11/07/2001
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New Hanover County Health Department
Revenue and Expenditure Summary
September 2001
Cumuiative: 24.99% Month 3 of 12
Revenues
Current Year Prior Year
ypeof Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount arned Remaining Amount Earned Remaining
$ 1,294,050 $ 1,213,437 6.23% 215,972 1,102,787 16.38%
$ 533,044 $ 405,571 23.91% 124,370 398,674 23.78%
$ 961,934 $ 773,991 19.54% 66,378 818,178 7.50%
$ 26,963 $ 2,301 0.00% 0.00%
$ 312,900 $ 249,238 20.35% 312,900 22.99%
$ 112,850 $ 76,252 32.43% 23.79%
$ 1,289,841 $ 1,084,393 15.93% 14.28%
Expenditures
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Budgeted
Amount
Current Year
Expended Balance
Amount Remalnin
%
Budgeted
Amount
Prior Year
Expended Balance
Amount Remalnin
%
Summary
Budgeted Actual %
FY 01-02 FY 01-02
Expenditures:
Salaries & Fringe $8.765,782 $1,894,902
Operating Expenses $1,589.671 $329,200
Capital Outlay $126,158 $33.521
Total Expenditures $10,481,611 $2,257,623 21.54%
Revenue: $4,531,582 $726,399 16.03%
Net County $$ $5,950,029 $1,531,224 25.73%~
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Revenue and Expenditure Summary
Fiscal Year 02
As of September 30, 2001
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NEW HANOVER COUNTY HEALTH DEPARTMENT
BOARD OF HEALTH (BOH) APPROVED
GRANT APPLlCATIO ~ STATIIS
Date (BOH) IGrant Requested Pending Received Denied
No activity to report for October 2001.
Family Assessment Coordination- March
9/5/01 of Dimes $16,500 $16,500
Folic Acid Project- March of Dimes $16,618 $16,618
Safe Kids Coalition- State Farm"Good
Neighbo(' $500 $500
TB Elimination and Prevention - CDC, '1;)00 'OtJO
8/1/01 NCDHHD, DPH, TB Control Program $10,000 $10,000
Teen Aids Prevention (TAP)- CFMF $45,500 $25,000 $20,500
Diabetes Today - Diabetes Prevention & Control
7/11/01 Unit, NCDHHS $10,000 $10,000
Lose Weight Wilmington - Cape Fear Memorial
Foundation $75,000 $75,000
Diabetic Care for Prenatal Patients-NC Medical
6/6/01 Society Foundation $25,050 $25,050
Healthy Homes- Asthma Program - Partnership
for Children (Smart Start) $28,060 $26,000 $2,060
No activity to report for May 2001....
Maternity Care Coordination Expansion Grant
4/4/01 NC DHHS $15,000 $15,000
Wilmington Housing Authority- Ross Grant.
TAP & Alternative HIV Test Sites for 3 year
funding $192,221 $192,221
Safe Kids Trailer-Safe Kids Safe Communlties-
NC Govemo(s Highway Safety $8,740 $8,480 $260
No activity toreportlor Jan, Feb and Mar 2001
Intensive Home Visitation Program Expansion
12/6/00 Grant - Smart Start $100,000 $96,000 $4,000
'!. ".'. .. .... , ....
Childhood Asthma Management & Control
Interventions- NC Department of Health &
Human Services, Division of Public Health, WCH
11/1/00 Section $23,000 $10,285 $12,715
....cc.. .. .
Capel'earMemorial Foundation-Lice --.-...- -...- ....
Eradication Program $5,000 $5,000
Healthy Carolinians- Office of Healthy
Carolinians, Division of Public Health, North
10/4/00 Carolina Dept of Health & Human Services $10,000 $10,000
March of Dimes- March of Dimes Birth Defects
Foundation Eastern Carolina Chapter $10,000 $8,250 $1,750
..
Enhanced Counseling Program for HIV I AIDS
9/6/00 Elton John Aids Foundation $48,000 $48,000
. .. .. ,. "'L....
,<'
Smart Start applying for Cape Fear Memorial
812100 Foundation Grant (MOW) $52,000 $50,000 $2,000
8
As of 10/24/01
. NOTE. Notification received since last report.
NEW HANOVER COUNTY HEALTH DEPARTMENT
BOARD OF HEALTH (BOH) APPROVED
GRANT APPIICATIO STATUS
Enhanced Counseling Program- Z, Smith
Reynolds Foundation $48,000 $48,000
Teen Aids Prevention- Z, Smith Reynolds
Foundation $59,000 $59,000
7/12/00 March Toward TB Elimination- NC DHHS $10,000 $7,200 $2,800
Cape Fear Memorial Foundation (TAP
Program)2 year request $55,000 per year $55,000 $35,000 $20,000
Diabetes Today. DHHS DDPH $10,000 $10,000
Totals $873,189 $53,618 $316,265 $503,306
6.14%
As of 10/24/01
. NOTE: Notification received since last report,
36.22%
57.64%
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Project Assist Budget Amendment for $350
Teens Against Tobacco Use
Subject:
Teens Against Tobacco Use (T,A.T,U.) MiniGrant Program
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Brief Summary:
We received notification of approval of a mini-grant application on 10/23/01 We
requested $350.00 for smoking prevention training for New Hanover County Schools.
Our Project ASSIST staffwill conduct the training in January, 2002 for 50 individuals on
a Saturday in Wilmington, NC. The money will be used to provide lunch and
refreshments for the participants. Our staff has received training as a T.A.T.U. fucilitator.
