February Board of Health Minute
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Dr. Melody C. Speck, Chairman, called the regular business meeting of the New Hanover County
Board of Health (NHCBH) to order at 8:00 a.m. on Wednesday, February 4, 2004 in the Thomas
Fanning Wood Conference Room of the New Hanover County Health Department located at 2029 S.
th
17 Street, Wilmington, North Carolina.
Members Present:
Melody C. Speck, DVM, Chairman Marvin E. Freeman, Sr.
Donald P. Blake, Vice-Chairman Cheryl Lofgren, RN
Sandra L. Miles, DDS Stanley G. Wardrip, Jr.
Edward Weaver, Jr., OD
Robert G. Greer, Chairman, County Commissioners
Members Absent:
Philip P. Smith, Sr., MD
John S. Tunstall, PE
James R. Hickmon
Others Present:
Betty B. Creech, (Retired) PHN Division Manager
Melissa Teachey, Environmental Health Specialist – Environmental Health Services
Ellen Harrison, PHN Supervisor, School Health, Personal Health Services
Dianne Harvell, Environmental Health Services Manager
Kemp Burpeau, Attorney, New Hanover County
Scott Harrelson, Health Programs Administrator, Health Programs Administration
Janet McCumbee, Personal Health Services Manager
Howard Loughlin
Monica Loughlin
David E. Rice, Health Director
Cindy Hewett, Business Manager
Marilyn Roberts, Recording Secretary
Invocation:
Mr. Donald P. Blake gave the invocation.
Minutes:
The minutes of the January 7, 2004 meeting were approved as submitted.
Recognitions:
Personnel
Service Awards
Mr. David Rice recognized the following Service Award recipients and introduced new employees.
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5 Years of Service
Cynthia W. Hewett, Human Services Agency Business Manager, Administration
Nancy Nail, Public Health Division Manager, Nutrition
20 Years of Service
Barbara J. Perilla, Administrative Support Technician, Administrative Support Services
Dr. Melody C. Speck and Board of Health members congratulated the staff on their long-term
employment.
Other Recognitions
Mr. David E. Rice recognized Betty B. Creech, (Retired) Public Health Division Manager, Personal
Health Services at the Board of Health Meeting on February 4, 2004 as being recipient of a
Resolution presented by the North Carolina Association of Public Health Nurse Administrators.
Ms. Betty Creech thanked the Board of Health members and staff and reminisced on her previous
years as a Public Health Nurse and stated that retirement is like being a “Medical Missionary with
benefits”.
Department Focal: Budget Request – FY2004-05
Ms. Cindy Hewett presented the Budget Request – FY2004-05. Ms. Hewett gave budget overview in
detail through a power point presentation explaining process to the Board of Health members.
ACTUAL ADOPTED REQUESTED % Change
FY 02-03 FY 03-04 FY 04-05 FY 05 -vs- FY04
HEALTH
EXPENDITURES:
$ $ $ *
SALARIES & BENEFITS 8,488,336 10,049,953 10,049,953 0.00%
OPERATING EXPENSES 1,875,408 1,353,187 1,372,776 1.45%
CAPITAL OUTLAY 135,106 35,000 306,200 774.86%
$ $ $
TOTAL EXPENDITURES 10,498,850 11,438,140 11,728,929 2.54%
REVENUE:
$ $ $
FEDERAL & STATE FUNDS 5,570,462 5,941,701 6,226,582 4.79%
$ $ $
NET COUNTY COST 4,928,388 5,496,439 5,502,347 0.11%
Budget Overview New Hanover County Health Department FY 04-05:
Temporary and OT/On Call –
1. Requested $3,000 increase for ACS based on actual money spent to date in FY 03-04
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2. Temporary included for Good Shepherd Ministries Outreach
3. Temporary included for TB Outreach (Duke Funding)
New Positions:
Note: Memos were received requesting the following positions, however due to County restrictions not
allowing requests of new positions for FY 04-05, these are being kept on file.
