11/03/2004
New Hanover County Health Department
Revenue and Expenditure Summaries for September 2004
Cumulative: 25.00% Month 3 of 12
.
Revenues
Current Year Prior Year
ype of Budgeted Revenue Balance Budgeted Revenue Balance %
Revenue Amount Earned Remalnln Amount Earned Remalnln
Federal & State $ 1,851,509 $ 1,016,582 $ 834,927 $1,659,620 463,661 $1,195,959 27.94%
C Fees $ 580,161 $ 155,373 $ 424,788 $ 570,161 91,147 $ 479,014 15.99%
Medicaid $ 1,138,039 $ 238,739 $ 899,300 $1,044,080 81,637 $ 962,443 7.82%
Medicaid Max $ 151,600 $ $
EHFees $ 300,212 $ 235,637 $ 300,212 264,361
Heafth Fees $ 113,545 $ $ 113,850
Other $ 2,421,354 $ $2,173,420
Expenditures
Type of
Ex ndlture
Budgeted
Amount
Current Year
Expended
Amount
Balance
Remalnln
%
Budgeted
Amount
Prior Year
Expended
Amount
Balance
Remalnln
%
.
$1,185,987 $8,562,19512.17%
185,746 $1,191,789 13.48%
12,738 $ 44,876 22.11 %
Summary
Budgeted Actual %
FY04-05 FY 04-05
Expenditures:
Salaries & Fringe $10,422,330 $1,949,730
Operating Expenses $1,578,519 $343,553
Capital Outlay $206,841 $15,858
Total Expenditures $12,207,690 $2,309,141 18.92%
Revenue: $6,556,420 $1,927,318 29.40%
Net County $$ $5,651,270 $381,823 6.75%
.
Revenue and Expenditure Summary
For the Month of September 2004
8
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NHCHD BOARD OF HEALTH APPROVED GRANT APPUCATION STATUS FY ~5
Date (BOHl Grant Reauested Pendlna Received Denied
Office of the Stete Fire Marshal- NC Department
of Insurance- Risk Watch continuation funding
8/412004 (3vears) $ 25,000 $ 25,000 .
NC Physical Activity and Nutrilfon Branch-Eat
Smart Move More North Carolina $ 20,000 $ 20,000
NC March of Dimes Community Grent Program.
7f712004 Smoking Cessation $ 50,000 $ 50,000
Wolfe-NCPHA Prenatal Grant- Diabetic Supplies
for Prenatal Patients $ 5,000 $ 5.000
6/2/2004 No activity to report for June 2004.
Kate B. Reynolds Foundation- Transportable
5/512004 Dental UnR Grant $375,000 $375,000
Cape Fear Memorial Foundatlol\-' Dental Grant $185,000 $175,000 .
Cape Fear Memorial Foundation- School Heafth
41712004 Emergency Dental Services Grant $ 15,000 $ 15,000
Safe Kids Coalltlon- Govemo(s Highway Safety
Program- (Coalition Vehide Request) $ 16,000 $ 16,000
Safe Kids Coalltlon- Safe Kids Buckle Up
31312004 Program- Child Safety Seat Grant $3.500 $3,500
214/2004 No actiVity to report for February 2004.
Cape Fea, Memortal Foundadon- Funds needed to
enhance health education in 4 areas other than Diabetes
11712004 (an enhancement to Diabetes Today Grant). (Uving WelO $20,000 $18,500 $1,500
121312003 No activity to report for December 2003.
Cape Fear Memorial Foundadon.. Funds needed to
cover dental services for needy children as identified by
11/512003 School Health Nurses. $3.000 $3,000
NC Medical Foundation. Through the Good Shephard
Ministries for nursing services to the population
frequenting the shelter. $25,000 $25,000
Duke University. To provide 10 hours of nursing services
for TB Outreach. $10,388 $10,700 -$312
NC Tobacco and Control Branch, OHHS. Continuation
of Tobacco Prevention Program. $100,000 $64,093 $35,907
1011/2003 No activity to report for October 2003.
New Hanover County Sate Schools- Uniting for
Youth "U4Youth"(funding will be received over a 3
91312003 year grant period) $49,000 $ 12,702 $36,298
Safe Kids Coalltlon- Fire Prevention (Plsase 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
71312003 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 Unlvarsity Nicholas School of the
Envlronment-Geographic Infonnation Systems
Granl (Env Health) $10,000 $10,000
Safe Kids Coalltion- Safe Kids Mobile Car Seat
Check up Van $50,000 $50,000
Totels $1,137,741 $440,000 $424,445 $283,296
38 87%
37.31%
23.14%
Pending Grants 3 14%
Funded Total Reauest 6 29%
PartiallY Funded 6 29%
Denied Tolal Reauest 6 29%
NumberS of Grants ADplied For 21 100%
9
As of 1012112004
. NOTE: Notification received since last report.
,
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~~
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Adion
Agenda: Consent Meeting Date: 11/08/04
A enda: IZI
Department: Health Presenter' Cindy Hewett, Business
Mana er
Contact: Cind Hewett, Business Mana er, ext 6680
Subject: Budget Amendment in the amount of$79,353 to Reduce Public Health
BioTerrorism Bud et ublic Health Re ional Surveillance Team-2
Brief Summary: The New Hanover County Health Department received notification
from the State that the Public Health Bioterrorism Program will receive $362,377 for
FY04-05; a reduction of $79,353 from Ado ted FY04-05 Bud et of$441,730
Recommended Motion and Requested Actions: To accept and approve the reduction in
Public Health Bioterrorism FY04-05 Budl!et in the amount of$79,353.
Funding Source: North Carolina Department of Health and Human Services, Division of
Public Health.
.
