06/07/2000
NEW HANOVER COUNTY BOARD OF HEALTH
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Dr. Thomas Fanning Wood Memorial Conference Room
New Hanover County Health Department
AGENDA
Date:
June 7, 2000
Time:
8:00 A.M.
Place:
Dr. Thomas Fanning Wood Memorial Conference Room
New Hanover County Health Department
Presiding:
Mr William T Steuer, Chairman
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Invocation:
Ms. Estelle G. Whitted
Minutes:
May 3, 2000
Recognitions:
- Mr. William T Steuer
Chairman
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Personnel
New Emplovees
~ ~ar~. Allen, Physician Extender, Community Health
.1lI:;, Kristen E. Keenan, Public Health Nurse I, Child Health ,/
~r""J L~ W Yusko Public Health Nurse I, Community Health
Depart~~~IEJ J 5W,J /n/eI'IJ JlfUUrf;". ~
Healthy Homes Program
Ms. Janet McCumbee
Child Health Director
Ms. LomaBlackIer
Licensed Practical Nurse
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Monthly Financial Report: April 2000
Ms. Cindy Hewett
Business Officer
Committee Reports:
Executive Committee (listed under New Business)
- Mr. William T Steuer
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NHCBH Agenda
June 7, 2000 - Page 2
Unfinished Business:
fiJ6Jf New Business:
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- Mr. William T Steuer
Generators/Hookups at Emergency Shelters
- Mr. William T Steuer
Grant Status Update
Healthy Homes Grant Reapplication @
Childbirth Classes Proposal f
F=;1, Plmmmg """""" Initi.ti,~ """'. APPIi~tiO@
Work Force Preparedness proposal@
Discussion on Diabetes /
Recommended FY2000-2001 Budget
(Budget Hearing June 5, 2000, 7'10 p.m.)
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Comments:
Board of Health Members
Health Director
~ Invocation Schedule (~r ) )
V 2. FY2001 Budget Appeal Memorandum {"~f'
3 Letter Regarding Mercury in Ocean.J:ishf.r=:",~,.)
4 Care to Collaborate, May 17, 200(~f)
5 Medical Records Renovation Update fAlif3 'fJ. fit '-it
6. Management Academy for Public Health (MAPH) GraduatesJ1b New Team ./tJI~.P~M I J f
7 N C. Institute for Public Health Update PIA4PI', 1&/111 s:. f,t#;lert~ ~/Jt. ,~~ j I..
8. National Association of Local Boarls qfJIealth 8th Annual Conference- July 26-29,2000 fYlI'Itf'
9 Customer-Letter of Appreciation (~V6'f') _ L J / L) '() aJ. .1- /J. L-
;0, Sq."lIeoJ' #100 U/J#Itfr#Jt ~cOUa~ fX)R15(fiW~ 1\ ref"'] ) -f, ~ ~
Other Business: II. \bv.. Hf,. Mr William T Steuer
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Adjourn:
- Mr. David E. Rice
Mr. William T Steuer
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Mr. William T. Steuer, Chairman, called the regular business meeting of the New Hanover County Board
of Health to order at 8:00 a.m. on Wednesday, June 7, 2000.
Members Present:
William T. Steuer, Chairman
Wilson O'Kelly Jewell, DDS, Vice-Chairman
Henry V. Estep, RHU
Micheal E. Goins, OD
Gela M. Hunter, RN
W. Edwin Link, Jr., RPH
Anne Braswell Rowe
Philip P. Smith, Sr., MD
Melody C. Speck, DVM
Estelle G. Whitted, RN
Members Absent:
Mr. Robert G. Greer
Others Present:
Mr. David E. Rice
Frances De Vane, Recording Secretary
Invocation:
Ms. Estelle Whitted gave the invocation.
Minutes:
Mr. Steuer asked for corrections to the minutes of the May 3, 2000 New Hanover County Board of Health
meeting. The Board of Health approved the minutes of the May 3, 2000 Board of Health meeting.
Recognitions:
Mr. Rice introduced Health Department new employees.
Personnel
New Emplovees
Kristen E. Keenan, Public Health Nurse I, Child Health
India Foy, Health Education Student Intern, Appalachian State University
Mr. Steuer welcomed Ms. Kenan and Ms. Foy.
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Department Focal:
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Healthy Homes Proe:ram
Ms. Janet McCumbee, Child Health Director, presented a department focal on the Healthy Homes
Program. She introduced Ms. Lorna Blackler, Licensed Practical Nurse, who works with the Healthy
Homes Program. Ms. ßlackler displayed drawings from the Draw A Breathe Asthma Contest sponsored
by the Asthma Task Force.
Ms. McCumbee gave a PowerPoint presentation on the Healthy Homes Program, a health department
program to increase public awareness of environmental impacts on a child's health and to provide
tangible household products to directly improve child care environment at Family Child Care Homes
(FCCHs). She explained the Healthy Homes Initiative Mini-Grant is currently funded (July 1999) by the
North Carolina Childhood Lead Poisoning Prevention Program ($16,111). The proposed budget request
for $20,000 is to continue the Health Homes Initiative Mini-Grant for FY2000-2001. The purpose of the
grant is to address both lead poisoning prevention and asthma control for children.
Ms. McCumbee reported from January through May 2000, 42 FCCHs were visited serving 269 children.
Accomplishments of the grant included Assessments of Environmental Health Asthma Triggers and Lead
Sources, the creation of the New Hanover County Asthma Task Force co-sponsors of World Asthma
Day, increased lead testing and follow-up, the installation of 115 mini blinds and 39 air filters, medical
and social services referrals, and evaluation of the Healthy Homes Initiative. The School Health nurses I
encouraged attendance at the American Lung Association Asthma Camp for children with Asthma.
Ms. Blackler introduced Ms. Cheryl Aguilar, owner of Precious Little Angel's Child Care, a participant in
the Healthy Homes Environmental Assessment. Lead was identified in her child care home, and the
initiative installed mini-blinds. Mr. Rice presented to Ms. Aguilar a Certificate of Appreciation for
Participation in the Healthy Homes Initiative. On behalf of the Precious Little Angel's Child Care Home
and Family Child Care Homes, Ms. Aguilar thanked the Board of Health and Health Department staff for
their assistance and for a most successful project.
Mr. Steuer thanked Ms. McCumbee for her presentation.
Monthly Financial Report:
April 2000 Monthly Financial Report
Mr. Steuer reported the Executive Committee reviewed the April Health Department Financial Summary
Report
Ms. Cindy Hewett, Business Officer, reported the April Health Department Financial Summary Monthly
Revenue and Expenditure Report reflects an earned revenue remaining balance $906,092 (78.82%), an
expenditure remaining balance of $3,128,447 (67.56%), and a cumulative percent of 78.82%. She stated I
the financial report is for 10 of the 12 months and is basically on schedule. Medicaid earnings are
$570,504 (71.18%). Animal Control Services fees are $329,474 (63.80%). Ms. Hewett advised
Medicaid is being billed and health department reimbursement will follow. Dr. Speck inquired about the
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reimbursement for Animal Control services and complaints regarding citations. Mr. Rice explained the
New Hanover County Information Technology (IT) Department is pleased with the implementation of
the Animal Control Services new computer system, the progress of the electronic billing system, and
with the improved method for the handling of citation complaints.
Committee Reports:
Executive Committee
Mr. Steuer reported the Executive Committee met at 6:00 p.m. on Tuesday, May 30, 2000. Items are
listed under New Business on the Board of Health Agenda.
Unfinished Business:
Generator Hookups at Emergency Shelters
Mr. Steuer, Chairman, gave an update on the generator hookups for emergency shelters. He reported
manual electrical transfer switches should be installed in the schools used for evacuation shelters at
Dorothy B. Johnson - June 22, 2000, Eaton - June 29, and Noble - July 5. Inner lock systems have been
ordered for Trask School and are to be installed upon arrival. Mr. Steuer clarified the School Retrofit
Project including the central school office and the Cape Fear Museum should be completed by mid-
hurricane season.
New Business:
Grant Status Update
Mr. Rice referred the Board to a Grant Status Report. He summarized from March 3, 1999 through May
3, 2000, the Health Department submitted 21 grant applications ($949, 064) and received 11 grants
($257,298). One Environmental Health grant proposal ($57,500) is pending. Eleven (11) grant
applications ($555,742) were denied. Mr. Estep noted the health department receives approximately 50%
of the grant requests. Ms. Whitted expressed it appears several infant/children grants were denied. Mr.
Rice stated there are actually more grants in this category.
Healthy Homes Grant Reapplication
Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and approve a
grant request to reapply for the Healthy Homes Initiative Mini-Grant for $20,000 from the North Carolina
Childhood Lead Poisoning Prevention Program.
This $20,000 grant request for second year funding includes salary and fringe for a Licensed Practical
Nurse @ 20 hours a week and departmental supplies. The purpose of the grant is to address children's
environmental health issues including lead poisoning prevention and asthma control.
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MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and
approve second year funding for $20,000 for the Healthy Homes Initiative Mini-Grant from the North I
Carolina Childhood Lead Poisoning Prevention Program, N. C. State Department of Natural Resources,
and to submit the grant renewal application to the New Hanover County Commissioners for their
consideration. Upon vote, the MOTION CARRIED UNAMIOUSL Y.
Smart Start "Servicios para Ninos" Grant Application
Mr. Steuer recommended from the Executive Committee for the Board of Health to approve a request for
the Child Service Coordination Program (CSCP) to enter into a contract with Smart Start to provide the
services of the Servicios Para Ninos Grant.
The New Hanover County Partnership for Children (Smart Start) submitted a Servicios Para Ninos Grant
Application for $50,000 to the Rehabilitation Therapy Foundation. The grant is designed to enhance the
CSCP of the Health Department by providing a Bilingual Child Service Coordinator, appropriate health
care, early intervention, and therapy for the at-risk Hispanic children under age five. The budget includes
salary and fringe for a Bilingual Child Service Coordinator, operating expenses, capital outlay for a
personal computer, and contracted services.
Motion: Mr. Steuer moved from the Executive Committee for the Board of Health to approve a request
for the Health Department Child Service Coordination Program to enter into a contract with the New
Hanover County Partnership for Children (Smart Start) to provide the services of the Servicios Para
Ninos Grant if funded by the Rehabilitation Therapy Foundation. Upon vote, the MOTION I
CARRIED UNAMIOUSL Y.
Childbirth Classes Proposal
Mr. Steuer recommended from the Executive Committee for the Board of Health to approve the
Childbirth Classes Proposal for the Women's Health Care Division to assume the responsibility of
conducting the childbirth education classes to Medicaid clients.
Ms. Mary Piner, Public Health Nurse, Women's Health Care, explained the proposal is for the Women's
Health Care Division to conduct Childbirth Education (Lamaze) Classes. For 20 years the New Hanover
Regional Medical Center conducted the childbirth classes. Since November 1999, the Coastal Area
Health Education Center (CAHEC) has coordinated this effort; however, CAHEC will discontinue the
classes effective May 3 1, 1999.
Dr. Goins expressed concern regarding the Health Department accepting this responsibility without
additional funding. He stated this could be a continuing trend when programs are discontinued at the
regional hospital and possibly referred to the Health Department without funding. Mr. Rice stated if the
Health Department does not offer these childbirth classes, they probably will not be available to Medicaid
clients. Ms. Piner advised two private Ob/Gyn offices employ Childbirth Educators. Ms. Hunter stated
these Lamaze classes should be available to all prenatal patients regardless of ability to pay. Dr. Speck
inquired if the additional responsibility of providing the childbirth classes will be revenue producing for
the health department.
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Ms. Piner advised this is a reimbursable service through Medicaid and should pay for the contract staff
(instructor) to conduct the classes, educational materials, and incentives. The proposed start date for the
classes is July 3, 2000. The proposed budget is $25,056 for conducting the childbirth classes and
contracted services.
Motion: Mr. Steuer moved from the Executive Committee for the Board of Health to approve the
Childbirth Classes Proposal for the Women's Health Care Division to assume the responsibility of
conducting the childbirth education classes to prenatal Medicaid patients. Upon vote, the MOTION
CARRIED UNAMIOUSL Y.
Grant Application for Family Planninl!: Outreach Initiatives
Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and approve a
Grant Application for Family Planing Outreach Initiatives for $22,180 from the North Carolina Division
of Public Health- Women's and Children's Health Section, Department of Health and Human Services.
The purpose of the grant is to address the preventive, follow-up care, and needs of Medicaid pregnant
women. Outreach efforts will include postpartum hospital visits, phone calls and appointment reminders,
home visiting, and outreach through the Women, Infants, and Children (WIC) Program.
Motion: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and
approve the Grant Application for Family Planing Outreach Initiatives for $22,180 from the North
Carolina Division of Public Health- Women's and Children's Health Section, Department of Health and
Human Services and to submit the grant application to the New Hanover County Commissioners for their
consideration. Upon vote, the MOTION CARRIED UNAMIOUSL Y.
Workforce Preparedness Proposal- UNC Letter of Support
Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and approve a
Workforce Preparedness Proposal in the amount of$12,500 developed by the North Carolina Institute for
Public Health, UNC School of Public Health.
The proposal is an opportunity for the Health Department to participate in the training and in the design of
the Workforce Preparedness Proposal. First year funding is $12,500 to cover the expense for a
coordinator for the proposal.
Motion: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and
approve the Workforce Preparedness Proposal in the amount of $12,500 developed by the North Carolina
Institute for Public Health, UNC School of Public Health. Upon vote, the MOTION CARRIED
UNAMIOUSL Y.
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Discussion on Diabetes
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Mr. Steuer advised the Executive Committee expressed concern and discussed the closing of the Coastal
Diabetes Center. He reported Mr. Bill Caster, Chairman of New Hanover County Commissioners; Mr.
Rice; and he met to address this issue. It would cost approximately $300,000 to $400,000 to continue
this educational program for diabetes patients.
Mr. Rice reported Dr. Bruce Chapman, a Podiatrist, addressed the Executive Committee about the need
to reestablish a diabetes education center in our community. Dr. Coleman presented a request for the
Board of Health to consider undertaking the responsibility of the Diabetes Center for the county.
Mr. Rice explained the Health Department received a Diabetes Today Community Planning Initiative
Grant from the North Carolina Department of Health and Human Services - Diabetes Prevention and
Control Unit for $10,000 to establish a Diabetes Coalition for education. He expressed a need to work
with the American Diabetes Society. Dr. Smith and Mr. Estep emphasized the importance of a healthy
lifestyle and patient involvement in both Diabetes prevention and treatment. They concurred the Coastal
Diabetes Center rendered a valuable service; however, the closing of the center is essentially economical.
Dr. Goins emphasized it is a tragic loss to the community and an economical matter of who pays and
why. Ms. Whitted stated Diabetes control is lifestyle; however, the Board must consider the issue, the
health of our children, and educate the public
Mr. Steuer explained the Board of Health does not have revenue to provide funds for this project unless
the county would provide funding. Ms. Rowe inquired if Health Promotion could provide the Diabetes I
patient education. Mr. Rice explained the division has the capability but not the capacity. He clarified
Coastal Diabetes Center had trained certified educators and consultants.
Recommended FY2000-2001 Bude:et - Bude:et Hearine: June 5. 2000
Mr. Steuer reported the FY2000-2002 Budget Hearing before the County Commissioners was held at 7: 10
p.m. on Monday, June 5, 2000, in the General Assembly Room of the New Hanover County Courthouse.
Ms. Cindy Hewett, Business Officer, presented a PowerPoint presentation on the County Manager's
Recommended FY2000-2001 Budget. She summarized Total Capital Outlay as follows:
Computer Costs Recommended
Capital Outlay Excluding Computers
- $169,628 (Requested $215,350)
- $122,223 (Requested $454,934)
Ms. Hewett explained the total recommended computers was 44 PC's (76 requested), 1 Laptop (10
requested), and 20 Desktop Printers (22 requested). The Total Capital Outlay Requested was $454,934,
and the Total Capital Recommended was $122,223. Recommended Capital Outlay deletions included
1 mow tractor, 2 mowers, I electronic gate, 2 generators, I 4x4-conversion van, I concrete patio, 1
partition for auditorium, 1 fire/smoke alarm, 12 workstation cubicles, 1 copier, and 1 audiometer.
Ms. Hewett stated the New Position request was for 20 New Positions and (1) Increase from PT to FT.
The Recommended Budget included 3 New Positions: 1 Environmental Health Specialist and 1 I
ClericalÆnvironmental Health funded with Water Sample Revenue and 1 Partnership for Children
Clerical PT-FT Position grant funded. Total New Positions - grant funded equal $77,178.
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Ms. Hewett presented the following Summary of Projected Expenditures for New Positions and Capital
Outlay for FY 2000-2001:
Salary and Fringe
Capital Outlay:
Computer Requests
Other Equipment
Vehicles
Building Improvements
$ 77,178
$119,300
$ 42,723
$ 79,500
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Ms. Hewett reported the Total Requested Expenditures was $10,227,300 and the Total Recommended
Expenditures was $9,378,72. The Total Requested Revenue was $4,402,776 and the Total Recommended
Revenue was $4,029,551. She stated the Recommended Budget for FY 2000-2001 represents a -1.4%
decrease in County Appropriations from FYI999-2000. It does not include merit or market increases for
staff but it does include a 4% increase for implementation of the Pay and Classification.
The following budget items were submitted to the County Commissioners for reinstatement in the
Approved Health Department Budget for FY 2001:
Positions
Epidemiologist
Administration
- I Full Time
Computer Support Specialist - 1 Full Time
Administration
Licensed Practical Nurse II - 1 Full Time
Jail
Capital Outlay
9 Laptop Computers for Environmental Health
Stratee:ic Plannine:
(Board of Health - Contracted Services $10,000)
(Board of Health - Departmental Supplies $2,000)
Other Expenditures:
Salary Lae:
(Maintain Salary Lag @ $225,000 instead
Recommended $300,000 based upon history
of Health Department Salary Lag)
Total Salarv/Frine:e
$52,848
$36,654
$29,356
Total for Re-Consideration
$ 22,500
$ 12,000
$225,000
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Mr. Steuer explained the Executive Committee approved the above budget items except for a request for I
one Licensed Practical Nurse (LPN) position in Jail Health. This nursing position was added to the
budget request following the Executive Committee meeting of May 30,2000. Sheriff Joseph McQueen
supported the budget request for the Jail LPN position.
Mr. Steuer stated the salary lag of $300,000 (based upon staff turnover for one year) is unreasonable. He
expressed the importance of planning for the next fiscal year budget.
Other Business:
Home Health
Mr. Rice advised the Board New Hanover Network may want to discontinue Home Health services. This
issue is being addressed by hospital and county officials. Mr. Rice expressed all stake holders need to
come together to find a solution to this patient care issue. He advised state legislation requires that Home
Health Services shall be provided in all counties.
Comments:
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Board of Health Members
Dr. Jewell commended Chairman Steuer for his excellent budget presentation at the Budget Hearing. He
stated the County Commissioners have many difficult decisions to make during the budgetary process.
Dr. Goins expressed concern over the trickle down effect of accepting the responsibility for discontinued
hospital programs without funding and emphasized the need to address alternate resources to provide
more public health services for our citizens.
Ms. Rowe thanked Mr. Steuer for his budget request presentation to the County Commissioners and
thanked those who attended the Budget Hearing.
Health Director
Invocation Schedule
Mr. Rice distributed a Board of Health Meeting Invocation Schedule.
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Letter Ree:ardine: Mercury in Ocean Fish
Mr. Rice reported he has not received a response to his letter to Mr. Bill Holman, Secretary of North
Carolina Department of Environment and Natural Resources, regarding the collection and frequency of
samples for the detection of mercury in ocean fish.
Care to Collaborate Aue:ust 17. 2000
Mr. Rice referred the Board to the Care to Collaborate May 17, 2000 Agenda and to a Southeastern N.
C. Regional Health and Human Service Needs Assessment.
Medical Records Renovation Update
Mr. Rice displayed photographs of the Health Department Medical Records Renovation and invited
Board members to take a walk-through tour of the construction project. He reported Phase I of the project
is almost completed, and the total renovation should be completed in approximately one and one-half
months.
