoer - MG07 Manaoer - MG07
Elisabeth Constandy Senior Health Educator- Health Education
PT04 SUDervisor - PT07
Diane Vosnock Medical Lab Supervisor - Medical Lab Supervisor-
PT07 PT09
Betsy Summey Public Health Nurse - PTOa Physician Extender -
PToa
These changes are made necessary by recent changes to the New Hanover
County Health Department organizational structure. Also attached is an
organizational chart.
-
The recommendation from the New Hanover County Human Resources
Department is for the Executive Committee to recommend approval of the
reclassifications to the Board of Health and for the Board to submit the
appropriate reclassifications to the New Hanover County Commissioners for their
consideration.
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"Healthy People, Healthy Environment, Healthy Community"
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NEW HANOVER COUNTY
INTER-OFFICE MEMORANDUM
New Hanover Cou<ny
NOt\'tH+tAAQL1N ,..
December 9, 2003
TO:
David E. Rice, Health Director
FROM:
Catherine Morgan, Senior Human Resources Analyst
THROUGH: Andre R. Mallette, Human Resources Director
SUBJECT: Reclassifications Resuhing from Reorganization
I have completed my reviews of several positions affected by the departmental reorganization and, based on
my fmdings, make the following reclassification recommendations:
. Reclassify the Public Health Division Manager over nutrition services and WIC (incumbent, Nancy
Nail) at Moo7 to Nutrition Services Supervisor at PT09. This is, in effect, a downgrade as well as a
reclassification.
. Reclassify the Public Health Division Manager over personal health services (incumbent, Janet
McCumbee) at Moo7 to Personal Health Services Manager at MG09.
. Reclassify the Public Heahh Division Manager over animal control (incumbent, Jean McNeil) at
Moo7 to Animal Control Manager at Moo7. This is simply a title change involving no pay grade
change.
. Reclassify the Public Health Division Manager over environmental heahh (incumbent, Dianne
Harvell) at Moo7 to Environmental Heahh Manager at Moo7. This, too, is simply a title change
involving no pay grade change.
. Reclassify Senior Health Educator (incumbent, Elizabeth Constandy) at PT04 to Heahh Education
Supervisor at PT07.
You may use this memo as documentation to accompany your request to the Board of Health and to the
Board of County Commissioners for approval of these reclassifications. According to our personnel policy,
these particular reclassification requests must be approved by the Board of County Commissioners because
the proposed classifications do not currently exist in our classification plan.
These reclassifications were made necessary by the recent changes to your department's organi7J1tional
structure. Three of these reclassifications represent significant changes in the position's placement in the
structure; the other two are merely title changes, which reflect no changes to the position but facilitate
_ changes to the classification structure. Fo1l9wing is a summary of the rationale for each reclassification:
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2
. Reclassify the Public Health Division Manager over nutrition services and WIC (incumbent, Nancy
Nail) at MG07 to Nutrition Services Supervisor at PT09. This is, in effect, a downgrade as well as a
reclassification. e
Prior to the reorganization, the nutrition (and WIe) services program was a division and the manager
reported directly to the health director. In the reorganization, these services have become a part of the
personal health services division. This manager no longer reports to the health director, but rather to the
personal heahh services division manager (Janet McCumbee). This position no longer has supervisory
responsibility for administrative support personnel (moved to the business manager's division). In the
personal health services division, positions comparable to this position are the public heahh nurse
supervisors who are at pay grade PT09.
. Reclassify the Public Health Division Manager over personal health services (incumbent, Janet
McCumbee) at MG07 to Personal Health Services Manager at MG09
Before the reorganization, there were four (4) nursing division managers. All of the nursing divisions
were combined into one under this position. In addition, nutrition services and the lab were brought into
this division, making it the "personal health services division." This division consists of over half of the
hea1th department staB: including most of the department's professional positions.
. Reclassify the Public Health Division Manager over animal control (Jean McNeil) at MG07 to
Animal Control Manager at MG07. This is simply a title change involving no pay grade change.
There is no change in the functions of this position, and it still reports directly to the heahh director.
Therefore, there is no basis for a pay grade change. A title change is recommended, however, to e
facilitate shaping the classification structure to the new organization structure. Before the reorganization,
there were eight (8) positions in the generic classification, Public Heahh Division Manager. The
reorganization recreated divisions with division managers which were evaluated at different pay grade
levels, depending on the division. Therefore, because we cannot have positions in the same classification
at different pay grades, it was necessary to create individual division manager classifications rather than
continue having them all in one generic classification. If Janet's position is to be upgraded, it has to be
reclassified to a separate classification, which would leave only two of the now five (5) managers in the
generic manager classification. The logical next step is to do away with the generic classification and re-
title the remaining two, the manager over animal control and the manager over environmental heahh.
. Reclassify the Public Health Division Manager over environmental health (incumbent, Dianne
Harvell) at MG07 to Environmental Health Manager at MG07. This, too, is simply a title change
involving na pay grade change.
The rationale for this reclassification is the same as for the animal control manager.
. Reclassify Senior Health Educator (incumbent, Elizabeth Constandy) at PT04 to Health Education
Supervisor at PT07.
This position has full supervisory responsibility for all health educators and administrative accountability
for health education programs, whereas when it was evaluated by the consultants it only had lead...
responsibility over a couple of staff: '.
New Hanover County Department of Human Resources
Andre R. Mallette, Director
910-341-7178
FAX: 910-341-4293
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INTER-OFFICE MEMORANDUM
NEW HANOVER COUNTY
:'leI.v Hanover COUIl~Y
NOI\'TH."^i\OL~!'t^
December 9, 2003
TO:
Allen O'Neal, County Manager
FROM:
Catherine Morgan, Senior Human Resources Analyst
THROUGH: Andre R Mallette, Human Resources Director
SUBJECT: Salary Upgrade Request-Medical Lab Supervisor, Health Department
Upon Health Director Dave Rice's request, I have reviewed the above-referenced position--along with
several others-to determine if changes to the position brought about by the departmental reorganization
warrant a reclassification or pay grade change. My recommendations on the other positions have been
sent to Dave for him to put on the agenda ofa Board of Co missioners meeting. They must be approved
by the Commissioners, as they do not currently exist in our classification plan. This position request
differs in that it is not a reclassification but rather a pay upgrade, which you may approve.