Will above action result in:
DNew Position Number ofPosition(s)
Dposition(s) Modification or change
IZINo Chan e in Position s
Explanation: Funding authorization has been received from the State indicating that the
Public Health Bioterrorism Program (PHRST-2) is being funded in the amount of
$362,377 for FY04-05 which is a reduction of$79,353 from the Adopted FY04-05
Bud et amount of$441,730.
I Attachments: Supporting documentation and budget amendment.
.
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NORTH CAROLINA
DEPARTMENT OF HEALTH AND HUMAN SERVICES
DIVISION OF PUBLIC HEALTH
FUNDING
AUlHORIZA liON
1
SSUED TO: NEW HANOVER COUNTY
STATE FISCAL YEAR
Public Health DepartmentIDistriet
FROM: July 1, 2004 through June 30, 2005
ACTIVITY: 513
EFFECTIVE
DATE
07/01104
AUTH#
2
NAME OF PROGRAM: PH Regional Response Team
Revision#
1
INmAL ALLOCATION
,
$350,413.00
PRIOR ADJUSTMENTS YEAR TO DATE. . . INCREASE (DECREASE)
INCREASE (DECREASE) THIS AUTHORIZATION
.00
511,964.00
NET ANNUAL ALLOCATION
5362,377.00
GRANT INFORMATION
Tvpe of Fund Service Months Payment Months Codes
ederal June-May July-June 1561 2681 ET
ederal Sept-May Oet-June 1561 2681 EU
Federal June- May July-June 15612688 ET
Total
Amount
CFDA#
5273,217.00
$77,196.00
511.964.00
$362,377.00
93.283
93.283
93.283
Received /a~.& by
~~/ ~O~tY
LoEal Health Director . ~ /
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Loeal Finance Officer-
lJTHORIZED SIGNATURE
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DATE: 09/14/04
DHHS-CO
7-04
13
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NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
.
Agenda: 0 Consent Meeting Date: 11/08/04
Agenda: [gJ
Department: Health Presenter: Cindy Hewett, Business
Manager
Contact: Cindy Hewett, Business Manager, ext 6680
Sub'ect: Bud et Amendment in the amount of $2,953 for Pro'ect Assist
Brief Summary: The New Hanover County Health Department received notification
from the State that Project Assist Program will receive $2,953 from the American Legacy
Foundation to be used to su ort American Le ac efforts.
Recommended Motion and Requested Actions: To accept and approve the $2,953
funding received from the American Legacy Foundation for the Project Assist Program to
use to su rt American Le ac efforts,
I Funding Source: American Legacy Foundation
Will above action result in:
DNew Position Number ofPosition(s) .
Dposition(s) Modification or change
[gJNo Change in Position{s)
Explanation: Funding authorization has been received from the State indicating that the
American Legacy Foundation is funding the New Hanover County Health Department
Project Assist Program in the amount of $2,953 to be used to support American Legacy
efforts,
I Attachments: Supporting documentation and budget amendment.
.
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NORTH CAROUNA
DEPARTMENT OF HEALTH AND HUMAN SERVICES
DIVISION OF PUBLIC HEALTH
FUNDING
AUTHORIZATIO
t
ISSUED TO: NEW HANOVER COUNTY
STATE FISCAL YEAR
Public Health DepartmentIDistriet
FROM: July 1,2004 througb June 30, 2005
ACTIVITY: 690
EFFECTIVE
DATE
07/01104
AUTH#
2
Revision#
1
NAME OF PROGRAM: Legacy Foundation Grant
INITIAL ALLOCATION
,
5.00
PRIOR ADJUSTMENTS YEAR to DATE... INCREASE (DECREASE)
INCREASE (DECREASE) THIS AUTHORIZATION
.00
52,953.00
NET ANNUAL ALLOCATION
52,953.00
GRANT INFORMATION
TvneofFund
Service Montbs
Payment Montbs
Codes
Amount
~
N/A
Otber Receipts
June-Feb
July-Mar
1551569004
52,953.00
Received and agreed to by
. ~ } dpth$. W ilA lof/jov
l,oeal.Healtb Director
-)~ ~ /012/0/
Local Finance Officer
AUTHORIZED SIGNATURE
~Jljj~
DATE: 10/07/04
DHHS-CO
7-04
17
.
.
.
"
,
,
.
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda:
Consent Meeting Date:
enda: [gJ
Presenter: David Rice
De artment: Health
Contact: Janet McCumbec
Subject: March of Dimes Grant Request
Brief Summary: The Maternal Health Program of the Health Dept. is submitting a mini-
grant to the March of Dimes for $3,000. This grant would provide funds to purchase both
educational supplies and incentives for pregnant women in our Maternity Care
Coordination Program. The Baby Bucks incentive program has provided incentives to our
maternity patients for good health behaviors and keeping prenatal appointments. This
effort has depended on donations from the community. If the March of Dimes funds are
received, we will purchase items such as baby supplies, books, child safety supplies, and
other educational materials.
Recommended Motion and Requested Actions: To approve the submission of the March
of Dimes ant and an bud et amendment related to the recei t of the $3,000.
.
Funding Source: March of Dimes, no inkind match needed for the grant. One time
award.
Will above action result in:
DNew Position Number of Position(s)
Dposition(s) Modification or change
No Chan e in Position s
Ex lanation: The ant will not be used for a staff osition.
I Attachments:
.
18
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Applicant Organization
Nil.) ~/JV.e.o.c.... Cml r1.~
~ ~9-d-~
March of Dimes
Chapter Community Grants Program
COMMUNITY AWARD ($3000 or lellll) COVER SHEET
Project Title
o~ Ibur.lc.s. ~q\IJ nMA t/Jlt~ C'a.Mn.-t
...:20~4 ~...h n t:h ~+.
\v;J~1M In.c 2&-403
_Ra,beCCa. P.,.. l,j.h tL!JA f</..J
<. CliO)
(qIO) ~4~-{P5"Oq ce.k( 2194-1(077 Fax
..... I
lM.~.e Pn~M..