1. (2) Environmental Health Specialists
2. (2) Animal Control Officers
3. (1) Animal Control Shelter Attendant
4. (1) Lead Animal Control Officer
Capital Requests:
1. Tractor for Vector Control: $86,200
2. Hematology Machine for Lab: $20,000
3. Replacement of Windows 98 Units: $150,000
4. W203 Server and AS400 Upgrade: $50,000
Salary & Fringe:
These are being calculated with a projected increase in Insurance and a 5% market/merit. (Estimates Only!)
Positions:
Several positions will need to be shifted for FY2004-05 based on funding and re-organization:
1. Administrative Support position from 5134 to 5154
2. School Health Nurse position from 5169 to 5161
3. School Health Nurse position from 5169 to 5161
4. School Health Nurse Supervisor position from 5161 to 5169
5. School Health Nurse Supervisor position from 5161 to 5169
6. Interpreter position from 5168 to 5151
Expenditures:
Operating expenses are being kept at the same level as FY 03-04 unless funding source increased (Grants).
Revenues:
1. Close monitoring of Medicaid generating programs is essential. Medicaid earnings are down
compared to FY 02-03. (CSC/MCC/MOW/Navigator/Ortho)
2. PHRST-2 funding is being calculated at level funding (based on this year’s adjusted funding).
3. WIC will receive an additional $30,908 state/federal funding. This will offset salary and fringe. The
county will still need to contribute to the WIC budget approximately $45,000.
4. HMHC funding is being reallocated at the State. HRM funding will be combined with HMHC funds
and included in the redistribution. We will not know how this is being distributed until a later date.
We are budgeting based on this year’s funding.
5. FP Waiver: Routinely, we have received $12,560 from the State for Depo-Provera – This funding will
be decreased FY04-05. The State is projecting an increase in Medicaid earnings to offset this decrease.
We do not know the amount of the decrease. We are budgeting based on current year funding.
6. CSHS funds are anticipated to remain as they are this year ($8,714). Medicaid patient caseload has
decreased in these clinics. Medicaid revenue is being decreased in FY04-05 budget based on current
year activity.
7. Project Assist funding is calculated based on recent information regarding funding for next 4 years
($64,093) per year).
8. Intensive Home Visiting funds will not be received from the State for FY 04-05. Medicaid earnings
will need to offset this decrease.
9. Animal Control Services Revenues are being distributed to reflect the collection process that was
implemented in FY03-04 with the County Legal Office. Adopted amount for FY 03-04 of $85,117
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will be distributed between Revenue Sources 4134: Citations and 4220: Collections. FY 04-05 amounts
will be distributed as $45,117 and $40,000, respectively.
Budgets are being combined for FY 04-05:
1. CSC/MCC/MOW/Navigator (The new budget will be Care Coordination)
2. FP/BCCCP/TANF (The new budget will be Women’s Preventive Health)
3. Personal Health/Ortho/Neurology (The new budget will be Community Health)
4. Injury Prevention/Health Education (The new budget will be Health Promotion)
After much discussion and comments from the Board of Health members, Ms. Hewett in closing
stated that the budget is quite an involved process and she had a good crew assisting her.
Dr. Melody Speck thanked Ms. Cindy Hewett for her presentation.
Monthly Financial Report – December 2003 (Including Grant Status Report)
Ms. Cindy Hewett, Business Manager, presented the December Health Department Revenue and
Expenditure Summary Report that reflects an earned revenue total of $3,021,833 with a remaining
revenue budget of $3,302,243 and an expenditure total of $5,139,828 with a remaining expenditure
budget of $6,934,685. A summary of the financial report is below:
Budgeted Actual
%
FY 03-04 FY 03-04
Expenditures:
Salaries & Fringe $10,021,623 $4,405,410
Operating Expenses $1,683,027 $653,112
Capital Outlay $369,863 $81,306
Total Expenditures $12,074,513 $5,139,828 42.57%
Revenue: $6,597,409 $3,021,833 45.80%
Net County $$ $5,477,104 $2,117,995 38.66%
Ms. Hewett stated that Federal and State monies receive as we bill them. The Fiscal Support position
for Animal Control Services working through the County Legal Department collected $19,000
through the month of December, 2003. Position is vacant at present and may show decrease in
collections but expects to be filled soon. Ms. Hewett stated we are back on track with Medicaid
earnings and Environmental Health Services slightly off in collections but overall is good. County
appropriations are inline as compared at 38.66%.