Manae:ement Academy for Public Health - May 10-12.2000
Ms. Smith, Ms. Hewett, and Mr. Rice attended and graduated from the 1999-2000 UNC Management
Academy for Public Health held from May 10-12, 2000. Ms. Dianne Harvell, Environmental Health
Director; Ms. Betty Jo McCorkle, Women's Health Care Director; Ms. Nancy Nail, Nutrition Director:
and Ms. Elizabeth Constandy, Health Educator; plan to attend the next Management Academy, a training
program for public health managers from North Carolina, South Carolina, and Virginia.
National Association of Local Boards of Health 8th Annual Conference - July 26-29.2000
Mr. Rice announced the 8th Annual Conference of the NALBH is to be held on July 26-29, 2000, at the
Sheraton Capitol Center, in Raleigh, North Carolina. He referred the Board to a brochure that contains a
program of schedule of events and forms for membership, registration, and nomination forms.
Customer Appreciation Letter
Mr. Rice presented a copy of a letter of appreciation from a health department client to the Women's
Health Care Division commending the health department staff for their excellent customer service.
North Carolina Institute for Public Health Uµdate
Mr. Rice reported Ms. Lynda Smith, Assistant Health Director; Deputy Director Rachael Stevens and
Dr. Bill Hertzog, North Carolina Institute of Public Health, UNC at Chapel Hill; and he met to discuss
Strategic Planning for the Health Department. Dr. Hertzog is to serve as facilitator for the planing
process and for a two-day retreat in September or October 2000.
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Summer 2000 Hurricane Recoverv Corps
College Intern Students from the Hurricane Floyd Recovery Corps will be placed in the Health
Department by the Department of Health and Human Services to perform public health outreach services
and to assist with a backlog of work due to the hurricane.
Information for Board of Health
Mr. Rice referred the Board to supplementary information in their folders, an EPI Information Newsletter,
and to a Dangerous Dog Report.
Adjournment:
Mr. Steuer adjourned the regular meeting ofthe New Hanover County Board of Health at 9:50 a.m.
d¿~ /~
William T. Steuer, PE/RLS, Chairman
New Hanover County Board of Health
David E. Rice, M.P.H.,M.A., Health Director
New Hanover County Health Department
Approved: July 12,2000
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Mr William T. Steuer, Chairman, called the regular business meeting of the New Hanover County Board
of Health to order at 8:00 a.m. on Wednesday, May 3, 2000.
Members Present:
William T Steuer, Chairman
Wilson O'Kelly Jewell, DDS, Vice-Chairman
Henry V Estep, RHU
Michael E. Goins, aD
Robert G. Greer, Vice-Chair, County Commissioners
Gela N. Hunter, RN, Nurse Practitioner
W Edwin Link, Jr., RPH
Anne Braswell Rowe
Philip P Smith, Sr., MD
Melody C. Speck, DVM
Estelle G. Whitted, RN
Members Absent:
Others Present:
Mr David E. Rice
Lynda F Smith, Assistant Health Director
Frances De Vane, Recording Secretary
Invocation:
Mr W Edwin Link gave the invocation.
Minutes:
Mr Steuer asked for corrections to the minutes of the AprilS, 2000 New Hanover County Board of
Health meeting. The Board of Health approved the minutes of the AprilS, 2000 Board of Health
meeting.
Recognitions:
Mr Rice introduced health department new employees
Personnel
New EmDlovees
Carolyn H. Allen, Physician Extender, Community Health
Kristen E. Keenan, Public Health Nurse I, Child Health
Leslie W. Yusko, Public Health Nurse, Community Health
Other Guests
Mr Rice introduced Mayor Ray Rothrock, Town of Carolina Beach, and Mr Don Yousey, Health
Director, Brunswick County
Mr Steuer welcomed the new health department employees and guests attending the Board of Health
meeting.
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Department Focal:
Ocean Fish and Mercurv - Dr. Luanne Williams. State Toxicolo!!ist
Mr Rice introduced Dr Luanne Williams, Toxicologist, N. C Department of Health and Human
Services, who presented a department focal on Ocean Fish and Mercury Mr Rice stated the Board of
Health is concerned about the issue of mercury in ocean fish and requested more information on the
health advisory regarding the higher than normal levels of mercury in large king mackerel caught off the
coasts of North Carolina, South Carolina, Georgia, and Florida. Dr Williams reported from August 1998
through October 1999, the Division of Marine Fisheries collected samples of 181 king mackerel for
mercury testing. She presented the findings of a risk assessment on the consumption of king mackerel
based on these samples.
Dr Williams explained on March 23, 2000, health officials from the above four southeastern states issued
a joint health advisory regarding the high mercury levels found in large king mackerel. The health
advisory was issued to protect the public's health since high levels of mercury can damage unborn babies,
young children, and women of childbearing age. The advisory stated king mackerel less than 33 inches
fork-length (from nose to where the tail forks) are safe to eat; however, king mackerel over 39 inches
should not be eaten. People should limit their consumption of 33 to 39 inch fish. Childbearing age
women and children age 0-12 should eat no more than one 8-ounce portion a month, and other adults
should eat no more than four 8-ounce portions a month. The advisory alerted fish processors not to
accept king mackerel over 39 inches long.
Dr Williams advised industrial sources spread mercury through the air The Environmental Protection
Agency (EPA) is working to control the level of mercury in the environment and trying to get legislators
to support the efforts to identify the risks of environmental mercury Dr Williams reported after
Hurricane Floyd tests were performed on a variety of finfish and shellfish taken from North Carolina
coastal waters and none of these samples contained mercury Large king mackerel, as well as, large
tunas, sharks, and swordfish contain high levels of mercury Large fish eat smaller fish and live longer
accumulating more mercury in their tissues. The Food and Drug Administration (FDA) samples large
fish other than mackerel.
A discussion followed on the validity of the mackerel consumption advisory, health problems, and
economical effects related to mercury levels in our ocean water and environment. Mr Steuer inquired if
there is a long history of high mercury levels in king mackerel. Dr Williams informed this is North
Carolina's first fish consumption advisory for ocean waters and fresh water sampling began in 1980.
There have been no fish advisories west oflnterstate 95 The Division of Marine Fisheries recommends
and plans to collect samples of ocean fish to test the mercury level in five years. The N C. Department
of Environment and Natural Resources routinely monitors water quality and fish tissue for potential
problems. Dr Williams advised Ms. Linda Rymer is the liaison between the EP A and the Division of
Marine Fisheries, N. C. Department of Environment and Natural Resources. Dr Williams stated the issue
of mercury in our environment is a global problem. She advised the Marine fisheries has are limited
resources to collect samples offish to test mercury levels.
Mayor Ray Rothrock, Town of Carolina Beach, asked if the four states will continue to issue food
consumption advisories and continue samplings. He stated it is easier to sample king mackerel during
tournaments. Dr Williams reiterated mercury is a global issue. The four bordering states have high
levels of mercury and problems areas will be targeted; however, it will be five years before the Marine
fisheries plans to test king mackerel for mercury Mr Greer stated the advisory was based upon testing
king mackerel once. Ms. Hunter expressed due to health concerns samplings need to continue more
frequently Mayor Rothrock reiterated concern regarding targeting recreational fishing for testing. He
requested samplings sooner than five years. Dr Goins stated commercial fishing is a multimillion
industry He expressed concern about the frequency of adequate fish samplings, health and economical
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issues, and about the possibility of addressing the environmental issue with the EP A and legislators. Mr
Greer advised environmental standards are being raised and these issues regarding regulations need to be
addressed with the EPA. Mr Steuer concluded it is a major public health, recreational, and economical
problem that needs addressing and needs to be better coordinated among governmental agencies. Ms.
Whitted stressed the public health issue related to mercury levels especially in women of child-bearing
age and young children.
It was the consensus of the Board of Health to prepare a letter to coastal legislators addressing the
concerns of the Board of Health regarding obtaining better controls, more research, and more frequent
monitoring of mercury levels in our environment and in ocean fish. The letter is to request the Division
of Marine Fisheries to collect samples for the detection of mercury levels in ocean fish within the next
two years instead of the scheduled five-year samplings.
MOTION: Dr Goins moved and Ms. Hunter seconded to prepare a letter to the Division of Fisheries
requesting obtaining better controls, more research, and more frequent monitoring and testing of mercury
levels in our environment and in ocean fish. Upon vote, the MOTION CARRIED UNAMIOUSL Y.
Mr Steuer thanked Dr. Williams for her presentation.
Monthly Financial Report:
March 2000 Monthlv Financial Renort:
Mr. Steuer reported the Executive Committee reviewed the March Health Department Financial Summary
Monthly Revenue and Expenditure Report. It reflects expenditure remaining balance of $3,128,447
(67.56%), an earned revenue remaining balance $1,22],533 (7140%), and a cumulative percent of
74.97%.
Committee Reports:
Executive Committee
Mr Steuer reported the Executive Committee met at 6:00 p.m. on Tuesday, April 25, 2000. Items are
listed under New Business on the Board of Health Agenda.
Unfinished Business:
Generator Hookups at Emernencv Shelters
Mr Steuer, Chairman, gave an update on the generator hookups for emergency shelters. He reported the
contractor plans to install manual electrical transfer switches at Dorothy B. Johnson, Trask, and Eaton
Schools by the middle of June and to install transfer switches at Noble and Codington Schools, the
central school office, and the Cape Fear Museum by June 30.
Mr Rice, Health Director, announced the School Retrofit Projects Steering Group plans to meet on May
15, 2000, to address emergency shelter issues.
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New Business:
Revision to Fee Policv - Personal Health
Mr Steuer recommended from the Executive Committee for the Board of Health to accept and approve
the revisions to the New Hanover County Health Department Fee Policy
Mr Rice reminded the Board that the Health Department Fee Policy is a fluid document that will change.
He presented three proposed revisions to New Hanover County Health Department Fee Policy, Section
IV, Personal Health - Women's Preventive Health (WPH). They are as follows:
1. Delete the following statement hased on N. C. Department of Health and Human Services,
Women's and Children's Health Section guidance .Patients who are certified for WPH services
under Title XX will not be charged for reimbursable WP H visits. Claims will be submitted to Title XX for
reimbursable visit.
2. Approved by the State with following recommended changes. Full charges will be assessed if
patient income falls at or above 250% of the Federal non-farm poverty level. (Pending state approval)
3. Delete the following Title XX* reference. Unemancipated minors seeking confidential services
are "a family of one" and are to be considered on the basis of their own resources. In such cases, the
minor's income must still be reported through the patient date system. Third party sources (e.g.
Insurance, Title XIX, *[Title XXI remove) should be billed if eligibility criteria are met.
Mr Rice explained the above first and third (#'s I and 3) policy deletions are based upon state guidance
to remove the above references to Title XX in the existing policy The second policy change (#2)
addresses charges assessed according to the N. C. Division of Public Health Women's and Children's
Health Section Annual Gross Family Income Sliding Fee Scale - 100% to 250% of Poverty
Dr Speck inquired about how the fee changes would effect our clients. Mr. Rice stated the revisions are
more for clarification and would not impact the patients.
MOTION: Mr Steuer moved from the Executive Committee for the Board of Health to accept and
approve the above revisions to the New Hanover County Health Department Fee Policy and to submit the
fee policy revisions to the New Hanover County Commissioners for their consideration. Upon vote, the
MOTION CARRIED UNAMIOUSLY.
New Hanover County Budl!et Calendar for Fiscal Year 2000-01
Mr Rice referred and presented the New Hanover County Budget Calendar for FYB2000-0 I to the Board
of Health. It is as follows:
May 19
May 22
Meeting
May 22-June 5
June 5
June 19
- Budget to Board of Commissioners
- County Manager Presents Recommended Budget at Board of Commissioners
- Board of Commissioners Work Sessions
- Budget Public Hearing
- Adoption of County Budget
Mr. Rice noted the Budget Public Hearing is on Monday evening, June 5 He will receive the County
Manager's Recommended Budget on May 22.
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Mr Steuer advised the Board of Health would not have an opportunity to review the County Manager's
Recommended Budget prior to the June 6 Budget Public Hearing. He invited the Board of Health
members to attend the May 30 Board of Health to review the changes to the County Manager's
Recommended Budget since the next Board of Health meeting is on June 7, 2000.
The Board of Health voted to attend the May 30th Executive Committee meeting to review the
recommended changes to the health department budget. Mr Rice advised a public notice of the full
Board of Health meeting with the Executive Committee will be prepared. Mr Rice informed the Board
he will not be present at the Executive Committee meeting on May 30 but will be available via telephone
conference call.
Mr Steuer reminded the Board members that the Budget Public Hearing at 6:30 p.m. on June 5 will be
held in the new conference room of the New Hanover County Board of Commissioners.
Proiect ASSIST - American Lel!acv Foundation Grant Application $57.500
Mr Steuer recommended from the Executive Committee for the Board of Health to accept and approve a
Project ASSIST American Legacy Foundation Grant in the amount of $57,500 annually for three years
beginning in September 2000 (FY200 I) continuing Fiscal Years 2002 and 2003
The purpose of the grant is for the New Hanover/Brunswick County ASSIST Coalition to expand youth
outreach efforts to reduce tobacco usage and to promote tobacco free generations. The grant funding
($57,500) is to begin in September 2000 (FY 2001) and is to continue at $57,500 for Fiscal Years 2002
and 2003 The budget request is for one (1) Health Educator position, a computer, youth incentives,
training and travel, program-training retreats for youth, and departmental supplies.
MOTION: Mr Steuer moved from the Executive Committee for the Board of Health to accept and
approve a Project ASSIST American Legacy Foundation Grant in the amount of $57,500 annually for
three years beginning in September 2000 (FY2001) continuing Fiscal Years 2002 and 2003 and to submit
the fee policy revisions to the New Hanover County Commissioners for their consideration. Upon vote,
the MOTION CARRIED UNAMIOUSLY.
Comments:
Board of Health Members
Staff Appreciation Luncheon
Ms. Hunter reported she has received positive comments regarding the Board of Health preparing the
hamburgers for the luncheon and cleaning following the Staff Appreciation Luncheon on Thursday, April
13, 2000.
Expiration of Billboard Moratorium
Ms. Rowe reminded Board members of the expiration of the billboard moratorium and those wishing to
should contact their legislative representatives. This issue will be voted on during this session of the
North Carolina General Assembly
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Health Director
AEIOU (Accessinl!, Evaluatinl!, Improvinl!. our Opportunities are Unlimited) Committee Update
Mr Rice gave an update on the activities of the AEIOU Team. He referred the Board to a Chart of
Organizational Capacity Survey Priorities for 2000. The first three priorities are (1) the health department
has clear authority act as a law enforcement officer for public health problems, (2) the health department
is regularly consulted by the local elected officials about aspects of local policy relating to health issues,
and (3) the health department has established a process for community health assessment and the
development of a community health plan.
Mr Rice reported in 1998, 67 strengths were recorded, and the strengths increased to 75 in 2000. The AEIOU
Team compared the indicators that were strengths for 1998 and 2000. The AEIOU Team is using 1998 as a
reference starting point in reviewing, revising, identifying, and analyzing strengths and opportunities to improve.
Staff Appreciation Luncheon - Thank You
On behalf of the health department staff, Mr Rice expressed his appreciation to the Board of Health for
sponsoring the Staff Appreciation Luncheon held from 12 Noon - 1.30 p.m. on Thursday, April 13, 2000.
He distributed photographs of the event and employee thank-you notes to the Board of Health and Mr
John Coble, Past Board Chair, for providing the Staff Appreciation Luncheon.
Azalea Festival Float - Health Department Float
In celebration of Public Health Month, the Health Department sponsored a float in the North Carolina
Azalea Festival Parade held on Saturday, April 7, 2000, in Wilmington, North Carolina. The float is an
employee project to market Public Health to the community No county tax dollars are spent for the float.
NHC Safety Award
The New Hanover County Safety Committee presented a Certificate of Safety Achievement in
Recognition of Six Years of Outstanding accident Prevention Efforts to the Health Department on April
19,2000. Mr Rice commended the health department staff for their safety record.
North Carolina Institute for Public Health Update
Mr Rice reported as a result of a March 29th meeting with Dr Rachael Stevens, Deputy Director of the
North Carolina Institute of Public Health, UNC at Chapel Hill, Mr Steuer, Dr Jewell, Mr Estep, Dr
Goins, Health Department Division Directors, and Mr Rice on developing Strategic Planning for the
Health Department; the Health Department will be the first to join and consult with the N. C. Institute for
Public Health on Strategic Planning. The Institute of Public Health will fund and provide the facilitators
for strategic planning. Mr. Rice and Ms. Smith plan to meet with Dr Stevens and Dr Bill Hertzog on
May 5 to address this issue.
Manal!ement Academv for Public Health - Mav 10-12,2000
Ms. Smith, Ms. Hewett, and Mr Rice plan to attend the 1999-2000 UNC Management Academy for
Public Health from May 10-12, 2000 for graduation activities. Other staff members plan to attend the
next Management Academy, a training program for public health managers from North Carolina, South
Carolina, and Virginia.
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Eastern District North Carolina Public Health Association - Mav 3-5. 2000
Ms. Smith, Ms. Susan O'Brien, Laboratory Director, and Mr Rice attended the Eastern District N. C.
Public Health Association Annual Meeting from May 3-5, 2000, held at the Sheraton on Emerald Isle,
North Carolina.
Information for Board of Health
Mr Rice referred the Board to supplementary information in their folders on Pfiesteria and to a
Dangerous Dog Report.
Other Business:
57th Case of Positive Rabies in New Hanover County - 1 ,t Case in 2000
Mr. Rice announced on April 25th, the 57th case of Rabies was reported in New Hanover County. This is
the first case in Year 2000. Animal Control Services caught and killed the rabid raccoon identified in the
Crosswinds subdivision in Wilmington, N. C. The state laboratory in Raleigh determined the positive
rabies.
Adjournment:
Mr Steuer adjourned the regular meeting of the New Hanover County Board of Health at 10:00 a.m.
William T Steuer, PE/RLS, Chairman
New Hanover County Board of Health
David E. Rice, M.P.H.,M.A., Health Director
New Hanover County Health Department
e Approved:
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New Hanover County Health Department
FY99-00
MONTHLY REVENUE REPORT
As of APRIL 30, 2000
Summary for the New Hanover County Health Department
Cumulative % 83.30% Month Reported Mon 10 of 12 Apr-OO
Current Year Prior Year
Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remaining Amount Earned Remaining
Federal & State 1,394,968 1,107,625 287,343 79.40% $ 1,377,269 1,081,466 295,803 78.52%
AC Fees 516,453 329,474 186,979 63.80% $ 493,100 312,630 180,470 63.40%
Medicaid 801,504 570,504 231,000 7118% $ 824,754 533,490 291,264 64.68%
Medicaid Max 366,891 366,891 100.00% $ 401,769 401,768 1 100.00%
EH Fees 312,900 251,051 80.23% $ 243,100 244,213 (1,113) 100.46%
Health Fees 109,515 109,614 100.09% $ 98,065 83,308 14,757 84.95%
Other 776,172 637,152 82.09% $ 572,457 472,291 100,166 82.50%
Note: County Appropriation is not calculated above. The County appropriation is the difference between the total amounts on the
program expenditure report and the totals on the program revenue report.
The budgeted amount for County Appropriation for FY 99 - 00 is ($9,703,333 - $4,278,403) = $5,424,930.
The expended amount for County Appropriation for this FY (year-to-date) is ($7,240,963 - $3,372,311) = $3,868,652.
