10/03/2007
r New Hanover County Health Mepartment
Revenue and Expenditure Summaries for August 2007
Cumulative- 96.67°/. MOrtth 2 of 12
Revenues
Currant Yaar Prior Year
Type of Budgatad Ravanua Balance % Budgatad Ravanua Balance
Ravanua Amount Earned Remaining Amoun[ Earned Remaln{ng
Federal S State $ 1.908.709 $ 364,138 $ 1,544,571 19.08% $ 1,881,157 $ 430.909 $ 1,450.248 22.91%
AC Fees $ 642,559 $ 98.817 $ 543,742 15.38% $ 611,161 $ 100,104 $ 511,057 16.38%
Medicaid $ 1.569.058 $ 2,917 $ 1,566.141 0.19% $ 1,839,994 $ - $ 1,839,994 0.00%
Medicaid Max $ 309.128 $ - $ 309,128 0.00% $ 17.000 $ - $ 17,000 0.00%
EH Fees $ 310.000 $ 42,111 $ 267,889 13.5891- $ 310.000 $ 40,050 $ 269,950 12.92%
Health Fees $ 344,700 $ 57.521 $ 287,179 16.69% $ 318,200 $ 38,196 $ 280,004 12.00%
Health Choice $ 35,125 $ 1.291 $ 33,834 3.68% $ - $ - $ -
Other $ 3.746.477 $ 302,419 $ 3,444,058 8.07% $ 2,630.955 $ 53.738 $ 2.517.217 2.04%
Totals $ 8,865,756 $ 869,215 $ 4,552.483 9.80% $ 7,608,467 $ 662,998 $ 6,945.469 8.71 M.
Expenditures
Currant Yaar Prior Yaar
Types o1 Bud9atad Expanded Bala nca % Budgeted Expanded Balance
Expa nditu ra Amount Amount Ramat ning Amount Amount Ramat ning
Salary S Fringe $ 13759049 $ 1.335,242 $ 12,423.807 9.70% $ 12,089,429 $ 1.213,125 $ 10,876,304 10.03%
Operating $ 2,,269,,685 $ 284,655 $ 1.985,030 12.54% $ 2,154,269 $ 326,313 $ 1.827.957 15.15%
Capital Outlay $ 25,900 $ - $ 25,900 0.00% $ 88,585 $ 30,940 $ 57.645 34.93%
Totals $ 16.054,634 $ 1.619,897 $ 14,434,737 10.09% $ 14,332.283 $ 1,570.378 $ 12,761,906 10.96%
Summary
B.,dgatad Actual
FY 07-08 FY 07-08
Expenditures:
Salaries a. Fringe $ 13.759.049 $ 1,335,242
Operating $ 2,269,685 $ 284,655
Capital Outlay $ 25,900 $ -
Total Expenditures $ 16,054,634 $ 1.619.897 10.09%
Ravanu¢: $ 8.865.756 $ 869,215 9.80
Net County $ 7.188,878 $ 750,682 10.44 %
Rcv anus and Expeu ditu re Summary
For the Montt. of August 2007
8
NHCHD BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 07-08 and P(06,07
Date (BOH Grant Requested Pending Received Denied
91512007 No Activity for September 2007
` 8/112007 No Activity for August 2007
711112007 WIC Mini-grant - Request to ratify application
for mini-grant funds for minor renovations to
the WIC registration workstations to improve
customer service. $18,000 $18,000
61612007 Landfall Foundation- Request for funds to
purchase 16 wheelchairs for the NHCHD
School Health Nursing Program. $2,700 -52;Mil-
61212007 Living well: Received notification from Cape
Fear Memorial Foundation of continuation
funding for the publication of the Living Well
newspaper insert . $0 $12,000
41412007 Ministering Cirele(Colposcopyfunding) -
Request for $12,000 start-up funds from
Ministering Circle for purchase of Colposcopy,
equipment. Also plan to request additional
funds from other grant sources such as Cape
Fear Memorial Foundation for expansion of
program to include a second polposcopy unit
and additional training, supplies and contract
services.
$12,000 $12,000
Cape Fear Memorial Foundation -
Colposcopy Program - Womens Preventative
` Health. $25,000 for start up cost for physician
and interpreter contracted services,
equipment, supplies, and training. $25,000 $25,000
31712007 Closing The Gap - Request for $225,000
($75,000 per year for 3 years) from North
Carolina Office of Minority Health and Health
Disparities for a Health Educator to focus on
prevention of HIV and other sexually
transmitted disease in the Latino and Afro-
American populations. $225,000 $225,000
21712007 CA -MRSA: Funding from UNC-Chapel Hill
School of Medicine to assist with research
related to the prevalence of community
associated methicillin resistant staphylowcus
aureus $12,600 $12,600
11312007 Smart Start -New Hanover County
Partnership for Children - Child Care
Nursing Program $178,500 $170,000 $8,500
12/612006 Duke Endowment Funds, NHRMC - Dental
Unit- Personal Health Services. $25,000for
indigent dental care and $15,000 for sedation
equipment $40,000 $20,000 $20,000
111112006 No Activity for November 2006
10/412006
March of Dimes - Maternity Care
Coordination expenditures for Baby Love
! Program Baby Boutique antl Learning Center $3,000 $3,000
91612006 No Activity for Se tember 2006
81212006 No ACTIvi for AU us12006
9
As of 9/1012007
NHGHU BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 07-08 and FY 06-07
Uate (BO") Grant Ra nested Pandin H:eoei-cl oanlaa
7/5/2006 erv ce oor nmt on am y
Counseling Program (Cape Fear Memorial
Foundation) - Funding for Licensed Clinical ,y
Social Worker for 3 years $260,000 $75,000 $1165,000 J
Eat mart Move Mora - ommunity rant
(NC Mept of Publio Health Physical Activity
and Nutrition Bran¢rl $16,495 $12,416 $4,079
Totals $793,295 $27,700 $335,016 $442,679
3.49 / 42.23% 55.79%
Pandin Grants 2 17
Funded Total Request 5 42
Partial) Funded f\ 4 33-1.
Denied Total Re u-.t 1 8%
Numbers of Grants Applied For 12 1 0
As oT 9/1 012007
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda: Consent Meeting Date:
Agenda: ® BOH: 10/03/07
CC: 1 O/1 5/07
Department: Health Presenter: Kim Roane, Business Manager
Contact: Kim Roane 798-6522
Subject: Budget Amendment - Additional Aid to County Funds for FY08 - Personal
Health Services - $15,000
Brief Summary: The New Hanover County Health Department has received
notification from the North Carolina Department of Health and Human Services, Division
of Public Health, that an additional $15,000 has been awarded to assist the county in
providing health services in the community- These funds are proposed to be used to pay
for increased cost of health-related supplies in our clinic programs.
Recommended Motion and Requested Actions: To accept and approve the $15,000
additional State funds to be used to support the New Hanover County Health Department
clinic expenditures £or IF--Y'08 and submit to the New Hanover County Commissioners for
their consideration.
Funding Source: N_C. State Department of Health and Human Services, Division cf
Public Health Aid To Count funds- No matchin Count funds are re wired.
Will above action result in:
QNew Position Number of Position(s~
~Position(s~ Modification or change
®No Chan e in Position s
Ex lanation-
Attachments: Division o£ Public Health Fund Distribution S -dsh-t
1 1
N.C. Division of Public H¢aith Budg¢ta ry Estim at¢ to Local Health D¢pa rtm ents SFV 07-08
Original _X Activity # 170 Activity Name= G¢n¢rat Aid-to-Counties
REV 6
ROVV 1 Fund/RCC/FRC Fund/RCC/FRC Funtl/RCC/FRC Fund/RCC/FRC Funtl/RGC/FRC
1410-4110-00
§ Total of All
Payment Period
07/07-06/08 Pa mant Parlod - Pa mant Period - Pa moni PaHOd - Pa mant Period -
Sarvlca Parlod
06/07-05/08 Sarvica Period - Sarvic¢ Period - Sarvic¢ Period - Service Period -
sourcea
COUNTY
. $15,00.00
01 ALAMANCE 15 , 000 00
01 ALBEMARLE REG $146 000.00 $145 0000.00
02 ALEXANDER $15,000.00 $15,000.00
04 -SON $35 000.00 $35 000.00
02 APPALACHIAN $45 000.00 S45000.00
0 7 BEAUFORT S15000-00 $15 000.00
09 BLAOEN $35 000.00 S35000.00
10 BRUNSWICK §15 000.00 $15 000.00
11 BUNCOMBE $1500000 §15 000.00
12 BURKE $15 000.00 S15. .-Oo
13 CABARRUS $15 000.00 $15 000.00
14 CALOWELL $15 000.00 $15 000.00
15 CARTERET $15 000.00 S15000.00
$1 s 022221 $1 s .00.00
17 CASWELL S15.000-00
16 CATAWBA $15 000.00
§15 000.00 $15 000.00
19 CHATHAM
20 CHEROKEE S1500000 $15,101-001
22 CLAY $15 000.00 $15 000.00
23 CLEVELAND $15 000_00 S15000-001
24 COLUMBUS $350., o. $35 000.00
25 CRAVEN $15 000.00 $15 000.00
26 CUMBERLAND $15 000.00 $15 000.00
26 .ARE $15 000.00 $15 000.00
29 DAVIDSON $1s 000.00 $15 000.00
30 DAME $15 OOO.00 5.000-001
31 0U1LIN $15 000.00 $15 000.00
32 DURHAM §15 000.00 $15 000.00
33 ED-COM.E $35 000.00 $35 000.00
$15.000.00
34 FORSYTH $15000.00
35 FRAN LIN $15 000.00 $1s 000.00
K $15 000.00
35 GASTON S15000.00
38 GRAHAM $15 000.00 $15 000.00
D3 GRAN-VANCE $50 000.00 §50 000.00
40 GREENE $35 000.00 $35 000.00
$1s oo..oo $1s ooo.oo
41 GUILFORD $35 000.00
42 HALIFAX $35 000.00
43 HARN ETT $35 000.00 $35 000.00
44 HAYWOOD $15 000.00 $15 000.00
45 HEN DERSON $1 S 000.00 $15 000.00
46 HERTFORD $35 000.00 $35 000.00
47 HOKE $35 000.00 $35 000.00
$15 000.00
48 HYDE $1s 000.00
49 IREOELL S1 5,000.00 $1 5,000.00
50 JACKSON $15.000.00 $15,000.00
§15,000.00
51 JOH NSTON $15,000.00
12
N_C_ Division o£ Pubtic Health Budgetary Estimate to Local Health D¢pa rtm¢nts~ SFY 07-08
/
Original _X Activity # 110 Activity Name= General Aid-to-4c-ti-
REV 6
ROW 1 Fuon/RCC/FRC and/RCC/FRC Fund/RCC/FRC Fund/RCC/FRC undIRCC/FRC - '
1410110-00 Total of A11 ii
Payment Period ~~r/
07/97-0B/OB Pa meni Period - Pa ment Period - Pa ment Period - Pa mant Period -
S¢rvice Period
06/07-05/08 Service Parlod - Service Pertod - Service Period - Sarvica Period -
COUNTV Sourcaa
52 JONES $15,000.00 $15 000.00
53 LEE $15 000.00 $15 000.00
54 LENOIR $35 000.00 $35.0000
0
55 LINCOLN $l5 000.00 $15 000.00
56 MACON $15 000.00 $15 000.00
57 MADISON 515 000.OO 515 000.00
O4 MAR-T'YR-WASH $1 OS 000.00 $105 000.00
60 MECKLENBURG 515 000.00 $15 000.00
62 MONTGOMERY $15 000.00 S15,00000
63 MOORE $15 000.00 S15.000.00
64 NASH $35 000.00 $36 000.00
0
65 NEW HANOVER $1....0-
S35.000.00
66 NORTHAMPTON $35 000.00 67 ONSLOW $15 000.00 $15 000.00
68 ORANGE $15 000.00 S15 000.00
69 PAMLICO $15 000.00 16 000.00
71 PENOER $15 000.00 *15,000.00
73 PERSON $15,000.00 $15 000.00
74 PITT $15 000.00 $15 000.00
76 RAN OOLPH 515 000.00 $15 000.00
77 RICHMOND $35 000.00 $35 000.00
7B .--SON $35 000.00 $35 000.00
'J
79 ROCKINGHAM $15 000.00 S15.000-001
60 ROWAN $15,000.00 E16 000.00