Ms. Hewett reported the Health Department Grant Status Report. Totals for grants requested
$1,146,759; received $717,585; and denied $366,848. To date pending grants are Cape Fear
Memorial Foundation – Funds needed to enhance health education in 4 areas other than Diabetes (an
enhancement to Diabetes Today Grant) $20,000; New Hanover County Safe Schools – Uniting for a
Youth “U4Youth” (funding will be received over a 3-year grant period) $49,000.
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New Business:
Ordinance Amendment – Animal Control Services
Dr. Jean McNeil, Animal Control Services Director brought forth from the Animal Control Services
Advisory Committee an Ordinance Amendment for Chapter 5, Animals (high priority for licensing
procedures).
Dr. McNeil explained that the current ordinance requires for citations to be served in person or by
registered mail with return receipt at a cost of $4.42 for each parcel. The cost of certified mail with
no return receipt is $.67 per parcel. Dr. McNeil stated that Animal Control Division mails a vast
amount of electronic citations per month and requests ordinance be amended to allow for certified
mailings.
Dr. McNeil stated that the current ordinance requires the violator to either pay the citation or make a
written appeal within 7 days of receipt of said citation. The Animal Control Division as well as the
Sheriff’s, Inspections and Fire Marshall’s offices allow 20 days from the date of the citation to pay or
appeal. Dr. McNeil stated that the ordinance amendment would also allow 20 days to respond with
payment or hearing.
Motion:
Dr. Melody C. Speck moved from the Executive Committee for the Board of Health to
accept and approve the Ordinance Amendment for Animal Control Services and to submit to the New
Upon vote, the MOTION CARRIED
Hanover County Commissioners for their consideration.
UNANIMOUSLY.
Budget Amendment – Women Infants and Children (WIC) Program ($30,908)
The New Hanover County Health Department has received an additional $30,908 of WIC funding to
be expended by June 30, 2004. These funds are to be used to support any of the four WIC activities
(Client Services, Nutrition Education, General Administration and Breastfeeding); however a
minimum of $5,170 must be used to support Breastfeeding.
Ms. Cindy Hewett explained further that additional funding would allow for staff training, contracting
with consultants and temporary assistance in WIC.
Motion:
Dr. Melody C. Speck moved from the Executive Committee for the Board of Health to
accept and approve the Budget Amendment – Women Infants and Children (WIC) Program - $30,908
Upon vote, the
and to submit to the New Hanover County Commissioners for their consideration.
MOTION CARRIED UNANIMOUSLY.
Budget Amendment – Communicable Disease ($2,259)
The New Hanover County Health Department will receive an additional $2,259 in Aid-to-County
Funding to be used to purchase new refrigeration equipment for vaccine storage and handling. These
funds must be expended by May 31, 2004.
Motion:
Dr. Melody C. Speck moved from the Executive Committee for the Board of Health to
accept and approve the Budget Amendment – Communicable Disease - $2,259 and to submit to the
Upon vote, the MOTION CARRIED
New Hanover County Commissioners for their consideration.
UNANIMOUSLY.
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Revisions to Fee Policy – Personal Health Services
Ms. Cindy Hewett, Business Manager submitted changes to the New Hanover County Health
Department Fee Policy Narrative which include:
1. Delete all references to the Jail Medical Health Program.
2. Narrative changes as they relate to services provided within our Personal Health Services
Division.