Street Address
City/State/Zip Code
Contact Name
Email
r ba..t -fna 'dU@ n h c.lj(W . c:.o fY\...
0'1O} 341 - 4/4-lD
Phone
Description:
(Please give a couple sentence description of how the Community Award funds would be used)
The Community Award request should address one of the fonowing priorities:
Increasing Access to and QuaOty of Health Care for Women and Infants
a) Enhancinl! educalion and SUDDon servi<>:~ for high-risk pregnant women. This may include March of Dimes programs
such ss Stork's Nest4P and Comenzando bien@. . and The Pregnancy Workshop.
b) Incressin anicipation in Slate or local maternal 'Id th TO ama (e.g. Medicaid, SCHIP, WIC) through
enhanced outreac ,e ucation and public awareness.
Increasing AvallabJUty of Prevention ServIces
c) Increasinl! smokin2 cessation services available to pregnant women who smoke. Preference wilJ be given to prenatal
health education and information/referral services that utilize the "5 A's" counseling approach. ..
d) Incressing education, screening and trealment (excluding billable services) for urinary and reproductive tract infections
in women. This may include sexuaIly transmitted infections.
e) Incressinl! prenatal health education and informatiOn/referral services available to pregnant women who use alcohol or
other drugs.
Increasing AvalJablUty of Genetics Services and FoOc Acid Education
f) Enhancing the availability, quality and utilization of genetics services and/or other patient services relaled to
preventable binh defects.
g) Incressing folic acid education and use of multi-vitamins among women of childbearing age.
. .
Amount of funds requested $ 3. DnO. Have you received funds from the March of Dimes before? No+- + ~ .,
. p ro5 va. rvL .
A W.9 form for taxpayer identification number wiJI be sent if your oganization is a Community Award
ndP'difl-'''P'Y_.' ~,. r.~ wm: :/:;mp:;::;:;;~
Signature - Director of Program Date Type Name and Title
Requests must be received by 4:00PM on Monday, October 18,2004.
Late applications will not be accepted.
19
NEW HANOVER,COUNTY
HEALTH DEPARTMENT
2029 sourn 17TI1 STREET
WILMINGtoN,NC 28401-4946
TELEPHONE (910) 343-6$00, FAX (910) 341-4146
.
September 24, '04
This Community Award request is made by Rebecca Balthazar, RN, BSN on behalf of
the New Hanover County Health Department Maternal Care Coordination Program. This
isa request to help fund efforts to support an incentive program offered. to Maternal Care
Coordination{ MCC) program participants who participate in the MCC ( Baby Love )-
program, keep preriatal appoint1nents, follow agreed upon care plans, and keep in contact
with their MCC providers. .
.
Currently the NHC Health Department provides Maternal Care Coordination services to
at least 300 pregnant women per month. Maternal Care Coordination services include
regular contacts at prenatal appointments, home visits, phone calls and letters where
educational topics such as healthy pregnancies, nutrition, breastfeeding, birth control,
parenting, family, safety, health, etc. are covered, as well as helping build a support
system for the client. The program also includes making referrals to other community
services, help in obtainment of supplies for new mothers and problem solving assistance.
This may include assignment of Maternal Outreach Workers, MOW (women trained to
help assist clients in achieving specific goals) There are currently 5 Fulltime RN's, 3 Full
Time Social Workers, and 2 IT MOW's providing these services,
Services are provided to pregnant women who meet guidelines for enrollment ( typically
on Medicaid) and answer positively to a risk assessment questionnaire that identifies risks
to their current pregnancy. These include issues with safety, housing, food, substance
abuse, depression, ability to keep prenatal appointments, social support, feelings about
the pregnancy, partner's substance habits, depression and health.
We have found it necessary to offef an incentive program to encourage compliance with
healthy behaviors. This incentive program is called "The Baby Bucks Boutique and
Learning Center". Clients earn" Baby Bucks" vouchers they may redeem at the
"Boutique". This is an event set up each month at the Health Department with items
needed for the baby. We offer essential items the mom may have difficulty purchasing or
may not purchase at all. At each Baby Bucks Boutique event, educational topiCs
encouraging healthy pregnancy outcomes are offered for clients to participate in. Topics
include smoking cessation, breastfeeding, dental care, diet, exercise, things to avoid,
safety issues, car seat safety, nutrition, etc. are presented. A " Baby Talk " monthly
group education and learning program is being offered starting in November to teen
pregnant women up to age 19, to coincide with th.e Boutique times. This will be a
monthly enrichment and educational group geared towards building positive feelings
!lbout self and family. .
.
The "Baby Bucks Boutique and Learning Center" has been funded from the start, in
2002, by donations made by staff, community groups and various fund raisers including a
community" baby shower". These efforts to fund the incentive program have not
generated ongoing support.
"Healthy People, Healthy Environmenl, Healthy Community"
20
e
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.
2
We are currently looking at various funding possibilities which include a donation from a
women's group, community fund raisers, etc, Due to the Health Department status we are .
unable to solicit funds from anyone who serves food. We, at the HD are very supportive
of MOD projects and priorities and are asking the March of Dimes to help support our
effort to continue to offer pregnant women in New Hanover County this important
- incentive program.
21
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Over 125 }Cars of
Public Health Service
2029 South 17th Street
Wilmington, NC 28401
910.343.6500
www.nhchd.org
Director-s Message
As Health Director of the
. New Hanover County Health
Department, I would like to
welcome you to our annual
report. Our mission is to assure
a safe and healthy community.
This is accomplished through
assessing the health needs of
the community and establishing
health objectives to maintain essential personal, family,
community, environmental, and animal control services.