Revenue Summary
For Month of APRIL 2000
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New Hanover County Health Department
FY99-00
MONTHLY EXPENDITURE REPORT
As of APRIL 30, 2000
Summary for the New Hanover County Health Department
Cumulative % 83.30% Month Reported Mon 10 of 12: Apr-OO
Current Year Prior Year
Type of Budgeted Expended Balance % Budgeted Expended Balance %
Expenditure Amount Amount Remaining Amount Amount Remaining
Expenditure Summary
For Month of APRIL 2000
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NEW HANOVER COUNTY HEALTH DEPARTMENT
BOARD OF HEALTH (BOH) APPROVED
GRANT APPLICATION STATUS
Date (BOH) Grant Reauested Pendina Received Denied
Project Assist-American Legacy
Foundation Grant ($57,500 for each of 3
05/03/2000 years) $57,500 $57,500
MOW Services (Infant Mortality)-NC
Healthy Start Grant Application (2yr Grant:
04/05/2000 $85,000 yr 1 and $43,845 vr 2) $128,845 $128,845
Skin Cancer Screening- NC Advisory
Committee on Cancer Coordiantion and
Control $1,500 $1,500
WIC Outreach- NC Dept of Health and
03/01/2000 Human Services $5,590 $5,590
No activttv to rennrt for Jan and Feb 2000
Child Health Consultant Grant- UNC Dept
of Matemal and Child Health- Contract with
NC Dept of Health and Human Services,
1210111999 Division of Women and Children's Health $48,210 $29,275
Healthy Carolinians Task Force- NC
11/03/1999 Office of Healthv Carolinians (FROZEN) $10,000 $10,000
Operation Reach Women- Susan G.
Komen, Breast Cancer Foundation $19,822 $19,822
North Carolina Chilhood Asthma
Initiative- NC Dept of Health and Human
Services, Women and Children's Health
Section (FROZEN) $7,500 $7,500
No activity to rennrt for Oct 1999.
School Health Lice Grant- Carolina Power
and Light Company Corporate Contributions
09/01/1999 Fund $4,900 $4,900
Growing Up Buckled Up- National
Highway Traffic Safety Administration
Cooperative Agreement $54,730 $54,730
Model Community Assessment Grant-
North Carolia Community Heal1h Initiative-
Healthy Carolinians- Center for Disease
Control and Prevention $17,375 $17,375
IDiabetes Today Community Planning
Initiative-NC Dept of Heal1h and Human
Services - Diabetes Prevention and Control
Unit $10,000 $10,000
No actlvltv to reDOrt for Aua 1999.
Healthy Women First- Community Health
07/07/1999 Improvement Program $24,692 $24,692
Teen Aids Prevention-Cape Fear
Foundation Grant $50,700 $35,000
As of 05/31/2000
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NEW HANOVER COUNTY HEALTH DEPARTMENT
BOARD OF HEALTH (BOH) APPROVED
GRANT APPLICATION STATUS
Date (BOH) Grant Reauested PendinG Received Denied
Healthy Homes State Grant- NC Dept of
Health and Human Services Childhood Lead
06/0211999 Poisoning Prevention Program $20,000 $16,111
Skin Cancer Health Education Project-
NC Dept of Health and Human Services,
Division of Community Health- Cancer
Control Program $10,000 $10,000
Safe Communities Grant Proposal-
05/1211999 Governor's Highway Safety Program $10,000 $10,000
Intensive Home Visiting Program - Office
of Juvenile Justice $100,000 $100,000
RECOGNITION, REWARD, AND
RENEWAL GRANT PROGRAM- North
Carolina Center For Nursing $5,000 $5,000
Community Dental Health -Community
04/07/1999 Health Improvement Program $20,000 $20,000
HIV Prevention- Kate B. Reynolds
03/03/1999 Charitable Trust Health Care Division $190,000 $190,000
Intensive Home Visiting Program-Smart
Start $100,000 $100,000
Hispanic Prenatal Project- Smart Start $12,700 $12,700
T ota.s $909,064 $57,500 $257,298 $555,742
As of 05/31/2000
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HEALTH
~;~ .-;.~~'.: :....~--:;~:_~:: -=::-..
NEW HANOVER COUNTY BOARD OF'
REQUEST FOR BOARD ACTION
Meeting Date: 06/07/00
Department: Health Presenter: Janet McCumbee, Child Health Director
Contact: Janet McCumbee/343-6559
SUBJECT:
Grant Application for HEALTHY HOMES INITIATIVE MINI-GRANT of $20,000
from the North Carolina Childhood Lead Poisoning Prevention Program for the
New Hanover County Health Department "Healthy Homes Initiative".
BRiEr SUMMARY:
We are requesting approval to apply for second year funding of the HEAL THY HOMES INITIATIVE
MINI-GRANT of $20,000 to continue the "Healthy Homes Initiative' which the New Hanover
County Board of Health approved in 1999 On July 12, 1999, the New Hanover County Board of
Commissioners accepted a mini-grant award of $16,111 from the North Carolina Childhood Lead
Poisoning Prevention Program: This grant funded the start-up of The New Hanover County
Health Department 'Healthy Homes Initiative:
The FY2000-2001 application form is attached for your review We are responding to the need in
our community to address both lead poisoning prevention and asthma control for children. The
goal of the "Healthy Homes Initiative' is to increase public awareness of how the environment
impacts a child's health and to provide tangible household products such as air filters and
mini-blinds, if necessary, to directly improve the child's childcare environment at registered
Family Child Care Homes (FCCHs).
Between January and May 2000, a Health Homes Nurse conducted scheduled home visits to 42
of the county's FCCHs serving 269 New Hanover children. An 'Environmental Health Assessment
of Asthma Triggers and Lead Sources" as completed for each site. Additionally, 16 medical or
social services referrals were made, 22 mini-blinds replacement vouchers (115 total mini-blinds
replaced), and 39 high efficiency air filter vouchers were issued.
Other accomplishments included formation of the "New Hanover County Asthma Task Force'
whose members successfully planned and implemented the World Asthma Day 2000 Fair in May,
and numerous other educational efforts and events.
RECOMMENDED MOTION AND REOUESTED ACTIONS:
Approve grant application for $20,000 and related budget amendment if grant awarded
FUNDING SOURCE:
North Carolina Childhood Lead Poisoning Prevention Program
ATTACHMENTS:
Yes-grant application for and summary page
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NEW HANOVER COUNTY
HEALTH DEPARTMENT
2029 SOUTH l-ru STREET
WILMINGTON, NC 28401-4946
TELEPHONE (910) 343-6500, FAX (910) 341-4146
............-,..-.
DAVID E. RICE, M.P.H., M.A.
Health Director
LYNDA F, SMITH, MoP.A.
Assistant Health Director
SUMMARY OF THE
HEALTHY HOMES INITIATIVE MINI-GRANT
New Hanover County Health Department
On July 12, 1999, the New Hanover County Board of Commissioners accepted a mini-
grant award of $16,111 from the "North Carolina Childhood Lead poisoning Prevention
Program." This grant funded the start-up of the New Hanover County Health
Department's "Healthy Homes Initiative."
The 2000/2001 application form is now available and reapplication is necessary to
continue this program in our county. We are requesting that the Board of Health and the
County Commissioners approve the application for a second year of funding. The budget
of $20,000.00 is attached for your review.
The initial 1999/2000 2l'ant oroposal and related activities/outcomes are summarized
below:
The New Hanover County Health Department is responding to the need in our
community to address both lead poisoning prevention and asthma control for children.
The goal of the "Healthy Homes Initiative" was to increase public awareness of how
environment impacts a child's health and to provide tangible household products such as
air filters and mini-blinds, if necessary, to directly improve the child care environment at
registered Family Child Care Homes.
Between January and May 2000, a Healthy Homes nurse conducted scheduled home
visits to 42 of the county's Family Child Care Homes serving 269 New Hanover children.
An "Environmental Health Assessment of Asthma Triggers and Lead Sources" was
completed for each site. Additionally, 16 medical or social services referrals were made,
22 mini-blinds replacement vouchers (115 total mini-blinds replaced), and 39 high
efficiency air filters vouchers were issued.
Other accomplishments included formation of the "New Hanover County Asthma Task
Force" whose members successfully planned and implemented the World Asthma Day
2000 Fair in May, and numerous other educational efforts and events.
..~ ~4/d-d..~"
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This vear's oroPOsal has two maior objectives:
To continue building on our earlier efforts by:
. Broadening our target population to include home visits to private homes of children
with asthma to assess for environmental triggers;
. Continuing the community networking and general asthma efforts of the new Asthma
Task Force;
. Enhancing our outreach efforts to increase pediatrician involvement and subsequent
referrals related to lead poisoning; and,
. Continuing to build a working relationship with the state Child Care Consultant to
explore the possibility of the Healthy Homes Nurse providing an environmental
assessment for lead poisoning hazards and asthma triggers prior to licensure of a
Family Child Care Home. .
To implement the State Health Director's "Enhanced Recommendations for Lead
Poisoning Prevention" which involves an increased number of lead screenings, lower
allowable blood lead levels, and improved follow-up of care with more nurse home visits.
Submitted by: Janet McCumbee
Child Health Director
(910) 343-6599
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2000 -2001 Healthy Homes Budget
Salary for Licensed Practical Nurse: 20 hours a week X 52 weeks
$12.03 hour + 2% end of probation raise
Also possible 4% merit/market = $12.75
Fringe includes: Soc. Sec.= $1014
Retire. = $328
Med./Dent.= $366
LT Dis.= $32
Total Salary and Fringe:
Printing:
Print flyers for special events
Departmental Supplies:
Office supplies, such as paper, pens, desk
organizers, calendar, etc.
Educational materials on Lead and Asthma
Lead free miniblinds
Heat/Air filters
Lead Check Swabs
Employee Reimbursements:
Around town mileage at .325/mi.
125 miles a month
Employee Reimb. Uniform:
Uniform for nurse (required)
Yo of $500 for FTE
Training and Travel:
Out oftown mileage at .325/mi.
Registration for workshops, Hotel,
food ($30.00/day max.)
Total for general operating:
Total Grant Request:
$13,260
$1740
$15,000
$500
$350
$350
$1500
$800
$150
$500
$250
$600
$5000
$20,000
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NEW HANOVER COUNTY
HEALTH DEPARTMENT
2029 SOUTH 17111 STREET
WILMINGTON, NC 28401-4946
TELEPHONE (910) 343-6500, FAX (910) 341-4146
Everywhere. Everyday. Everybody.
DAVID E. RICE, M.P.H., M.A.
Health Director
LYNDA F. SMITH, M.P.A.
Assistant Health Director
Summary Of Grant Submitted By Smart Start
Servicios Para Ninos
May 2000
On April 28, the New Hanover County Partnership For Children (Smart Start) submitted the
Servicios Par Ninos grant to the Rehab Therapy Foundation. The Foundation's priorities
include: serving children with developmental disabilities and their families and impacting
inadequately insured or under-served children with developmental disabilities and their families.
This grant application was made in response to the growing Hispanic population in New Hanover
County and the increase in the health and developmental needs identified by Child Service
Coordinators.
e
The Servicios Para Ninos grant, if received, would provide up to $50,000 for Smart Start to
contract with the Child Service Coordination Program (CSCP) of the New Hanover County
Health Department for services. The main purpose of the grant is to fund a bilingual (Spanish
speaking) professional to provide Child Service Coordination to Hispanic families with children
identified as meeting the state guidelines for the CSCP. CSCP children are considered at risk for
developmental delays/disabilities.
We presently have approximately 25 Hispanic families in the CSCP, which require an interpreter
to accompany the nurse or social worker on home visits. The visits take twice as long and cost
more. With a bilingual professional, the existing staff time would be positively impacted and the
families would relate better to the bilingual CSC.
The additional money, above salary, would be used to pay for doctors' visits, therapies,
equipment, transportation, etc., when no other payment source is available. Many of these
children are not insured and do not qualify for Medicaid.
If Smart Start receives this grant, we are requesting the Board of Health's approval for the Child
Service Coordination Program to enter into a contract with Smart Start to provide the services in
the grant. We also request approval (if grant approved) to submit a budget amendment for
$50,000 to the County Commissioners which would include hiring a new Child Services
Coordinator (nurse, social worker, or child development specialist). This is one year funding;
however, Smart Start is committed to looking for continued funding if this project is effective.
Also, some of the children are Medicaid eligible and some revenue would be generated.
e Submitted by Janet McCumbee, Child Health Director
15
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May-19-00 09:2BA
P.02
Rehab Therapy Foundation
Rehab Therapy Foundation, .10 Flnt Umon NatiODaI B8IIIt, At1D: PailDeI' W1bon, NC 115!1
Two y,nt Union Cen1er, Toll, 301 Soutll TryOD Stred. Charlotte, NC 281l1l1-l1S!I, RdIabThoran..FoundatJvn.o",
COVER SHEET
ORGANIZATION
OfIlcbdN_oorOrganl7.atlon: ~F.W "'IlNOV~1? 1"0 PllDTIII....,mru 1>...'" IRS statuS: SOlC'!
CHILDREN
Allacll IRS ItatD iIId~ SOI(c!(!1) e...... AtIIu:IJ _ ,.<<1ft ~ rllUllfcUll A..dit .\'1.._
Contact",noon: Janet Nelson
'I1t1e: 1O'v~rol14- 4 VA ni "'I!lat"'~n""
MaDingAdd......: lOO-A Eastwood Road, Suite 18, Wilmington, NC 28403
Phone: CllO_7q,_F,1F.O FAXNwnber:Q10_7q'-F.04.11 ElDaDAddras: 'l.....F..9~'o;>l gQm
SlllDlDarizeacthitlouftlleOrgllllizatlon: New Hanover Co. Partnership for Children, Inc.
is committed to ensuring that all chitdren, ages birth to five have the
heatth, family support and early childhood education services that they
nee~ to arrive at schoot healthy, motivated and ready to succeed. To
this end, the Partnership supports activities that assist families in
their role and responsibitity for choosing resources that result in
mentally and physically bellthy young chil~ren. our programs, in
collaboration and cooperation with community agencies, include support
preventive and routine ~ealth care, child care quality enhancement,
and community education.
APPUCANT PROJECT
Proj~ Servicios oara Ninos
Attach C",,",,,'''''' VII4I of Proied Dinctor (IJIIIX, 2 .~.
ProJcdDIndor: Janet McCumbee
A""cJr b of JIHrd or1JiHdDrr GIld titla.
Brlefde!ICrlptioDOrProject: Servicios para Nt nos 1.s a project designed to enl1ance
the Child Services Coordination project of the Nev Hanover County
Health Department by providing a Bilingual Child Servlce Coordlnator
and appropriate health care, early intervention, and therapies for
the at-ris~ Hispanic children under age five.
SUBM1TI'ED BY:
'ttiL,~- ~,C'M"V'"
~atu orCJO~t of Board of Di_ten
_~ fl. /W'<'<no-/
D . TE SIGNED: 4/ .2f/ /)tJ ..
, .
The Rev. Lynn M. Sanner
l)po Name or CEOlPretldeat of Board of DlredOn
Janet Il. Nelson
Executive Director
I
I
..-. .-.---'
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May-19-00 09:2BA
P.03
Rehab Therapy Foundetlon Grant Application
Need: Child Services Coordination Program (CSCP) is a statewide prog....lJn to ehildren with
special need., and their families and is funded at New Hanover County Health dcpartment (NlICIID)
by Medicaid revenues and a small state grant. Children, ages birth to five. are referred to CSCP
because they are considered at-risk and/or have a diagnosis of developmental delays/disabilities,
chnmic illnesses, or sociaVemotional disorders. There is no financial eli&ibility requirement. The
program is provided free of charge to the families, but Medicaid is billed for those who are Medicaid
eligible. The C\llTCTlt budget supports a staff of nurses. social workers. and clerical support. which
provide services of over 400 children. Each Child Service Coordinator has a cascload of
approximately 60 children.
New Hanover County has experielll:ed tremendous growth in the Hispanic population over
the past few years. NHCHD is presently serving several hundred non.EngIish speaking Hispanic
families in a variety of programs. There are approximately 2S non-English speaking Hispanic
families being served through CSCP. The addition of non-English speaking clients has put a
tremendous burden on CSCi'. The CS Coordinators must be accompanied in the clinic or on home
vi..iL'l by a qualified interpreter Ifworking with the non-English spealtiog client. This process doubles
the client Cllntact time. There is no reimbursement fuT the interpreter services or additional staff
time. Therc is significant ~ for Child Service Coordinator that is bilingual and able to perform !he
CSCP services without the assistance of an interpreter.
Hispanic children born in the United States are eligible for Medicaid; however. many
Hispanic clients were not born here and aro not eligible for any governmcnt-SPOIL""red child heahh
insurance. The Iow- income jobs that many Hispani<: f.uniHes depend on do not provide cmployer-
sponsored insurance; therefore many of the children in these families have no health insuratll:e.
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May-19-00 09:Z9A
P.04
CSCP provides developmental screenings and often identifies the need of early intervention or
special therapies to prevent developmental disabilities or improve outcomes for th<:se children
considered "at-risk." CS Coordinators find it difficult to connect the many Hispanic f.unilics with
appropriate s<:Mces because often there is either no metbod of payment or only Medicaid. More
comprehensive s<:rvices are needed of Hispanic children birth to five years old that are likely to have
developmental delays or disabilities.
PufllC*: S~rviclos p""" N"UlOII is del,-igned by The New Hanover County partnership for Children
(Smart Start) to enhance CSCP in New Hanover County and to provide appropriatc health care,
early intervention, and therapies for the at-risk Hispanic children under age five. Serriclos JIlIN
Nliios will include hiring a bilingual professional (nurse, social worker, or child development
spec:ialist) to providc CSCP to non-English b-peaking Hispanic familics. This is more cost effe<:tive
(no interpreter) and also allows for establishing a better relationship with the client. Grant money will
be budgeted to pay for doctor visits, special equipment, dental care. speech and physical therapy,
tralll'IXlrtBtion, etc.. when no other source of payment is available.
Servlcios p/lrtl Nllios is significant in that the children under six in Hispanic population, which are
presently inadequately served with health care. dental care, and developmental services will have
services available. NHCHD can provide early intervention to prepare these <:hildren for school and
prevcnt long tenn negative outcomes. which will cost more to address in their futures.
Specific Goals:
1. To provide more a comprehensive CSCP for the non-English sl""'lci'1g mllpanic families in New
Hanover Comty.
Activity A: Hire bilingual Hispanic professional (nurse, social worker. or child development
~-pecialist) to provide service coordination to !he at- risk Hispanic children (birth to five years).
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May-19-00 09:29A
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Adlvlty B: Bilingual CS Coordinator will make home visits, and phone or c\inie contacts
(monthly) per CSCP guidelines to assist Hispanic families with identiiYing their strengths and
need.; 10 assess child development and parent -child interaction; \0 develop a plan of care; and to
coordinate services with other service providers to ensure the child is healthy and developing to
his/her potential or receiving all needed corrective measures.
Activity C: Bilingual C:S Coordinator will translate all CSCP written materials to an
understandable level of Spanish for non-English speaking Hispanic clien\.~.
Activity D: E~1ablish the need for additional reimbursement sources for CSCP services and
determine appropriate caseload numbers for a Sen>iclos JHUII Niiios worker.
II. To a....ure a method or payment for services needed by children in the Servicios para Niftos
caseload.
Activity A: All fiunilies in the project will be referred to social services for dctermination of
cligibility fur any available financial a....istanee, and child health insurance.
Activity B: Servicios P/I,./I Nlilo!l will establish contracts with agencies or organizations that will
provide services or special equipmenl to low-income Ilispanic clients on a minimal reimbursement
scale. The scrvices or special equipment will he obtained and paid Ihr by grant funds only when
no other method of reimbursement is available. (Usual public heahh financial eligibility guidelines
will be followed.)
Activity C: Senicios para N'Ulos will mi1ize all existing state and local services available for at-
risk children, i.e.. Dcvc10pmenlal Evaluation Center, Mental Hcahh early childho(ld intervcntion
and cOWlsclingflreatment services, the school system preschool services for special needs children,
Family Support Network, and IIIlII1Y more.
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Outc:omCII:
I. The non-English speaking Hispanic ramilies with children under five at risk for dewlopmclllal
disabilities will receive euhurodly sensitive services from a bilingual professional in CSCP.
n. Servlcios para Nilio., will be provided in a more cost effective manner (no interpreting time.)