D5 R-P-M $45 00.00 S45,00000
02 SAMPSON S..:2
00.00 $35 000.00
63 SCOTLAND $35 000.00 535 000.00
64 STANLY $15 000.00 $15 OOD.00
85 STOKES $15 000.00 $15 000.00
66 SURRV S15,000.00 515 000.00
87 SWAIN $3. $35 000.00
08 TOE RIVER $455, 000000.000 0 $45 000.00
8H TRANSYLVANIA 515,000.00 STS 000.00
90 UNION $15 000.00 $15 000.00
92 WAKE $15 000.00 $15 000.00
93 WARREN $35 000.00 S35.00000
96 WAY NE $l5 000.00 $1H,022 00
WILKES $15 000.00 $100.00
98 WILSON $35 000.00 535 000.00
99 VAOKIN $1 S 000.00 S15,000.00
TOTALS BY CENTER S2,000,000.00 $0.00 $0.00 $0.00 $0.00 $2,000,00000
CHECK GRANU TOTAL $Z,000.000.00
Sig nature and Oata - OPH Program Ad mints[ra<or Sig natu r¢ and Oate- Oiviaion of Public Healtb Budget Otflc¢r
Signature and Oata - OPH 3actlon C11[ef --I..000
33
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda: Consent Meeting Date:
Agenda: ® BOH: 10/03/07
CC: 1 O/1 5/07
Department: Health; Health Programs Presenter: Scott Harrelson, Deputy Health
Administration Director
Contact: Scott Harrelson 798-6592
Subject: Grant Application - Healthy Carolinians Funding - Health Programs
Administration - $ 12,048
Brief Summary: The Office of-Healthy Carolinians within the NC Division of Public
Health has funding available for local certified Healthy Carolinians task forces. Cape
Fcar Healthy Carolinians is a certified task force serving Brunswick and New Hanover
counties. Each county health department is allowed to request up to $12,048 in funding
to support the infrastructure of the local task force through: salary/overhead, programs,
marketing, membership recruitment and board development, training, resource
development, evaluation and community health assessment- New Hanover County
Health Department will apply for funding to cover the salary for the Coordinator, which
will be a contractor paid as services are rendered rather than a new position. The
application deadline is October 1, 2007. Due to the short timaframa requiring submission
prior to the next meeting date , ratification of the application for fundirt is re nested.
Recommended Motion and Requested Actions: Approval/ratification to apply for and
accept Healthy Carolinians' grant funding in the amount of $12,048 and to submit to the
New Hanover County Board of Commissioners for their consideration.
Funding Source: North Carolina Division of Public Health, OFSce o£ Healthy
Carolinians ~RFA was received too late to avoid ratification of application due on
October I"). No matching County funds arc required. Contract will end once grant
funding is ex ended.
Will above action result in:
ONew Position Number of Position(s)
=Position(s) Modification or change
®No Change in Position~s~
Explanation: No new position. Contract Coordinator for 15-20 hours per week at
$ 1 5/hour .
Attachments: List of essential duties and bud et
14
' Healthy Carolinians Coordinator
Essential Duties
Take minutes and send out the meeting summary for the monthly Cape
Fear Healthy Carolinians (CFHC) Steering Committee meetings
Take minutes and send out the meeting summary for the full task force
meetings 3-4 per year
Attend the November ~fA training with the Steering Committee
Assist sub-committee chairs in reaching their desired outcomes for each of
the committees
Maintain pertinent documentation to maintain Healthy Carolinians
certification
Ensure that the CFHC website is up to date and changes requested by the
Steering Committee are made
Oversee the task force budget and give budget reports to the Steering
Committee at monthly meetings and the full task force meetings
Coordinate communication with all committees
Work with local media to ensure coverage for CFHC events
Assist committees with developing grant applications for continued
programs
Assist the steering committee in applying for funding through the Office of
Healthy Carolinians
`.r
15
Cape Fear Healthy Carolinians
Task Force Budget 2007- 2008
Fundinit Categorv Explanation Amount
HC Coordinator to 6e paid $15/hour for
Salary/Overhead 15-20 hours each week $ 12,048
16
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda: Consent Meeting Date:
Agenda: ® BOH: 10/03/07
CC: 1 O/1 5/07
Department: Health Presenter: Kim Roane, Business Mara er
Contact: Kim Roane 798-6522
Subject: Grant Application - ACHIEVE Grant - Centers for Disease Control, National
Association of Chronic Disease Directors, and YMCA - $40,000
Brief Summary: Local health departments have been provided an opportunity to apply
for ACHIEVE community grant funding sponsored by the Centers for Disease Control,
National Association of Chronic Disease Directors, and YMCA. The grant funding is
offered to support policy and environmental change related to physical activity and
nutrition through community coalitions of stakeholders that include local YMCA's- One
of the top priorities identified by the Board of Health and staff, in the 2007 strategic
pla ing retreat was wellness. Our team of staff and community partners for the 2007-08
Management Academy for Public Health has begun work developing a business plan to
address the need for employee wellness opportunities in New Hanover County- This
team includes Health Department staff and representatives from County Human
Resources and PPD Inc. No County matching funds are required- Program is
anticipated to be sustained with earned fee-based revenues from local employers once
grant start-up funds are expended.
The grant application will be completed by members o£ the Management Academy team
and re area for submission b the October 12i~ deadline-
Recommended Motion and Requested Actions: To approve the submission of an
ACHIEVE grant application requesting $40,000 from the Centers for Disease Control,
National Association of Chronic Disease Directors, and the YMCA for development of
an employee wellness initiative, and acceptance of funds if awarded and submit to the
New Hanover Count Commissioners for their consideration.
Funding Source: Centers for Disease Control, National Association of Chronic Disease
Directors, and YMCA
Will above action result in:
New Position Number o£ Position~s~
~Position~s~ Modification or change
®No Change in Position~s~
Ex lanation: No new ermanent ositior s. Tem orar contract ]Program Coordinator .
17
s
Attachments: Grant bud et
1S
ACHIEVE Grant Fund
Budget Request
Employee Wellness Initiative
Contracted Services $ 25,000
Marketing/Advertising $ 4,000
Supplies $ 2,000
Supplies - Incentives $ 4,000
Printing $ 1,500
Employee Reimbursements $ 500
Total Expenses- $ 40,000
19
H
• Z
RAJ
wwILA
Q-
~Q
NEW HANOVER COUNTY HEAZ-~
Over 7 2S Yeczrs of
Public He~zl~h Service
2029 South 17th Street
Wilmington, NC 28401
910_798_6500
www_nhchd_org
~,,,.Jirector's Messczge Manczge ent Teczm
Tlc¢ Ncw Hanover County Board of Health and the staff of the New
Hanover county Health Department Deputy Health Director
Scott Harrelson, MPA
ar pleased co provide you with our
annual report for ftacal year 2006-07_ Environmental Health Services Manager
Diarlne M_ Harwell, REHS
This report was created to inform
Personal Health Services Manager
New Hanover County residence and Janet B_ McCumbee, RI\T, BSN
oFfaeials of the diverse programs and
Animal Control Services Manager
a¢rvi¢¢a off-.- byyt)ur local health a¢part.tt¢nt_ sin¢¢ 1879, our health Jean P_ McNeil, DVM
department has provided health promotion, disease prevention, and ~jyrS ZZZeSS MQYZLZgeY
health protection services to the people of New Hanover County Klrrlberly A_ lZOarie
-From the Northeast River to Feaeral mint, ana r om m¢ cape F¢ar t° Administrative Support Coordinator
y~ the Sea-City, Suburb, village and Farm-we are one people a[ri..ing Marilyn O_ Roberts
rfor healthful and useful living."
During fiscal year 2006-07, the Health Department experienced many
challenges and opportunities. Among the moat notable experiences
Our Mission and Vision
were-
-Revision co Animal Control Ordinance The mission Of the NeW HanOVer COilnty
-Pandemic intlnenaaAwarenas summit Health Department is to assure at safe and
-Regional Maus Dispensing Exercises
-UNC Chapel Hill Child Care MRSA Project healthy Commun><ty.
-Mental Health Services in Schools
-Mobile Dental Unit Services The Vision Of the NeW Hanover COllnty
-Internatio°'1 r`a"elclit'i° Health Department is= Healthy Peopte
-colposcopy Services s
Healthy Environment Healthy Community~
As you read thin report, I'm certain you will agree that dais has been
a very productive year Eor the Health Department and its Euture
Motto
promises to be brigh[ with numerova posaibiliti¢s to serve our "Your Health - Our Priority"
community- We hope you find our report u~efulDavid E. Rice, MPH, MA
Healtkt Director
~nimczl Control Services
"""Your Pet, Our Priority
'Tbe fiscal year began relatively quiet for Animal Control Services <ACSj. The team
maintained the usual influx of unwanted animals through the shelter during the summer
months, with the assurance that the spay/neuter facility was available for neutering
the pets prior to placing them in the adoption area. This has been a valuable asset in
decreasing the animal overpopulation issue in our county, especially since more than
600 surgeries are performed each year. The overpopulation issue was highlighted in a
major news story featuring animal injection euthanasia that ran for February sweeps.
Our hope is to bring the problem before the group that can most make a difference[ the
individual animal owners who should be responsible for their pets.