We have dedicated employees working to enhance the
health and well being of our county's residents and
visitors. The Health Department works with other
health care providers, contractors and other agencies
in an integrated and coordinated effort with the goal of
developing strong partnerships.
With the support of the community, we will meet the
future health needs of New Hanover County as we
experience the rewards and satisfaction of practicing
public health. During fiscal year 2003-2004, the
Health Department experienced many challenges and
.opportunities, including:
. Participating as a pilot county for the North Carolina
Local Public Health Accreditation Program
~
~...'~'
~'.'~
t(
~. If .
. Celebrating 125 years of public health service in New
Hanover County
. Relocation of Environmental Health offices
. Construction of Animal Control Spay/Neuter Facility
. Renovations of Clinic area
David E. Rice, MPH, MA
.Health Director
Management Team
Administrative Support Coordinator
Marilyn O. Roberts
Animal Control Services Manager
Dr. Jean P. McNeil
Business Manager
Cindy Hewett
Dental Health Manager
Dr. David W. McDaniel
Health Programs Administrator
Scott Harrelson
Environmental Health Manager
Dianne M. Harvell
Personal Health Services Manager
Janet B. McCumbee
Physician Epidemiologist
Dr. Thomas Morris
Our Mission and Vision
The mission of the New Hanover County
Health Department is to assure a safe and
healthy community.
The vision ofthe New Hanover County Health
Department is: Healthy People, Healthy
Environment, Healthy Community.
Motto
"Your Health - Our Priority"
"From the Northeast River to Federal Point, and from
the Cape Fear to the Sea-City, Suburb, Village and
Farm-we are one people striving for healthful and
useful living. .
Geography, Demograhics, and History
Jew Hanover County, located in southeastern North
.arolina, was established in 1729. It was formed from
Craven County, one of the original three counties in
North Carolina. The second-smallest county in the
state, New Hanover County encompasses 185 square
miles. Population data for 2004 approximates a county
population of 175,000 people, reflecting a 33% growth
in the population since 1990. The City of Wilmington
and Town of Kure Beach have experienced growth of
60% and 145%, respectively, since 1990.
The City of Wilmington, along the Cape Fear River,
is the New Hanover County seat. In 1994, Wilmington
was ranked the 5th-largest city in North Carolina and
its fastest-growing metropolitan area. Wilmington is the
cultural, medical, educational, and economic center for
the southeastern region of the state. The city is rich in
historical significance including an architectural heritage
reflected in the recently revitalized 200-block National
Register Historic District. Wilmington played a vital role
during the Civil War as a center for Confederate blockade
running; it was the final spot in tlie South to fall to the
.nion. In the 20th century, the city's economy shifted
from river commerce to the railroad. Wilmington proper
is the epitome of what the emerging "New South" is all
about. Its inviting business climate has attracted giants
like G.E., DuPont, Coming, PPD and Verizon, in addition
to smaller, high-tech firms and corporations.
Population
The area south of Wilmington has beautiful beaches,
the Fort Fisher state historic site, and the North Carolina
Aquarium. The Wilmington area is blessed with many
natural attributes, and is home to a diverse and friendly
population.
Although Wilmington is the largest city in southeastern
North Carolina and the fastest growing metropolitan area
in North Carolina, it retains a small town atmosphere.
Residents continuously strive to improve all aspects oflife
in the Port City, because they know it is possible for the
Wilmington area to maintain the same charm and natural
beauty that has been celebrated for over 250 years.
Wilmington is known for historic preservation, its close
proximity to area beaches, annual events such as the North
Carolina Azalea Festival and Riverfest, and as home to
a major film studio. All of this adds up to the pleasant
lifestyle that growing numbers are enjoying.
Because so much of the area's growth is due to the influx of
working age and retired adults, it can be expected that the
median household size will tend to decrease and the age
of the population will tend to increase. These tendencies
are reflective of both national and state population trends.
information and demographicsfrom Greater Wilmington Chamber a/Commerce;
www.wilmingtonchamber.org
AREA 1990 2004 % Growth 1990-2000
New Hanover County 120,284 175,000 33%
Wilmington 55,530 94,600 62%
Carolina Beach 3,630 5,095 40%
Kure Beach 619 1,517 145%
Wrightsville Beach 2,937 3,182 8%
Median Household Size
1970 1980 1990 2000
New Hanover County 3.08 2.69 2.43 2.3
Brunswick County 2.93 2.45 2.52 2.56
Columbus County 3.24 2.74 2.56 2.47
Pender County 3.14 2.74 2.56 2.47
rommunity Health Assessment Highlights for 2004
~ajor Morbidity and Mortality Rates
I
As with the majority of counties
and municipalities nationwide,
the leading cause of death in New
Hanover County is from heart
disease. While New Hanover
County has lower overall mortal-
ity when compared to the state
average, there are specific types
of heart disease that are higher
than North Carolina rates and spe-
cific populations that are suffering
disproportionately. Minority males
and females have higher overall mortality rates when compared to North Carolina as a whole. Other leading causes of
morbidity and mortality have similar statistics. New HanoverCounty has highertotal mortality rates for cerebrovascular
disease (stroke) and diabetes mellitus when compared to state rates. When broken down into specific populations, minor-
ity males and females have significantly higher mortality rates for stroke and diabetes. White males have higher rates for
diabetes. While total mortality rates for cancer are equal to state rates, it is again apparent that there are specific types
of cancer that have higher mortality rates, and also certain population groups that are disproportionately represented.
.hronic diseases such as these continue to be the leading cause of death nationwide, and trend statistics indicate
that the situation will most likely deteriorate before it begins to improve. New Hanover County has some strengths
and weaknesses in this particular area when compared to North Carolina as a whole.
Age Adjusted Mortality Rates for Selected Causes, 1999-2001
a
!i 300
::l
8: 250
o 200
~ 150
o
o
- 100
8. 50
o
laNHC]
.NC
..