In the reorganization, the position of medical lab director (Public Heahh Division Manager, MOO?) was
eliminated and reclassified to another classification elsewhere in the department. The lab was moved to
be a unit under the newly created Personal Health Services Division (managed by Janet McCumbee).
Diane assumed full responsibility for the lab. She reports directly to Janet. She still has direct
supervision of all lab personnel including medical lab technologists and medical lab assistants and, in
addition, has most of the administrative functions formerly performed by the lab director. Putting this
position at PT09 would make it the same pay grade as the public heahh nursing supervisors under
Janet's direction. .
New Hanover County Department of Human Resources
Andre R. Mallette, Director
910-341-717l1
FAX: 910-341-4293
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NEW HANOVER COUNTY
.-
INTER-OFFICE MEMORANDUM
:-Iew Hanover COUll~y
NOR'tH+C,,""'QLS!'t1lt
December 9, 2003
TO:
Allen O'Neal, County Manager
FROM:
Catherine Morgan, Senior Human Resources Analyst
THROUGH: Andre R Mallette, Human Resources Director
SUBJECT: Reclassification Request-Public Health Nurse to Physician Extender, Health
Department
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This request is to restore Betsy Summey, who is a Physician Extender and is doing physician extender
work, to the correct classification, Physician Extender. Prior to the Health Department reorganization,
Betsy was a Senior Physician Extender. In the reorganization, her position was changed to a Physician
Extender and she was transferred to the clinic to be the TB coordinator and community health Physician
Extender there. The only vacancy there was in the clinic was the Public Heahh Nurse position she is in.
They wanted keep the Physician Extender position where she was and fill it with another Physician
Extender, which they did. They waited to request reclassification of the position Betsy is in to see if the
arrangement worked out well. They have had enough time now to make the transition and evaluate the
organization.
There will be no monetary increase as the resuh of this reclassification. When Betsy was transferred,
she suffered no monetary loss. The position she vacated was downgraded from Senior Physician
Extender (PTIO) to Physician Extender (PT08). The position in the clinic which she is currently in
would be upgraded, in effect, from PT06 to PT08.
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New Hanover Conoty Department of Human Resources
Andre R. Mallette, Director
910-341-71'll1
FAX: 910-341-4193
41
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NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda: Consent Meeting Date: 12116/03
Agenda:
Department: Health Presenter: Betty 10 McCorkle
Contact: Betty 10 McCorkle, Supervisor, Clinical Services
Subject: Purchase ofFluMist Vaccine
Brief Summary: Request approval to purchase and begin offering FluMist intranasal
vaccine for the purchase price of $20 per dose (State Contract Price) and a totai of 500
doses - total expenditure of$IO,OOO
Recommended Motion and Requested Actions: Approve $10,000 expenditure.to
purchase FluMist Intranasal vaccine to address the shortage of the injectable flu vaccine
I Funding Source: County Funds
Will above action result in:
[]New Position Number ofPosition(s)
DPosition(s) Modification or change
lJNo Change in Position(s)
I Explanation: "
I Attachments: See Standing Order, Proposed Fee
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NEW HANOVER COUNTY
HEALTH DEPARTMENT
2029 SOUTH 17m STREET
WILMINGTON, NC 28401.4946
TELEPHONE (910) 343.6500 FAX (910) 341-4146
.'
December 16, 2003
From:
New Hanover County Board of Health
Cynthia W. Hewett, Business Managerc.lIl~
To:
Subject:
Addition of New CPT Code and Fee
We are requesting approval for the addition of the following CPT Codes and Fees as the result
of the introduction of Flu Mist vaccine:
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Change Needed CPT Code Fee Justification
Addition 90660 $40.00 Establishing fee for
Flu Mist intranasal flu
vaccine
Addition 90473 $20.00 Establishing fee for
Administration of
Flu Mist intranasal flu
vaccine
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"Healthy People, Healthy Environment, Healthy Community"
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New Hanover County Health Department
Standing Order
Standing Order Coven:
2003-2004 Formula - Live Intranasal (FluMist) - live attenuated virus, trivalent-cold-
adapted, Dasally administered vacCine
Each O.sml dose ofFluMist contains thl'l flu strains recommended by the US Public
Health Service for the 2003-2004 flu season:
. AlNew Caledonial20/99 (HlNl), AlPanama/2007/99 (H3N2), AlMoscow/lO/OO-like),
and B-Hong Kong/330/2001 viruses.
Indications
FluMist is-Indicated for active immunization for the prevention of disease caused by influenza A-'-
and B vinises in healtl1y children and adolescents 5-17 years of age and healthy adults 18-49-
years ofage. -
FluMist is NOT indicated for immunization of individuals <Syears of age or 50 years of age
Healthcare pr9viders only can administer this vaccine
Healthy MediCaid recipients aged 5 to 49 who share a house with another Medieaid recipient
who is at high-risk for flu complications: .
_ children 6 to 23 months of age
_ people who have chronic health conditions
_ women in their second or third trimesters of pregnancy
- seniors over 65
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EligibDity
Healthy children and adults from age 5 to age 49 .
High risk Medicaid recipients who are household contacts ofh~thy children and/or
adults - '
Precautions
Prior to administration ofFluMist. ~dividuals or their parent/guardian should be asked about
their current health status, their personal medical history and the medical history ofhousehold
and close contacts, iric1uding immune status, to determine the existence of any eontraindications
to immunization with FluMist FluMist recipients should avoid close contact (i.e., within the
same household) with immunocompromised individuals for at least 21 days. -
Administration ofFluMist ~hould be postponed until after the acute phase (at least 72 hours) of
febrile and/or respiratory illness.
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Drug Interactions e
Children or adolescents who are_ receiving aspirin therapy or aspirin-containing therapy should
not receive FluMist FluMist should not be administered to persons on immunosuppressive
therapy. '
The concurrent use ofFluMist with antiviral compounds that are active against inflUenza A
and/orB viruses has not been evaluated. However, based upon the potential for interference
between such compounds and FluMist, it is advisabie not to administer FluMist until 48 hours
after the cessation of antiviral therapy and that antiviral agents not be administered until two (2)
weeks after administration of FluMist unless medically indicated.
There are no datuegarding co-administration ofFluMist with other intranasal preparations,
including steroids.
Concurrent Administration with Other Vaccines
The safety and immunogenicity ofFluMist when administered concurrently with other vacCines
haVe not been determined. Therefore, FluMist should not be administered concurrently with
other vaceines.