Public outcry secured directional signage at either end of Division Drive, so patrons
can more easily find the shelter to adopt or redeem their pet. Citizen discontent also
fueled a fierce battle against New 14-cr's anti-tethering law. The county upheld the
ordinance, which had been in place for nearly twelve years. It remains as a standard
against at least one form ofanimal cruelty, and we are the lone county in the state that
Canine positive case 1¢s[ y¢¢r
has this statue in place.
Rabies surveillance and control continues to be a priority for the team- Positive rabies cases were few, but at least one was of
monumental importance. The first canine positive in nearly sixty years was identified just before the Christmas holidays. Potential
human exposure resulted in almost fifty people undergoing post-exposure vaccinations. This is the highest number known in recent
years statewide.
Staffresponded by continuing our prevention measures. Several no cost rabies clinics were offered to the community during the
year, both in the inner city and at the shelter. A public health forum was developed to educate area veterinarians and their lay staff.
The presentation included input from the rabies state veterinarian. A partnership was strengthened with the pre-veterinary medical
association at the university, which has resulted in a mentoring program to carry rabies education into the area schools.
Since customer service is a county and a divisional priority, the shelter re-opened their doors for Saturday hours in March 2007. This
makes our services more readily available to the community, which should increase our adoption rate as well. Fencing was erected
for the adoption play area in front of the facility, to enable prospective owners some additional space to bond with the dogs. These
are just a few examples of why our motto is, "Your Pet, Our Priority."
f
Surgeries perjorsxed ¢t Spery/Neuter ¢cittty ¢t Antm¢I Control Services
Environment~zl He~rlth Services
~ Yector Control Program
J)~+ ` Mosquito control has historically been a highly visible public health
service made available to citizens and tourists alike throughout
municipal and unincorporated areas ofthe county. Bounded by the
Cape Fear and Northeast Cape Fear Rivers in addition to the Atlantic
Ocean, much of New Hanover County offers an ideal habitat £or the
than forty species of mosquitoes found in this region.
Why control mosquitoes? Beyond the "nuisance factor", mosquitoes
are capable of transmitting diseases some of which can be fatal or
can leave victims with long term health effects- Acutely aware of
this potential, New Hanover County Health Department (NHC HD~
Environmental Health Services staff devotes a great deal of effort
to the surveillance and control ofmosquitoes_ Multiple indicators
simultaneously invoking enhanced control measures are used to
deteri-ine when the public faces the greatest risk of diseases such as
eastern equine encephalixis and West Nile virus. If active disease is
present, it infects the "host" through injected saliva when a mosquito
first bites, The itch and welt usually resulting solely from the saliva
Extreme weather conditions such as late summer o-f 2006, is simply your body's reaction and defense to this small amount of
require aerial treatment of-Lc-agle Island with environmentally foreign substance. The appearance and recognition of actual disease
sate mosquito Iarvrcide products symptoms occurs several days or even weeks after an infective
mosquito bite-
'Five full-time employees and one halt=time employee work year round performing a variety oftasks with the goal ofsuppressing
mosquito activity in the county to a tolerable level- Environmental Health Specialists from other specialized disciplines are cross
trained to support mosquito control responsibilities during and subsequent to catastrophic or persistent high rainfall weather
conditions Customers access Vector Control Program services via the NHCHD Environmental Health Services office in the
Government Center located between College and Eastwood Roads, while staffwork from a satellite location off Division Drive.
Dredge spoil deposits up and down the intracoastal waterway as well as the shipping corridor ofthe Cape Fear River create optimum
habitat For certain native mosquito species. As fine sediments from the bottoms ofthesa boating channels are removed and placed
on the land surface to drain and dry, deep fissures develop and retain water. Past experiences exploring this terrain have revealed
copious populations of mosquito larva.
The entity responsible for maintaining navigable waterways, the
United States Army Corps OF Engineers, bas thus partnered with
NHCHD Environmental Health Services continuously For more
than Is years to develop and fund an integrated pest management
program consisting of surveillance, water management, and
biological and chemical control- Our most critical challenge
relative t- this environment is Eagle Island located partially on
the 13l W~swick County side ofthe Cape Fear River and directly
across from the North Carolina State Ports facility and the heart of
Wilmington.
Vector Control Operator conriructing drainage features
on Fag1e island
Heczlth Progr~zms 14d~ainistration
Pandemic Influenza Awareness Summit ,~~~~s.<_ _
Pandemic In fl uenza Awareness Summit was held on February
17, 2007 at Shell Island Resort at Wrightsville Beach.
Approximately 75 area health care professionals, emergency
responders, law enforcement and neighboring county health
department staffattended the halfday event. Participants were _
informed of the North Carolina Division cf Public Health
pandemic influenza preparation plans.
NC Pandemic InJtuenza Response Plan Presentation
2007Regiorrzal Strategic National Stockpile Mars Dispensing Exercises
Mass dispensing, Strategic National Stockpile (SNS), Incident Command System (TCS), Point of Dispensing (POD). All these
concepts and activities became a little clearer on March 29 and 30, 2007 when the New Hanover County Health Department
completed the Local Receiving Site and Mass Dispensing Drive 'Through (POTS) Exercises-
Scenario: It has been determined to be in the best public health interest oftha
citizens (approximately 200, 000) cf New F-I-er County to receive a flu shot
within the next 24 hours to maximize the opportunity of combating the effects of
pandemic influenza.
Under Emergency Support Function #8 (ESF 8 - Health and Medical), New
Hanover County Hcalth Department is tasked with performing this Function. In
order to achieve this, 833 people per hour would have to be vaccinated, upon
receipt ofthe vaccine/medical supplies through the Local Receiving Site (LRS).
The exercises on March 29 and March 30 allowed the Health Department and
partner agencies to act as if the scenario were real, and open the LRS and the Drive
Through POD.
After six (6) months of meeting and planning with staff, from New Hanover County
Sheriff's Office, Departtitent of Emergency Management and Fire Department,
Southeastern Regional Advisory Committee (SERAC), New Hanover Regional
Medical Center, New Hanover County Schools, City of Wilmington and the NC-
Division of Public Hcalth contracted consultant - Envi-Safc, the time had come to
Receiving Site Exercise fir Mars Dispensing demonstrate the capabilities of the county.
On March 29, 2007, the New Hanover County Health Department conducted the first training exercise in North Carolina to determine
readiness for receiving shipments cf material from the Strategic National Stockpile (SNS) for mass dispensing to the public. Local
health departments must be prepared to receive large shipments of drugs and other supplies from the federal Receiving, Staging and
Storage (RSS) warehouse located in Raleigh, and secure the material while preparing it for local distribution. The exercise objectives
included: ensure site security, conduct a call-down of staffto report to the site, credentialing of staff, conduct an incident briefing,
A
/erforrti just in time (JIT)training, receive SINS delivery from the federal RSS delivery driver, create pick list for order, pick the
rl`..4rder and transfer order to delivery driver, perform quality assurance at each step, use of appropriate signage in warehouse, test radio
communications, ensure chain of authority For security of material, and partner with community agency and other county departments.
Health Programs Administration
Strategic National Stockpile Receiving Site
Exercise "First in North Carolina"
The exercise was completed successfully, meeting all exercise
objectives. Our staff did a fantastic job working with other
r local agencies to receive the shipment and have it ready to go
on schedule. Observers from the state Office of Public Health
Preparedness and Response noted that realism was added to the
exercise, excellent teamwork and coordination of community
and county partners was evident, and reported that photos and
documents from this exercise will be used to demonstrate the
receiving site process to other counties in North Carolina. We
learned a great deal and now we have a much higher comfort
level with our ability to receive an SNS shipment. This is a
crucial component in our mass dispensing efforts. It is one of
County Employees check-in at the staging area the first local efforts in processing large amounts of vaccines or
for the Mass Dispensing Exercise medicines out to the public.
On March 30 we had the second half of our exercises, the mass dispensing, at Veterans Park. We had 21 partner agencies and
over 300 staffers working together. Our primary goal was to process 833 people per hour. We processed 650 per hour with
one of our two dispensing areas barely seeing anyone. It was not because they were not prepared. We just didn't have enough
participants to keep them busy. If we had more participants we could have done 1000 or more with the staff we had available.
What we did learn is that we can actually process 833 people per hour. According to local, state and federal representatives and
the evaluators, we did very well. We were the first state sponsored mass dispensing drive through exercise. We pulled together
and worked with our key partners and learned how to improve our process. Thanks to all the staff for making these exercises
such a success!
New Hanover County Health Department 2006-2007
National Incident Management System Training Progress Report
Percent Percent Percent of
0 0 90%
0 97% 87%
ICS-200 garir Incodent Command System 0 87% Exempt
Intprmadiate lor-orlent Command System 0 Exempt Fypmnt
0 100% 81%
0 77%
F!jkrsonnal by Tragnong Levels
Executive: Health Director, Deputy Health Director,
Managerial: Division Managers, Supervisors and Epi
Team Members,
RLzrponder- All Staff-
Personczl I ~ecal~h Services
UNC Chapel HiQ Chlid Care
Community Acquired-Methicillin Resistant Staphylococcus Aureus ACA-MRSA)
Research Project
The New Hanover County Health Department- Personal Hcalth Services- Child Care
Nursing Program participated in a research study to investigate the prevalence of
Community Acquired Methicillin Resistant Staphylococcus Aureus (CA-MRSA) in child care
facilities. This study was conducted by the Medical Microbiology and Public Health
research team from the University of Nortb Carolina at Chapel Hill <UNC-CH). -F-he research
project was a collabrative efF-rt between the university, our Child Care Nursing Program, and
eighteen (18) area child care facilities. Our nurses completed parent permission forms and
collected a total of 751 nasal swabs between the months of February- May 2007 to determine
the prevalence of CA-MRSA in child care facilities. The prinicipal
investigative team consisted of David Weber, MD, MPH, Melissa Miller, MD, MPH, Jennifer
Goodrich, PhD, with coordination provided by Jonathan Kotch, MD, MPH, Viet Nguyen, Chttd Care Heo![h Consu[ronr
MD, PhD, and Patricia Isbell, PhD, MPH, MEd. The final report is pending and will be working with portent
provided to the Health Department For review.
School of Mental Health
New Hanover County Schools and the New Hanover County Health Department have joined
togetheto provide mental health services in the schools- This program was originally developed
by the school system and Southeastern Center for Mental Hcalth /Developmental Disabilities /
Substance Abuse Services (MH/DD/SAS) in 2001 but, due to State Mental Health Reform, had to be
divested from Southeastern Center at the end ofthe 2006-07 fiscal year. The New Hanover County
Health L':) epartment participated in discussions earlier this year to take over this program, with the
- strong support from the Board of Healtb and the County Commissioners. In June 2007, the transfer
was successfully negotiated and the program became a part ofthe Health Departttient in July 2007.