.c
1ii
..
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Total Heart
Disease
Cerebrovascular
Disease
Total Cancer
Diabetes Mellitus
Age Adjusted Death Ratas for Minority Males, 1999-2001
c
8 450
" 400
~ 350
j{ 300
o
~ 250
g200
-: 150
l,oo
J! 50
i 0
c
EJ Minority Males NHC
. Minority Males NC
Diabetes Mellitus Total Heart Disease Cerebrovascular
Disease
Total Cancer
Cancer Lung,
Bronchus, Trachea
Age Adjusted Death Rates for Minority Females, 1999.2001
c
8 300
..
a 250
8. 200
~ 150
8
- 100
! 50
i 0
.! Diabetes
Mellitus
.
. Minority Females NHC
. Minority Females NC
Total Heart Cerebto\8acular Total Cancer Cancer Lung,
Disease Disease Bronchus,
Trachea
I
[Unintentional Injuries
~w Hanover County rates well for overall mortal-
ity rates from unintentional injuries and motor vehicle
unintentional injuries, as compared to state data. However,
when the data is broken down into population groups it is
apparent that disparities exist. Mortality rates for white
females are only slightly lower than the state average, and
the rates for both minority males and females are both
higher than the state. Unintentional injuries continue to
be a leading cause of death for children age 0 to 14, both
locally and across the state.
Mortality Ratas for UnlntsntionallnJur1es
c
850
....
a4Q
8.35
030
l!. 25
o
o 20
:: 15
l10
i 5
a o.
IBNHCI
.NC
White Males White Minority Males MinOl1ty
Females Females
Sexually Transmitted Disease
Trend data indicates that sexually transmitted disease cases in New Hanover County have been rising, even as
state rates are falling. Aggregate data for the number of AIDS and Syphilis cases show a steady rise for the total
population. However, even though the incidence rate is higher than state average, the county mortality rate for
.IDS is lower than the state rate.
AIDS Incidence Ratss,1994-2001
8 ,.
II ,.
:I 14.
~ 12
1'0
- .
g .
l 4
S ~
ImNHcl
.NC
1994 - 1998
1996 - 2000
1997 - 2001
.
c
~60
I:
130
1i20
: 10
l 0
!
Minority Syphilis Rats,
1994 -2001
[BNHcj1
~
1994 - 1998
Primary and
Secondary Cae
Rat.
1996.2000
Primary and
Secondary Case
Rat.
1997 - 2001
Primary and
Secondary Case
Rat.
Total Syphilis Rats,
1994-2001
c
iu_
: 19 [lINHC I
8 6 .NC
_ 4
2
8. 0 .
!I 1994 - 1998 1996 - 2000 1997.2001
~ Primary and Primary and Primary and
Seccndary Case Secondary Case Secondary Case
Rate Rate Rate
~dOlescent Pregnancy Rates
.
Overall, New Hanover County compares favorable to state rates for adolescent pregnancy Fortunately, rates have
been dropping locally and statewide since the late 1990s. However, while local rates have been dropping among
the 15 - 19 year old population, there is still room for improvement among minority pregnancy rates. Overall, the
minority rate has dropped, but not as aggressively as the state rate.
Adolescent Pregnancy Rates for Ages 15-19
c
,g 140
~ 120
~ 100
~ 80
o 80
~ 40
~
8. 20
S 0
~:e
'" 0
-....
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00
N....
-ii
00
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Provision of Health Department Services
Administration
Animal Control
In an effort to bring accountability and continuity to the
health depamnents across the state, the NC Division of
Public Health along with the NC Association of Local
Health Directors and the UNC School of Public Health
worked together to pilot an accreditation process for
local health depamnents. Initially six health depamnents
were chosen from the entire state for the pilot project,
including New Hanover County Health Depamnent.
With the assistance of state consultants we underwent
a self appraisal to determine depamnental capacity to
meet the required objectives. A site visit was conducted
by an audit team of health professionals to veritY
documentation and to obtain answers for any questions
that they may have had. Our application and supporting
information was sent to the Accreditation Board and
.we were presented with our certificate of Accreditation
on May 28, 2004. New Hanover County was one of
the first accredited health depamnents in the state. We
continually strive for excellence for our clients and this
is further confirmation that we are succeeding.
Spay/Neuter Facility
The addition of the Animal Control Services spay/neuter
facility was completed this fiscal year. The structure
was built by Property Management utilizing funds
collected in the animal trust fund. The facility should
become operational in the 2004-2005 fiscal year after
equipment is purchased and staffing issues are resolved.
Animal Cruelty Case
Animal Control Services staff cared for 54 birds and 43
dogs from October 2003 until February 2004 as legal
issues were determined in an animal cruelty case. The
animals had been housed in a single residence in the
Castle Hayne area of the county. We were notified by
concerned citizens about the unsanitary conditions and
poor quality of care for the multitude of pets. This was
another landmark case for our division, with a favorable
outcome for the proceedings.
Dental
Access to Care
~e Dental Division has been involved in many access to Recruiting Positions
care activities during 2003 - 2004. In January 2004, Dr.
David McDaniel met with the President of the Wilmington A high priority this fiscal year has been advocating
TriCountyDentaISocietyandothersinordertodesignlocal for new Environmental Health Specialist positions.
activities for the "Give Kids a Smile" Program. "GiveKids By January 2005, we should begin scheduling new
a Smile" is a national umbrella for dental access activities Specialists for individual field evaluation by the
which took place across the country during February, NCDENR Regional Environmental Health Specialist.
with dentists and staff providing educational outreach, They must demonstrate competence in the principles of
screening, preventive care and treatment to millions of food safety and implementing state laws/administrative
underserved children. The Wilmington TriCounty Dental code to be granted authorization by the state to
Society, the New Hanover County Dental Program, inspect and score the compliance level of food service
the North Carolina Dental Health Section, and Cape establishments. Greatly needed capacity will be achieved
Fear Community College worked together to sponsor by Spring 2005
activities in our community. Local activities included
local dentists providing preventive and restorative care
for needy low-income children. Additionally, a Sealant
Clinic took place on February 27 at Cape Fear Community
College. The Sealant Clinic was extremely successful
with 40 children receiving exams, x-rays, prophylaxis,
as well as 186 sealants. "Give Kids a Smile" was a huge
success with well over $15,000 of dental services donated
eo underserved children in our area.