Warnings
Persons who should NOT be vaccinated with FIuMist:
- persons aged <S years of those aged ~ 50years; tit
_ persons with asthma, reactive airWays disease or other chronic disorderll of the
pulmonary or cardiovascUlar systems; persons with other underlying medical conditions,
including such metabolic diseases as diabetes, renal dysfunction, and
hemoglobinopathies; or persons with known or suspected immunodeficiency diseases or
who are receiving immunosuppressive therapies;
_ children or adolescents receiving aspirin or other saIicylates (because of the association
ofReye syndrome with wild-type influenza inf!lCtion);
- persons with a history of GuiUliin-Barre syndrome;
- pregnant women; or
_ persons with a history ofliyPersensitivity, including anaphylaxis, to any of the
components ofFluMist or to eggs
As with any vaccine, FluMist may not prptect 100% of individuals receiving the vaccine.
ContralndicatioD8
Under no circumstances should FluMist be administered parenterally.
I. Individuals with a history of hypersensitivity, especially anaphylactic reactions to any
component of FluMist, incl,uding eggs or egg produ~, shouid not receive FluMist.
FluMist is contraindicated in children and adolescents (15-1 i years of age) receiving aspirin
therapy or aspirin-containing therapy, because of the association of Reye syndrome with aspirin a
and wild-type influenza infection. .
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FluMist should not be administered to individuals who have a: history of Quillian-Bane
syndrome.
As with other live virus vaccines, FluMist should not be administered to individuals with known
or suspected immune deficiency diseases such as combined immunodeficiency,
agammaglobulinemia, and thymic abnormalities and conditions such as hlll1Ull1
immunodeficiency virus infection, malignancy, leukemia, or immUnosuppressed or have altered
or compromised immune status as a consequence of treatment with systemic corticosteroids,
alkylating drugs, antimetabolites, radiation or other immunosuppressive therapies.
2. FluMist can be Administered to persons with minor acute illness (e.g., , diarrhesor mild upper
respiratory tract infection with or without fever). However, ,if clinical judgement indicated nasal
congestion is present that might impede delivery of the vaccine to the nasopharyngeal mucosa,
deferral of the ad1"'ini!ltration should be considered until resolution of the itlne!J"
3. The effect on safety and efficacy ofFluMist COAdministration with influenza antiviral
medications has not been studied. However, because influenza antivirals reduce the replication
of influenza viruses, FluMist should not be Administered until 48 hours after cesSation of
influenza antiviral therapy, and influenza antiviral medications should not be administered for 2
weeks after receipt of FluMist. '
4. Whether con,<urrent adrninistrationofFluMist with other vaccine affects the safety or efficacy
of either FluMist or the simultaneously administered vaccine is UnknoWn. In the absence of
specific data indicating interference, following the ACIP (Advisory Committee on Immnni7J1tion
Practice) for immunization is prudent. Inactivated vaccines do not interfere with the immune
response to other inactivated vaccines or to live vaCcine. Two live virus vaccines not.
adininistered qn the same day should be Administered four (4 ) weeks apart.
Possible Side Effects
1. The most common signs and symptoms reported among children and adults included runny
nose or nasal congestion and headache
2. In children, there were also reported signs and symptoms of fever, Vl1miting, abdominal pain
and myalgia.
3. In adults, signs and symptoms included sore throat, chills and tiredness/weakness
4. Serious adverse reilction among healthy children aged 5-17 years or healthy adults 19-49
years occurred ata rate of <1 %
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Dosage and Administration
1. FluMist is lldministered for nasal use only. Do not administer parenterally.
2. FluMist should be administered according to the following schedule:
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Age
Vaccination Statal
Dosage
1# of Doses
5-8 years
Not.previously vaccinated
with FluMist
O.5ml
2 doses
(0.5 ml each,
60 days apart)
5-8 years
Previously vaccinated with
FluMist
O.5ml
1 dose
per season
Children & adults
9-49 years
Not Ilppli~le
O.Sml
1 dose
per seI1SOn'
3. FluMist musi be thawed immediately prior to administration. The vaccine should be
administered immedil1tely thereafter.
4. Administration Instructions:
, ,
lL ,FluMist shou1d be thawedimmedilltely prior to administration by holding the sprayer in the
palm of the hand; supporting the plunger rod with the thumb. Do not roll the sprayer or depress a,
the plunger. ..
b. Remove rubber tip protector.
c. While patient is in an upright position.with head tilted bllCk. place the tip just inside the nostril
to ensure FluMist is delivered into the nose. Depress plunger to spmy Ilpproximately O.2Sml
(i.e., half of the dose from a single FluMist spmyer) into the nostril.
d. PinCh and remove dose-divider clip from plunger.
e. Place the tip just inside the other nostril and depress plunger to deliver the JP.t\1Aining vaccine.
f. If the vaccine recipient sneezes, after lldministration, the dose should NOT be repeI1ted.
g. Once FluMist is administered, the used spmyer should be disposed of IlCCOrding to the
standard procedures for biohazmdouS waste products.
Fees
The NHCHD Fee Policy will apply for FluMist vaccine.
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North Carolina Local Public Health Accrsdite#on Program
Agency Self-Assessment
BOARD OF HEALTH
FUNCTION: ASSESSMENT
ESSENTIAL SERVICE 1: Monitor health status to identify community health
problems.
;';,,;"/';
Standard 1: The Board of Health(S
quality ofcomlTlunity health status,
lvelyinvoJ~ ina~~~ring,
, , i ' ":\!. '1:~} ;/:.
ACTIVITIES
(EVIDENCE I EXPLANATION)
MET NOT N1A CONFIRMED
MET (sVY use Only)
Activity 1.1: BOH identifies and facilitates appropriate
resources (financial, technical, personnel) to support and
improve community health status monitoring.
Documentation: BOH minutes; evidence of support of
grant applications and for additional public health
funding; public health budget reflects pUblic health
priorities and needs.
Evidence / Explanation:
Activity 1.2: BOH assures the development,
implementation and review of policies designed to
facilitate monitoring and progress toward meeting locally
established health priorities.
Documentation: BOH minutes; written policies
established to guide data sharing among entities that
supply public health services to the community.
Evidence / Explanation:
Board of Heelth
BOH 1
North Carolina Local Public Health AccrsdiIB#on Program
Agency Self-Assessment
.