Ms. Hewett stated that focus is on revenue and explained all verbiage changes. Ms. Hewett explained
the Federal Poverty Levels for 2003, the Sliding Fee Scale as used in our clinics and the verbiage
changes in the Bad Debt Write Off Policy.
Ms. Hewett explained that all changes in Fee Policy have been made with guidelines from the state.
Motion:
Dr. Melody C. Speck moved from the Executive Committee for the Board of Health to
accept and approve the Revisions to the Fee Policy – Personal Health Services and to submit to the
Upon vote, the MOTION CARRIED
New Hanover County Commissioners for their consideration.
UNANIMOUSLY.
Budget Request – FY2004-05
Ms. Cindy W. Hewett presented the requested Budget for FY2004-05.
Motion:
Dr. Melody C. Speck moved from the Executive Committee for the Board of Health to
accept and approve the Budget Request for FY2004-05 as presented and to submit to the New
Upon vote, the MOTION
Hanover County Commissioners for their review and recommendations.
CARRIED UNANIMOUSLY.
Board of Health Committee Assignments
Dr. Melody C. Speck presented the following 2004 New Hanover County Board of Health Committee
assignments:
Executive Committee:Environmental Health Committee:
Dr. Melody C. Speck, Chairman Dr. Edward Weaver, Jr.
Mr. Donald P. Blake, Vice-Chairman Mr. James R. Hickmon
Mr. Marvin E. Freeman, Sr. Mr. John S. Tunstall
Dr. Sandra L. Miles Mr. Donald P. Blake
Dr. Edward Weaver, Jr.
Personal Health Committee: Animal Control Services
Advisory Committee:
Mr. Marvin E. Freeman, Sr., Chairman
Dr. Philip P. Smith, Sr. Dr. Melody C. Speck
Mrs. Cheryl Lofgren
Association of NC Boards of Health
Dr. Sandra L. Miles
Mr. Stanley G. Wardrip, Jr. Dr. Melody C. Speck
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Wildlife Regulation – Request for Exemption
Request for Exemption from the Wildlife Regulation by Mr. & Mrs. Howard Loughlin brought to the
Board of Health regarding the issue of twin Himalayan Black bears being kept at their residence on
Mohawk Drive in Wilmington. The Request for Exemption included the Wildlife Regulation, letters,
pictures, site plans, petitions, Asiatic Black Bear fact sheets, receipts and miscellaneous information.
Mr. & Mrs. Loughlin expressed desire to maintain bears at their residence after the recent closing of
the Totem-in-Zoo where the bears were born. Dr. Bill Rohn, from Port City Animal Hospital is the
veterinarian and is supportive. The bears have been neutered and front paws declawed. The
Loughlins stated that the housing structure is fit, locks are secured and pens are cleaned three times
daily.
Dr. Melody C. Speck showed the Board of Health the exact location of where the bears would be
housed using a map generated through the Geographical Information System (GIS).
After much discussion and questions from the Board of Health, Dr. Melody C. Speck thanked Mr.
and Mrs. Loughlin for attending the Board of Health meeting and explained Board of Health
members would review material presented, and would have to decide if decision would be made
today on the Request for Exemption and that they would be contacted at a later date.
Mr. Kemp P. Burpeau, Deputy County Attorney was in attendance during presentation by Mr. and
Mrs. Loughlin.
Animal Control Services staff discussed the Himalayan Black bears at their January 5, 2004, meeting.
General Consensus was to keep these animals from being allowed to be housed in a residential
location in NHC. Dr. McNeil stated ACS staff has concerns about the addition of a potential rabies
vector, and who would police after animals if they were to get loose. The couple, Monica and Howard
Loughlin, though appearing very responsible, cannot guarantee that their pet bears will not present a
danger to the county citizens.