North Carolina Oral Health Survey
During 2003 - 2004, staff conducted dental exams
on students at Pine Valley Elementary, D. C. Virgo
Middle, Hoggard High School, Laney High School, and
Lakeside School as part of the North Carolina Oral Health
Survey (NCOHS). The NCOHS included both written
questionnaires and dental examinations of randomly
selected students across the state. The NCOHS will help
determine the extent of dental disease in North Carolina.
As a result, we will be able to design more appropriate
interventions to address dental disease across our state.
Environmental Health
Relocation
Environmental Health Services opened for business at
its new location in the Market Place Mall September
.' 2003. Office hours, 7:30 a.m. to 4:30 p.m., coincide
with the NHC Inspections Depamnent as many clients
will now conduct business with both offices during their
visits to this location.
/'
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Mosquito larvae at Eagle Island
Health Programs Administration
Health Planner
In the event of a terrorist attack or a major natural
disaster, supplies of critical medical items in New
Hanover County will be rapidly depleted. In anticipation,
the Federal Government established the Strategic
National Stockpile (SNS) to augment local supplies
of critical medical items. The SNS is managed by the
Centers for Disease Control and Prevention (CDC) and
contains large quantities of medicines, antidotes, and
medical supplies needed to respond to a wide range
of expected problems or scenarios. Potential scenarios
include attacks using nerve agents, such as sarin, and
biological agents, such as anthrax, plague, and tularemia.
With the help oflocal agencies our Health Planner and a
working SNS Committee created our local county SNS
plan so that we may receive and quickly dispense these
.ruCial supplies needed to respond to a terrorist attack.
Health Promotion
The Health Promotion Team's largest success for
the year was completing the application process and
securing continuation funding for the Project ASSIST
tobacco prevention position. This funding became
highly competitive for the first time since the inception
of the initiative one decade ago. Continuation funding
will ensure several more years of tobacco prevention
education in a newly expanded tri-county area (also
included are Brunswick and Pender Counties). Other
grant highlights include securing funding as a Risk Watch
"Champion Team" county for childhood injury prevention
education, and partnering with UNC Wilmington and
Carolina Beach State Park to convert a nature trail to meet
Universal Accessibility guidelines per the Arnericans with
Disabilities Act.
.
Swimming lessons were provided to children in an effort
to reduce injuries and drownings,
PHRST
PHRST (Public Health Regional Surveillance Team)
has been tasked with assisting our seven county region
to have the capabilities to identify, prepare and respond
to bioterrorism events and infectious disease outbreaks.
The PHRST team took on a more expanded role as an all
hazards response team this past year. In addition to their
regular duties such as technical advisors, trainers and
.errorism response they also have been deployed to do
damage assessments for tomados in the region and have
assisted local health department staff with communicable
disease outbreaks.
Personal Health Services
The Personal Health Services Division provides health,
nutrition, social work and laboratory services. Though a
major reorganization of staff had occurred by July 1, the
Personal Health Services Division continues to evaluate
the services being provided, phasing out unneeded
services, and adding services by public demand. The
satellite well- baby clinics were all combined with other
child health clinics and moved back into the building.
Orthopedic Clinic also moved back to our building, but
continues to be staffed by a private Orthopedist. The
finances, staffing, and services of the Neurology Program!
Clinic have been reviewed and a plan developed to better
utilize our resources. The Jail Health Program, formerly
staffed, administered, and supervised by the Personal
Health Division, went under a private contract through
the Sheriff's Department on July 1,2003. A Reduction in
Force policy determined which staff from the Jail clinic
returned to positions in the main Health Department.
Personal Health staff received Respiratory Protection
Training and Fit Testing for N 95 Masks.
The 2003 Flu Season brought many challenges. We
operated a Flu shot clinic out of our auditorium for the
month of October, so these clients could avoid the regular
clinic flow. An early Flu Season, and early Flu related
child deaths nationwide, prompted new recommendations
for vaccination of children. Local providers ran out of
Flu vaccine earlier than usual, and we became the
primary source of vaccination. We also purchased the
new FluMist nasal vaccine for eligible populations. By
January, the State Immunization Branch was supplying
the Health Department with Flu vaccine to give to the
general public free.
One of our significant accomplishments was an enhanced
partnership with the Good Shepherd Homeless Day
Shelter. Our Tuberculosis (TB) Program nurses had an
established relationship with the staff at Good Shepherd,
as they often met TB clients there to deliver medications.
The need to provide health services for the homeless
resulted in a contract, funded by the N.C. Medical
Society, to set up a clinic at the Good Shepherd to serve
the homeless population three mornings a week. Another
new grant (Safe Schools) was received as a contract with
the New Hanover County Schools. This grant (three-year
project) added a Child find Specialist to the Child Service
Coordination Team to identify preschool children who
may need intervention before entering Kindergarten.
All nurses in the care coordination programs began doing
postpartum, newborn home visits. The Maternity Care
Coordinators (MCC) and Maternal Outreach Workers
_MOW) accepted the challenge to participate in a
tate MCC Best Practice Pilot ro ram. The received
training in the fall of
2003 and began a new
screening procedure,
with mandatory home
visits, and new referral
criteria for MOWs.