,
BOARD OF HEALTH
-
FUNCTION: ASSESSMENT
ESSENTIAL SERVICE 1: Monitor health status to identify community health
problems.
,,' I
iJIilnlfflird1:(Continued).
,
REQUIREMENT I QUESTION MET NOT N1A CONFIRMED
(EVIDENCE I EXPLANATION) MET (SVT USB Only)
Activity 1.3: BOH promotes broad-based participation
among all entities active In collecting, analyzing and
disseminating community health status data.
Documentation: BOH minutes; minutes from appointed
task forces, work groups and/or advisory councils.
Evidence / Explanation:
COMMENTS (For evaluation purposes):
e
e
Board of Health
BOH 2
~;
e
e
e
North Carolina Local Public HBBIth AccreditBUon Program
Agency Self-Assessment
BOARD OF HEALTH
FUNCTION: ASSESSMENT
ESSENTIAL SERVICE 2: Diagnose and investigate health hazards in the
community.
$tandafd2: ,The Board of Health assuresthatthe community Is adequately ,
se ' , 'apublichealth labor~tory, an Infectic>us'diseaseepldemlology "
p nd,the teehnologlcalcapae<1ty 10 conduct appropriate epidemiological
~tty, .. ,. "j;;-:.','"., '';,' , , " . ~""~~~" _,,'; "i'''~;':::;;-' ',':.::.>:::;.-;' ,"'-' -::;-.
, ....,.:..... ....... ,.,c .-.....:..-",.,..,."..,.".,,:'~':.::i.,':.:.':::.::.:.:,,::-.;
. ]1:., . . ,-,-- --::i:;;:X:!:'..
ACTIVITIES
(EVIDENCE I EXPLANATION)
MET NOT N1A CONFIRMED
MET (SVT USB Only)
Activity 2.1: BOH assures the development, implementation
and review of policies to ensure the diagnosis and
investigation of health threats to the community.
Documentation: BOH rules and BOH minutes.
EvIdence / ExplanatIon:
Activity 2.2: BOH assures the development, implementation
and review of appropriate policies and procedures for public
health emergencies.
Documentation: BOH minutes.
Evidence / Explanation:
COMMENTS (For evaluation purposes):
Board of HBBlth
BOH 3
North Carolina Local Public Health Accreditation Program
Agency Self-Assessment
BOARD OF HEALTH
FUNCTION: POLICY DEVELOPMENT
ESSENTIAL SERVICE 3: Inform, educate and empower people about health
issues.
,
Standard 3:. The Board of Health Is actively Involved in assuri!'lgthe adequate
staff, resources and authority are available to Implement appropriate publlQ "',' .
health policies and programs.;
ACTIVITIES
(EVIDENCE / EXPLANATION)
MET NOT N1A CONFIRMED
MET (SVT Use Only)
Activity 3.1: BOH identifies and facilitates access to
national, state and local resources.
Documentation: BOH minutes; evidence of BOH
members' participation In national, state, and local
associations; evidence of support for staff participation In
national, state, and local associations; evidence of
support of grant applications and for additional public
health funding; public health budget reflects public health
priorities and needy.
Evidence / Explanation:
,,, .
Activity 3.2: BOH assures the development,
implementation and review of written policies.
Documentation: BOH rules; local ordinances;
policy/procedures for creation and review of policies; BOH
minutes, documents,.
Evidence/Explanation:
Board of Haalth
SOH 4
I'
e
e
e
.
.'
e
e
e
North Carolina Local Public Health Acr"'ditation Program
Agency Self-Assessment
BOARD OF HEALTH
FUNCTION: POLICY DEVELOPMENT
ESSENTIAL SERVICE 3: Inform, educate and empower people about health
issues.
Standard 3: (Continued).
ACTIVITIES MET NOT N1A CONFIRMED
(EVIDENCE / EXPLANATION) MET (SVT Use Only)
Activity 3.3: BOH assures mechanism for community
involvement representing all segments of the community in
developing and reviewing policies.
Documentation: BOH minutes; minutes from appointed task
forces, workgroups, advisory councils; documentation of
outreach mechanisms.
Evidence / Explanation:
COMMENTS (For evaluation purposes):
Board of Health
BOH 5
North Carolina Local Public Health Accreditation Program
Agency Sell-Assessment
BOARD OF HEALTH
FUNCTION: POLICY DEVELOPMENT
ESSENTIAL SERVICE 4: Mobilize community partnerships to identify and solve
health problems.
Standard 4: The Board of Health creates a supportive environment that assures
traditional and nontraditional partners have meaningful opportunitie$.to identify
and address public health problems.
ACTIVITIES
(EVIDENCE I EXPLANATION)
MET NOT N/A CONFIRMED
MET (SVT Use Only)
Activity 4.1: BOH participates in activities to increase its
members' awareness and capacity to engage diverse
communities.
Documentation: Evidence of training; BOH
agendas/minutes; assessment of BOH development needs.
Evidence / Explanation:
Activity 4.2: BOH seeks opportunities to meet with
community members and LPHA staff to gain increased
understanding of public health needs and build
relationships.
Documentation: BOH minutes; communications to health
director; evidence of attendance at community events.
Evldence/Explanatlon:
Board of Health
BOH 6
.
e
e
e
e
e
e
North Carolina Local Public Health Accreditation Program
Agency Self-Assessment
BOARD OF HEALTH
FUNCTION: POLICY DEVELOPMENT
ESSENTIAL SERVICE 4: Mobilize community partnerships to identify and solve
health problems.
Standard 4: (Continued).
...
ACTIVITIES MET NOT N/A CONFIRMED
(EVIDENCE I EXPLANATION) MET (SVT Use Only)
Activity 4.3: BOH recognizes agency staff and community
partners for their commitment and role in addressing
public health goals.
Documentation: Evidence of staff recognition (BOH
agenda, minutes, special programs); evidence of
recognition of community partners (awards program).
Evidence / Explanation:
COMMENTS (For evaluation purposes):
Board of Health
SOH 7
North Carolina Local Public Health Accreditation Program
Agency Sell-Assessment
BOARD OF HEALTH
FUNCTION: POLICY DEVELOPMENT
ESSENTIAL SERVICE 5: Develop policies and plans that support individual and
community health efforts.