The Animal Control Services Advisory Committee Meeting was held on January 21, 2004. The
Advisory Committee had the same concerns as ACS staff, specifically the threat of adding another
rabies vector to the animal roster in NHC. The Committee questioned the couple’s ability to have
insurance coverage in case of damage by the bears. They had no immediate answer. The Committee
also was concerned about county liability, if we are the overseeing group granting permission for the
bears to reside here. They are seeking the right from the Board of Health to house their pets in NHC.
Reference Wildlife regulation per Board of Health, in particular, Section Two regarding maintenance
of wild or exotic animals.
Dr. McNeil shared with the Executive Committee members on January 27, 2004 a number of letters
and signed petitions from neighbors to support their right to house the bears at their home. Dr.
McNeil stated that the Loughlins’ even have a scrapbook. Executive Committee looked at pictures of
fencing in Loughlin’s backyard. Zoning, the USDA, and the Wildlife Commission have no
restrictions for them to keep them here. Mr. Holt Moore, Attorney for New Hanover County was in
attendance and there was much discussion and comments from Executive Committee.
After further discussion and comments from the Board of Health, general consensus was to go ahead
and move on decision. Board of Health members expressed concern and compassion for the
Loughlins’. Mr. David E. Rice restated the New Hanover County Health Department mission was to
assure a safe and healthy community.
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Dr. Edward Weaver, Jr. stated the question, “Will the Board of Health allow Mr. and Mrs. Loughlin
the Request for Exemption from the Wildlife Regulation?”
Motion:
Dr. Edward Weaver, Jr. moved from the Board of Health to deny the Loughlin’s request for
exemption from the Board’s Wildlife Regulations. Mr. Marvin E. Freeman, Sr. seconded the motion.
Upon vote,
Motion passed to deny the Request for Exemption by Mr. and Mrs. Howard Loughlin.
the MOTION CARRIED UNANIMOUSLY.
Mr. Kemp Burpeau, County Attorney’s office will draft a letter and after approval of Dr. Melody C.
Speck, Chairman, it will be mailed to Mr. and Mrs. Loughlin advising them of the Board of Health
decision.
Comments:
Health Director
2004 State Health Director’s Conference
Mr. David E. Rice announced that he attended the 2004 State Health Director’s Conference with
Local Health Directors On January 29-30, 2004 at the Marriott Raleigh Crabtree Valley Hotel in
Raleigh. Presentation entitled “Shadows on the Land” – included five shadows: 1) Smallpox, 2)
SARS, 3) WNV, 4) Isabel and 5) Influenza.
Dr. Melody C. Speck, Chairman, Mr. Scott Harrelson, Dr. Thomas Morris, and Judy Agner were also
in attendance. He thanked the Board of Health for the opportunity to attend this conference.
Update – Accreditation Process
Mr. David E. Rice informed the Board of Health the self-assessment was completed on January 29.
The Site Visit Team is scheduled to be in the Health Department on February 24–26, 2004.
Budget Process FY2004-05
Mr. David E. Rice extended thanks to all New Hanover County Health Department staff who assisted
in preparing the Requested Budget for FY 2004-05.
NHCBH New Member Orientation
Mr. David E. Rice announced that Orientation for the three new Board of Health members was held
on January 13, 2004.
U.S. District County Case #7:03CV244FL1
Mr. David E. Rice informed the Board of Health members regarding the case of a pending lawsuit
regarding the New Hanover County Jail Health Services.
Influenza Update
Mr. David E. Rice reminded Board of Health members that flu season is not over and there was
plenty of flu vaccine available as well as the FluMist.
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NC Area Maritime Security Executive Committee
Mr. David E. Rice reported that he has been appointed to the NC Area Maritime Security Executive
Committee.
Adjournment
Dr. Melody C. Speck adjourned the regular business meeting of the Board of Health at 9:45 p.m.
________________________________
Dr. Melody C. Speck, Chairman
New Hanover County Board of Health
________________________________
David E. Rice, Health Director
New Hanover County Health Department
Approved: February 3, 2004
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