Ill. Hispanic children at risk for developmental disabilities will receive regular check-ups according
to the Heahh t.'heck-Medicaid well care schedule. immunizatiollS, denial care, therapies (speech and
physical). and equipmelll needed to develop to their full potential in preparatiun for sehool entry-
IV. Non-English speaking Hispanic filmilies will become more self -suffident and be able tu become
their'ehild's own service coordinator by program closure.
Timellne
.July 2000 _ New Hanover COUnly Partnership For Children (NHCPFC) will contract with New
Hanover ColDlty Health Department to provide Semci05 J1G'tI NiJios servioes to project population.
August _ September 2000 -- Health Department rccruilment and hiring ofbtlingual CS Coordinator.
October _ December 2000 -- Bilingual cS Coordinator will receive orientation and extensive
training. colllracls for services will be initiated a.. outlined in goals/activities.
January 2001 ._ Bi1ingual CS Coordinator will establish caseload and accept new referrals.
February _ JUDe 2001 __ Routine CSCP guidelines will be followed for provision of services.
Hispanic caseload will be monitored for appropriate capacity. (This capacity will be less than the 60
children carried by the other coordinators, due to complexity of fami1y need...)
Evalua'lon
Bilingual CS Coordinator will evaluate all statistics and outcomes from contacts, refumlls. and
services provided, etc. at the end or one year to determine whether identified needs of children
have been met.
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May-19-00 09:29A
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Families in Servicios pafU Nmos will be surveyed to dctermine whether their nccds have been met.
NHCPFC staff will review the stated activities timeline and projected outcomes of the project
quarterly.
Budget for Servlclos Pam Nlfios
Salary Ilnd Frlnlle
Pcrsonnel-- Public Health NurselSocial Womer/Child Development Specialist (I fuU time)
Salary x 11 months-$30,010
2% end of probation raise (4 mo.) ~ $218
Social security x II mo. - $2.295
Retirement (4 mo.) = S540
Medical insurance x II mo. .. $3,883
Tolal Salary and Fringe'" 536.946
Operating Expenses
T e1cphone instaDation = $60
Cellular phone for home visiting at $16.00/100. x 12 mo. - $192
Printing of Spanish educational materials .,... $500
Supplies __ routine office supplies (peDS, paper, day planner. etc.) = $300;
software, printer" 51,000; DeI1ver Screening Kit and Hear Kit .. $200;
briefCase = $50; office chair = $200; desk = $300: desk organi7.CTS '" $200;
nurse uniform (required) '" $500; mileage around town ($.325/mi) at
200 mileslmo. x $.325 x 12 mo. = $780 Total - 54,282
Training and Travel (out of town) -- registTalion fees (CSC two day training, Parent-Child
I ntcrvcntion 9 day training, Early Intervention 3 day training) = $500; hotel - $1.000; food
($30/day) at 13 days x 30 = $420; out of town mileage ($.325/mile) - $600 Total - 52,520
Total OperatIng Eltpenses '" 56,802
Capital (Equipment)
Personal computer for CSC = $1,200
Contracted Servleell
Equipment, services. therapies for children .. $5,052
Note: NHCHD will provide space, supervision, administrative support, and training. The NHPI1C
staff will administer and oveTSCC the grant. Medicaid billing can be done for the Mcdicaid-eligible
clients.
Otller FUDdinll - No other grants have been written at this lime for this project.
Continuation - Possibilities:
Slate increase in CSCP funding or increa.'IC in Medicaid reimbursement.
Smart Start grant locally, ifmoney is available and NHPFC Board agrees the SBvicios pam
NlIID5 fits strategic plan. Other grant sources will be sought.
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May-19-00 09:30A
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New Hanover County Partnership for Children. Inc. is committed to ensuring that all
children, ages birth to five have the health, fiunily support and early childhood education
scrvices that they need to arrive at school hcalthy, motiviated and ready to succccd. To
this end, the Partnership supports ~vities that a.'lSist families in their role and
Tellpom.;bility for choosing resources that result in mentally and physically healthy young
children. Our programs, in collaboration and cooperation with community agencies.
include support prevenlive and routine health care, child care quality cnhanccment, and
community education.
Project: Servicios ptlra Niiios
DescrlptloB: Servlcios ptI1'II Niii()$ ill a project designed to enhance the Child Services
Coordination Project oCthe New Hanover County Health Department by providing a Bi.
lingual Child Service Coordinator and appropriate health care. early intervention, and
theropiell ror the at-risk Hispanic children under agc five.
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ProlJosal to Bevin O(ferinv Childbirth Education Classes at the New Hanover County Health
D(J)artment
The New Hanover County Health Department has been approached by Coastal AHEC to assume
the responsibility of conducting childbirth education classes for the public and private OB
patients within the county. These classes (sometimes called Lamaze) have been offered within
our community for more than 20 years. They had been scheduled and carried out by NHRMC
until November 1999. At that point, Coastal AHEC began coordinating the effort. As of May
31, 2000, Coastal AHEC will no longer be providing this service due to a shift in their workload
and a more focused look at their goals and objectives. It is felt that childbirth education classes
do not address their primary area of focus.
Two of the private Ob/Gyn offices in Wilmington employ their own childbirth educator. The
Medicaid patients served through the health department and affiliated prenatal clinics do not have
an option for these classes. The health department feels an obligation to offer this education, at
least for this population. It is definitely related to the mission of the Women's Health Care
Division.
The health department's role in the provision of childbirth education classes will consist of
registration for patients, coordination of instructors and billing. This is a reimbursable service
through Medicaid. The health department staffhas registered patients for the classes in the past
and find that it is a fairly simple process of including their name in a log book at the prenatal
clinic while discussing the importance of preparation for childbirth ( a role we already assume).
Coordination of the instructors is being analyzed now. The current instructors (most are hospital
employees) are interested in continuing to provide the education@ a contracted rate of$25/hr.
We hope to be able to hold the classes in the health department auditorium, which will be
convenient for inner-city residents. Space is currently reserved at Cape Fear Memorial Hospital.
Medicaid billing would be the responsibility of the women's health clerical staff. Medicaid
billing would be carried out through the current patient registration data system utilized by the
health department and entered by the clerical staff.
Provision of services for the private offices would entail additional time and money in
registering, collecting cash, mailing advance notices and bills, etc. This would require additional
health department time and resources and could be a financial burden.
lbis additional responsibility for the health department should be budget neutral. We would
collect funds from Medicaid reimbursement which would, in turn, pay for the contract staff,
educational materials, refreshments and incentives.
Proposed Start Date: July 3, 2000
e See attached budget page for budget explanation.
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BUdfet - PrQPosed Childbirth Classes
4 classes in a series
2 series per month
1 instructor per series
12 (average) Medicaid participants attending per series
Medicaid reimbursement rate - $87 per participant (W8203)
Medicaid reimbursement for 1 year
- $87 x 12 participants = $1 044 (per series)
- $1044 x 2 series per month x 12 months = $25,056
Contracted services (instructor)
- $600 per instructor per series
($25/hr. x 3 hours each class x 4 classes in a series)
Contracted Services for 1 year
- $600 x 2 instructors = $1200 per month x 12 months = $14,400
$25,056
- 14.440
$10,656 revenue +
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Hfl2\LTH
NEW HANOVER COUNTY BOARD OF OOMMI8SIONER!
REQUEST FOR BOARD ACTION
Meeting Date: 06/~
07/rX:>
Department: Health Presenter: Betty Jo McCorkle, Director Women's Health
Contact: Betty Jo McCorkle 343-6660
SUBJECT:
Grant Application for FAMILY PLANNING OUTREACH INITIATIVES for $22,180
from the North Carolina Division of Public Health-Women's and Children's
Health Section.
BRIEF" SUMMARY:
We are applying for $22,180 for Family Planning Outreach Initiatives. The allocation is for 1
year only, fiscal year 2000-2001 (additional second year funding is subject to availability of
federal funds).
Women's Health Services are available through numerous facilities in New Hanover County, but
many private providers do not accept Medicaid. Though the private sector may accept and
provide prenatal services reimbursed by Medicaid for Pregnant Women (MPW), services are
discontinued to these women following the termination of their MPW benefits. These women are
still in need of preventive and follow-up care. The New Hanover County Health Department is a
primary source for women seeking preventive women's health care, and our statistics (see
attached grant application for statistics) document many high risk women in need of these
services.
Outreach, recruitment and retention of family planning patients can dramatically improve the
negative statistics. With the grant we request employing a half time (50% full time equivalent)
Registered Nurse for outreach efforts. The outreach efforts would include postpartum hospital
visits, appointment reminder letters, appointment reminder phone calls, home visiting for
delinquent or missed appointment patients, outreach through the Women, Infants, and Children
program and pregnancy testing outreach.
RECOMMENDED MOTION AND REOUESTED ACTIONS:
Approve grant application for $22,180 and the related budget amendment if grant awarded.
FUNDING SOURCE:
North Carolina Department of Health and Human Services, Division of Public Health.Women's
Preventive Health Unit. No matching funds are required to qualify for these funds.
ATTACHMENTS:
Yes-5 pages grant application and 2 page memo.
25
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Application and Contract Addenda for Familv Planninl! Outreach Initiatives
Julv 1. 2000 - June 30. 2001 and Julv 1. 2001- June 30. 2002-Pal!e One
Name of Applicant Organization: N",u lhmn'TiPT" rm",....y ~O~,....1-. nt:lp~n.t'moT'\t"
I. Documentation ofUnmet Need in the Service Area
(Statistics such as pregnancy rates, out-of-wedlock birth rates, teen pregnancy rates, etc.
may be used as well as income levels, uninsured populations, minority populations,
numbers of women in service area who are on MPW [Medicaid for Pregnant Women]
and other data. Data on family planning program services and private provider
services-if available--should also be included to show the level of unmet need among
populations in need of subsidized services.)
Women's Health Services are available through numerous facilities in New Hanover
County. Many private providers, however, do not accept Medicaid. The prenatal
population, for example, has the option of private care, but services are
discontinued in the private setting for Medicaid patients following the termination
of their MPW benefits. New Hanover County currently has 4040 active MPW cases.
The New Hanover County Health Department (NHCHD) is a primary source for women who
are seeking preventive women's health care. New Hanover County data documents many
high risk women in need of preventive and follow-up care. Our population consists of
8.3% minority females of childbearing age. The total population reflects approximatel
20% minority. Medicaid mothers in New Hanover County represent 46% of the total
population. The population reflects 11% who are uninsured.
New Hanover County's STD infection rate was more than 2 times the State average in
1997. In 1998 there was a high (20-25%) prevalence of short-term birth intervals.
New Hanover County's rate was 15.7 compared to the NC rate of 13.1. New Hanover
County's out-of-wedlock rate in 1998 was 32.6. The teenage pregnancy rate in 1998
was 69.1 (white = 52.6, non-white = 118.1).
Outreach, recruitment and retention of family planning patients could dramatically
improve these negative statistics.
Documentation of agency's capacity to expand services to address unmet need.
II.
A. Description of health department facilities (numbers of exam rOoms available for
family planning, size of waiting room, other space which could be made available,
etc.)
Recent renovations in our family planning clinic space enlarged our waiting area
and our clerical/reception areas. This allowed for additional privacy which also
enhanced confidentiality. This effort was seen as a marketing tool for recruitment
and retention of new patients. The setting is now "female friendly" which includes
the use of pastel colors and wallpaper borders. Our waiting area is now separated
from the main health department waiting room (which further increases privacy
and confidentiality) and has a capacity of 25-30 patients. We operate four (4)
exam rooms and utilize two (2) full-time nurse practitioners.
26
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Application and Contract Addenda for Familv Planninl! Outreach Initiatives
Julv 1. 2000 - June 30. 2001 and Julv 1.2001 - June 30. 2002-Pal!e Two
B. Description of other facilities or planned expansion (include estimated date of
completion). If additional space is needed, describe arrangements which are being
made (such as negotiations to lease, anticipated moves by other agencies, etc.) to
provide additional space. (Title X funds cannot be used for construction or purchase.)
Not Applicable
c. Description of current schedule of family planning clinics and any plans for
expanding clinics
(i.e., offering more convenient timesllocation of services to working women, teens,
etc.)
e
The current family planning schedule allows for am, pm, evening, appointment
and walk-in clinics. We offer clinics every day and see adults and teens.
Our site provides group and one-on-one education and provides education
and treatment for male partners. We offer walk-in pregnancy testing daily.
We plan to offer additional appointment slots with this grant.
D Describe current staffing offamily planing clinics and describe how staff would be
expanded or utilized differently.
Current staffing in our family planning clinics consists of two (2) Nurse
Practitioners, four (4) RNs, two (2) CHAs and two (2) clerical specialists.
We also employ one (1) 50% FTE RN who is housed @ DSS as a TANF outreach
worker. An additional 50% FTE would allow for outreach efforts to recruit
and retain new and continuing patients. Some of these outreach efforts
would include postpartum hospital visits, appointment reminder letters,
appointment reminder phone calls, home visiting for delinquent or missed
appointment patients, outreach through WIC and pregnancy testing outreach.
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Annlication and Contract Addenda for Familv Planninl!: Outreach Initiatives
Julv 1. 2000 - June 30. 2001 and July 1.2001 - June 30. 2002-Pal!:e Three
III.
E. Summarize any additional plans for increasing capacity (i.e., holding simultaneous
clinics for Family Planning and WIC).
Employ one 50% FTE RN to provide the following outreach efforts:
* postpartum hospital visits
* appointment reminder letters
* appointment reminder phone calls
* home visiting for delinquent or missed appointment patients
* WIC outreach
. * . pregnal)cy..test;i.ng outn,acb. . . .,
ObjectIveS tor slgmtlcanUy expan<1mg tiulllly planmng services. ObjectIves must be
time-framed and measurable and must address both recruitInent and retention of patients.
Objectives must be written for both FY 00-01 and 01-02 (assuming that there may
be funding for a second year). As stated in the instructions, projects will be
required to report on progress (including progress toward stated objectives) on a
quarterly basis. Forms and specific guidance for these reports will be furnisbed by
tbe Women's Preventive Health Unit.
~
"By July 1,2001, the number of new clients seen in family planning clinics will
increase by .2..-% for a total of 32 new patients seen in clinics."
"By July 1,2001, the number of return visits for continuing clients seen in family
planning clinics will increase by --5--0/0 for a total of 55 patients continuing
in clinics."
"By July 1,2002, the number of new clients seen in family planning clinics will
increase by ~o for a total of 34 new patients seen in clinics."
"By July I, 2002, the number of return visits for continuing clients seen in family
planning clinics will increase by 5 % for a total of 5 a patients continuing
in clinics:"
****NOTE: Although it would be realistic to see a measureable change in
statistics by July 1, 2001, the change would not reflect an entire year.
Recruitment, hiring and training of an RN would not be complete until
October, 2000 (average time). Therefore, implementation of our plan
would not begin before October, 2000 and would reflect less than one full
year of data by the end of the FY July 1, 2000 - June 30, 2001.
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An~lication and Contract Addenda for Familv Plan nine Outreach Initiatives
Jul 1. 2000 - June 30. 2001 and Julv 1. 2001 - June 30. 2002-Pal!:e Four
(Objectives Continued)
IV.
Annual budgets for this expansion activity (covering both July 1,2000 - June 30, 2001
and July 1,2001- June 30,2002) must be presented in detail. Examples of major
categories: Salaries, Supplies, RecruitInent Materials, etc. Be as specific as possible.
REMINDER: The allocation currently is for one year only. Additional funding for the
second year is subject to availability of federal funds.
July 1, 2000 - June 30, 2001
RN Salary - 50% FTE
$16,522 (base salary)
$ 5,658 (fringe packet)
$22,180 TOTAL
July 1, 2001 - June 30, 2002
RN Salary - 50% FTE (with 5% increase)
$17,348 (base salary)
$ 5,941 (fringe packet)
$23,289 TOTAL
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Annlication and Contract Addenda for Familv Planninl! Outreach Initiatives
Julv 1. 2000 - June 30. 2001 and Julv 1. 2001 - June 30. 2002-Pa2e Five
V. Describe prior expansion activities undertaken in the last three years. Address costs,
strategies, and outcomes.
Strategies:
Expansion of pregnancy testing to include daily testing on a walk-in basis
Addition of evening clinic for working adults
Outreach Efforts: TANF position @ DSS, weekly outreach @ Community College
to distribute women's health information, establish family planning
appointments, etc.
Marketing: remodeled clinic area to target new and 'returning women, created
a brochure for distribution within the community to advertise the services
we offer to women
Provided incentives for long-term patients and provided patient appreciation
events - both efforts aimed at retention of patients
Outcomes: Over the past three (3) years, we have documented an increase of
57 new patients and 122 returning patients.
Costs: Costs of the above strategies have been absorbed within our routine
operating budgets which include both state and county dollars. We have
absorbed the workload with existing staff (excluding the TANF position).
Brainstorming among the team and extra efforts to evaluate the effectiveness
and productivity of the staff have been of major importance.
Signature of Local
Director
Date
The application must be signed by the local director. Upon approval of the application, the WPH
Unit will incorporate the approved proposal into the Consolidated Contract as a part of the
Family Planning Contract Addenda. The Unit wiJl initiate a budget revision with the approved
amount which wiJl be mailed to the Director for local action and return to the Unit.
Signature of Supervisor
of Women's Preventive Health
oS #1 Jot)
I '
Vb /Jf~ f1~
~
Date
30
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Nortb Carolina
Department of Health and Human Services
Division of Public Health
1916 Mail Service Center. Raleigh, North Carolina 27699-1916
1330 Saint Mary's Street. Courier 56-23-01
Ann F Wolle, M.D., M.P.H., Director
April 20, 2000
FROM:
Local Health Directors
Family Planning Clinic Coordinators
Margaret Woodcock, MPA, SUPerviSO~rfI~
Women's Preventive Health Unit v'T' \
TO:
RE:
New Competitive Title X Funding
(Applications Due June 1, 2000!)
e
Recently the Region IV Family Planning staff notified all states in the region of some funds which
will become available July 1,2000 and which may be available for a two-year period. Along with
notification of the funding, state Family Planning programs have been notified (1) that Congress
has withheld a significant amount of the new appropriation due to concerns about declines in the
numbers of patients served and (2) that the intent of this funding is to increase the numbers of
family planning patients being served in Title X-funded clinics.
Over the past several years, patients served in family ,planning clinics have declined significantly at
the national level. In North Carolina, there were modest increases during most of the last several
years except for a statewide decrease of 5,000 patients in CY 1999. However, the Deputy Assistant
Secretary for Population Affairs, Denese Shervington, had to promise members of Congress that
there will be an increase of some 500,000 clients nationally in order to get a portion of the new
funding released to the states. Expectations are that states will hold local agencies strictly
accountable for using these funds for the purpose of increasing the numbers of individuals
served.
North Carolina's share of these new funds is approximately $280,000. Because the funding is
short-term, quite limited, and intended to be used to demonstrate the ability of a local project to
increase the number of individuals receiving services, the funds will be handled through a
competitive process with approximately 10 or 12 health departments being funded. Attached is an
RFP that provides guidance in applying for this funding. You will note that the application process
is simple and brief and that the departments applying for this funding must show (1) that they can
document significant unmet need in their counties/districts, (2) that they have the capacity to
expand services significantly either on site or through a well-thought-out process for utilizing other
facilities, (3) that they have developed a workable plan to expand services, (4) that the costs of
expanding caseload are reasonable, and (5) that they can document success over the past three years
in recruiting and retaining patients.
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EveryWhere. EveryDay. EveryBody.
An Equal Opportunity / Affirmative Action Emplayer ~
31
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The experience gained through these special projects will be extremely important in our future
statewide effort to increase services to women, men, and teens through a Medicaid waiver currently
being prepared. If North Carolina is successful in gaining HCFA's approval of the waiver, men and
women at or below 185% poverty will be eligible for Medicaid coverage of their reproductive
health needs. Teens are also included in the proposed waiver, and their eligibility will be
determined based on their own income.