There are currently 13 mental ]-health therapists covering 15 elementary and middle schools plus
students transitioning from Lake Forest Acadcmy-
Miles of Smiles
The "Miles of Smiles" mobile dental unit has traveled New Hanover and Brunswick Counties since arriving in June 2006. The unit
has served seven (7) public schools with two of these schools visited twice. The New Hanover County schools include Johnson
Elementary, Freeman Ele~~me\ntary, Gregory - Williston, and Sunset
Park Elementary. The 73~~~_ \~_.swick County schools served were
Lincoln Elementary, Bclville Elementary and Supply Elementary.
In the time period of July 2006 - June 2007, we have seen 716
children with 1,452 dental visits and 6,957 dental procedures. s,
In February 2007, we welcomed Dr_ Zachary Hunter as our new
contract dentist- Dr. Hunter comes from Michigan where he worked
with a large practice serving primarily Medicaid clients and has
a special interest in children. Other highlights this year include
a gift of $ 10,000 from 13rahrtswick County and $5,000 from the
Duke Endowment for charity dental care. In addition, the Duke
Endowment has committed $15,000 for equipment to provide future
hospital sedation For children with severe dental problems that cannot
be performed in a regular dental setting. "1.7te mobile dental unit Mobile dental unit- "Miler qf-Smt[es ° on site or Freemon
serves children between the ages of 3-18, who have Medicaid or NC Eaemenrory School. lVttmtngron
*4%..,,, "ealth Choice insurance and children with no dental insurance on a
sliding fee scale-
Personczl He~zlth Services
International Travel Clinic
The International Travel Clinic has been a huge success with the public's demand for vaccinations and anti-malarial medications For
their travel needs at a reasonable cost- In addition, we have provided our
clients with travel information based on their travel itinerary. Our clients
have been both pleased and gratcful that we have taken such an interest in
their travel needs and their general health while traveling-
Our travel clinic began on March 2, 2007 as the Foreign Travel Clinic.
Since then, we have adopted and changed the name of our travel clinic to
the international Travel Clinic. This change emphasizes travel to specific
countries and not simply travel to a Foreign area- We have had 303 visits
in almost four months and have also expanded our appointment times from
morning only to include the entire day.
We provide much more than vaccinations in our travel clinic- Inrernarrona! Travel C[treic
We provide a great deal of in Form anon, including: screening our
patients before receiving vaccinations or anti-malarial. for any possible
contradications, providing the proper documentation on the International Certificate of Vaccination card, and how our clients can
better prepare for a trip and stay safe. Our nurses have also received many compliments and cards thanking them for their time,
information, and caring. -Fhe travel clinic has been a very positive experience for our staff-and community.
Syphillis Outbreak Colposcopy
New Hanover County was involved in a large syphilis We received notification I--om Coastal OB-GYN that we would
outbreak in May 2007- One female was identified as an active no longer be able to send low risk patients with abnormal
syphilis case with approximately 200 sexual contacts reported. pap tests in need of cclposcopy to their agency April 2007. A
Approximately 116 individuals were identified by the North patient waiting list was established with thirty three patients
Carolina Department of Health and Human Service (NCDHHS) awaiting colposcopies_ We requested and received 11--ding from
disease intervention specialists as contacts to active syphilis Ministering Circle to purchase supplies and equipment to perform
cases and were evaluated and treated at the health department. our own coloposcopies May 2007. After receeving supplies and
Eleven (1 1) new cases of syphilis were identified from these equipment our staff were trained on how to use the equipment,
contacts. pathology preparation, the cleaning and sterilization process,
and clinical duties. We secured a contracted physician to provide
Control Measure Violators: colposcopics after hours to our patients weekly.
-Fhrcc (3) Sexually Transmitted Disease (STD) control measure
violators were identified by the health department with The first clinic was held on June 12, 2007 with five patients
assistance from the 1VCDHHS disease intervention specialists. receiving colposcopies and again on June 1, 2007 with another
The department took the appropriate action to pursue legal five patients served. Two cf those patients were referred for
action and all 3 were prosecuted. They each received sentences fiarther evaluation after receiving the pathology results. Currently,
0£60 days in jail and 5 years of supervised probation. patients are seen within one month of this agency receiving an
abnormal pap test result instead ofwaiting for up to four months
with our previous provider.
Communicable Disease Trends
Reportable Coxtzxiiunicable Diseases
(with more than 1 case reported)
T-1- 1 '>016 -Jxxne 30- 2007
AIDS 30 fETlLCtlon 42
~'/Yi~~PPrflydlCrsis .S PO~isrts/s 13
IR)O!!OC]/l!C 2 S~isfottaN+e 8d
-;D;-. Adrtfto 8 S,yfs/Jr~tl#a-.TOtat Sa
Findnciczl Mcznczgement
~rNew Hanover County Health Department's "Buildfng Fund"
Creation of Escrow Account for Medicaid Cost Settlement Funds
A new financial tool has been created For the Health Department- Approval was granted by the New Hanover County Board o£
Health and the New Hanover County Commissioners to establish an escrow account for deposit of surplus Medicaid revenues...
similar to a "savings account" for the department Annually, the state Division of Medicaid Assistance conducts a review of services
provided by local health departments to determine the actual average cost of providing Medicaid-eligible services throughout the
state- A cost settlement is then determined on a county-by-county basis, providing additional Medicaid revenues to supplement the
cost incurred by local health departments in providing services to Medicaid recipients.
Funds received via the cost settlement must be used in the pro&- generating the revenues- The annual consolidated agreement
the County enters into with the State of North Carolina in order to rec. ive program funding requires that any unused Rinds must be
carried forward to the next fiscal year. The establishment of this escrow account, with an initial deposit of $ 187,000, satisfies both
Rmding requirements. Funds deposited in the escrow account are intended For the purebase oFa new building, lease ofadditional
space, or other use in those programs in which the revenues were earned.
The establishment of a "building fund" supports one of the strategic planning initiatives identified by the Board of Health during
their April 2007 retreat. Funds will be expended only upon approval of a budget amendment brought before the Board of Health and
County Commissioners, or via the annual budget process.
New Hanover County Health Department Budget
The New Hanover County Health Department Amended Expenditure Budget (Adopted Budget plus any amendments that were processed
during the fiscal year) for FY 2006-2007 was $14,201,646. Actual expenditures for FY 2006-2007 were $13,020,988. 71ia Health
Departtnent's budget was composed .1-30 individual programs. Division Managers submitted a line item budget For each program within
their respective divisions- -17-he Health Director and Business Manager reviewed all budget requests- Budget hearings were conducted
and a Budget Workbook including all programs with line item narrative j ustifications 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
Figure 1 illustrufer how the A,r_I Expenditure Budget is divided among Salaries/Fringes, Operating and Ccspital Outlay items.
Figure 7 To~tai Actuai E ~qa ®r~d itu res
F Y
C7peratir-e g: 2006-2007 C:a pitaI Clltltl ay:
$ 1 .a oo.S8 6 $ 9E ,581
1 4 °!o l
Sala r r 8~
Fri"ga:
$ 1 1 . 1 23 ,722
SO °f.
Fincznciczl M~zncz~ement
Figure 2 illustrates the breakdown -J-the Health Department's total earned revenue ($7,686, 890)
through Health Fees, Medicaid,
Environmental Health (EHJ Fees, Animal Control (ACS Fees, and Other (including Miscellaneous grams and school contribu[tortsJ.
It also shows Federal and State Grans [hmugh the North Carolina Department o_fHeal[h and Human Services ('$1,90S,297
which is
included in the above total revenue fzgureJ and County Appropriations ($5,334, 098.
Figure 2= Totai Earned Revenue for FY 2dd6-2O Q7
Courity
Rpp rte p ri ati on s
$5 334,098 Fe tle ral B. States
Outer 40% $1 ,908,287
$2,601 ,723 15
20%
Health Choice RC Fags
$21 ,822 $733,732
0.2% Metlicaitl 6
H ealtri Fees Metlic aitl Max $1.264,840
$407,896 $2SF 530 $497,049 1 O
"Figure 3 represents total revenues earned versus total revenue budget.
Figure 3= Total Revenue Earned vs_ Budgeted FY 2006-2007
$3 JDOO ,000
$2 Soo ,ooo
$2.000 JDOO
$1 S00 p00 Budget
~ Earned
$1 JDOO JDOO
$soo po0
Federal 8. .4C Fees Medicaid Medicaid EH Fees Health Health Other
SY ate Max Fees Choice
ti
North Carolina Department of Health and Human Services
2001 Mail Service Center Raleigh, North Carolina 27699-2001
Tel 919-733-4534 - Fax 919-715-4645
Michael F F_asley, Governor
Dempsey Benton, Secretary
September 18, 2007
Mr_ David Rice, Health Director
New Hanover County Health Department
2029 South 17th Street
Wilmington, NC 28401
Dear Mr_ Rice=
I am pleased to appoint you to the North Carolina Public Health Task Force
2008 which will continue the excellent work of the previous Task Forces of 2004 and
2006 _
As a member of the Public Health Task Force 2008, you and other leaders from
the legislature, public health, the community and health care will complete new
recommendations where challenges remain for our public health system.
A strong public health infrastructure and strong partnerships in our communities
are necessary for success. This Task Force reflects the commitment of our Department to
work with the General Assembly and with you to achieve improved health for every
person in North Carolina. I appreciate all that you are undertaking in devoting your time
to this effort and look forward to working with you on the North Carolina Pubtic Health
Task Force 2008.
Thank you for agreeing to serve in this critical effort to improve health for all
people in North Carolina.
Sincerely,
Dempsey Benton
® Location: 101 Blair Drives • Adams Building • Dorothea Dix Hospital Campus • Raleigh, 27,603 I
An Equal Opportuniry / Affarm axrve Action, Employer
KS's F, Pub ic
Health Task Force 2008 to
Build 2004-.2-006 Accomplishments
t Caro Ina
Public Health Working for a Healthier and Safer North Carolina
NC Public Health: Everywhere, Everyday, Everybody
Strengthening the Public Health System Through
State Level Investments and Innovations
Standardizing Public Health Capacity Building New Facilities
The first mandatory system of $101 million was approved to build a new Public
accreditation for local/district health Health Laboratory and Medical Examiner Office.
departments in the country has been The groundbreaking will occur in late 2007 at a
established. Initial legislation provided site close to the N.C. State University College of
$700,000 per year in recurring funds for Veterinary Medicine.
the accreditation process. Of the 85 local
county health departments, 30 have been
accredited as of July 2007. Implementing New Technology
• The first state level Pilot Accreditation effort The statewide Health Information System (HIS)
nationally was successfully completed in is being implemented supported by a state and
February 2007. Based on the local contribution of $15 million. Full
recommendations of the site visit team, implementation of this system will occur by the
performance improvement teams have been end of 2008.
established to address the findings and
recommendations.