Clinic renovations
provided additional
exam rooms and
work up rooms. Staff
received cross training
in all clinical areas in
preparation for the Open
Access Scheduling clinic
concept. A full time
Spanish Interpreter was
added to the clinical
.
area, with contract interpreters for relief and home
visits. Our Licensed Clinical Social Worker began
providing Intense Psychosocial Counseling services.
With regional STD consultants assuming responsibility
for contact investi ation, we were able to reclassify our
Disease Intervention
Specialist to a Public
Health Clinic Nurse. The
Wisewoman Program,
an enhancement of the
Breast and Cervical
Cancer Control
Program, was started,
to provide additional
services related to
cardiovascular health.
The state provided us
with Twinrix (Hepatitis
Am Vaccine) for at.risk
populations.
Maureen Lamphere, RN, discusses health history with a
participant of the Homeless Veteran ~ Standown 2004
Reportable Communicable Diseases
July 1,2003 - June 30, 2004
The Laboratory received
several new pieces of
equipment, necessitating procedural changes while
new procedures for packaging and shipping specimens
were also implemented. Our Laboratory served as a
Referee Lab for the State Laboratory Competency
Assessment Program.
AIDS 22
Campy/obacter 16
Chlamydia 551
E Coli 0157:H7 3
Gonorrhea 296
Hepatitis A 4
Hepatitis B, Acute 5
Hepatitis B, Chronic Carrier 29
HIV Infection 31
Legionellosls 1
Lyme Disease 6
Pertussis 5
Roclcy Mountain Spotted Fever 8
Salmonella 75
Shigella 4
Syphilis, Latent and Late 4
Vancomycin Resistant Enterococci
(VRE) 10
The Women, Infants, and Children's (WIe) Nutrition
Program served 102% of assigned caseload, and
additional funds were received to provide temporary
breastfeeding support services. The WIC/Nutrition
team participated in a state pilot program to look at
best practice and our WIC program won the state
"Innovative WIC Program Operation Award" for
their MCC and DSS referral system. The WIC video,
"Welcome to WIC: The Story of Maria and Gabriella",
was filmed in October using several of our staff, and
is being used statewide as an outreach video.
School Health received enough funding from the Board
of Education to place a nurse in every school. New
legislation required school nurses to provide training
on Diabetes to all school staff. School nurses and
child care nurses coordinated Potassium Iodide (KI)
distribution for staff and students in the school and
childcare facility at Carolina Beach. New mandatory
training for Child Care Providers on SIDS and Back
To Sleep was initiated.
Support Services
This Division was formed in October 2003. The Human
_ervices Agency Business Manager was appointed as the
~anager for this newly formed division. Support Services
is comprised ofInforrnation Technology, Customer Care,
Medical Records, Billing, Fiscal Operations, Accounting,
Program Support and Administrative Support for Animal
Control Services and Environmental Health Services. This
division consists of 42 full-time employees and 7 part-time
employees.
Financial Management
The New Hanover County Health Department Amended
Budget (Adopted Budget plus any amendments that were
processed during the fiscal year) for FY 2003-2004 was
$12,221,335. Actual expenditures for FY 2003-2004
were $10,756,707. The Health Department's budget
was composed of 41 individual programs. Division
Managers submitted a line item budget for each
program within their respective divisions. The Health
Director and Business Manager reviewed all budget
requests. Budget hearings were conducted and a Budget
.orkbook including all programs with line item narrative
justifications was prepared and submitted to the Board
of Health for approval.
The Health Department's Business Manager was
responsible for preparing expenditure reports that
ensured billing and receipt of the Health Department's
state grant funds. The Health Department complied with
New Hanover County Financial Policies and Procedures,
which included an annual audit.
Total Revenue Earned FY 2003-2004
Other: $2,440,696
22%
~icaid:
$1,131.454\
11%
Anirral Control
Fees: $ 671 ,321
6%
County
Appropriations:
/ $4,:;321
"-
.
Environrrental
Heanh Fees: $ ./
278,678 ----
,/
Heanh Fees:
$173,172
2%
~ Federal & State:
$1,675,068
16%
Figure 2
In the fall of 2003, New Hanover County Health
Department underwent a comprehensive Medicaid
audit for year ending June 30, 2002. The audit was
conducted by the Department of Health and Human
Services, Division of Medical Assistance. The following
areas were addressed during the audit: units of service
documentation, time studies, financial statements,
expenditure report analysis, labor estimates and pay
rates, depreciation expense, billing procedures, lease and
rental expenses, contracted services, and transactions
with related organizations. The audit was conducted to
evaluate NHCHD's compliance with Federal and State
regulations. Overall the findings in the audit report were
favorable.
Total Actual expenditures for FY 2003-2004
Operatin9
$ 1,521,259-
14%
Capital
OJtlay. $
I r 240,933
/ 2%
/
,
Sa"ries &
Fringes
$8,994,518
84%
Figure I
Figure I illustrates how the Actual Expenditure Budget is divided
among Salaries! Fringes, Operating and Capital Outlay items.
Figure 2 illustrates the breakdown of the Health
Department's total earned revenue ($6,370,389)
through Health Fees, Medicaid, Environmental
Health Fees, Animal Control Fees, and Other
(including miscellaneous grants and school
contributions), It also shows Federal and State
Grants through the North Carolina Department of
Health and Human Services ($1,675,068, which
is included in the above total revenue figure) and
County Appropriations ($4,386,321).
(Note: Of the $1,131,890 Medicaid Revenue,
$337,717 is Medicaid Cost Settlement Funds.)
.