Standard 5: The Board of Health reviews policies and procedures within the
existing legal scope of authority.
ACTIVITIES MET NOT NJA CONFIRMED
(EVIDENCE I EXPLANATION) MET (SVT Use Only)
Activity 5.1: BOH develops and/or adopts pOlicies
regarding administration of the local agency, and
administrative and programmatic policy manuals are
available to staff. .
Documentation: Written policies; policies manuals.
Evidence / Explanation:
Activity 5.2: BOH assures that elected officials and
community boards are Informed of existing or revised
policies.
Documentation: BOH minutes, agendas, correspondence,
fact sheets, etc. ,
-.
Evidence / Explanation:
"L.."..
Board of Health
BOH 8
e
e
e
e
e
e
North CslO/ins LocsJ Public Hsslth Accraditslion Program
Agency Sell-Assessment
BOARD OF HEALTH
FUNCTION: POLICY DEVELOPMENT
ESSENTIAL SERVICE 5: Develop policies and plans that support individual and
community health efforts.
Standard 5: (Continued).
ACTIVITIES MET NOT N1A CONFIRMED
(EVIDENCE I EXPLANATION) MET (SVT Use Only)
Activity 5.3: BOH seeks legal consultation in drafting and
adopting local ordinances and local BOH rules.
Documentation: contract/memorandum of understanding
with attorney, evidence of communication with attorney
(legal correspondence, memos, emails).
EvidencelExplanatlon:
COMMENTS (For evaluation purposes):
Board of He_
BOH 9
North CalOlina Local Public Health AccreditaVon Program
Agency Se/f.Assessmsnt
BOARD OF HEALTH
FUNCTION: POLICY DEVELOPMENT
ESSENTIAL SERVICE 5: Develop policies and plans that support individual and
community health efforts.
Standard 6: The Board of Healthpromo,tes federal, stateal'ld local l89illlrrtiql1
and regulations appropriate for implementing corepublicchea!tt!funl?tiomt.,'
REQUIREMENT I QUESTION MET NOT N/A CONFIRMED
(EVIDENCE I EXPLANATION) MET (l!lVT use Ol)ly)
Activity 6.1 : BOH shares information relative to
community health with elected officials in a timely manner.
Documentation: BOH presentations, memos, emails;
agendas for official meetings.
Evidence / Explanation:
Activity 6.2: BOH regularly evaluates the need for
additional rules, regulations or ordinances to carry out
public health protection.
Documentation: Notes from public meetings, public
hearings; ordinances.
Evldence/Explanation: .
Board of Health
BOH 10
--
e
e
e
e
e
North Carolina Local Public Health AccredilaYon Program
Agency Seff-Assessment
BOARD OF HEALTH
FUNCTION: POLICY DEVELOPMENT
ESSENTIAL SERVICE 5: Develop policies and plans that support individual and
community health efforts.
Sta!'l~.rcl6:(Continued).
REQUIREMENT I QUESTION MET NOT N1A CONFIRMED
(EVIDENCE I EXPLANATION) MET (SVT Use Only)
Activity 6.3: BOH drafts and presents local ordinances and
rules to elected officials as needed in order to implement
or enforce local public health prevention and protection
activities.
Documentation: Items listed on addenda with elected
officials; memos.
Evidence/Explanation:
COMMENTS (for evaluation purposes):
Board of Health
BOH 11
North Carolina Local Public Health Accradi/affon Program
Agency Seff-Assessment
BOARD OF HEALTH
FUNCTION: POLICY DEVELOPMENT
ESSENTIAL SERVICE 5: Develop policies and plans that support individual and
community health efforts.
(--~"" <
. Sti<<\dard7: The Board of Healthu.ndel'stands, exercises and advocates for U.
liIuthoritytoiinprove public healthandsl,lppgrtthecommunity health -
Ul1provement process.
..
ACTIVITIES MET NOT N1A CONFIRMED
(EVIDENCE I EXPLANATION) MET (SVT Use Only)
Activity 7.1 : BOH assures the annual availability of "Assess,
Address, Assure" handbook for its members.
Documentation: Evidence that handbook has been
reviewed, updated and distributed to members.
Evidence / Explanation:
Activity 7.2: BOH assures new members receive orientation
at the time of appointment and that all members receive
appropriately updated training on an annual basis.
Documentation: Review of consolidated agreement
requirements; BOH minutes.
Evidence / Explanation:
Board of Health
BOH 12
e
e
e
e
e
e
North Carolina Local Public Health Accrsdi/e#on Program
Agency Self.Assessment
BOARD OF HEALTH
FUNCTION: POLICY DEVELOPMENT
ESSENTIAL SERVICE 5: Develop policies and plans that support individual and
community health efforts.
Standard 7: (Contin\Jed).
ACTIVITIES MET NOT N1A CONFIRMED
(EVIDENCE I EXPLANATION) MET (SVT Use Only)
Activity 7.3: BOH develops mission statement, bylaws, and
other strategic planning documents to evaluate, set goals
for, and monitor Improvement In community health status.
Documentation: Evidence of mission statement, bylaws;
other planning documents.
Evldence/Explanation:
Activity 7.4: BOH facilitates timely appointment of new
members, holds meetings at least quarterly, and monitors
regular attendance of members.
Documentation: BOH minutes, agendas; updated
membership list; attendance records; correspondence;
public announcements.
Evidence / Explanation:
COMMENTS (For evaluation purposes):
BosrrJ of Health
BOH 13
North Caroline Local Public Heelth Accreditation progrem
Agency Self-Assessment
BOARD OF HEALTH
FUNCTION: ASSURANCE
ESSENTIAL SERVICE 8: Enforce laws and regulations that protect health and
safety.
Standard 8: The Board of Health assures that public health laws, rules and
regulations designed to protect the health of the community are appropriately
adopted, disseminated, evaluated, improved and enforced in a timely and
cOJl"lplete manner. .-
ACTIVITIES MET NOT N1A CONFIRMED
(EVIDENCE I EXPLANATION) MET (SVT Use Only)
Activity 8.1: BOH assures that appropriate legal authority
exists to protect the health of the community.
Documentation: BOH minutes; bylaws; manual and state
statutes.
Evidence I Explanation:
Activity 8.2: BOH assures that Its bylaws; rules and
procedures comply with local, state and federal statutes and
regulations.
Documentation: BOH bylaws.