For the first time in over 30 years, state level Protecting Health
• public health funds to support provision of
The excise tax on "spit" tobacco products and
the ten essential public health services cigars was increased from 2% to 3% of the actual
provided by local health departments was cost. The tobacco tax was increased from 5¢ to
increased by $2 million. 35¢ in 2005.
• New legislation prohibits smoking in buildings
owned, leased or occupied by state government
Increasing Collaborations and authorizes local governments to regulate
smoking in buildings owned or leased by local
• The North Carolina General Assembly governments. Another legislative success was
(NCGA) budgeted $1,000,000 in recurring making all North Carolina public school grounds
funds to establish and support seven public tobacco free campuses.
health incubators to support regional
collaboration and innovation. Over 300 new school nurse positions improved
the nurse to student ratio from 1:1897 in the
The NCGA appropriated $1,400,000 for 2003-04 school year to 1:1260 in school year
local Healthy Carolinians partnerships for 2007-08. 37 of 155 LEAs now meet the
capacity development. recommended 1:750 ratio in 2006-07.
Preparing for All Hazards
The NCGA increased state support for the Approximately $700,000 in funding to support universal vaccine program by appropriating - -.rf
$5,526,095 to support the provision of response for food-borne illness, infectious
influenza and Tdap vaccines- diseases such as tick-borne illness was
appropriated-
- The regulation of private wells has been
added as a mandated program- Over $9.2 million in antiviral medications was
appropriated for pandemic flu
preparedness- additional $12
millionappropriationto provide fo_ r. early The first state law -ill hospital
intervention to select children 0-3 years- - cmergericy departments to report specific health
data to the State Health Depai-tment_
The Division of Public Health was
designated as the lead agency for injury
prevention in North Carolina Eliminatinm Disparities
- There has been an increase of $1,000,000 in state
New funding for chronic disease targeting appropriations for ADAP in FY `06 and
cancer, stroke and diabetes totaled $3 $2,000,000 for HIV preven.tion_ AIDS Drug
million in 2007_ Assistance eligibility has been significantly
raised-
• Support for infectious disease testing was
provided for the public health lab and for - The NCGA appropriated $350,000 in recurring
outbreak investigation of food-borne and funds for new full-time positions for interpreter
vector-borne diseases- services at local health departments. --.owi
- The NCGA approved $5,000,000 for all - The Office of Minority Health &a Health
primary care safety net clinics for FY 2007 Disparities received $2,500,000 for co "m Aity-
including local health departments. focused initiatives targeting the elimination of
The Division of Public Health was health disparities-
designated the lead agency in North Carolina
for the prevention of child maltreatment-
Tusk Force 2008 Kicks off
October 10 2007
o Focus Areas
Healthy Families
Nort Caro Ana Communicable Disease
Public Health
Chronic Disease Prevention
http=//www.ncpublichealth.com/ Health Disparities/Health Equity
Ten Essential Services
Page 1 of 1
Rice, David E.
From: Roane, Kim
Sent: Monday, September 17, 2007 3:56 PM
To: Rice, David E.
Subject: F.A.C.T. Recommendations - September 2007
The following recommendations are made by the F.A.C.T. after discussion at the September 2007 meeting:
• Establish a new code - 90772 (Therapeutic, prophylactic or diagnostic injection) with a fee of $5.00, to
replace code 90782 (Therapeutic injection) as per guidance from Joy Reed
• Fee for flu vaccine to remain at $30.00, which is the same cost currently in our fee schedule. This fee
matches one neighboring county fee (others have not set fees yet), and will cover the BCBS
reimbursement ($22.16) and Medicaid reimbursement ($26.77) amounts. Medicare has not yet
communicated their reimbursement rate, and it is not expected to be known for several weeks.
• Fee change for 88142 90 Pap Tests from $10.69 to $12.33, based on state lab costs.
Respectfully request your approval for implementation.
Thanks,
Kim
Kim Roane
Business Manager
New Hanover County Health Department
(910) 798-6522
fax (910) 341-4146
9/17/2007
N_C. Division of Public 13ealth Budgetary Estimate to Local 14ealth Departments, sFY 07-08
Original Activity # 110 Activity 1-4u- General Aid-to-Counties
REV 6
M.m. $145 000.00 $145 000.00
02 ALEXAN OER $15,000.00 $15,000.00
04 ANSON $36 000.00 $35 000.00
02 APPALACHIAN $45 000.00 S45.00000
07 BEAUFORT $15 000.00 -5.000-001
29 BLAOEN $35 000.00 $35 000.00
10 BRUNSWICK $15 000.00 $15 000.00
11 BUNCOMBE $15 000.00 .15.000-00
12 BURKE $15 OOO.Oo $16 000.00
13 CABARRUS $16 ooo.oO 15 000.00
14 CALOWELL $15 ooo.00 $15 000.00
16 CARTERET $15 000.00 $15 000.00
$15 OOo.oo $15 000.00
17 CASWELL $15 000.00
1R CATAWBA $15
19 $1 5 000000.000 0
. $15 000.00
CHATHAM
$15 000.00
20 CHEROKEE S15,0229
22 CLAY $1s 000.00 $15 000.00
23 CLEVELAND $15 000.00 $15 000.00
24 COLUMBUS $35 000.00 $35 000.00
25 CRAVEN $15 000.00 $15 000.00
26 CUMBERLAND $15 000.00 $15 000.00
28 DARE $16 0o0.00 $16 000.00
$1s 000.00 s1s 000.00
za DAViosoN $ts 000.00
3o D/av1E als 000.00
31 DU PLIN $t6 000.00 $15 000.00
32 DURHAM $l5 000.00 $15 000.00
33 EDGECOMBE $35 000.00 $35 000.00
34 FORSY TH $15 000.00 $l5 000.00
$15 000.00 $16 000.00
35 FRANKLIN $l5 000.00
36 GASTON $15 000.00
3H GRAHAM $15 000.00 $15 000.00
O3 GRAN-VANCE $50 000.00 $50 000.00
40 GREENE $35 ODO.00 $35 000.00
41 GUILFORD $16 000.00 $t6 000.00
42 HALIFAX $35 000.00 $36 000.00
43 HARN ETT $35 000.00 $35 000.00
44 HAYWOOD $15 000.00 $15 000.00
45 HENDE RSON si 5 o00. o0 $15 000.00
46 HERTFORD $3s,000.00 $35 000.00
47 HOKE $35 000.00 $35 000.00
46 HV DE $15 000.00 $l5 000.00
49 IREDELL $t 5,000.00 $1 5,000.00
50 JACKSON $15,000.00 $15,000.00
51 JOHNSTON $15,000.00 $16,000.00
12
N_C. Division oT Public H¢alth Budgetary Estimate to Local H¢alth Depart-ts. SFY 07-08
Original _X_ Activity # 110 Activity Name: G¢neral Aid-to-C ouuiies
REV 6
ROW 1 and/RCC/FRC Fund/RCC/FRC Fuud/RCC/FRC and/RCC/FRC Fu~d/RCCFRC y
1410-411 O-0O Total oT All ,~~I
Payment Period
O>/O>AB/OB Pa men< Period - Pa ment Period - Pa mant Period - Pa ment Parlod -
Service PaHOd
06/0>-OS/O8 Sarvica Period - Service Period - Service Period - Sarvlca Period -
sotarcas
COUNTY $15 000.00
52 JONES $15,000.00
53 LEE $15 000.00 §15 000.00
$35 000.00
54 LENOIR $35 000.00
$15 000.00
55 LINCOLN $15 000.00 §15 000.00
56 MACON $15 000.00
57 MApISON $15 000.00 $15 000.00
p4 MAR-TVR-WASH $1 OS 000.00 $105 000.00
a1s 000.00
BO MECKLEN BU RG $15 000.00
.....o
62 MONTGOMERY $15,000.00
$15 000.00
B3 MOORE $15,000.00
64 NASH $35,000.00 $35 000.00
65 NEW HANOVER $15 000.00 §15 000.00
535 000.00
66 NORTHAMPTON $35 000.00
§15 000.00
B> ONSLOW $15 000.00
$1 s 000.00
68 ORANGE $15 000.00
§15 000.00
69 PAMLICO $15 000.00 $15 000.00
>1 PENpER $15 000.00
§16 000.00
73 PERSON $15 000.00
$1s 000.00
74 PITf $15 000.00 §15 000.00
76 RAN-R. $l5 000.00
$35 000.00
» RICHMONp $35,000.00
>8 ROBESON $35 000.00 $35 000.00 y
§15 000.00
>9 ROCKINGHAM $15 000.00
$1s 000.00
80 ROWAN $15,000.00
§45 000.00
p5 R-P-M $45 000.00 $35 000.00
82 SAMPSON $35,000.00
$35 000.00
83 SCOTLAND $35 000.00
$15 000.00
84 STANLY $15 000.00
$15 000.00
85 STOKES $15 000.00 $15 000.00
86 BURRY $15 000.00
$35 000.00
87 SWAIN $35,000.00
$45 000.00
p6 TOE RIVER $45,000.00
§15 000.00
BB TRANSV LVANIA $15 000.00
$15 000.00
90 UNION $15 000.00 §15 000.00
92 WAKE $15 000.00 .35000-00
93 WARREN $35 000.00
$15 000.00
96 WAVNE $l5 000.00 $15 000.00
97 WILKES $15 000.00 $35 000.00
98 WILSON $35 000.00 $15 000.00
99 YAOKIN $15 000.00
TOTALS BY CENTER $2 000 o00.00 $0.00 $0.00 $0.00 $0.00 $2 000 000.00
$2 000 000.00
CHECK GRANp TOTAL
Signature and Oafs - pPH Program Administrator Slg nature and pats- pNislon of Public H¢altM1 Budget OMCar
Signature and pata - -H Section CM1ie1
13
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
~r Request for Board Action
Agenda-- Consent Meeting Date:
Agenda: ® BOH: 10/03/07
CC: 1 0/ 1 5/07
Department: Hcalth; Health Programs Presenter: Scott Harrelson, Deputy Health
Administration Director
Contact: Scott Harrelson 798-6592
Subject: Grant Application - Healthy Carolinians Funding - Health Programs
Administration - $12,048
Brief Summary: The Office of -Healthy Carolinians within the NC Division o£ Public
Health has funding available for local certified Healthy Carolinians task forces- Cape
Fear Healthy Carolinians is a certified task force serving Brunswick and New Hanover
countics- Each county health department is allowed to request up to $12,048 in funding
to support the infrastructure of the local task force through: salary/overhead, programs,
marketing, membership recruitment and board development, training, resource
development, evaluation and community health assessment. New Hanover County
Health Department will apply for funding to cover the salary for the Coordinator, which
will be a contractor paid as services are rendered rather than a new position. The
application deadline is October 1, 2007- Due to the short timeframe requiring submission
prior to the next meetirt date , ratification of the application for funding is re uested.