NEW HANOVER COUNTY
HEALTH DEPARTMENT
2029 SOUTH 17TH STREET
WILMINGTON, NC 28401-4946
TELEPHONE (910) 343-6500 FAX (910) 341-4146
November 1, 2004
North Carolina Board of Nursing
Post Office Box 2129
Raleigh, North Carolina 27602-2129
RE: Proposed Rule Changes- 21 NCAC 36 .0321 Curriculum in Schools of
Nursing
To Whom It May Concern:
The New Hanover Board of Health and Staff of the New Hanover County Health
Department have expressed concerns regarding the proposed rule changes in
the section .0321- Curriculum. Our concern is about removing content specific
requirements and, even more specifically, the removal of "Cd) the curriculum for a
baccalaureate nursing program shall also include public health nursing.
Instruction shall include both theory and clinical learning experiences."
.
A BSN degree has long been the national standard for entry into public health
nursing, with the understanding that BSN programs include the public health
course. When we hire nurses without the BSN, we are required to send them to
the "Introduction to Public Health" course through UNC-CH. If the prescriptive
language is removed from the rule, we fear that Schools of Nursing will delete
public health courses from their curriculum. Public Health Nursing is a unique
field of nursing, with both preventive-focused and population-based health care.
We believe strongly that student nurses should to be prepared with a public
health nursing curriculum.
We request more information about why the proposal includes removing the
prescriptive language regarding the curriculum requirements for Schools of
Nursing. We have seen the reason given on the web: "to provide flexibility for
programs to develop creative curricula". Our request is for the NC Board of
Nursing to respond more specifically as to whatlwho prompted the
proposed changes and why; and the potential impact on the nursing
profession.
Thank you in advance for responding to our request.
.
"Healthy People, Healthy Environment, Healthy Community"
Accreditation Resolutions as of 10/11/04
Passed - Board of Health:
A{\lamance County
.Albemarle District
Brunswick County
Burke County
Carteret County
Chatham County
Columbus County
Craven County
Dare County
Davie County
Duplin County
Durham County
Edgecombe County
Gaston County
Granville- Vance District
Greene County
Halifax County
Haywood County
Lincoln County
New Hanover County
Northampton County
Onslow County
.range County
amlico County
Richmond County
Robeson County
Sampson County
Scotland County
Surry County
Union County
Wake County Human & Environmental Services Board
Warren County
Passed - Public Health Authoritv Board
Cabarrus County
Hertford County
Passed - Board of Commissioners
Brunswick County
Cabarrus County
Craven County
Hertford County
Lincoln County
Northampton County
ARichmond County
.ampson County
Surry County
'1
.
,
,
E. coli 0157:H7 Fact Sheet
What is E. coli?
It is a bacteria that lives in the guts of healthy humans and animals. Most types ofE. coli are
harmless, but E. coli 0157.H7 produces a powerful toxin and can cause severe illness.
How do people become infected with E. coli?
The most common ways people become infected with E. coli are:
. From animal to person or from person to person: this can happen when not washing the
hands frequently and thoroughly, especially before eating, after using the toilet or
changing diapers and after petting or handling animals, especially farm animals.
. Eating raw or rare meat, especially hamburger.
. Eating raw foods that have been contaminated with E. coli.
. Drinking unpasteurized milk or juice.
· Swimming in or drinking water contaminated with E. coli.
What are the symptoms of E. coli?
Symptoms usually begin 3 to 4 days, and up to 2 to 8 days, after becoming infected Some
people show not sign of illness. However, they can still pass the infection to others. The signs
and symptoms can include:
· Diarrhea (loose or watery stools); bloody diarrhea is common.
. Severe abdominal cramping.
. Nausea.
. Dehydration
. No fever or a low grade fever.
· Hemolytic uremic syndrome (HUS), a serious complication that occurs in high risk
people (most often in children), which can cause kidney failure, seizures, and even
death.
How is E. coli diagnosed?
Diarrhea is a common illness and can have many different causes, therefore a laboratory test is
needed to diagnose E. coli, usually from a stool (feces) specimen. Your doctor can request a
special test for E. coli 0157:H7 from a laboratory.
What should I do if I think I have an E. coli infection?
. See your doctor right away Most people get better without specific treatment in 5 to 10
days. Others become seriously ill. It is difficult to tell how a person will do, so seeing
your doctor is very important.
Page I of2
E. coli 0157:H7 Fact Sheet
. Drink plenty of fluids, such as water or soft drinks. Anti-diarrhea drugs, e.g., Imodium@,
Pepto-Bismol@ and similar medicines should not be taken unless your doctor
recommends it. .
. People who prepare and serve food or work with ill people (hospital or hospice workers)
or children (child care providers), should contact their local health department for
specific recommendations.
. If someone in your family has this infection, ask your doctor what precautions to take or
contact your local health department to get specific recommendations.
How can E. coli infection be avoided?
. Wash your hands thoroughly with soap before and after handling foods, before eating,
after using the toilet or changing diapers, and after contact with animals, especially farm
animals.
. Eat only thoroughly cooked meats and poultry (using a meat thermometer is the only way
to insure that food is thoroughly cooked).
. Do not place cooked food on a plate or other surface that previously contained raw meat
or poultry without first washing it thoroughly.
. Use only pasteurized milk and dairy products.
. Drink only pasteurized juices.
. Wash cutting boards and utensils thoroughly with soap and water in between uses. If
possible, use separate cutting boards for preparing raw meats and poultry, and for
preparing vegetables or other uncooked or light cooked foods.
I
. Avoid sewage-contaminated water.
. Wash all fruits and vegetables before eating.
Protect the health of those you love.
If you or someone in your family has diarrhea follow these simple rules:
. Do wash your hands often and thoroughly with soap and water.
. Do not swim in public pools or lakes.
. Do not share baths with others.
· Do not allow children with diarrhea to share baths, or go to school or day care.
. Do not prepare food for others.
*
Source: General Communicable Disease Control Branch, Epidemiology Section, Div Of Public Health, NC-DHHS
Adapted from a document published by the Public Health Regional Surveillance Team 4 (Durham, NC)
Page 2 of2