Because the Title X funding has only recently become available and because we hope to have the
competitive process completed by July 1, we have prepared a very simple RFP. Applications will
be due June 1. Please feel free to call on your regional nurse consultant or Margaret Woodcock
(919-715-3393) or William Brown (919-715-3394) if there are any questions.
cc: Ann Wolfe, MD, MPH, Director
Division of Public Health
Women's Health Regional Nurse Consultants
WCH Regional Social Work Consultants
Kevin Ryan, MD, MPH, Chief
Women's and Children's Health Section
Joy Reed, RN, EdD, Head
Nursing and Professional Development
Joe Holliday, MD, MPH, Head
Women's Health Branch
Dennis Harrington, MPH, Chief
Local Health Services
Enclosures
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NEW HANOVER COUNTY
HEALTH DEPARTMENT
2029 SOUTH 1 JIH STREET
WILMINGTON, NC 28401-4946
TELEPHONE (910) 343-6500, FAX (910) 341-4146
__,.E_.
DAVID E. RICE, M.P.H., M.A.
Health Director
LYNDA F. SMITH, M.P.A.
Assistant Health Director
May 24, 2000
Rachel H. Stevens, EdD, RN
Deputy Director and Clinical Professor
The North Carolina Institute for Public Health
UNC at Chapel Hill
CB# 8165
Chapel Hill, NC 27599-8165
Dear Dr. Stevens:
We are pleased to be part of the North Carolina Center for Public Health
Workforce Preparedness Proposal, which has been developed by The North
Carolina Institute for Public Health, UNC School of Public Health. By having the
opportunity to participate in basic training as well as design of the local model
surveillance to assure our workforce and partners, our health department will
have enough benefits.
Further, we understand that you are requesting a part-time local health
department person to serve as a liaison with the school and coordinate local data
activities. For that we would receive $12,500 for the first year to cover this
expense and a slightly lower amount in years two and three.
Speaking as the Health Director of the New Hanover County Health Department,
I am indicating our interest to be a partner in this endeavor. If funded, we
understand you will plan the next steps with our staff.
Good luck with the grant application.
~
David E. Rice, MPH, MA
Health Director
N ~ -;p,~ _ t'.. AM..~"
33
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NEW HANOVER COUNTY
OFFICE OF THE COUNTY MANAGER
320 CHESTNUT STREET, ROOM 502
WILMINGTON, NORTH CAROLINA 28401-4058
TELEPHONE (910) 341-7184
FAX (91 0) 341-4027
ALLEN O'NEAL
County Manager
ANDREW J. ATKINSON CPA
Deputy County Manager
PATRICIA A. MELVIN
Assistant County Manager
May 22, 2000
DAVID F. WEAVER
Assistant County Manager
414 Chestnut Street, Room 101
Telephone (910) 341-7139
Fax (910) 341-4035
To the New Hanover County Board of Commissioners and Citizens:
I am pleased to present the recommended budget for fiscal year 2000-2001. After
thorough review, I propose a tax rate of 59.5 cents, an increase of 3 cents over the
current tax rate.
e
The increase in the tax rate will partially cover the increased debt service on bonds
issued for New Hanover County Schools and Cape Fear Community College. The debt
service increase results from bonds passed by the voters in 1997 and it will continue to
increase for the next few years as full funding of the debt occurs. Future budgets will
also be impacted by additional operating and staffing costs of new facilities.
Operational efficiencies gained through modern technology will not offset the increased
operating costs of the expanded and additional facilities.
Debt service will increase in future years as the debt requirements of currently approved
projects are fully funded. These projects include the jail expansion, judicial building,
administration building, and Veterans Park.
The tax rate is proposed to fund a portion of the debt service increase and will fund
basic County operations with no expansions or enhancements for the next fiscal year.
Funding expanded facilities at a minimum level can't be continued into the future if the
citizens are to receive the services they demand. The decisions made to balance the
recommended budget with this tax rate will have some affect on long-term plans for the
County.
e
Involuntary annexation by the City of Wilmington continues to have a negative impact
on revenues for the County, Fire Service District, school system, and beach
municipalities. The primary impact is on sales tax. The County is losing $1.6 million in
sales tax growth, which would have occurred if the city had not annexed. This is
equivalent to one cent of the property tax rate. There is no significant decrease in the
County's service demands following city annexations. As this budget is being
presented, there is another phase of annexation under litigation. If the court's ruling is
in the city's favor, and becomes effective prior to September 1, there will be additional
revenue loss (for the County and other units impacted by annexation) for the third
quarter of FYOO-01. This potential loss in sales tax revenue is not included in the
budget. The financial impact will depend on when the annexation takes place.
42
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New Hanover County Board of Commissioners and Citizens
May 22, 2000
GENERAL FUND
Public Schools:
A transfer of $55,402,836 is recommended for the schools from the General Fund. Of
this amount, $5,488,648 is funded by the portion of sales tax designated for the schools.
No growth is projected in this revenue source for the schools due to the city's
annexation.
This transfer and $1,000,000 from the schools' fund balance will help fund the
$4,837,969 increased debt service and a 3 percent increase in operating and capital
expenditures over the FY 99-00 level. This is less than recent increases for the
schools, but more than the percentage increase in the General Fund. An increase of 10
cents in the tax rate would have been required to fund the total schools' request. It will
be up to the Board of Education to determine how the increased dollars for operating
and capital expenditures should be allocated.
Cape Fear Community College (CFCC):
Funding of $3,172,409 (an increase of $247,866, or 8.5 percent) is recommended for
Cape Fear Community College. The funding will be used to hire in-house custodial
staff, address deferred maintenance needs of existing college buildings, and fund
additional parking.
It should be noted that debt service in the General Fund will increase $858,581 for
CFCC bonds passed by the voters.
Personnel Issues:
Of 59 positions requested by department heads in the General Fund., 11 are
recommended. All of these positions will provide basic level service to expanded
facilities. An explanation of the recommended positions follows:
. Airlie Gardens (2):
A total of six positions were requested for the continued development of Airlie
Gardens and two are recommended.
. Governing Body (1):
A Clerk to the Board Trainee is recommended for one-half year to prepare for the
transition when the current Clerk retires and to assist with the growing workload
and complexity of the Clerk's Office.
. Finance (2):
The Insurance Advisory Committee function will reorganize effective August 31,
2000, resulting in the addition of two positions in the Finance Department. The
positions' cost will be paid by the participating organizations that benefit from the
service.
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New Hanover County Board of Commissioners and Citizens
May 22, 2000
. Health:
Two Environmental Health positions were approved on April 17, 2000. The
positions' cost for one year is equivalent to revenue that the Health Department
anticipates from a one-time project that will be conducted in FY 99-00. These
positions will be reviewed as new positions as part of the FY 01-02 budget
process.
. Parks (2):
Two Groundskeepers are recommended to maintain County parks. The Parks
Department requested a total of six positions.
. Property Management (4):
Three additional maintenance positions were requested. One Tradesworker is
recommended to maintain County buildings. In addition, three Housekeepers
are recommended to provide in-house custodial services for the Southeastern
Mental Health Center. Southeastern will reimburse the County for the cost of
these services.
Employees:
A Pay and Classification Study approved last year will be presented for implementation
in FY 00-01. An amount equivalent to 4 percent of salaries and impacted benefits is
included for implementation of the study. New Hanover County employees provide a
complex and varied array of services that citizens expect and enjoy. The country is
experiencing one of the most competitive employee markets ever. To employ and
retain a qualified, trained, and educated workforce will require a substantial expenditure.
The cost of not doing so will be much greater.
An amount of $960,000 is included for the County to fund the health insurance plan's 15
percent increase. There is no increase anticipated in the dental plan. An amount of
$120,000 is included to lower the out-of-pocket cost for prescription drug~: The increase
in out-of-pocket cost of prescriptions during the current fiscal year has been a concern
to employees.
County employees will not have an increase in their cost for health or dental insurance.
Also included is the amount of $30,000 to continue the county-wide employee training
program developed and .operated by the Human Resources Department. The training
program has proven very effective.
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New Hanover County Board of Commissioners and Citizens
May 22, 2000
OTHER
District Attorney:
County funds are included in the District Attorney's budget to contract with the State for
an Assistant District Attorney. While this position will be cost-effective, it is another
example of the County supporting programs that are the State's responsibility.
General Government:
An amount of $262,800 is included to begin implementation of an integrated 'financial
system. This amount reflects the first-year cost. The total project is estimated to cost
$1,000,000 and will be financed over a three-year period.
Museum:
An amount of $400,000 is included to continue efforts to stop water intrusion and correct
problems caused by settling of the building. This is necessary to protect Museum
visitors and guarantee the insurability of the artifacts.
Library:
An increase of $118,913 in the budget for books will enhance library operations in the
current facilities, as well as the Northeast Regional Library, which is scheduled to open
in September 2000.
Department of Social Services:
The department's budget is based on continuation of the contract for support
enforcement and continuation of the current favorable economic conditions. If the
Board of County Commissioners decides to change the existing contract or designate
anothereiltity to administer Child Support, additional County dollars may be required. If
the economy takes a downturn and unemployment increases, the Work First caseload
may increase resulting in an increase in County cost of the department. The increase in
County dollars for DS~ is 2.5 percent.
Sheriff's Department:
Funding is recommended at over $100,000 a month to transport and house inmates in
other facilities to relieve overcrowding in the jail. It is essential that construction of the
new jail be completed as soon as possible to eliminate this cost and overcrowding
problem.
Southeastern Mental Health Center:
An increase of $116,305 is recommended to fund additional staff for the Juvenile Sex
Offender Program to enhance the delivery of treatment and support to children. .
44
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New Hanover County Board of Commissioners and Citizens
May 22, 2000
Outside Agencies:
There are some minor shifts in funding for outside agencies, which can be reviewed in
detail on Pages 26-29. In Human Services, there is a slight increase in total funding for
agencies. The Human Services Allocation Advisory Committee makes
recommendations on the Human Services' funding.
Broadcasting:
An amount of $135,000 is included to begin broadcasting of Commissioners' meetings
via cable television. Additional resources may be added to that capability to meet the
growing demand to keep citizens informed as the cable franchises are renegotiated.
REVENUES
The growth in the tax base between FY 99-00 and FY 00-01 is expected to be 3.2
percent. This small increase is the result of the slowed growth the County is
experiencing. The increase in the tax rate of 3 cents will partially cover the increased
debt service.
The current ad valorem tax base is estimated to be $16 billion. Based on this estimate,
a penny will be worth $1,568,000.
There is no increase estimated In sales tax in the current fiscal year due to the city's
recent involuntary annexation. Local option sales taxes are distributed by the ad
valorem method and are the second largest revenue source for the Coun1y.
The County, beach municipalities, schools, and Fire Service District portions of the
sales tax will continue to be impacted by the city's involuntary annexation. If the next
phase of annexation, which is currently being litigated, would take place before
September 1, 2000, the revenue from sales tax would decrease during the last quarter
of FY 00-01 and the budget may need to be adjusted.
Due to less-than-anticipated growth in sales tax, the amount budgeted for sales tax may
not be realized in the current fiscal year. The possibility of shortfall is based on only two
quarters of data.
Approximately $2 million of the undesignated portion of the two one-half cent sales
taxes is being used for General Fund operations. In the past, revenues from this source
have been transferred to the Water and Sewer Fund, and to a lesser extent, the
Environmental Management Fund. The reduction in the transfer to the Water and
Sewer District impacts future plans for the water and sewer system.
45
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New Hanover County Board of Commissioners and Citizens
May 22, 2000
Inspections:
A fee schedule that is more responsive to market conditions while maintaining the
department's self-sufficiency is being developed. The Inspections staff has been
working with the contracting community through committees and presentation/feedback
sessions. Together, they have developed a solution that I feel will be workable. The
fee schedule will be presented May 22, 2000, for Board approval and adoption. Major
changes have not occurred in the fee schedule in over a decade.
Sheriff:
During FY 99-00, the County began receiving revenue from the State-implemented 80
cents per month surcharge on cellular telephone service. These funds are being
accumulated for future needs of the 911 Center.
FUND BALANCE
No fund balance is appropriated in the recommended budget. The County's strong fund
balance is important to our continued financial strength and maintenance of our
excellent bond rating.
ENVIRONMENTAL MANAGEMENT FUND
A transfer of $2.4 million from the General Fund is projected to balance the
Environmental Management Fund. Fund balance from the Environmental Management
Fund in the amount of $1.7 million is also appropriated.
The recommended tipping fee is $32, an increase from the current fee of $28 per ton.
Staff and the Solid Waste Advisory Board, who are knowledgeable in this field, continue
to review ways to provide waste disposal services to the citizens in the most efficient
and equitable manner.
FIRE SERVICE DISTRICT
The current tax rate of 3.5 cents is recommended for the Fire Service District.
The impact of the city's annexation plan on the Fire Service District will continue to be
reviewed. Implementation of the next annexation phase (currently being litigated) prior
to September 1, 2000, will impact the District and its budget. The Board will be kept
abreast of changes.
46
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New Hanover County Board of Commissioners and Citizens
May 22, 2000
WATER AND SEWER DISTRICT
The District currently provides service to approximately 26,000 water and sewer
customers (residential and commercial). The District's current operation and future
expansion are funded by user fees and a $2.4 million transfer from the General Fund.
CAPITAL IMPROVEMENT PROGRAM
No funds are included for directly funding capital projects. Plans call for financing the
cost of developing Veterans Park, administration building, judicial building, and jail
expansion. The Board may want to increase the budget to fund some of these projects
on a pay-as-you-go basis.
ACCOMPLISHMENTS
The County had a successful year. Summarized below are a few of the many items the
County and its staff have accomplished during the past fiscal year.
. Assisted citizens through preparation and recovery from three hurricanes.
. Recognized the employees of the Landfill for recording 5,000 consecutive days
without a lost-time incident.
. Moody's Investment Corporation upgraded New Hanover County's bond rating
from Aa3 to Aa2 on General Obligation Bonds and A 1 to Aa3 on existing
Certificates of Participation.
. Expanded the amount of information available to citizens via the Internet. The
new Register of Deeds system will be online in November and greatly increases
the convenience offered to the public.
UNKNOWNS
There are a number of items that are unknown, which may impact this budget prior to
the end of the fiscal year.
. The best way to fund and address the County's drainage needs.
. Future annexations by the City of Wilmington.
. The County's role in Legion Stadium renovations.
,
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47
New Hanover County Board of Commissioners and Citizens
May 22, 2000
e
. The most efficient way to provide child support services.
. The best way for the County and schools to plan and meet the future needs of
students at an acceptable tax rate.
. The State's actions on mental health.
There are many expenditure demands facing the County. This is coupled with a slower
growth in the tax base and decrease in sales tax revenue. This tightening of the
revenue stream is exacerbated by the city's involyntary annexation.
The State Legislature must be kept aware of the needs of local governments for
alternate sources of revenue. Additionally, the financial hardship that program
mandates and shifting of program responsibility has on local governments must be
made clear.
The revenue assumptions and human services funding levels are based on no major
downturn in the economy. This is a very tight budget. If economic conditions worsen or
other unforeseen events occur, I may have to bring budget amendments back to you
during the year. The estimates for revenues and expenditures are sound, but with no
e comfort margin for shifts in the economy.
There is no funding set aside for future projects. While not budgeting for future needs
has no impact on FY 00-01 operations, plans that have been established for the future
will need to be altered.
Thanks to County employees, New Hanover County continues to provide high quality
services to the citizens. As the County faces many challenges, I know the citizens can
continue to expect and rely upon a high level of employee dedication. But static staffing
of expanding facilities can only be stretched so far.
The staff and I look forward to working with you as the FY 00-01 budget process is
completed.
Q/\k~
Aile O'Neal
County Manager
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REQUESTED AND RECOMMENDED POSITIONS
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Department t Position Classification Funding a.. t
Aging. Nutrition 1 Case Manager Social Worker Gene",' Fund
Aging - Senior Center 1 Office Aaalstant - Reception/Switchboard General Fund
Aglng- Nutrition.. Congregate 0 Nutrition Site Manager (Castle Hayne) General Fund
Cooperotlve . Alrlle 2 Landscape Technician General Fund
CooperatIve . Alrlle 4 Gfounda"- GenenlI Fund 2
County Commissioners 1 Clerk to the Beerd Trainee General Fund 1
DSS . Admlnl_on 1 Income Maintenance Caseworker I 100% State Funds
DSS . Admlnl_on 1 Automation Specialist 153% Slate/Fed 47% County
DSS - Admlnl_on 1 Communltv Services Coordinator 153% Slata/Fed 47% County
DSS . Admlnl_on 1 Clerlcel Specialist I 153% Slatelfed 47% CountY
DSS . Admlnl_on 1 Clerlcel Speclallal I 153% Slate/Fed 47% County
Finance 0.28 Parking A....nclant City of Wilmington 0.28
Finance Risk Manager Oeneral Fund/Other EntItI8I 1
Finance Administrative Secretary Gunerel Fund/Other EntltI. 1
Health - Administration 1 Epldemlologlal General Fund
HeaIth.Admlnl_n 1 Clerlcel Speclallal II General Fund
Health . Admlnlatratlon 1 Compulllr Support Speclallal GenenlI Fund
Health . Animal Control 1 Sh_ AlIlmdant GenaraIFund
Health. Child Health 1 Medlcel OIlIce Allalatant General Fund
Health. Comm. 01.._ 1 Clerlcel Speclallal I (Part-time 50%) General Fund
Health .. Environmental Health 1 Clerlcel Speclallat I General Fund 'l FII>R;:~ :ut": of
Health - E...."'nm_IHeaIth 1 Envl",nmentlll Health Speclallat General Fund. \ a..wi... I~FI '.:IOO:U
Health .111III_ Home VIall 1 PHNI Grant a Medlceld Revenue
Health. Jall_ 1 LPN II General Fund
Health - Partnerehlp for Children 0.5 Clerlcel Specialist I Grant 0.5
Health. School Health 9 PHNI NHC Schools
Health . School Health 1 Clerlcel Speclallal I NHC Schoola
Legal 1 Clerlcel Specialist I Revenue Generated
Ubrarv 1 Compulllr Support Specialist General Fund
Ubrary 1 Ubrarl.n II "Electronic Reaourcea" General Fund
Ubrarv 1 Llbrarv __ General Fund
Parka 1 Tradeswo_ I General Fund
Parka 4 Ground.keeper General Fund 2
Parka 1 AllallII8nt Parka Dlractor General Fund
Property Managament 1 0lIlce Allallll8nt o.nerBr Fund
Property Man_ant 2 Tradeawo_ II General Fund 1
Property Management 1 Maintenance Mechanic General Fund
Propertv Management 0 Housekeeper II 100% SEMH 1
Property Menagemant 0 HousekeeDer I 100% SEMH 2
Sherllf - Admlnl_on 3 -a General Fund
Sherttf.. Admlnlstndlon 1 Clerical Allalalant General Fund
SherIII. Admlnlatratlon 2 Clvtl Deputy General Fund
Sherllf - Admlnlatratlon 1 Data Entrv Operator 1 General Fund
Sheriff .. Administration 1 Clerlcel Allalalant Ganel'lll Fund
Sherllf -Admlnl_on 1 Deputv SharllllSchool Resou"", Officer General Fund
SherIII. Admin_on 1 Program SpeclallatfGrant Wrt... GenaralFund
SherlfI-Admlnl_on 1 Computllr Syatama Admlnl_r II Gen..... Fund
Fire Services .. Admlnlatnltlon 1 Fire Training Coordinator Fire Service Dlatrlct Tax
Fire Services - Operations 5 Flrellghter/Apparatua Operator Fire Service Dlatrlct Tax
We... a S_r . Finance 1 Accounting Technician I W.ter a _ Dlatrlct 1
Water a S_ . Engineering 1 UtIlity Grounds Maintenance Worker II W.... a _ Dlatrlct 1
_ a S_ - Engineering 1 General Service Worker w_a _ Dlatrlct 1
_a _ - Englneerlna 1 Allalstant UtIlItY Plumber w_a_~ 1
_a _. Engineering 1 Clew Leader I W_ a _ 0_ 1
_ a 8_. Engineering 1 Assletant Camera Operator Water a S_ Dlatrlct 1
TOTALS 71 0.T5 17 0.75
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General Fund 89 0.75 General Fund 11 0.75
Fire ServIces . Fire ServIces 0
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TOTAL: 71. 0.75 TOTAL: 17 0.75
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NEW HANOVER COUNTY
HEALTH DEPARTMENT
2029 SOUTH 171H STREET
WILMINGTON, NC 28401-4946
TELEPHONE (910) 343-6500, FAX (910) 341-4146
e~ &v.ydI.,. Ewcr,bodr.