Recommended Motion and Requested Actions: Approval/ratification to apply for and
accept Healthy Carolinians' grant funding in the amount of $ 1 2,048 and to submit to the
New Hanover Count Board of Commissioners for their consideration.
Funding Source: North Carolina Division of Public Health, Office of Healthy
Carolinians ~RF'A was received too late to avoid ratification o£ application due on
October 15~~. No matching County funds are required- Contract will end once grant
fundin is expended-
Will above action result in:
=New Position Number of Position~s~
QPosition~s~ Modification or change
®No Change in Position(s)
Explanation: No new position. Contract Coordinator for 15-20 hours per week at
$1 5/hour -
Attachments: List of essential duties and bud et
14
Healthy Carolinians Coordinator
Essential Duties
Take minutes and send out the meeting summary for the monthly Cape
Fear Healthy Carolinians (CFHC) Steering Committee meetings
Take minutes and send out the meeting summary for the full task force
meetings 3-4 per year
Attend the November VTA training with the Steering Committee
Assist sub-committee chairs in reaching their desired outcomes for each of
the committees
Maintain pertinent documentation to maintain Healthy Carolinians
certification
Ensure that the CFHC website is up to date and changes requested by the
Steering Committee are made
Oversee the task force budget and give budget reports to the Steering
Committee at monthly meetings and the full task force meetings
Coordinate communication with all committees
Work with local media to ensure coverage for CFHC events
Assist committees with developing grant applications for continued
programs
Assist the steering committee in applying for funding through the Office of
Healthy Carolinians
15
Cape Fear Healthy Carolinians '
Task Force Budget 2007- 2008
Fundino Cateciorv Ex ola nation Amount
HC Coordinator to be paid $15/hour for
Salary/Overhead 15-20 hours each week $ 12,048
1 6
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1
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda:? Consent Meeting Date:
Agenda: ® BOH: 10/03/07
CC: 10/15/07
Department: Health Presenter: Kim Roane, Business Manager
Contact: Kim Roane 798-6522
Subject: Grant Application - ACHIEVE Grant - Centers for Disease Control, National
Association of Chronic Disease Directors, and YMCA - $40,000
Brief Summary: Local health departments have been provided an opportunity to apply
for ACHIEVE community grant funding sponsored by the Centers for Disease Control,
National Association of Chronic Disease Directors, and YMCA. The grant funding is
offered to support policy and environmental change related to physical activity and
nutrition through community coalitions of stakeholders that include local YMCA's. One
of the top priorities identified by the Board of Health and staff in the 2007 strategic
planning retreat was wellness. Our team of staff and community partners for the 2007-08
Management Academy for Public Health has begun work developing a business plan to
address the need for employee wellness opportunities in New Hanover County. This
team includes Health Department staff and representatives from County Human
Resources and PPD Inc. No County matching funds are required. Program is
anticipated to be sustained with earned fee-based revenues from local employers once
grant start-up funds are expended.
The grant application will be completed by members of the Management Academy team
and prepared for submission by the October 12th deadline.
Recommended Motion and Requested Actions: To approve the submission of an
ACHIEVE grant application requesting $40,000 from the Centers for Disease Control,
National Association of Chronic Disease Directors, and the YMCA for development of
an employee wellness initiative, and acceptance of funds if awarded and submit to the
New Hanover County Commissioners for their consideration.
Funding Source: Centers for Disease Control, National Association of Chronic Disease
Directors, and YMCA
Will above action result in:
FNew Position Number of Position(s)
?Position(s) Modification or change
®No Change in Position(s)
-Explanation: No new permanent positions. Temporary contract Program Coordinator.
17
1
Attachments: Grant bud et
18
ACHIEVE Grant Fund
Budget Request
Employee Wellness Initiative
Contracted Services $ 28,000
Marketing/Advertising $ 4,000
Supplies $ 2,000
Supplies - Incentives $ 4,000
Printing $ 1,500
Employee Reimbursements $ 500
Total Expenses. $ 40,000
39
z
- • 4
Q~
O~
NEW HANOVER COUNTY HEP.t-:"rqZ~
Over 12S Yeczrs of
Public Heczl~h Service
2029 South 17th Street
Wilmington, NC 28401
910_798_6500
www nYichd_org
„~irec~or's Messezge M.-w"" e ent TeQna
The New Hanover County Board of Health and the staff of the Ncw
Deputy HetzZth Director
Hanover County Hcalch Department
Scott Harrelson, MPA
are pleased to provide you with our
anneal report for Bscal yea= zoo6_07. Environmental Health Services Manager
Dianne M_ Harwell, REHS
This report was c-reared to inform
Personal Health Services Manager
N¢w Hanwe= county reaiaenta ana Janet B. McCulrlbee, RN, BSN
ofRciala of the diverse programs and
Animal Control Services Manager
services offered by your local health department- Since 1579, our health JOa l P. McNeil, DVM
department has provided health promotion, disease prevention, and BZLSZiZ2SS M472CZg2Y
health protection services to the people of New Hanover Couuty_ I~1Illberly A. Roane
°From the Northeast River to Federal Point, and from the Cape Fear to AdmZYlZS tYQ tZVe .SZLppOYt COOYCIZMRtOY
t~.,. tae sea-ci[y, Suburb, village ana Farm-we a=e one pet,ple striving Marilyn O. Roberts
~£or aealclaful arcs useful living.,,
Ducitcg fiscal year 2016-07, the Healch Dcparcment experienced many
challenges and opportunities- Among the moat notable experiences
Our Mission and Vision
w¢r¢c
-Revision to Animal Conccol Ordinance The mission Of the NQW Hanover County
-Pandemic IaAvenza A arenas Summit HQaItH Department is t0 assure a safe and
-Regional Maaa Dispensing Exercises
-UNC Chapel Hill child Care MRSA Project Healthy COmmnnlty.
-Mental Health Services in Schools
-Mobile Denial unit se=t.i¢ea The vision of the New Hanover County
-Interna[ional Travel Clinic
-ColposcopyServicea HealtH Department is= Healthy People,
Healthy Envzrortment, Healthy Community_
As you read this report, I'm certain you will agree char this has been
a very produc-xiv¢ year for the Health Department and its future
Motto
promises co be bright with numerous possibilities xo serve our ~°Your Health -Our Priority°~
community- We hope you find our report useful.
David E. Rice, MPH, MA
H¢altlt Di=actor
Aninr~zl Control Services
Your Pet, Our Priority
The fiscal year began relatively quiet for Animal Control Services (ACS). The team
maintained the usual infi ux cf unwanted animals through the shcltcr during the summer
months, with the assurance that the spay/neuter Facility was available for neutering
the pets prior to placing them in the adoption area- This has been a valuable asset in
decreasing the animal overpopulation issue in our county, especially since more than
600 surgeries are performed each year. The overpopulation issue was highlighted in a
major news story featuring animal injection euthanasia that ran for February sweeps.
Our hope is to bring the problem before the group that can most make a difference: the
individual animal owners who should be responsible for their pets.
Public outcry secured directional signage at either end of Division Drive, so patrons
can more easily nd the shelter to adopt or redeem their pet. Citizen discontent also
fueled a fierce bfiattle against New Han-er's anti-tethering law. The county upheld the
ordinance, which had been in place For nearly twelve years. It remains as a standard
against at least one Form of animal cruelty, and we are the lone county in the state that
has this statue in place. Canine positive case last year
Rabies surveillance and control continues to be a priority for the team. Positive rabies cases were few, but at least one was of
monumental importance. The first canine positive in nearly sixty years was identified just before the Christmas holidays. Potential
buman exposure resulted in almost fifty people undergoing post-exposure vaccinations. This is the highest number known in recent
years statewide.
Staff responded by continuing our prevention measures- Several no cost rabies clinics were offered to the community during the
year, both in the inner city and at the shelter. A. public health forum was developed to educate area veterinarians and their lay star
~.r The presentation included input from the rabies state veterinarian. A partnership was strengthened with the pre-veterinary medical
association at the university, which has resulted in a --t-ring progr to to carry rabies education into the area schools.
Since customer service is a county and a divisional priority, the shelter rc-opened their doors for Saturday hours in March 2007 This
makes our services more readily available to the community, which should increase our adoption rate as well. Fencing was erected
for the adoption play arcs in front o£thc facility, to enable prospective owners some additional space to bond with the dogs. These
are just a few examples ofwhy our motto is, "Your P¢t, Our Priority."
i
ii
Surgeries performe at Spery/Neut¢r acility at Anima! Con<ro! Servsces
Environmental Health Services
Vector Control Program
Mosquito control has historically been a highly visible public health
service made available to citizens and tourists alike throughout
' municipal and unincorporated areas of the county. Bounded by the
Cape Fear and Northeast Cape Fear Rivers in addition to the Atlantic
Ocean, much of New Hanover County offers an ideal habitat for the
A y
more than forty species of mosquitoes found in this region.
a
Why control mosquitoes? Beyond the "nuisance factor", mosquitoes
are capable of transmitting diseases some of which can be fatal or
can leave victims with long term health effects. Acutely aware of
this potential, New Hanover County Health Department (NHCHD)
Environmental Health Services staff devotes a great deal of effort
to the surveillance and control of mosquitoes. Multiple indicators
simultaneously invoking enhanced control measures are used to
determine when the public faces the greatest risk of diseases such as
eastern equine encephalitis and West Nile virus. If active disease is
present, it infects the "host" through injected saliva when a mosquito
first bites. The itch and welt usually resulting solely from the saliva
Extreme weather conditions such as late summer of2006, is simply your body's reaction and defense to this small amount of
require aerial treatment of Eagle Island with environmentally foreign substance. The appearance and recognition of actual disease
safe mosquito larvicide products symptoms occurs several days or even weeks after an infective
mosquito bite.
ive full-time employees and one half-time employee work year round performing a variety of tasks with the goal of suppressing
mosquito activity in the county to a tolerable level. Environmental Health Specialists from other specialized disciplines are cross
trained to support mosquito control responsibilities during and subsequent to catastrophic or persistent high rainfall weather
conditions. Customers access Vector Control Program services via the NHCHD Environmental Health Services office in the
Government Center located between College and Eastwood Roads, while staff work from a satellite location off Division Drive.
Dredge spoil deposits up and down the intracoastal waterway as well as the shipping corridor of the Cape Fear River create optimum
habitat for certain native mosquito species. As fine sediments from the bottoms of these boating channels are removed and placed
on the land surface to drain and dry, deep fissures develop and retain water. Past experiences exploring this terrain have revealed
copious populations of mosquito larva.
The entity responsible for maintaining navigable waterways, the
United States Army Corps Of Engineers, has thus partnered with
NHCHD Environmental Health Services continuously for more
than 15 years to develop and fund an integrated pest management
program consisting of surveillance, water management, and
biological and chemical control. Our most critical challenge
relative to this environment is Eagle Island located partially on
the Brunswick County side of the Cape Fear River and directly
across from the North Carolina State Ports facility and the heart of
Wilmington.