EvldencelExplanatlon:
Board of Heefth
BOH 14
L
e
e
e
e
e
e
North Carolina Local Public Health Accraditaffon Program
Agency Self-Assessment
BOARD OF HEALTH
FUNCTION: ASSURANCE
ESSENTIAL SERVICE 6: Enforce laws and regulations that protect health and
safety.
..~~~~~~..~;(CO!1ti!1I.1~).
ACTIVITIES MET NOT NIA CONFIRMED
(EVIDENCE I EXPLANATION) MET (SVT U$$ Only)
Activity 8.3: BOH assures access to legal counsel.
Documentation: Contract or memorandum of
understanding with county attorney; evidence of
communication with attorney (legal correspondence,
memos, emall).
Evidence/Explanation:
Activity 8.4: BOH Identifies and advocates for the
enactment and retention of beneficial laws, rules and
regulation
Documentation: BOH minutes; evidence of BOH member's
participation In state and national boards of health, county
managers and public health associations.
Evidence / Explanation: .-
COMMENTS (For evaluation purposes):
Board of Health
BOH 15
North Carolina Local Public Health Accreditation Program
Agency Sell-Assessment
BOARD OF HEALTH
FUNCTION: ASSURANCE
ESSENTIAL SERVICE 8: Assure a competent public and personal health care
workforce.
Standard 9: The Board of Health advocates for funding to assure initial
competence of the pUblic health workforce; the availability of workforce training
programs for both the workforce personnel and members of the boar~ of he,lth;
an". the availability of leadership development programs fot those 9h1rgedlilfi1:h. ..
. ~d"'istrative and executive. roles. . . . -.... . ... -:.. . .... X
ACTIVITIES MET NOT N1A CONFIRMED
(EVIDENCE I EXPLANATION) MET (SVT Use Only)
Activity 9 1: BOH assures that the health director meets
minimal statutory qualifications.
DocumentatIon: Personnel records
Evidence / ExplanatIon:
Activity 9.2: BOH advocates for policies and funding to
assure health department personnel have access to state,
local or national training available for workforce
instruction, leadership development and continuing
education
Documentation: BOH minutes.
Evidence/Explanation:
Board of Heaffh
BOH 16
e
e
e
e
e
e
North Carolina Local Public Health Accreditation Program
Agency Self.Assessment
BOARD OF HEALTH
FUNCTION: ASSURANCE
ESSENTIAL SERVICE 8: Assure a competent public and personal health care
workforce.
Standard 9: The Board of Health advocates for funding to assure initial
competence of the public health workforce; the availability of workforce training
programs for both the workforce personnel and members oUhe board of helilllth;
and the availability of leadership development programs fortholiSe charge". ~!tl1
administrative and executive roles. . _ 'd;t~[I"'!!',[i'~~~tF1:~,,;"i;.,
ACTIVITIES
(EVIDENCE I EXPLANATION)
MET NOT N1A CONFIRMED
MET (aVT Use Only)
Activity 9.3: BOH assures new member orientation at the
time of appointment or on an annual basis.
Documentation: Review of consolidated agreement
requirements; BOH minutes.
Evldence/Explanation:
COMMENTS (For evaluation purposes):
Board of Health
BOH 17
North Carolina Local Public Health AccrsditaUon Program
Agency Self-Assessment
BOARD OF HEALTH
FUNCTION: ASSURANCE
ESSENTIAL SERVICE 9: Evaluate effectiveness, accessibility, and quality of
personal and population-based health care services.
Standard 10: The BOH is responsible for the overall quality of essential public
health services provided to the community.
,
ACTIVITIES MET NOT N1A CONFIRMED
(EVIDENCE I EXPLANATION) MET (SVT Use Only)
Activity 10.1: SOH assures the development,
Implementation and review of pOlicies supporting periodic
evaluations of population-based and personal health
services, including processes and outcomes of health
improvement activities.
Documentation: SOH minutes; mission statement;
strategic plan.
Evidence I Explanation:
COMMENTS (For evaluation purposes):
Board of Health
BOH 18
e
e
e
."
.
I
t.
e
e
e
INFLUENZA SENTINEL SURVEILLANCE PROGRAM UPDATE #6
(December 31, 2003)
In a joint effort with the State Laboratory of Public Health, the Gener!,1 Communicable Disease Control Branch has
expanded its participation in the U.S. Influenza Sentinel Physicians Surveillance Network to more effectively
monitor the status of statewide influenza activity Sentinel physicians, university health centers, and public health
agencies report "influenza-like illness" (ILl) to CDC each week and collect representative samples for virus strain
identification. [For purposes of this surveillance program, the ILl case definition is fever (100 degrees F or higher,
oral or equivalent) and cough or sore throat.] This provides important epidemiologic data to the State Health
Department for the monitoring of influenza activity in North Carolina and also supports CDC influenza surveillance
throughout the U.S. Moreover, this effort can provide timely rec,ognition of new influenza strains with pandemic
potential throughout the influenza season. This is the fifth consecutive year that the Division of Public Health has
participated in this surveillance program.
Each week the participants in this program report information to CDC, which is then consolidated by CDC into
figures for the entire state. The information reported is as follows:
. The total number of patient visits each week.
. The number of patient visits for ILl each week, broken down into four age groups.
During the 2001-2002 winter season 36 health providers throughout the state regularly reported ILl to CDC, and 39
actively participated in the surveillance program during last winter. This 2003-2004 winter season, 53 health
providers in 36 counties are reporting influenza surveillance data to CDC. This group of sentinels consists of a wide
variety of practice types (pediatrics, family practice, internal medicine, etc.) in 14 local health departments, 11
university student health centers, and 29 private practices. Consequently, physicians and health personnel
throughout the state report ILl, while university health providers enable the Division of Public Health to monitor
influenza in a very diverse student population that includes students from other states and countries. The influenza
sentinel surveillance program began on September 28, 2003 and will conclude on May 22, 2004.
This expansion of the influenza surveillance program helps public health personnel monitor the spread of influenza
in the state more effectively than during previous years. In addition to helping detect new strains with pandemic
potential, timely identification of circulating influenza virus strains also can help determine whether antiviral drugs
might be useful in preventing or treating ILL
Attached is the most current influenza surveillance information available from CDC and the State Laboratory of
Public Health. [Last winter's sentinel-reported influenza activity throughout the state (shown as chart data) is
provided in order to provide perspective at this early point of the 2003-2004 season.]