DAVID E. RICE, M.P.H., M.A.
Health Director
LYNDA F. SMITH, M.P.A.
Assistant Health Director
June 5, 2000
To:
New Hanover County Board of Commissioners
From:
New Hanover County Board of HeaIth
Subject:
FY2001 Budget Appeal
The following items were requested in the Health Department's original FY200 I Budget Request
but not included in the FY2001 Recommended Budget. On Tuesday, May 30, 2000 the
Executive Committee of the New Hanover County Board of Health passed a motion to request
reinstatement of these items in the Health Department's Budget for FY200 I
Positions: Original County For Re- Proposed Total
Budget Recommendation Consideration Salary I Fringe
Request
Epidemiologist I 0 1 $52,848
(FTE) (FTE)
Computer Support I 0 I $36,654
Specialist (FTE) (FTE)
Licensed Practical ] 0 I $29,356
Nurse II (FTE) (FTE)
Justification:
Administration: Epidemiologist- The Epidemiologist will apply the disciplines of epidemiology
and bio-statistics as diagnostic tools to evaluate and affect the public health. This position will
enable environmental and public health programs to improve the health status of our
community. This will be accomplished through analysis, research and study of various
environmental and health data generated in the community; thus allowing for more thorough
investigation of outhreaks (food-borne or other) and other public health threats. This position
will identify factors associated with disability, morbidity, mortality and other deterrents to
physical, mental and social well being. This position will recommend interventions, policies, and
legislation appropriate to mitigate contributing factors and, thereby, optimize the quality of life.
This position assesses health problems, determines their origin, tests means for dealing with them
and measures progress against them. This position predicts the probability of disease or of being
at a particular point in the health spectrum as a function of biology, environment, nutrition and
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behavior This position conducts epidemiological studies, field surveys and individual case
investigations to determine the routes and magnitude of human exposure to environmental
pollutants, toxic substances and infectious diseases. This position examines distribution of a
disease or particular point in the spectrum of health together with distribution of the above noted
factors in the whole population. This position examines strength of the observed association, its
consistency, its specificity, its coherence, the chronology of events (exposure preceding outcome)
and other plausible cause to determine risk factors and to determine degree for a given outcome.
Administration: Computer Support Specialist- This positIon will provide support to all
department PC users in the areas of hardware and software including installation, networking,
training and maintenance. Currently, the Business Officer is providing this in-house support.
Our Computer Systems Administrator provides support for most of our QS in-house patient-care
management computer software and our AS400 system. The Business Officer has basically taken
on the responsibilities that the County Information Technology Department previously provided
for the health department. This in itself is requiring a tremendous amount of time. We are
transitioning to a department wide PC based environment which will require even more time for
someone to provide the training, troubleshooting, daily maintenance and support necessary for
our end users. In order for our department to migrate towards becoming self-sustaining in the area
of Information Technology, this position is needed. This position is also needed in order to
alleviate unnecessary down time for our end users thus improving overall efficiency and
effectiveness for our department as a whole. This position will also eventually assume
responsibility for maintaining the newly implemented software application, Chameleon, for
Animal Control.
Jail Health: Licensed Practical Nurse 11 - This position is needed for several reasons to
include: medication administration at the jail has increased by more than 50% and dental
medications are now also being prepared. Federal requirements have increased to include
tuberculin skin tests and additional paperwork is required when inmates are transferred. Written
requests have replaced verbal ones when obtaining approval for payment for services outside the
jail. Inmates are remaining in jail longer and we are now doing second annual physicals on some
of them. There are an increased number of homeless patients with chronic diseases that require
ongoing evaluation and treatment. Our Nurse Practitioners and Nurses must work overtime to
meet inmate needs.
The county will see benefit from this position for health care that is required by law will be
provided and working conditions for our current staff will improve thus promoting stability
within the workforce and reducing staff turnover If this position is not funded then patients will
not receive the care they need and cannot access for themselves.
Capital OutIay- Original County For Re- Proposed Total
Equipment: Budget Recommendation Consideration for Line Item
Request
Administration- $ 22,500 $0 $ 22,500 $ 192,128
Laptops for
Environmental
Health
(5131 - 6399)
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Justification:
Administration: Laptops for Environmental Health- We are requesting nine laptops for our
Environmental Health Division. These laptops would serve as replacements for the current
laptops being used daily in the field by our environmental staff. Due to constant use, the current
equipment is in need of ongoing repair and maintenance. It is not uncommon for at least one of
our current laptops to be "in the shop" for repair The use of laptops enables real-time capture of
data as opposed to manually recording and keying at a later time; therefore, significantly
increasing accuracy and efficiency ofthis process. Laptops also enable our staff to produce at the
conclusion of an establishment's evaluation a printed report of non-compliant items; therefore,
facilitating communication with the establishment's operator thus enhancing their ability to
immediately address problems. Laptops have proven to be an integral part of our daily routine
and are necessary to continue delivering quality service for our community
Other Original County For Re- Proposed Total
Expenditnres: Bndget Recommendation Consideration for Line Item
Request
Board- Strategic $ 10,000 0 Increase of $ 12,700
Planning $ 10,000
(5132-3700)
Board- Strategic $2,000 0 Increase of $ 2,000
Planning $ 2,000
(5132-4210)
Justification:
Board: Strategic PIanning- The New Hanover County Board of Health would like to implement
a strategic planning process in order to develop goals and objectives to improve the efficiency
and effectiveness of our department for the citizens of our community The total amount being
requested for this process is $12,000. Of this amount, $10,000 will be used to contract a
facilitator for this process and the remaining $2,000 will be used for supplies to carry out this
process. Strategic Planning is essential to provide direction to the Board of Health and to health
department staff.
Other Original Connty For Re- Proposed Total
Expenditures: Budget Recommendation Consideration for Line Item
Request
Salary Lag $225,000 $300,000 $225,000 $225,000
(5161)
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Justification:
Salary Lag- Our request is for the amount of salary lag to be maintained at the current fiscal year
amount of $225,000. We understand that this amount is based on staffturnover however this year
resulted in a higher turnover rate than we have experienced in the past. We do not want our
operations and services to be placed in jeopardy based on one year of data. We anticipate that
staff turnover for the upcoming year will decrease and that we will not be able to meet the
$300,000 salary lag being recommended from the County Frequently, because of turnover, we
must request temporary help to assist in our clinics in order to provide our services to our citizens.
We believe our ability to use temporary help until vacancies are filled will be jeopardized by the
increase of salary lag to $300,000 We also believe that the amount of $225,000 is a more
realistic amount for our department.
~#~,-,~~
William T. Steue, E,RLS
Chairman, New Hanover County Board of Health
CC: Allen O'Neal, County Manager
Pat Melvin, Assistant County Manager
Carn Griffin, County Budget Director
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NEW HANOVER COUNTY
BEALm DEPARTMENT
2029 SOUTII 11"' STREET
WILMINGTON, NC 28401-4946
TELEPHONE (910) 343-6500, FAX (910) 341-4146
.........-. ....,...,.
DAVID E. RICE, M.P.H., M.A.
Health Director
LYNDA F. SMITH, MoP.A.
Assistant Health Director
May 18, 2000
Bill Holman, Secretary
NC Department of Environment
and Natural Resources
1601 Mail Service Center
Raleigh, NC 27699-1601
Dear Mr. Holman:
The purpose of this letter is to formally request the NC Department of
Environment and Natural Resources, Division of Marine Fisheries collect the
necessary samples and take another look at the issue of mercury in ocean fish
within the next two years. The New Hanover County Board of Health believes
that it is important to the coastal counties of Eastern North Carolina to validate
the fish consumption advisory due to high levels of mercury.
At its May 3, 2000 meeting, the New Hanover County Board of Health
discussed the issue of mercury in ocean fish. Dr. Luanne Williams, Toxicologist
with the North Carolina Department of Health and Human Services presented the
findings of a risk assessment on the consumption of king mackerel. This
assessment was based on the mercury sampling results of the Division of Marine
Fisheries. 181 king mackerel (NC-112, SC-28, GA-20, and FL-21) were collected
off the coast of North Carolina, South Carolina, Georgia, and Florida in 1998 and
1999. Reviewing the results, it appears that there were variations among the
states in both the numbers collected and the mercury tissue levels.
The North Carolina Department of Health and Human Services recently
issued a fish consumption advisory based on the above samples. The public has
been advised not to consume king mackerel larger than 39-inches and to limit
consumption of 33 to 39-inch king mackerel. We believe this was an important
step to protect the public's health.
In addition, economic impact will be felt up and down the coast of North
Carolina, as this is a prized catch to commercial and recreational fishermen.
This confirms the loss a valuable natural resource that may not be restorable and
moreover, suggests that other large Atlantic species may also be suspect.
N ~ -:l<r:,/d - d.. .AMtl~'"
Bill Holman, Secretary
May 18, 2000
Page 2
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We look forward to your favorable consideration of our request to re-
sample ocean fish for mercury within the next two years.
David E. Rice
Health Director
Cc: Senator Charles W. Albertson
Senator Patrick J. Ballantine
Senator Marc Basnight
Senator Luther Henry Jordan, Jr.
Senator Beverly Eaves Perdue
Senator R. C. Soles, Jr
Representative William T. Culpepper, III
Representative Dewey L. Hill
Representative Daniel Francis McComas
Representative Edd Nye
Representative Jean R. Preston
Representative E. David Redwine
Representative Ronald L. Smith
Representative Nurham O. Warwick
Representative Thomas E. Wright
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Care to Collaborate
May 17,2000
Agenda
1 :00-1 :30 Opening Remarks
Bill Caster, Chair, New Hanover
County Commissioners
Leo Petit, CEO Bladen Hospital
Thad Wester, M.D., N.C. State
Board of Healthy Carolinians
1 :30-2:15 Needs Assessment Preliminary Report
Focus Groups
Sandy Diehl, Coastal AHEC
Melissa Hockaday Coastal AHEC
Greg Barker, NHRMC
Bruce Lockwood, V. P., PRC
Secondary Data
Telephone Survey
2:15-2:30 Break
2:30-3:45 Round table discussion- Please participate in one of the following
discussion groups:
. Tobacco and Substance Abuse
. Health Education and Preventive Services- Awareness of existing services
. Health education and Preventive Services- Need for additional services
. Senior Issues
. Transportation and Traffic Issues
. Youth Issues- Children
. Youth Issues-Teens
. Environmentallssues
. Crime ---,------~-"--
. Economic Development
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3:45-4:00 Break
4:00-4:45 Group reports
Facilitator reports for group
4:45-5:00 Closing Remarks
Bill Shepley, Exec. Director,
Coastal Carolina Health Alliance
Bill Atkinson, Ph.D., President
and CEO. New Hanover Health
Network
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Southeastern North Carolina
Regional Health and Human Service Needs Assessment
In Spring, 1999, a collaborative group representing agencies and organizations serving
southeastern North Carolina began exploring how they might update the 1996 Coastal
Carolinas Community Health Needs Assessment compiled by the Coastal Carolina
Health Alliance. The vision shared by this group is "a collaborative initiative by
communities, organizations and individuals working together to improve the social,
physical and mental well-being of people in southeastern North Carolina". The group
realized that current data were needed before priorities could be established and action
plans developed.
The goals of the Southeastern Regional Health and Human Service Needs Assessment
include:
. To gather primary and secondary data from the region regarding health and human
service needs.
. To develop a cost-effective needs assessment process that can be replicated every two
years, providing a consistent means to measure current health and human service
needs of the region.
. To develop a tool that meets the needs of many different organizations.
. To mobilize available resources throughout the region to implement the needs
assessment, thereby building new collaborative relationships.
The needs assessment process began in June, 1999, with participation from organizations
in Bladen, Brunswick, Columbus, Duplin, New Hanover, Pender, Robeson and Sampson
counties. Data collection methods included telephone survey, focus groups, and
compilation of secondary data from local, state, and national sources.
The preliminary data from the needs assessment is now available to the public through
contact persons in each county. Please call the contact person for your county for
additional information or data.
Bladen- Joy Grady, Bladen Healthwatch, 910.862.1499
Brunswick- Fred Michael, Brunswick County Health Department, 910.253.2298
Columbus- Debbie Albritton, Columbus County Hospital, 910.642.1734
Duplin- Cindy Slaughter, Duplin General Hospital, 910.296.2694
New Hanover-Sharon Benoit, New Hanover Health Network, 910.343.2131
Pender- Sharon Benoit, New Hanover Health Network, 910.343.2131
Robeson- Mary Black, Southeastern Regional Medical Center, 910.671.5830
Sampson- Helen Harris, Sampson County Health Department, 910.592.1131
The needs assessment data will be available on the internet at www.nhrmc.org in late
September, 2000.
~
2000 Southeastern Region Health & Human Services Needs Assessment
-
PRC Health & Human Services Telephone Survey
SummarY of Findings
Professional Research Consultants, Inc. (PRe) conducted the telephone survey over the 8-county region.
The sample design utilized for this effort consisted of 2,100 random individuals aged 18 and older in the
dermed community In order to eliminate any naturally occurring bias, PRC weighted the randomized data
so that the results of the random sample matched the demographic characteristics of the population
surveyed.
Human Service Issues
Among the 8-county Southeastern Region, the greatest issues perceived to be facing the area include traffic
and roads, drug use, education, overpopulation, access to health and human services, pollution,
unemployment, poverty, and crime. In addition, respondents were specifica\1y asked to assess the level of
seriousness of a variety of issues in specific areas of concern. These areas included: Community Issues,
Employment Issues, Environmental Concerns, Family Issues, Health Concerns, and Senior Citizen Issues.
Specifica\1y, "serious" areas of concern most often mentioned were basic education, availability of entry-
level jobs with benefits, mosquitoes, teen pregnancy, drug or substance abuse by minors, and the cost of
prescription drugs for senior citizens.
Health Status
Compared to the nation as a whole, rmdings for mental health status in the 8-county region are positive,
with fewer days of poor mental health found locally. However, in comparison to national benchmarks,
health status in the region is helow average in many regards, including many factors relating to physical
health status, such as activity limitation and obesity In particular, the prevalence of activity limitations is
significantly higher in Southeastern North Carolina (18.7%) than it is in the US overa\1 (14.9%). Also,
there is a significantly higher portion of individuals diagnosed with diabetes (9.9% regiona\1y as compared
to 5.4% nationa\1y).
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Modifiable Healtb Risks
In comparison to national averages, positive rmdings relating to modifiable health risk behavior include a
lower prevalence of alcohol use in the region, as we\1 as a lower percentage of drinking and driving when
compared to the nation as a whole. On the other hand, nutrition and tobacco usage were of particular
concern. Less than one-fourth (24.3%) of adults in the region eat 5 or more servings of fruits and
vegetables per day, significantly lower than the 30.0% found nationwide. Nearly 3 in 10 adults in the
region are currentsmokers (28.2%), significantly higher than the 22.8% found nationwide.
Prevention
Regarding preventive care measures, the 8-county region fares better than the nation as a whole in regard
to routine physician visits, but worse than the nation as a whole in regard to routine dental care. More
specific areas of concern that were higher than average are: number of women over age 40 who have had
mammograms, number of adults age 65 and over who have had influenza and pneumonia vaccinations, and
number of adults who have had a routine checkup in the past year.
Amn
Access is a key issue for communities across the country Barriers such as cost and insurance coverage can
be prohibitive factors for many residents. It is particularly important to consider how these barriers impact
various subsegments of the population, particularly low-income and minority residents. Of particular
concern is that 13.9% of area adults indicate cost prevented a physician visit in the past year, higher than
10.4% found across the nation. The percentage rises to 24.6% among those living at or near the poverty
level and 17.9% among African-Americans. A total of 11.2% of adults ages 18 to 64 indicate they do not
have health insurance, we\1 below the 15.6% found among adults nationwide. Lack of insurance coverage
is most noted among those at the lowest income and education levels (24.5% and 16.0%, respectively).
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2000 Southeastern Region Health & Human Services Needs Assessment
Secondary Data
SummarY of Findines
Existing data on the 8-county region was compiled from a variety of sources. These data were then
compared to statistics to both state and national levels. These data were also used in comparison to the
results of the telephone survey by Professional Research Consultants, Inc. (PRe).
Statewide Risk Factor Data
Statewide risk factor data are provided where available as an additional benchmark against which to
compare regional rmdings. These data are reported in the 1998 BRFSS (Behavioral Risk Factor
Surveillance System) Summary Prevalence Report published by the Centers for Disease Control and
Prevention and the U.S. Department of Health and Human Services. Additional data were referenced from
the North Carolina Center for Health and Environmental Statistics, Sheps Center for Health Services
Research, North Carolina Health Professions Data System, and North Carolina Department of Health and
Human Services.
Nationwide Risk Factor Data
Nationwide risk factor data are taken from the 1999 PRC National Health Survey Data have also been
compiled from the Centers of Disease Control and the North Carolina Center for Health and Environmental
Statistics.
Healthv Peonle 2010 Goals
"Healthy People 2010: Understanding and Improving Health" is part of the Health People 2010 initiative
that is sponsored by the U.S. Department of Health and Human Services. Healthy People 2010 outlines a
comprehensive, nationwide health promotion and disease prevention agenda. It is designed to serve as a
road map for improving the health of a\1 people in the United States during the first decade of the 21st
century
With [specific] health objectives in 28 focus areas, Healthy People 2010 wi\1 be a
trernendously valuable asset to health planners, medical practitioners, educators, elected
officials, and a\1 of us who work to improve health. Healthy People 2010 reflects the very
best in planning - it is comprehensive, it was created by a broad coalition of experts from
many sectors, it has been designed to measure progress over time, and most important, it
clearly lays out a series of objectives to bring better health to all people in the country
~Donna Shalala,.SecrelMY of Health anUIUIIl8D Services _________.
Like the preceding Healthy People 2000 initiative - which was driven by an ambitious, yet achievable, 10-
year strategy for improving the Nation's health by the end of the 20th century - Healthy People 2010 is
committed to a single, overarching purpose: to promote health and prevent illness, disability, and
premature death.
Areas of Concern
Review of the secondary data revealed three primary areas of concern for Southeastern North Carolina.
These areas included tobacco and substance abuse, health education and preventive services, and economic
development. A higher number of individuals than average use tobacco and tobacco-based products
compared to state levels. With respect to health education and preventive services, there is an increased
number of new UN cases reported in Southeastern North Carolina than compared to state levels. In terms
of economic development, there are a higher number than average of Medicaid births and higher poverty
rates in the region as compared to state indices.
,~
2000 Southeastern Region Health & Human Services Needs Assessment
Coastal Area Health Education Center
Focus Group Data
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Focus groups are being conducted to gather input about the needs and strengths of our community This focus
group data complements two other types of data being collected for the regional needs assessment. Preliminary data from
30 focus groups conducted in 5 southeastern North Carolina counties are presented below Three other counties that are
participating in the assessment are still in the process of collecting focus group data and are not included in this summary
Complete information will be presented in the fmal report.
Key contacts in each county identifIed focus group moderators and helped to organize their county's focus groups.
Coastal AHEC provided moderator training. Each moderator and note taker prepared summary reports of each group's
discussion. Each county was asked to conduct six groups, (two key leader groups, two service provider groups, and two
community member groups). Suggestions to make each group diverse in order to capture a broad representation of
opinions were provided during moderator training. The focus group discussion focused on three key areas: broad
questions about the community, questions about health and welfare improvement, and questions about health and human
services. Moderators were asked to tape record group discussions, however some counties elected to only take notes
according to participants' preferences.