Vector Control Operator constructing drainage features
on Eagle Island
Heczlth Pro~rczrns ~drninistrczz`ion
Pa~zdemic Irsf[i uenz~s Awdr¢reess Summit w:°~ s, - - '
Pandemic Influenza Awareness Summit was held on February -
17, 2007 at Shell Island Resort at Wrightsville Beach.
Approximately 75 area health care professionals, emergency
responders, law enforcement and neighboring county health
department stafFattended the halfday event. Participants were _
informed ofthc North Carolina Division of Public Health
pandemic influenza preparation plans. -
NC Pandemic Z-fl. tzza Response Plan Presentation
2007 Regional Strategic National Stockpile Mass Dispensing Exercises
Mass dispensing, Strategic National Stockpile (SNS), Incident Command System <ICS), Point of Dispensing (POD). All these
concepts and activities became a little clearer on March 29 and 30, 2007 when the New Hanover County Health Department
completed the Local Receiving Site and Mass Dispensing Drive Through (POD) Exercises
Scenario: It has been i.t.-incd to be in the best public health interest oftl-ie
citizens (approximately 200, 000) cf New Hanover County to receive a flu shot
within the next 24 hours to maximize the opportunity ofcombating the effects of
pandemic influenza.
Under Emergency Support Function #8 (ESF 8 - Health and Medical), New
Hanover County Health Department is tasked with performing this fittzction. In
order to achieve this, 833 people per hour would have to be vaccinated, upon
receipt o£the vaccine/medical supplies through the Local Receiving Site (LRS).
The exercises on March 29 and March 30 allowed the Health Department and
partner agencies to act as if the scenario were real, and open the L- IS and the Drive
Through POD.
xs
After six (6) months of meeting and planning with staff, from New Hanover County
Sheriff's Office, Department of Emergency Management and Fire Department,
Southeastern Regional Advisory Committee <SERAC), New Hanover Regional
Medical Center, New Hanover County Schools, City of Wilmington and the NC-
Division of Public Health contracted consultant - EnviroSafc, the time had come to
Receiving Si- k-isa_for Mass Dispensing demonstrate the capabilities cf the county.
On March 29, 2007, the New Hanover County Health Department conducted the first training exercise in North Carolina to determine
readiness for receiving shipments of material from the Strategic National Stockpile (SNS) for mass dispensing to the public. Local
health departments must be prepared to receive large shipments of drugs and other supplies from the federal Receiving, Staging and
Storage (11-SS) warehouse located in Raleigh, and secure the material while preparing it for local distribution. The exercise objectives
included: ensure site security, conduct a call-down o£staffto reportto the site, credentialing of staff conduct an incident briefing,
->erform just in time (JIT)training, receive SNS delivery from the federal RSS delivery driver, create pick list for order, pick the
V*.., der and transfer order to delivery driver, perform quality assurance at each step, use ofappropriatc signage in warehouse, test radio
communications, ensure chain cfauthority for security ofmaterial, and partner with community agency and other county departments.
Health Programs Administration
Strategic National Stockpile Receiving Site
Exercise "First in North Carolina"
The exercise was completed successfully, meeting all exercise
objectives. Our staff did a fantastic job working with other
local agencies to receive the shipment and have it ready to go
on schedule. Observers from the state Office of Public Health
Preparedness and Response noted that realism was added to the
exercise, excellent teamwork and coordination of community
and county partners was evident, and reported that photos and
documents from this exercise will be used to demonstrate the
receiving site process to other counties in North Carolina. We
learned a great deal and now we have a much higher comfort
level with our ability to receive an SNS shipment. This is a
crucial component in our mass dispensing efforts. It is one of
County Employees check-in at the staging area the first local efforts in processing large amounts of vaccines or
for the Mass Dispensing Exercise medicines out to the public.
On March 30 we had the second half of our exercises, the mass dispensing, at Veterans Park. We had 22 partner agencies and
over 300 staffers working together. Our primary goal was to process 833 people per hour. We processed 650 per hour with
one of our two dispensing areas barely seeing anyone. It was not because they were not prepared. We just didn't have enough
participants to keep them busy. If we had more participants we could have done 1000 or more with the staff we had available.
What we did learn is that we can actually process 833 people per hour. According to local, state and federal representatives and
the evaluators, we did very well. We were the first state sponsored mass dispensing drive through exercise. We pulled together
and worked with our key partners and learned how to improve our process. Thanks to all the staff for making these exercises
such asuccess!
New Hanover County Health Department 2006-2007
National Incident Management System Training Progress Report
Percent Percent Percent of
ICS-1 00 Introdur-t*nn to the Incedpnt Command System 0 0 90%
ICS-200 t Command System 0 97% 87%
ICS-300 Intermpefintp Incident Command System 0 87% Fytzmnt
IC-R-400 Advanced loredent Command System 100% Exempt Exempt
IC-R-7(10 National Inradent Management System (NIMS) 0 0 81%
0 77% Exempt
2ersonnal by Training Levels
Executive: Health Director, Deputy Health Director,
and Personal Health Servings Manager
Managerial: Division Managers, Supervisors and Epi
Responder All Staff
Personal Health Services
~kw UNC Chapel Hill Child Care
Community Acquired-Methicillin Resistant Staphylococcus Aureus (CA MRSA)
Research Project
The New Hanover County Health Department- Personal Health Services- Child Care
Nursing Program participated in a research study to investigate the prevalence of
Community Acquired Methicillin Resistant Staphylococcus Aureus (CA-MRSA) in child care
facilities. This study was conducted by the Medical Microbiology and Public Health
research team from the University of North Carolina at Chapel Hill (UNC-CH). The research
project was a collabrative effort between the university, our Child Care Nursing Program, and
eighteen (18) area child care facilities. Our nurses completed parent permission forms and
collected a total of 751 nasal swabs between the months of February- May 2007 to determine
the prevalence of CA-MRSA in child care facilities. The prinicipal
investigative team consisted of David Weber, MD, MPH, Melissa Miller, MD, MPH, Jennifer
Goodrich, PhD, with coordination provided by Jonathan Kotch, MD, MPH, Viet Nguyen, Child Care Health Consultant
MD, PhD, and Patricia Isbell, PhD, MPH, MEd. The final report is pending and will be working with patient
provided to the Health Department for review.
School of Mental Health
New Hanover County Schools and the New Hanover County Health Department have joined
together to provide mental health services in the schools. This program was originally developed
by the school system and Southeastern Center for Mental Health /Developmental Disabilities /
Substance Abuse Services (MH/DD/SAS) in 2001 but, due to State Mental Health Reform, had to be
divested from Southeastern Center at the end of the 2006-07 fiscal year. The New Hanover County
Health Department participated in discussions earlier this year to take over this program, with the
Mc
strong support from the Board of Health and the County Commissioners. In June 2007, the transfer
was successfully negotiated and the program became a part of the Health Department in July 2007.
There are currently 13 mental health therapists covering 15 elementary and middle schools plus
students transitioning from Lake Forest Academy.
Miles of Smiles
The "Miles of Smiles" mobile dental unit has traveled New Hanover and Brunswick Counties since arriving in June 2006. The unit
has served seven (7) public schools with two of these schools visited twice. The New Hanover County schools include Johnson
Elementary, Freeman Elementary, Gregory - Williston, and Sunset
Park Elementary. The Brunswick County schools served were
Lincoln Elementary, Belville Elementary and Supply Elementary.
In the time period of July 2006 - June 2007, we have seen 716
children with 1,452 dental visits and 6,957 dental procedures.
In February 2007, we welcomed Dr. Zachary Hunter as our new
"
contract dentist. Dr. Hunter comes from Michigan where he worked
with a large practice serving primarily Medicaid clients and has
a special interest in children. Other highlights this year include
a gift of $10,000 from Brunswick County and $5,000 from the
Duke Endowment for charity dental care. In addition, the Duke
Endowment has committed $15,000 for equipment to provide future
hospital sedation for children with severe dental problems that cannot
be performed in a regular dental setting. The mobile dental unit Mobile dental unit "Miles of Smiles" on site at Freeman
serves children between the ages of 3-18, who have Medicaid or NC Elementary School, Wilmington
Health Choice insurance and children with no dental insurance on a
sliding fee scale.
Personal Health Services
International Travel Clinic
The International Travel Clinic has been a huge success with the public's demand for vaccinations and anti-malarial medications for
their travel needs at a reasonable cost. In addition, we have provided our
clients with travel information based on their travel itinerary. Our clients
have been both pleased and grateful that we have taken such an interest in
their travel needs and their general health while traveling.
Our travel clinic began on March 2, 2007 as the Foreign Travel Clinic.
Since then, we have adopted and changed the name of our travel clinic to
the International Travel Clinic. This change emphasizes travel to specific
countries and not simply travel to a foreign area. We have had 303 visits
in almost four months and have also expanded our appointment times from
morning only to include the entire day.
We provide much more than vaccinations in our travel clinic. International Travel Clinic
We provide a great deal of information, including: screening our
patients before receiving vaccinations or anti-malarials for any possible
contradications, providing the proper documentation on the International Certificate of Vaccination card, and how our clients can
better prepare for a trip and stay safe. Our nurses have also received many compliments and cards thanking them for their time,
information, and caring. The travel clinic has been a very positive experience for our staff and community.
Syphillis Outbreak Colposcopy
New Hanover County was involved in a large syphilis We received notification from Coastal OB-GYN that we would
outbreak in May 2007. One female was identified as an active no longer be able to send low risk patients with abnormal
syphilis case with approximately 200 sexual contacts reported. pap tests in need of colposcopy to their agency April 2007. A
Approximately 116 individuals were identified by the North patient waiting list was established with thirty three patients
Carolina Department of Health and Human Service (NCDHHS) awaiting colposcopies. We requested and received funding from
~4w disease intervention specialists as contacts to active syphilis Ministering Circle to purchase supplies and equipment to perform
cases and were evaluated and treated at the health department. our own coloposcopies May 2007. After recieving supplies and
Eleven (11) new cases of syphilis were identified from these equipment our staff were trained on how to use the equipment,
contacts. pathology preparation, the cleaning and sterilization process,
and clinical duties. We secured a contracted physician to provide
Control Measure Violators: colposcopies after hours to our patients weekly.
Three (3) Sexually Transmitted Disease (STD) control measure
violators were identified by the health department with The first clinic was held on June 12, 2007 with five patients
assistance from the NCDHHS disease intervention specialists. receiving colposcopies and again on June 1, 2007 with another
The department took the appropriate action to pursue legal five patients served. Two of those patients were referred for
action and all 3 were prosecuted. They each received sentences further evaluation after receiving the pathology results. Currently,
of 60 days in jail and 5 years of supervised probation. patients are seen within one month of this agency receiving an
abnormal pap test result instead of waiting for up to four months
with our previous provider.