This periodic report also is available on the N.C. Division of Public Health's Communicable Disease Control
website at www.eoi.state.nc.us/eoi/2cdclflu.html. CDC information may be viewed on the CDC website,
www.cdc.20v/ncidod/diseaseslfluiweeklv.htm. Additional information of a more general nature is available on the
CDC's National Immunization Program flu web page, which is www.cdc.20v/niolfluidefault.htm.
For questions about North Carolina's adult immunization program, contact Sandy Allen in the Immunization Branch
at (919) 715-0080 or at Sandv.AlIen@ncmail.net. Additionally, I can be reached at (919) 733-1193 or by email at
Torrev .McLean@ncmail.net.
We are very grateful to the sentinels for their participation in this important surveillance program and their
contribution to North Carolina's public health program.
Torrey Mclean
General Communicable Disease Control Branch, Epidemiology Section
Division of Public Health, DHHS
ATTACHMENT
INFLUENZA-LIKE ILLNESSES REPORTED BY SENTINEL SITES, 2003-2004
(
Week No. - Ending No. ILl Patient Visits % ILl , .
#40 - 10/04/03 30 11,088 0.27% e
#41 - 10/11/03 52 12,675 0.41%
#42 - 10/18/03 59 13,567 0.43%
#43 - 10/25/03 71 12,964 0.54%
#44 - 11/01/03 77 15,190 0.50%
#45 - 11/08/03 111 13,913 0.79%
#46 - 11/15/03 173 14,428 119%
#47 - 11/22103 204 13,064 1.56%
#48 - 11/29/03 241 9,869 2.44%
#49 - 12/06/03 674 15,333 4.39%
#50 - 12/13103 1,202 14,591 8.23%
#51 - 12120103 500 9,114 5.48%
#52 - 12/27103 238 4,191 5.67%
NFLUENZA VIRUS ISOLATES IDENTIFIED DURING THE LAST TWO WEEKS BY THE STATE
LABORATORY OF PUBLIC HEALTH
Week No.lEndingf(Total Confirmed)
#51 - 12120/03 - (75)
Countv
Alamance
Buncombe
Cabarrus
Carteret
Granville
Guilford
Halifax
Henderson
Hertford
Iredell
Macon
Mecklenburg
Pasquotank
Pitt
Sampson
Wake
Watauga
Wilkes
#52 - 12/27/03 -
(26)
Brunswick
Buncombe
Cabarrus
Cherokee
Forsyth
New Hanover
Pitt
Rockingham
Sampson
Virus Tvoe
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
A1H3
No. Isolates of Same Virus
01
12
14
01
04
01
01
01
02
01
02
03
01
21
06
02
01
01
e
01
03
04
01
01
01
12
01
02
TOT AL ISOLATES IDENTIFIED TO DATE DURING THIS WINTER SEASON:
AIHI
A1H3
B
o
322
..J!
322
e
;~
t,
-
e
-
INFLUENZA LIKE ILLNESS IN SENTINEL SITE PATIENTS
NORTH CAROLINA, 2003-2004 (Solid Line)
(with comparative 2002-2003 data, Dashed Line)
10.0%
9.0%
8.0%
7.0%
6.0% ~
~
5.0%
..
4.0% 1
/
3.0%
J /r "\
2.0% . \
7 I ..
oJ
1.0% ./ .....'
...... ....
0.0% :..' ......-...................r ~.. .... ...............
~ ~ ~ ~ ~ ~ tf 'II ~ <0 <0 ~ ~ :t ~ ~ ~
WEEK #
For more information about comparable national data, visit www.cdc.Qov/ncidod/diseases/flulweeklv.htm and in particular,
click on the link "View Chart Data" on the right of the "Percentage of Visits for Influenza-like Illness Reported by Sentinel
Physicians National Summary, 2003-2004" graph.
",~j
A ~ ~ _ _~~
. ~ ".lrrr. -
-, '. -'- =--,
.~ '.......---
~---..,
.....:- ~lIJr,r-~....... --
PublishedJor Members oJLocal Boards oj Health
c
r
""'--
November 2003
President's Message
Connie ratton
More than two centuries ago, Paul Revere chaired the first board of health
meeting in Boston in 1799 to address the growing health concerns of the
commonwealth. With no national or state public health system in place,
cities and towns were largely responsible for local public health measures. In
1850, Lemeul Shattuck submitted a Report of the Sanitary Committee of
Massachusetts to the state legislature. In the report, Shattuck called for
the establishment of state and local boards of health and included the major concepts and activities
of today's public health practices, Over the next half-century, state and local health departments
and boards of health were established all across the country
During the last half of the nineteenth century and the first half of the twentieth century, public
health officials struggled against infectious diseases. Strategies included major sanitation measures,
drugs, the development of effective vaccines and mass immunizations. That struggle was so
successful, that today, only one percent of the people who die before age 75 in the United States
die from infectious diseases.
In 1900, the leading causes of death were influenza, pneumonia, diphtheria, tuberculosis, and
gastrointestinal infections, a mortality rate of 580 per 100,000 people. Today, only 30 people per
100,000 die from these diseases each year These gains were achieved through improved
sanitation, better nutrition, the pasteurization of milk, and the control of infectious diseases rather
than treatment and curative medicine.
Modern public health faces a different challenge. With the decline in the major acute infectious
disease rates between 1900 and 1970, the proportion of mortality from major chronic diseases such
as heart disease, cancer, and stroke increased by more than 25 percent. Cardiovascular disease
Continued on page 2
November Means Think Membership
By Ron Burger, NAL-BOH Membership Chair
Is YOUR board of health a NAL80Hian? If so, congratulations, thanks, and please renew. If not,
why not? We need YOU and your board as well as others of you who are not with a board of health
or a governing/advisory/policy body of a health department. We need you if you are a member of
state, territorial or tribal association of boards of health, if you are a retired board of health member,
if you are a full time student or individual who is committed to NALBOH's goals and objectives. We
also need any private organization, agency, or corporation committed to our mission. NALBOH's
mission is to strengthen local boards of health, enabling them to promote and protect the health of
their communities, through education, technical assistance and advocacy We need YOU' The
bottom line is that if you are reading this, you need to be a member of NALBOH in 2004.