Data were analyzed by coding information and identifying key themes. Themes were analyzed within the 3 broad
categories of questions and by type of group (i.e., key leader, service provider, or community member) for each county
To determine regional issues, we examined county reports of key themes and synthesized data according to type of group.
Themes that appeared frequently in all 3 types of groups across the region emerged as top issues. These issues are
presented below
Key Leaders
Service Providers
Challenees
Public transportation
Challenees
Knowledge of available services
Cultural diversity & language barriers
Maior Concerns for Health & Welfare
Water quality
Preventive services and health education
Services
Improve awareness/communication of services/resources
Medical specialists located in counties
Recreation/social activities for seniors
Maior Concerns for Health & Welfare
Access to health care
Water quality & farm pollution
Health education & prevention
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Services
Needs of indigent & non-English not being met
Public transportation is barrier to access
Shortage of providers, especially medical specialists
Activities for youth
- Community MeiDbers.---
Top Regional Issues
Challenees
Public transportation
Specialists & health care services
. Transportation
. Environmental issues - Water quality, insects,
farming pollution
. Health education & preventive services
. Awareness of services/resources
. Need for specialty services in counties
. Need for youth/senior recreation/activities
. Bilingnal information & translators
Maior Concerns for Health & Welfare
Environmental
Health
Services
Activities/recreation for youth & seniors
Better health care insurance to help with costs
Health education and support/prevention programs
Better service at clinics
Publicity/advertisement for services - bilingual
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~ Raleigh, North Carolina Skyline
Assuring Critical Capacities
in Public Health:
The Role of Local Boards of Health
in Building Infrastructure
July 26-29, 2000
Sheraton Capitol Center
Raleigh, North Carolina
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National AssociatIOn ot Local Hoards of Health
In Cooperation with
Association of North Carolina Boards of Health
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ATTENTION NALBOH MEMBERS:
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-Wednesday, July 26. 2000 -9.00 a.m. to 4.30 p.m.
Sheraton Capitol Center Hotel
RaleIgh, North Carohna
The Workshop
Aqenda
Presented by Amencan's for Nonsmokers
RIghts Foundatlon(ANRF)
9.00 a.m. RegIstration and Coffee
9.30 a.m. Welcome & Day OvervIew
9.45 a.m. Icebreaken...
10.00 a.m. Prepanng the SOlh
11.00 a.m. Break
11.1S a.m. Knowmg the OpposItion
12.1S p.m. Lunch (provIded)
1.00 p.m. In the MIX...
2.00 p.m. Break
2.1S p.m. Implementation Issues.
3.00 p.m. Mock Board of Health Debate
4.1S p.m. Closmg Remarks
4.30 p.m. ADJOURN
ANRF IS d ndtlondlly recognized orgdnlzdtlon
thdt promotes smoke-free environments.
ANRF will conduct thIS one-ddY workshop on
cledn Indoor dlr poliCIes dnd rt!!fuldtlons to
provide locdl bodrd of hedlth members With
tools to formuldte dnd endct effectIVe cledn
Indoor dlr rt!!fuldtlons. PdrtlClpdnts Will ledrn
the nuts dnd bolts of d winning cledn dlr
polley InltldtlVe.
Sponsored by.
-Amencans for Nonsmokers RIghts Foundation (ANRF)
-Centers for DIsease Control and Prevention, Office on SmokIng & Health
-National Asso(1atlon of Local Boards of Health(NALBOH)
--------------------------------------------------------.
"Back to BaSICS" Workshop RegIstratIon
As a current member of NALBOH, I would like to take advantage of this membership benefit. Enclosed is a check for $25 to
cover breaks and lunch, payable to the National Association of Local Boards of Health.
Name
Organization
"'-.
Address
E-mail
--./"
Phone Fax
Mail by June, 19,2000 to: NALBOH, 1840 East Gypsy Lane Road, Bowling Green, OH 43402. If you have any questions,
please call our office at (419) 353-7714.
--------------------------------------------------------.
o
PrograID..
Sched.'-1I.e o~
E-v-en:t;s
I
Wednesday, July 26,2000
9:00 a.m.-4:00 p.m.
9:00 a.m.-4:3O p.m.
12:00 p.m.-2:00 p.m.
3:00 p.m.-7:00 p.m.
4:15 p.m.-5:00 p.m.
Q p.m.-6:15 p.m.
6:30 p.m-7:45 p.m.
8:00 p.m.-9:00 p.m.
9:00 p.m.-l0:00 p.m.
f
\.....
9:00 p.m. & 10:00 p.m.
NALBOH Executive Board Meeting
Back to Basks:
Passing Clean Indoor Air
Ordinances-separate registration
required
ANCBH Board of Directors
Luncheon Meeting
Registration
Poster Session Set Up
Exhibitors Set Up
Raleigh Trolley Transports from
Hotel to Opening Event (several
trips will be made)
Reception and Guided tour of the
North Carolina State Capitol
Building
This National Historic Landmark is a fine
example of Greek Revival architecture
built between 1833 & 1840.
Dinner in the Lobby of the North
Carolina Museum of History
View exhibits covering North Carolina
history from pre-Colonial times to the
present. Current exhibits include:
North Carolina and the Civil. War,
Health & Healing Experiences in
North Carolina,
North Carolina Legends
North Carolina Sports Hall of Fame
Virginia and the Carolinians
Entertainment in Auditorium of
North Carolina Museum of History
Enjoy "Good Ole" toe tapping traditional
bluegrass and old time music
North Carolina Museum of History:
Open exclusively to NALBOH guests
Raleigh Trolley transport to Hotel
(several trips will be made)
Thursday, July 27,2000
7:00 a.m.-5:00 p.m.
Registration
Exhibits Open
7:30 a.m.-8:3O a.m.
President's Breakfast:
National Associations
Presidents, Past Presidents
Presidents-Elect, Executive Directors
Breakfast with roundtables
by Region
8:30 a.m.-8:45 a.m.
Honor Guard Ceremony
Wayne County. Sheriff's Department
National Anthem Singer- TBA
8:45 a.m.-9:00 a.m.
Opening Welcome
Governor James B. Hunt, IT Invited
Greg Patterson, Chair,
Wake County Human Senlices Board
9 a.m.-l0:15 a.m.
Keynote Speaker
The Role of Local Governments in
Responding to Natural Disasters
Senator Beverly Eaves Perdue
(D, 3rd District, NC)
Concurrent Sessions:
10:45 a.m.-Noon
Update on Food Safety Standards
Betty Harden, R.S.
FDA Center for Food Safety & Applied Nutrition
Supervisor, Retail Food & Interstate Travel Program
This session will focus on an overview of FDA's Recommended
National Regulatory Retail Food Program Standards and the success
of their application when field tested. The dynamics of their
relationship to other advances in food safety at the retail level will be
discussed. Coordinated efforts involving FDA, CDC, USDA, other
federal agencies, and state, tribal, and local jurisdictions via the Food
Safety Initiative, FoodNet, the Federal Food Safety Coalition, and lhe
National Food Safety System, will be discussed within the perspec-
tive of the Program Standards.
Hurricane Floyd- A Public Health Response Panel
Ronald C. Burger, Senior Emergency Response Coordinator, CDC
Chair, Rockdale County Board of Health, GA
Michael Kelly, CPM, Director, Hurricane Floyd Response Coordination
Center
Jim Baluss, Health Director, Edgecombe County, NC
Rev, A.C. Batchelor, Chairman, Edgecombe County Board of Health. NC
Hurricane Floyd was the largest national disaster in North
Carolina IS history This session will examine the public health
response to Hurricane Floyd from the perspective of local, state, and
federal public health officials. Presenters will discuss the immediate
and long term public health needs and issues that are associated
with such catastrophic events.
Improving Health Status with Healthy People 2010 Tools
Ron Bialek, MMP, Executive Director
Stacy Baker, Senior Project Manager
Public Health Foundation
Participants in this session wiIlleam about opportunities, governance
roles, and planning resources linked to this important national
initiative. Featured will be the Healthy People 2010 Toolkit and the
Community Health Status Indicator (CHSI) Project reports for
counties. The Toolkit provides guidance, technical tools, examples, and
resources to help communities develop and promote successful 2010
plans. The Community Health Status reports provide county baseline
data for many Healthy People 2010 objectives and uses an easy-to-
understand format to help communities compare their status to peer
counties. This session will explain how local boards of health can use
these resources to identify priorities, improve planning efforts, and
gain stakeholder support for health improvement initiatives.
Transition from Genetic Discoveries to Actions that Improve
the Health of the Public
Timothy G. Baker, B.S.
Deputy Director
eDe Office afGenetics and Disease Prevention
Rapidly advancing human gene discoveries and technologies are creat-
ing enormous opportunities and challenges for health policy makers,
public health programs, and health care providers. This session will
discuss national developments that relate to needed genetic oversight
functions, legislative assessment, training of the public health work-
force, development of data and information to guide policy develop-
ment, and the integration of genetics into planning at the national, state,
and community levels.
Violence in the Community: A Public Health Issue
Center to Prevent Handgun Violence (Invited)
Scott Harshbarger, President, Common Cause (Invited)
Violence is a topic on all prevention professionals' minds these days.
Senior health outreach staff from the center to Prevent Handgun
Violence will provide an update on guns as a public health issue and
will review specific advocacy and program approaches designed for
the health community
12:30 p.m.-2:00 p.m. LuncheonfPlenary:
Boards of Health - the Untapped
Resource of Public Health
Maurice Mullet, MD,
President Public Health Foundation
Concurrent Sessions:
2:15 p.m.-3:3O p.m.
Communkating with the Public in Times of Peace and Chaos
Donna R. Dinkin, MPH, Project Director
Southeast Public Leadership Institute;
Christopher Cooke, MA, MS
NC Dept. of Environment, Health & Natural Resources
Boards of Health have an important role in communicating the status of
public health in times of peace and in crisis. This session will focus on
the key points of a strategic communication plan for members of boards
of health. It will showcase a successful public awareness campaign
implemented by the State of North Carolina and will highlight the
elements of a crisis communication strategy
Dental Access to Care Issues for North Carolina's Medicaid
Population and Other Underserved Groups ~
Dr Betly King-Sutton, Dental Program Director l.J.I )
North Carolina Department of Health & Human Services
Division of Medical Assistance
This session is an overview of why access to dental care for the
indigent population is an issue not only in North Carolina but
across the United States. This will be a discussion of barriers to care
and possible solutions to this issue with the help of the audience.
Legal Authority for Tobacco Control in the United States
Rebecca Edwards, MPH, NALBOH Project Director
John Saccenti, M.S., Ed. Spec., PROF Dip., Chair, NALBOH Tobacco
Committee
NALBOH has just completed a study of the legal authority for
tobacco control in the United States and will present these findings
in this workshop. The state specific reports identify who legally has
the authority to pass tobacco control ordinances on a range of
issues. Obtaining this information is a crucial step that should be
made prior to any tobacco control efforts to avoid wasting valuable
resources.
Boards of Health and Health Officers- Part I
Margaret Carlson, PhD, Institute ofGovernment,NC
Stephen Papenberg, NALBOH SecretaryfTreasurer, Health Officer, NJ
This session will identify some common problems that boards and
directors encounter when they plan and conduct a performance
evaluation and will describe a process that will increase the
likelihood that the evaluation will be a valuable experience for all
involved. 0
Board of Health Training: Products and Opportunities
Sarah Chard, M.A., NALBOH Project Director
Harvey Wallace, PhD, NALBOH President-Elect
This session will explore current and upcoming opportunities for
board of health training. The newest videotape developed through
NALBOH's HRSA training grant will be premiered and evaluated
by the audience. NALBOH's vision for the Board of Health
Training Institute (BOHTI) will also be presented for audience
discussion and input.
3:45 p.m.-4:45 p.m.
Best of Boards Presentations
To Be Announced
5:00 p.m.-6:00 p.m.
Presidents' Reception
Honoring LBOH Leaders
LBOH Presidents,
Past Presidents, Presidents-Elect
6:00 p.m.-8:3O p.m.
Awards Dinner/Plenary:
Leadership and Health: A Vision
for the Nation
Senator John McCain (Invited)
\
-...J
Friday, July 28
Om.-4:oo p.m.
Registration
Exhibits Open
7:30 a.m.-8:3O a.m.
Presidents Breakfast:
State Associations
Presidents, Past Presidents,
Presidents-Elect, Executive Directors
Breakfast with roundtables by Interest
Topics
8:30 a.m.-9:oo a.m.
Opening Welcome:
Focus on ANCBH and NALBOH's
Highlights
Lee K. Allen, ANCBH President
Vaughn Upshaw, NALBOH President
9:00 a.m.-10:oo a.m.
Plenary Session:
National Public Health Performance
Standards Program Update
Paul Halverson, Acting Director
Division of Public Health Systems, CDC
Vaughn Upshaw, NALBOH President
Haroey Wallace, County Commissioner &
Liaison to the Marquette County
Board of Health
Orrent Sessions:
10:15 a.m.-ll:30 a.m.
Resistance to Technology: Could it put you out of business?
David s. Baldwin, M.Ed.
President, Aquarian Technology Systems, Ltd.
This session will focus on how consumers today are using technology
in every aspect of their lives, expecting immediate access to
information, prompt response and innovative approaches to public
health problems. Technology is empowering individuals and
businesses in ways that might render obsolete those health depart-
ments who cannot or will not adapt.
Epidemiology I: Epidemiology in Action
Vicki Benard, PhD
Newt MacCormick, MD, MPH
Stephen R. Keener, MD, MPH
Susan Long-Marin. DVM, MPH
Council of State & Territorial Epidemiologist
Moderator- L. Fleming Fallon, Ir., MD, DrPH
Associate Professor, Public Health Program
Bowling Green State University
This session will describe epidemiology and the role of epidemiologists
at local. state, and national levels. It will also include an overview of
the Council of State and Territorial Epidemiologists.
c,
Boards of Health and Health Officers- Part II
Ed Peloquin, South Brunswick Tawnship Board Member
Ken Hartke, NALBOH Regional Trustee
This session will discuss the need for strategic manpower planning,
focusing on board of health roles in identifying and developing the
future needs of their departments and how to plan for and imple-
ment the growth of present and future staff.
Bioterrorism Updat~ Building Infrastructure
Rosemary Bakes-Martin (Invited)
This session will present an update of the nation's bioterrorism
preparedness efforts, and examine the role of local agencies on the
issue of bioterrorism.
Older Adult Public Health Issues:
The Role for Boards of Health
Nancy K. Beaumont, MSN, RN, Regional Coordinator
Cheryl I. Carothers, M.A, LSW
Western Reseroe Geriatric Education Center
Bowling Green State University
By 2030, almost one-fourth of the population will be over 65. This
session will examine the increasing public health needs of older
adults, and how boards of health can help to address these issues.
12:00 p.m.-1:30 p.m.
Trustee & Legislative Awards
Luncheon/Plenary:
HRSA's Commilrnentto Partnership
Building on the Local Level
C. Earl Fox, MD, MPH, Administrator
Health Resources and Seroices
Administration (HRSA)
Concurrent Sessions:
2:00 p.m.-3:15 p.m.
Performance Standards for Local Public Health Systems
Pom Sinnock, Associate Director for Science
CDC, Division of Public Health Systems
The purpose of this session is to update participants on the National
Public Health Performance Standards and the current status of the
state, local, and governance instruments. The results of field testing
of the governance, and the state and local tools in Florida and
Missouri will be presented. Participants will have the opportunity to
provide comments on the tools. In addition, the final draft of
Healthy People 2010, Chapter 23: Public Health Infrastructure will be
shared and discussed.
MAPP: Mobilizing for Action through Planning and
Partnership (formerly APEXCPH)
Paul f. Wiesner, MD, 1;)irectoT
DeKalb County Board of Health, GA
This session introduces the new Assessment and Planning
Excellence for Community Partners tool (MAPP), which will be
released by NACCHO in late 2000. MAPP is a strategic planning
tool for community health improvement. Participants will discuss
how boards of health can be a driving force behind implementing
this process. Connections to the National Public Health Perfor-
mance Standards Program will also be highlighted.
Local Tobacco Control Efforts: Experiences to Learn From
1999-2000 NALBOH Tobacco Fellows
NALBOH's 1999 tobacco fellowship awardees will interact with the
attendees of this session while reporting on the outcomes of their
local tobacco control efforts over the past year. This session will
include information on 1) forming local tobacco control
coalitions, 2) activities used to get teens involved in the decision not
to use tobacco products, 3) getting more involved in compliance
checks in local communities, and more.
Health Alert Network
To Be Announced
This session will discuss the development of the Health Alert
Network and its roles as a resource for public health information
and emergency communication.
Epidemiology II: Translating Epidemiology into Policy
Ronald Levine, MD, PhD, PHLP
Public Health Leadership Program
Iohn Booker, PhD
Director, State Center for Health Statistics
Moderator- L. Fleming Fallon, Ir., MD, DrPH
Associate Professor, Public Health Program
Bawling Green State University
This session will examine the ways in which epidemiology informs
local and national policy, highlighting how boards of health can
use epidemiological data as they develop recommendations
and/ or policies.
3:30 p.m.-4:40 p.m.
NALBOH Membership
Business Meeting
5:15 p.m.
Departure by Private Bus to
Durham Bulls Athletic Park
(pre-registration required)
7:00 p.m.
Durham Bulls vs Richmond Braves
at Durham Bulls Atheletic Park,
Durham, North Carolina
Saturday, July 29
8:00 a.m.-9:00 a.m.
0)\
President's Breakfast:
Local Boards of Health
Presidents, Past Presidents,
Presidents-Elect
General Breakfast
9:15 a.m.-l0:30 a.m. LBOH Training Certificate Program
Restricted (Attendees must
pre-register)
Developing an Environmental Health Primer for Local
Boards of Health
Gary Silvennan, Director, Environmental Health Program
Bowling Green State University
To address the needs of members of local boards of health for
environmental health education, a primer was prepared through a
joint effort between faculty in environmental health programs
(accredited by the National Environmental Health Science and
Education Accreditation Council (EHAC)) and members of NALBOH.
The materials are now being field tested prior to distribution to boards
across the nation. In this session we will discuss how these materials
were developed and how they may be used.
12:30 p.m.
NALBOH Golf Outing
at Hedingham Golf Club,
Raleigh, North Carolina
(pre-registration required)
01
)
-"
'-"
A.................................................................................................
V ~ POSTER SPECIAL INVITATION ~
: SESSION :
: TO:
IDE AS! LOCAL BOARDS OF HEALTH & '
STATE ASSOCIATIONS
.
.
,
.
~.~
National AssociatioD
of
Local Boards of Healtb
EIGHTH ANNUAL CONFERENCE
July 26-29, 2000
WHAT IS THE PURPOSE OF A POSTER SESSION?
EVERY BOARD OF HEALTH HAS A PROGRAM OR EVENT DURING THE
YEAR THAT IS NOTEWORTHY OR OF SPECIAL INTEREST TO OTHER
BOARDS.
ASSURING CRITICAL CAPACITIES IN
PUBIC HEALTH
The Role of Local Boards of Health
in Building Infrastructure
NALBOH HAS CREATED A SPECIAL FOCUS AT THIS CONFERENCE ON THE
ROLE OF LOCAL BOARDS OF HEALTH IN BUILDING INFRASTRUCTURE
AND THE ROLE LOCAL BOARDS AND STATE ASSOCIATIONS PLAY IN
THE ADVANCEMENT OF PUBLIC HEALTH ACROSS THE UNITED STATES.
Sberaton Capital Center
Raleigb, Nortb Carolina
A SPECIAL AREA FOR THE DISPLAY OF "POSTERS" FROM LOCAL BOARDS
OF HEALTH AND STATE ASSOCIATIONS WILL BE AVAILABLE FREE OF
CHARGE. THREE POSTERS WILL BE CHOOSEN FOR A 10 MINUTE VERBAL
PRESENTATION DURING THE BEST OF BOARDS SESSION AT H5 P.M. ON
THURSDAY
(OJ
.