Communicable Disease Trends
Reportable Communicable Diseases
(with more than 1 case reported)
July 1. 2006 -June 30, 20
AIDS 30 HIV Infection 42
CryptosporidWis 4 Pertussis 13
pa"Xie an CA4pWd#b$ OF)1*1* M' 33
Enrilichlosas m nocytic 2 salman"m 88
dommov" no $ 1t;3
HepaWs 5 - Acute 5 Syphtllis-Total 53
Fincincial Manczgenaent
INew Hanover County Health Department's "Building Fund"
Creation ojEscrow Accountfor Medicaid Cost Settlement Funds
Al new financial tool has been created for the Health Department Approval was granted by the New Hanover County Board o£
Health and the New Hanover County Commissioners to establish an escrow account for deposit oFsurplus Medicaid revenues-..
similar to a "savings account" for the department. Annually, the state Division of Medicaid Assistance conducts a review of services
provided by local health departments to determine the actual average cost o£ providing Medicaid-cligible services throughout the
state. A cost settlement is then determined on a county-by-county basis, providing additional Medicaid revenues to supplement the
cost incurred by local health departments in providing services to Medicaid recipients.
Funds received via the cost settlement must be used in the programs generating the revenues. The annual consolidated agreement
the County enters into with the State of North Carolina in order to receive program Binding requires that any unused funds must be
carried forward to the next fiscal year. The cstablishment of this escrow account, with an initial deposit f$187,000, satisfies both
Funding requirements. Funds deposited in the escrow account are intended for the purchase of a new building, lease of additional
space, or. other use in those programs in which the revenues were earned.
The establishment of a "building fiord" supports one ofthc strategic planning initiatives identified by the Board cf Health during
their April 2007 retreat. Funds will Be expended only upon approval oFa budget amendment brought before the Board cf Health and
County Commissioners, or via the annual budget process.
New Hanover County Health Department Budget
The New Hanover County Health Department Amended Expenditure Budget (Adopted Budget plus any amendments that were processed
during the fiscal year) For FY 2006-2007 was $ 14,201,646. Actual expenditures for FY 2006-2007 were $ 13,020,988. The Health
Department's budget was composed of30 individual programs. Division Managers submitted a line item budget £or each program within
their respective divisions- The Health E>irector and Business Manager reviewed all budget requests. Budget hearings were conducted
and a Budget Workbook including all programs with line item narrative justifications was prepared and submitted to the Board of Hcaltb
For approval.
The Health Department's Business Manager was responsible for preparing expenditure reports that ensured billing and receipt of the
Health Oeparunent's state grant Bmds. The Health Department complied with New Hanover County Financial Policies and Procedures,
which included an annual audit.
Figure I illustrates how the Actual Expenditure Budget is divided among Salaries/Fringes, Operating and Capital Outlay items.
Figure 't To~tai A~tuai E ~qs er>td itu res
F Y
Operatirly: 2006-2007 Ca pitaI C7utl ay:
$1 ,800,686 $96,581
1 4 °fo 1 °fo
Sala r~r 8~
Fridge:
$1 1 ,1 23,22
8~.1-Ofo
Financial Mana~e~ent
Figure 2 illustrates the breakdown of"rhe Health Department's total earned revenue 7,6S6, 890) Lhrough Health Fees, Medicaid
Environmeniat Heatih ~EH) Fees, Animat Controt SAC) Fees, and Other ~inctuding Miscettaneous grants and school contributions).
!t also shows Federal and State Grouts through the North Carolina Department o_jHeal[h and Human Services ~$I, 908,297 -W -h is
inctuded in the above total revenue figure) and County Appropriations ($S, 334, 098).
Figure 2: Toted Earned Reve"Lie far FY 2006-2007
C o-Ity
App roprlations
$5,334,098 Federal a, State
Ott~ar 40 % $1 .908,297
$2,60'1 ,723 15
20%
H --It" C_r' cB AC Fees
$21 ,822 $733,732
0.2 % Medicaid 6
H aalth Fees Medic aid Max $1.264,840
$407,896 EH Fe $497,045 O
3°l0 1.!530
4
2°l0
Figure 3 represents total revenues earned versus Lo[at revenue budget.
Figure a: Total Revenue Earned vs_ Budgeted PV 2008-2007
$3 JDOO poO
$2X00 JDOO
$2 JDOO JDOO
Budget
$1 ,500 JDOO
Earned
$1 JDOO JDOO
$500,000
Federal 8._ AC Fees Medicaid Medicaid EH Fees Health Health Other
State Max Fees Choice
~ N
Nortl>< Carolina Department of Health and Humaa Services
2001 Mail Service Center • Raleigh, North Carolina 27699-2001
Tel 919-733-4534 • Fax 919-715-4645
Michael E Easley, Governor Dempsey Ben con, Secretary
September 18, 2007
Mr. David Rice, Health Director
New Hanover County Health Department
2029 South 17th Street
Wilmington, NC 28401
Dear Mr_ Rice:
I am pleased to appoint you to the North Carolina Public Health 7-"-V* Force
2008 which will continue the excellent work of the previous Task Forces of 2004 and
2006.
As a member oFthe Public Health TasJc Force 2008, you and other leaders from
the legislature, public health, the community and health care will complete new
recommendations where challenges remain for our public health system-
,A, strong public health infrastructure and strong partnerships in our communities
are necessary for success. This Task Force reflects the commitment of our Department to
work with the General Assembly and with you to achieve improved health for every
person in North Carolina. I appreciate all that you are undertaking in devoting your time
to this effort and look forward to working with you on the North Carolina Public Health
Task Force 2008_
Thank you for agreeing to serve in this critical effort to improve health For all
people in North Carolina-
Sincerely,
Dempsey Benton
® Locations 101 Blair Drive - Adams Building - Dorothea Dix Hospital Campus Raleigh, N.C. 27503 I
An Equal Opportunity / A}Farm ative Action Employer
O
~.l01-t Caro Ana S
Public Health Workingfor a Healthier and Safer North Carolina
NC Public Healthy Everywhere, Everyday, Everybody
Streszgthenzng the Publzc Health System Through
State Level Investments and Innovations
StandardizinE Public Health Caaacity Suildin~ New Facilities
The first mandatory system of - $101 million was approved to build a new Public
accreditation for local/district health Health Laboratory and Medical Examiner Office.
departratents in the country has been The groundbreaking will occur in late 2007 at a
established. Initial legislation provided site close to the State University College of
Medicine-
$700,000 per year in recurring funds for Veterinary
the accreditation process- Of the 85 local
county health departments, 30 have been
accredited as of July 2007_ Impl¢m¢ntiin~ New Tech noloQv
The first state level Pilot Accreditation effort The statewide Health Information System (HIS>
nationally was successfully completed in is being implemented supported by a state and
February 2007_ Based on the local contribution of $15 million. Full
recommendations of the site visit team, implementation of this system will occur by the
performance improvement teams have been end of 2008_
established to address the findings and
recommendations _
For the first time in over 30 years, state level Protecting Health
public hcalth funds to support provision of - The excise tax on "spit" tobacco products and
the ten essential public health services cigars was increased from 2% to 3% of the actual
provided by local health departments was cost- The tobacco tax was increased from 5¢ to
increased by $2 million- 35¢ in 2005_
New legislation prohibits smoking in buildings
owned, leased or occupied by state government
Incr¢asin~ Collaborations and authorizes local governments to regulate
smoking in buildings owned or leased by local
• The North Carolina General Assembly governments- Another legislative success was
(NCGA~ budgeted $1,000,000 in recurring making all North Carolina public school grounds
funds to establish and support seven public tobacco free campuses_
health incubators to support regional
collaboration and innovation. Over 300 new school nurse positions improved
the nurse to student ratio from 1: 1 897 in the
1yy~„ The NCGA appropriated $1,400,000 for 2003-04 school year to 1: 1260 in school year
local Healthy Carolinians partnerships for 2007-08_ 37 of 155 LEAs now meet the
capacity development- recommended 1:750 ratio in 2006-07.
Preparing for All Hazards
• The NCGA increased state support for the Approximately $700,000 in funding to support
universal vaccine program by appropriating `rado
$5,526,095 to support the provision of response for food-borne illness, infectious
influenza and Tdap vaccines. diseases such as tick-borne illness was
appropriatedThe regulation of private wells has been
added as a mandated program- Over $9.2 million in antiviral medications was
appropriated for pandemic flu preparedness.
• The NCGA has provided an additional $ 12
The appropriation to provide for early e first state law requiring all hospital
ecific health
P Port sP
intervention to select t children 0-3 years- emergehcY re
data to the state Health Depai-tment_
The Division of Public Health was
designated as the lead agency for injury prevention in North Carolina Eliminatirzi Disparities
• There has been an increase of $1,000,000 in state
New funding for chronic disease targeting appropriations for ADAP in FY `06 and
cancer, stroke and diabetes totaled $3 $2,000,000 for HIV prevention. AIDS Drug
million in 2007_ Assistance eligibility has been significantly raised- Support for infectious disease testing was
provided for the public health lab and for The NCGA appropriated $350,000 in recurring
outbreak investigation of food-borne and funds for new full-time positions for interpreter
vector-borne diseases. services at local health departments- _.Jo
• The NCGA approved $5,000,000 for all The Office of Minority Health 8r. Health
primary care safety net clinics for FY 2007 Disparities received $2,500,000 for commurnity-
including local health departments- focused initiatives targeting the elimination of
The Health was health disparities.
• Division of Public
designated the lead agency in North Carolina
for the prevention of child maltreatment-
Task Ponce 2008 Kicks off
October 10 2007
'-o Focus Areas
Healthy Families
IVOrt ca.o .na Communicable Disease
Pubic Health
Chronic Disease Prevention
http=//www.ncpublichealth.com/ Health disparities/Health Equity
Ten Essential Services
Page 1 of 1
Rice, David E.
From: Roane, Kim
Sent: Monday, September 17, 2007 3:56 PM
To: Rice, David E.
Subject: F.A.C.T. Recommendations - September 2007
The following recommendations are made by the F.A.C.T. after discussion at the September 2007 meeting:
• Establish a new code - 90772 (Therapeutic, prophylactic or diagnostic injection) with a fee of $5.00, to
replace code 90782 (Therapeutic injection) as per guidance from Joy Reed
• Fee for flu vaccine to remain at $30.00, which is the same cost currently in our fee schedule. This fee
matches one neighboring county fee (others have not set fees yet), and will cover the BCBS
reimbursement ($22.16) and Medicaid reimbursement ($26.77) amounts. Medicare has not yet
communicated their reimbursement rate, and it is not expected to be known for several weeks.
• Fee change for 88142 90 Pap Tests from $10.69 to $12.33, based on state lab costs.
Respectfully request your approval for implementation.
Thanks,
Kim
Kim Roane
Business Manager
New Hanover County Health Department
(910) 798-6522
fax (910) 341-4146
9/17/2007