It is so easy to become a member of one of the most exciting voluntary public health organizations
representing America's public health system, Boards of health truly are the "Grass Roots of Public
Health," They are the hub of the public health system. They help to keep our communities
protected and our public health workers prepared. The application is included in this NewsBrief (see
page 14) or go to our website at <www.nalboh.org> Renewal invoices will be sent out via postal
mail beginning in November
Con~nued on page 2
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NALBOH NewsBrieJ
November 20031
National Association of Local Boards of Health
Boards of Health: Prevention, Preparedness & Power
July 28-31, 2004
Omni Interlocken Resort
Denver, Colorado
Continue to visit <www.nalboh.org> for conference updates or to view hotel information visit
< www.omnihotels.comjhotelsjdefault.asp?h_id=48>
For more information visit<www.nalboh.org> or call the NALBOH office at (419) 353-7714.
Photos courtesy of Denver Metro Convention and Visitors Bureau
National Association of Local Boards of Health
1840 East Gypsy Lane Road
Bowling Green, OH 43402
E-mail: <nalboh@nalboh.org>
Website: <www.nalboh.org>
NON PROFIT ORG.
U.S. Postage
PAlO
Bowling Green, OH
Permit No. 47
/-~
\
'<-'/
~Page16-
,
"
'.
SANITATION TIPS FOR FOOD WORKERS
Wint.r 2003
Also in this issue...
Tampering 'news flash'
Page 2
Hepatitis A outbreak
Page 2
How to tell when it's cooked
Page 2
Prevent cross-contamination
C Page 2
Food safety training online
Page 1
Raw or undercooked foods-
who's most at risk
Page 1
Test yourself on food safety
Page 4
"That listeria, she really gels around:'
Copyright 2003
Pike & Fischer, Inc.
1-800.255-8131
Dealing with a Tough Bug-
Listeria monocytogenes
Did you know that Listeria monocytogenes can grow on food even when irs
stored in a refrigerator?
This tough bug is found in soil, water, animals and birds and can even lurk in
food processing plants-in such places as drains and ventilation systems-just
waiting for a chance to get onto food. You can't see or smell Listeria, but you need
to take precautions against it.
The Food and Drug Administration recently released the results of a major
assessment of the risks of Listeria monocytogenes and the agency is now using
the results to develop an action plan to control the bug. FDA's 's researchers found
that keeping ready-to-eat foods at 40 degrees Fahrenheit or below throughout
the food chain and using the foods as quickly as possible are the best ways to
reduce listeriosis, the illness caused by Listeria infection.
Although listeriosis is very rare and has been on the decline in recent years, it
kills roughly one in five of its victims. Pregnant women, older adults and people
with weakened immune systems are at higher risk of illness. Symptoms include
fever, fatigue, nausea, vomiting, diarrhea, meningitis (brain infections) and septi-
cemia (bacteria in the bloodstream).
L monocytogenes is found in a variety of raw foods, such as uncooked meats
and vegetables, as well as processed foods that become contaminated after pro-
cessing. It is also found in soft cheeses and cold cuts at the deli counter. Unpas-
teurized (raw) milk or foods made from unpasteurized milk may contain the bug.
Vegetables can become contaminated from soil or from manure used as fertilizer.
A Iiey goal of FDA's risk assessment was to find the ready-to-eat foods most in
need of Lm control measures. The assessment targeted 23 types of foods includ-
ing seafood, produce, meats, dairy products and deli-type salads. According to
figures from the Centers for Disease Control and Prevention, there were an esti-
mated 1,500 cases of listeriosis and 300 deaths in 2002. FDA officials are hoping
to lower those numbers to 750 cases and 150 deaths by the end of 2005.
Things You Can Do
Food handlers play an important role in reducing contamination by Lm and
other harmfull pathogens by'
keeping precooked or ready-to-eat foods refrigerated at 40 degrees F or
below;
using ready-to-eat food by the "use by" expiration date on the label;
thoroughly washing raw vegetables;
keeping uncooked meats separate from vegetables, cooked foods and ready-
to-eat foods; and
washing hands, knives and cutting boards thoroughly after handling un-
cooked foods.
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FOOD TALK
WINTER 2003
! -....,
'.-/
Test Your Food Safety Know-How
1. Which of the following foods should not be rejected upon
delivery?
a. Fresh fish that has dull, sunken eyes and soft flesh
b. Poultry with darkened wing tips and soft flesh
c. (anned fruit with small amounts of surface rust on the
lid of the can
d. Fresh beef products that are delivered at 4SoF (70C)
2. What is the best way to thaw potentially hazardous foods?
a. In the microwave oven
b. At room temperature
c. In the refrigerator
d. Under 700F (210C) running water
3. All potentially hazardous foods that have been cooked and
cooled need to be reheated to an internal temperature of
within two hours to be safe,
a. 1400F (60oC)
b. 14SoF (630C)
c. ISS0F (680C)
d. 16S0F (740C)
4. All precooked and ready-to-eat foods that are to be held
cold should be held at or below:
a. 400F (soC)
b. SOOF (lOoC)
c. 700F (210C)
d. QOF(_180()
Sources: "Essentials of Food Safety and Sanitation: Prentice
Hall, Food and Drug Administration
S. According to the FDA Food (ode, foods that are cooked
and then cooled must be cooled in which of the following
ways?
a. From 1400F to 410F (60'( to S'C) in 12 hours
b. From 140'F to 41 'F (60'( to S'C) in 8 hours
c. From 140'F to 70'F (60'( to 21 'C) in 2 hours, and from
70'F to 41 'F (21 '( to S'C) in another 4 hours.
d. From 140'F to 70'F (60'( to 21'() in 4 hours, and from
70'F to 41 'F (21 '( to S'C) in an
additional 2 hours.
6. According to the FDA Food (ode, aUpotentially_hazardous_
foods that are to be held hot must be held at or above:
a. 70'F (10'C)
b.o 98'F (37'C)
c. 120'F (49'C)
d. 13S'F (S7'C)
7. The best method for measuring the temperature of
frozen food products is by'
a. Inserting the sensing probe into the center of a frozen
food package until the recorded temperature stabilizes
b. Inserting the sensing probe between two packages of
frozen foods until the recorded temperature stabilizes
c. Measuring the ambient temperature of the frozen food
compartment of the delivery vehicle
d. Looking for signs of freezing and thawing, such as large
ice crystals and frozen juices in the bottom of the box
..../
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