FOR MORE INFORMA nON OR HELP
WITH YOUR POSTER - PLEASE CONTACT
MARIE M. FALLON
AT
PHONE: (419) 353-7714,
FAX. (419) 352-6278, OR
E-MAIL. MARlE@NALBOH.ORG.
CONFERENCE ATTENDEES SHOULD BE ABLE TO READ YOUR POSTER
AND GAIN IDEAS TO DISCUSS AND PERHAPS TAKE BACK HOME TO
THEIR OWN BOARDS. HANDOUTS ARE WELCOME.
.......................................................................................
Ik-
--------------------------------------------------,
Best of the Boards Poster SessIOn RegIstration
I would like to participate in the poster session. I am enclosing my completed registration along with a list of any equipment
needed for this event.
Name
Organization
Address
Phone
Fax
E-mail
Description of Poster Topic
I
I
I
Ii
'I
I
!
Ii
II
I
II
I
Equipment needed (easel, pin board, display table etc.)
C(
Mail or fax by June 19, 2000 to: NALBOH, 1840 East Gypsy Lane Road, Bowling Green, OH 43402. If you have any I
I questions, please call our office at (419) 353-7714 or fax: (419) 352-6278. I
I I
~--------------------------------------------------~
Hey, Batta, Batta, Swing II
0)]
''Take me out to the ballgame.....
Come see the
Durham Bulls vs Richmond Braves
When: Friday, July 28, 2000
Where: Durham Bulls Athletic Park
Game Time: 7 p.m.
Cost: $14
(price includes roundtrip transportation and ticket)
Departure time is 5:15 p.m.
________________________________________________________________(J)
NALBOH Golf Outing
You're invited to join us for the afternoon
When: Saturday, July 29, 2000
Time: 12:30 p.m.
Where: Hedingham Golf Club
(15 minutes from the hotel)
Type of Game: Best Ball Scramble
Cost: $4S
(price includes TeeTime, Cart, and Prizes)
Rental clubs are also available for $10
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REGISTRA nON FORM
National Association of Local Boards of Health, Eighth Annual Conference
July 26-29, 2000
Sheraton Capitol Center Hotel
Raleigh, North Carolina
(919) 834-9900
Please make checks payable to NALBOH. Send this form with payment or a purchase order" to NALBOH, 1840 East
Gypsy Lane Road, Bowling Green, OH 43402. Please contact the NALBOH office with any questions:
Phone (419) 353-7714, Fax: (419)352-6278, or E-mail. nalboh@1nalboh.orr!.
Rel!istration Information (Please list name as it should appear on conference badge)
Name:
Title:
Organization:
Street Address:
City.
State:
Zip:
Telephone:
Fax:
E-mail:
Rel!istration Fees (Includes Wednesday Evening Opening Event, President's Reception, Awards Dinner, Breakfast i 3),
Luncheons (2), Registration Packet, and NALBOH Tote Bag)
Early Bird (by 7/1100)
Regular (after 7/1/00)
Members'
Nonmembers"
$240
$275
$270
$305
$
$
'] 0% discount can be applied for member boards sending 3 or more members and registering them together
.. Registration fee includes an associate membership in NALBOH for the remainder of2000.
One-Dav Rel!istration (Please circle choice)
Earlv Bird (by 7/1/00)
Regular (after 7/1/00)
Thursday 7127
Friday 7/28
Saturday 7/29
Member
$130
$100
$15
Member
$150
$115
$20
Nonmember
$170
$135
$30
Nonmember
$155
$120
$25
$
$
$
Thursdav Registration includes: Breakfast, Luncheon, Reception and A wards Dinner, Registration Packet and Tote Bag.
Fridav Registration includes: Breakfast, Luncheon, Registration Packet and Tote Bag.
Saturdav Registration includes: Breakfast, Registration Packet.
SUBTOTAL (Please carry to reverse side) $
Maior credit cards acceoted: Visa, MasterCard and American Express.
Cancel/ation Po/icv' All cancel/ations must be in writing; 90% refunds will be made on cancellations postmarked on or
before 7/1/00; 50% refunds on cancellations postmarked on or before 7/10/00; no refunds thereafter
Purchase orders will be acceptedfor registration; checks must be received by NALBOH no later than July 20, 2000.
(See reverse side for Saturday Certificate Session, Extra Tickets and Optional Events)
REGISTRATION FORM (Continued)
National Association of Local Boards of Health, Eighth Annual Conference
July 26-29, 2000
Sheraton Capitol Center Hotel
Raleigh, North Carolina
DYes, I plan to attend the NALBOH members only certificate program on the Environmental
Health Primer on Saturday, July 29, 2000 at 9: 15 a.m. There is no additional cost to attend.
To address the needs of members of local boards of health for environmental health education, a primer
was prepared through a joint effort between faculty in environmental health programs (accredited by the
National Environmental Health Science and Education Accreditation Council (EHAC)) and members of
NALBOH. The materials are now being field tested prior to distribution to boards across the nation. In
this session, we will discuss how these materials were developed and how they may be used.
Extra Tickets
Reception, Dinner & Opening Event:
Wednesday
Thursday
Thursday
Friday
$
$
$
$
$40
$35
$20
$20
x
x
x
x
A wards Dinner
Luncheon
Luncheon
I would prefer vegetarian meals: _
Optional Events
Golf Scramble (Saturday, 12:30 p.m,)
Baseball Game (Friday, 7 p.m.)
$45
$14
$
$
x
x
SUBTOTAL $
SUBTOTAL (From previous page) $
TOTAL $
Mujor credit cards accepted: Visa, MasterCard and American Express.
Cancellation PO/iC)I" All cancellations must be in writing; 90% refunds will be made on cancellations postmarked on or
before 7/1/00.: 50% refunds on cancellations postmarked on or before 7/10/00; no refunds thereafter
Purchase orders will be acceptedfor registration: checks must be received by NALBOH no later than Julv 20,20.0.0.
Room reservations are the responsibility of attendees. A $79 per day (single or double) special room rate is available
fur conference attendees. Con/acl directly'
Sheraton Capital Center Hotel
421 South Salisbury Street. Raleigh, North Carolina 27601
Phone' (919) 834-9900; Fax: (919) 833-1217
Sales Office: (919) 834-9900. ext. 400
www.sheratoncapita/.com
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[
"" - ~-~~-=-=---------~-=----=-=-~~-=-=_._~=_:=- -_. - - - - - ..
. .
O. ·
. I ~.
. Submission Deadline: June I, 2000
"" 0 Rev. Everett I. Hageman Award
. This award, named for one of the founding members of NALBOH, is the most prestigious.
. award given to a current or past board of health member who has demonstrated outstanding.
. leadership to a board of health and commitment to and enthusiasm for local public health.
. . 0 State or Local Health OfficerjCommissionerjDirector Award ·
. This award is given to a current state or local health official who has: (1) contributed.
. significantly to state or local public health; (2) contributed to the training, support and strength.
. of a local board of health or state association of local boards of health. .
. 0 Legislator of the Y ear Award .
:: This award is given to a national leader who: (1) is currently serving in the United States
~ Congress; (2) has shown outstanding leadership in promoting public health, (3) has sponsored .
. or contributed significantly to bills championing public health issues. .
. 0 Regional Trustee Award .
. This award is given at the sole discretion of the Regional Trustee of NALBOH to a current or .
past local board of health member who has donated significant time and energy in supporting
I state and/ or local public health issues. .
0: Nominee's Name: Occupation: :
: I Address:
. Home phone: Work phone: .
I Department/Board of Health: .
Offices and Committee Positions:
I Legislative or Department/ Board of Health years of service: .
I Outstanding achievements: .
.
.
.
.
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.
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.---=-=-=----- -----=-=-=-=-=-=-=----=--- --~ --- - - - - - ..
Nomination Form
for NALBOH Recognition Awards
I
I
~ Examples of public health enthusiasm:
,
I
-I I . th ./ / . I'"
. nvo vement ill 0 er commuruty state nationa actiVIties:
~ Nominator's name and title:
I Address:
~ Daytime phone:
c:
I
",
.
..
Please attach ollrer pertinent information as necessary (two-page limit).
Send nomination form to:
NALBOH, 1840 East Gypsy Lane Road
Bowling Green, OH 43402
Fax: 419-352-6278
r
:1
National Association of Local Boards of Health ~)
ANNOUNCEMENT-FELLOWSHIP OFFERING TO NALBOH MEMBERS
We are pleased to announce a special opportunity for NALBOH members. Through the support
of the Centers for Disease Control and Prevention - Office on Smoking and Health (CDC-OSH),
NALBOH will be offering ten NALBOH Tobacco Fellowships for $500 each. These awards are
to assist members oflocal boards of health to attend the NALBOH Annual Conference from July
26-29,2000 in Raleigh, North Carolina.
This fellowship program is designed to allow local board of health members to participate in all
tobacco related sessions including Back to Basics: Passing Clean Indoor Air Ordinances (7/26),
and concurrent sessions - Legal Authority for Tobacco Control in the United States (7/27), and ~
Local Control Efforts: Experiences to Learn From (7/28). NALBOH Tobacco Fellows will also \J.YI
have additional opportunities to develop skills and gain information useful in their role as public
health policy makers through participation in the full spectrum of events at our national
conference,
If selected, NALBOH Tobacco Fellows will have the following responsibilities:
I Attend all tobacco related programs at the conference;
2, Complete an evaluation form on the sessions attended and the conference as a whole;
3 Return to their local board and engage in tobacco control programs including policy
development and implementation; and,
4 Make every effort to attend NALBOH's year 2001 conference in Cleveland, Ohio and serve
as a presenter or panel member, or participate in the poster session to share the
accomplishments, successes and roadblocks of their local board's tobacco control efforts.
Enclosed is a NALBOH Tobacco Fellowship application for you to complete and return to the
NALBOH office by Thursdav, June I, 2000. Applicants will be notified of awards by Tuesday,
June 20, 2000 If you have any questions, please call Rebecca Edwards at (4 I 9) 353-7714
National Association of Local Boards of Health
1840 East Gypsy Lane Road, Bowling Green, OH 43402
Telephone: (419) 353-7714, Fax: (419) 352-6278
E-mail: rebecca@nalboh.org: Web: www.nalboh.org
'\\
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~
National Association of Local Boards of Health
2000 NALBOH Tobacco Fellowship Application
. Board Member Applying
. Title/Position
I
I
. Telephone Number
. E-mail Address
. Name of Board
. Address
Fax#
. Type of Local Board
Governing
Advisory
If you presently have local tobacco control ordinances in place, what types do you have?
Please describe:
2. What tobacco control goals would you like to achieve in the next 15 months? (include any
specific local tobacco control ordinances you would like to have enacted)
!
(over)
National Association of Local Boards of Health
2000 NALBOH Tobacco Fellowship Application
3 What policies and programs would you attempt to implement to achieve the goals
outlined in question #2?
Statement
The undersigned certifies that (1) I represent the board of health in my community and that
I am a member of that board; (2) I will return from the NALBOH conference and work in
my board's jurisdiction and in my community, attempting to implement new tobacco
control policies, ordinances, and programs; (3) I am committed to share the results of our
work on tobacco control, policy development, and education with other members of local
boards of health at NALBOH's year 2001 annual conference in Cleveland, Ohio through
participation as a speaker, panel member or through a poster session presentation (Note.
There IS no guarantee of fellowship funding for year 2001 attendance); (4) If my
application is accepted, I will receive a check for $500 as a NALBOH Tobacco Fellowship
at the conclusion of the conference to offset the cost of attending the 2000 NALBOH
Annual Conference in Raleigh, North Carolina from July 26-29, 2000.
(Signature of Board Member Applying)
(Date)
D
~
-...J"
Nomination Form
Please Circle Nominating Position:
NALBOH Officers and
Trustees
East Great Lakes Trustee
Return by June I, 2000
President-Elect North Atlantic Trustee Second State Affiliate West Great Lakes Trustee West Trustee
Candidate Name:
Occupation:
Address:
Daytime Phone:
On what board of health do you serve?
s board of health a member of NALBOH? Yes No
Education/Degrees:
Years served:
Offices Held (Board of Health, State, National):
Spectfic Skills:
Contributions Made to Local Public Health and Community,
Nominated by (Optional):
Address:
'-
Daytime Phone:
Please al/ach curriculum vitae or resume if available
l'lt\lSl' sl'lId 110111111.11 lOllS to: l'\AJ.I~l)ll, I S40 List Cypsy LlIll' Road, Bowlltl:':' l;rL'l'tl, 011 4:qO~
Other Raleigh Attractions
North Carolina Museum of Art
2110 Blue Ridge Road
919-839-6262
Free admission
Special exhibit: rare, comprehensive Rodin exhibition
April 16-August 13
(for more information on the city's entire Rodin celebration visit
www.festivalrodin.com)
North Carolina Executive Mansion
200 Blount St.
919-733-3456
Tours availahle Thursdays
at 2:00, 2:30. and 3:00
Free admission, hours vary
The executive mansion is the historic, Victorian home of
North Carolina's governors.
North Carolina Museum of Natural Scieuces
11 West Jones Street
Bicentennial Plaza
1-877-462-8724
Free admission
~'~
Mordecai Historic ParklPresident Andrew Johnson1s
Birthplace
Corner of Mimosa St. and Wake Forest Rd.
919-834-4844
Cost: $4 adults; $2 children
Mordecai Park features an antebellum plantatiou house
and other historic buildings from the 19'" century, 60
minute tours begin on the hour; Closed Tuesdays.
0:-
National Association of
Local Boards of Health
1840 East Gypsy Lane Road
Bowling Green, OH 43402
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EPllnformation
May 2000 New Hanover County Health Department Betsy Summey, F.N.P, Editor
111"~.I~!!II!!!lt:!;[
:':::::':::::::,:::::'::::'::::::,::::"':':::::::'::':::::::::::::::::::::::::::::::;:::::;:::::;:;:::;:;:::;:;:::;:;:::;:::::::;:;:;:::::::::;::::;:::
...................................
In August and September 1999,
two outbreaks of arboviral
illness occurred in New York
City and surrounding areas. One
outbreak was zoonotic and
involved dead crows and exotic
birds at the Bronx Zoo; the other
involved hum~ns. The cluster of
human cases grew quickly,
affecting primarily older people--
seven of the 61 documented cases
were fatal.
The zoonotic ontbreak was due
to the West Nile Virus, the
human ontbreak to the Saint
Louis Virus. Mosquitoes
transmit both strains. New
York City began aerial and
ground mosquito adulticide
spraying to stop transmission.
Recently it was documented that
the virus had survived in
mosquitoes that overwintered in
the Northeast, and that a red-
tailed hawk found dead in
February had died from West
Nile Virus infection. Another
Contents
Hep B ............. 2
HIV ...............2
Stats . . . . . . . . . . . . . . 2
outbreak could occur, possibly
of larger scale and not limited
to the Northeast, since
migratory birds left the region
in the fall for their winter
destinations.
Mosquito surveillance and
control, chicken flock
surveillance for arboviral
activity, and human and
veterinary surveillance are
essential this spring and summer
to monitor the spread of West
Nile Virus and direct control
activities. The CDC is
sponsoring enhanced surveillance
and monitoring activities in areas
defined by bird migration
patterns, from Massachusetts to
Texas, along the Atlantic and
Gulf coasts. There are four
sentinel chicken flocks being
monitored for arborviruses in
New Hanover County
The North Carolina Division of
Public Health is asking the
medical community to
promptly report suspected
cases of encephalitis to local
health departments. Laboratory
testing is available at the State
Laboratory on acute and
convalescent sera, CSF
specimens, and CNS tissue
specimens. Call the
Virology/Serology Branch of the
State Laboratory of Public Health
at (919) 733-7544 for more
information and prior to
submitting any specimens.
Acute and convalescent serology
specimens are necessary to
confirm a diagnosis. Report any
suspected cases of arboviral
encephalitis or encephalitis of
unknown etiology to Cammie
Marti, RN, at 343-6532 or Anne
Lawrence, RN, at 343-6523, at
New Hanover County Health
Department.
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For several years mv ITB
connection issues have been
stressed both to health care
providers and to clients.
Emphasis has been on the
increased risk for developing TB
if mv positive, but other
important issues are duration of
preventive therapy as it relates to
mv status and the mandate for
TB skin tests for newly diagnosed
mv positive persons. The
Health Department offers and
encourages all individuals with
any risk for HIV disease to get
an HIV test.
Recently the mv ITB connection
issue has become very real with
50 % of New Hanover County
TB cases reported mv positive.
Directly observed therapy, where
the patient is observed
swallowing the medication, is
standard for all TB cases. It is
2
There may be other perinatally ~
infected individuals approaching .,.
adolescence who need special
attention regarding sexuality
issues, such as the importance of
understanding control measures
and protecting themselves and
others. As with other 14 year
olds, pregnancy postponement
through abstinence should be
encouraged. NHCHD staff is
available to assist with this effort.
also a goal for high-risk
individuals on preventive
medication, i.e., those who are
mv positive. Currently the
Health Department has one
individual receiving directly-
observed preventive therapy
-
Anew dosing schedule option
is available for Hepatitis B
vaccine use in adolescents aged
II to 15 years. The new dosing
schedule was approved by the
Food and Drug Administration
for an application by Merck
Vaccine Division for use only
with Merck's Recombivax HB
adult vaccine and only for
adolescents aged 11 to 15 years.
The two doses should be
administered 4 to 6 months apart.
Sero-conversion rates and final
antibody titers for the two-dose
alternative schedule are similar to
the three-dose schedule.
If a child has started on the
traditional three-dose schedule he
or she should not be changed.
The two-dose schedule must not
be started before the eleventh
birthday and must be completed
before the 16" birthday
The Advisory Committee on
Immunization Practices passed a
resolution to add Merck's two-
dose alternative to the VFC
program. Vaccine supplied
through the VFC program will
not be available, however, until
the CDC negotiates a vaccine
contract for this alternative
schedule.
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Recently a health care
provider notified New
Hanover County Health
Department (NHCHD) of an mv
positive 14 year old who had self-
reported her H1V status to the
provider and was desiring to
become pregnant. The adolescent
had requested several pregnancy
tests over recent months.
NHCHD was contacted for
guidance. The adolescent
was perinatally infected and
diagnosed at age seven.
Physicians are req uired to
report HIV positive individuals
who they suspect are
noncompliant with HIV control
measures. If the medical
provider is unsure whether
someone has been reported,
reporting is encouraged so that
partner notification and control
measures can be discussed.
In this case, as with others, e
knowing control measures did not
necessarily change behaviors but
NHCHD is obligated to assure
they understand them. Enhanced
counseling is being offered to this
teen. Contact Beth Jones, RN,
at 343-6648 or Vivian Mears,
RN, at 343-6653 for more
information.
Communicable Disease Statistics
New Hanover County
July 1, 1999 - April 30, 2000
.'.......'::'::::::c::<::.::::::::::O".".:-:.;.:-;._.;-:....-;.,:,'........'...-........-.'....
-A~PS _ _, _ _ ~.:::y,_.._,:~:~':::~_;:,<~::-:~)~::j::;/:),>>::-':'6
Campylobacter ...... 17
Chlamydia . . . .. . . .. 270.
E. Coli 0157:H7 . . . . . .. 2
Gonorrhea. . . . . . . '.' 305
Hepatitis A .......... 2
Hepatitis 8 (acute) . . .. 12
. Hepatitis 8 (carrier) .... 6
Hepatitis C (acute) . . ; . . 0
HIV Infection. . . . . . .. 31
Lyme Disease . . . . . . .. 1
Penussis .. .. .. .. .... 6
Rky. Mtn. Spotted Fever; ,
. Salmonellosis ...... 102
Scombroid . . . . . . . .. .. 0
Shigellosis. .. . . . ... .. 15
Staphylocoi:cal foodborne.'
Strep, Group A Invash;e .2
Syphilis. . .~ .. . . . . :. 56
Tuberculosis ......... 4
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