Funding Source:
The Health Action Council of North Carolina
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Project Assist Budget Amendment for $11,800
Robert Woods Johnson Youth Center Grant
Subject:
Receipt of$II,800 from the Robert Woods Johnson Youth Center
Brief Summary:
The health department has been asked to receive money from the Robert Woods Johnson
Youth Center (R WJYC) as a pass-through agency for Wilmington Health Access for
Teens - Youth Tobacco Prevention Project. The health department's Project ASSIST
works closely with this project. The RWJYC operates on a January I-December 31 fiscal
year and has recently received additional funds that must be expended by December 31,
2001. The RWJYC is requesting that the money be passed through a state agency for
ease and swift time management of the funds. Otherwise, the funds may be lost. Once
the funds are disbursed to a state agency, there are no time restrictions for expending the
funds (other than the health department's fiscal year constraints).
The funds will be utilized to assist with a major media campaign, TV NCR, laptop,
speakers, and a digital camcorder.
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NEW HANOVER COUNTY BOARD OF J}fM~J~I(JN~
REQUEST FOR BOARD ACTION
Meeting Date: 1.1-__. _1
II /0'7/01
Department: Health Presenter: Betty Jo McCorkle, Director Women's Health Care
Contact: Betty Jo McCorkle, 343.6660
SUBJECT:
Grant Application to the Office of Healthy Carolinians, North Carolina
Department of Health and Human Services for $10,000 to fund Cape Fear
Healthy Carolinians
BRIEF SUMMARY:
We are requesting approval to apply for a $10,000 grant for our local Cape Fear Healthy
Carolinians, from the Office of Healthy Carolinians, North Carolina Department of Health and
Human Services. As a Healthy Carolinians Certified County, New Hanover is qualified to apply for
funding. New Hanover County Health Department will act as the fiscal agent for these funds if
awarded, since the funds need to pass through a public health agency through the state's
Consolidated Agreement.
The funds will be used to implement initiatives which focus on Diabetes and Access to Health
Services. The goal is to further Healthy Carolinians initiatives in New Hanover County
Cape Fear Healtlhy Carolinians is made up of representatives from Wilmington Health Access for
Teens, Cape Fear Community College, New Hanover Health Network, Catholic Social Ministries,
New Hanover County Department of Social Services, and New Hanover County Health
Department.
No county funding, match, or positions are required. The funding period is July I, 2001 through
June 30, 2002.
RECOMMENDED MOTION AND REOUESTED ACTIONS:
Approve grant application and budget amendment for $10,000 if grant awarded
FUNDING SOURCE:
North Carolina Office of Healthy Carolinians, North Carolina Department of Health and Human
Services
ATTACHMENTS:
Yes
16
.
GENERAL INFORMATION ABOUT COMPLETING YOUR
APPLICATION/AGREEMENT ADDENDUM FOR
HEALTIIY CAROLINIANS FuNDING
.,
-
This provides general information about applyingJor Healthy Carolinians
unds. More s eei Ie in ormation is attached to the a lieation.
Fundine Availability
A maximum of$10,000 per county is available in Healthy Carolinians funding. Funds must be spent by
June 30, 2002. Any funds not expended by June 30, 2002 will revert to the State's General Fund.
Submission Reouirements
The Application/Agreement Addendum along with the budget request/justification and at least 4
letters ohupport must be submitted by the November 30 deadline. The health director's signature on the
application indicates that he/she agrees that the local health department will serve as the fiscal agent for
these funds and that these funds will be used only for HeaIthy Carolinians activities as determined by the
Hea1thy Carolinians partnership.
Timeline
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October 22 Applications for the Healthy Carolinians funds are distributed in conjunction with a
statewide teleconference. Fonns are published on the Hea1thy Carolinians website
November 30 The Application/Agreement Addendum along with appropriate supporting materials
should be submitted as soon as possible but no later than November 30. A completed
budget request! justification and two DHHS 2948 fonns signed and dated by the Health
Director must accompany your Application/Agreement Addendum. Tbis deadline is
firm.
January 2 Between November 30 and January 2, your application will go through a review
process. If the funds are used to establish and/or maintain a Hea1thy Carolin;ans
Partnership (as described in the Appropriation bill), your application will be approved
quickly. An Agreement Addendum and Budgetary Estimate (budget papers) will be
signed by both the healtb director and OCHIHE, DPH, DlIHS. This is a new process
and it may go more quickly than outlined in this timeline.
Submitting your application correctly will enhance your ability to access these funds
quickly.
. Certified Partnerships: Your application must conform to the guidance provided
-in the-t O-Opfio!iS-liSted oil the applicatioii for certifiedHeaIthycarolinian~.
. Counties that are NOT certified: Your application must conform to the guidance
given for the Healthy Carolinian~ Benchmarks.
Marcb 1 An interim report is due to the Office of Healthy CarolinianslHea1th Education.
Guidance for this report will be available February I, 2002.
July 30 The funding period ends June 30. You will be asked to submit a report by July 30 that
identifies how the funds were used and the outcomes reaIized from this money. Unused
funds will revert to the General Fund.
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if
.
Send ~ copies of your Application/Agreement Addendum, Budget Request! justification, letters of
support to:
"
Mary Bobbitt-Cooke, Director
Office ofHeahhy CarolinianslHeahh Education
Division of Public Health, NC DHHS
1915 Mail Service Center
Raleigh, NC 27699-1915
-t Send another copy of your application, budget justification to your regional healtb education
consultant. Your regional consultant is part of the review process and will be able to spot areas
where your application may bave difficulties.
tit
State Reviewers will use the followinl! criteria in assessin2 applications for fundin2:
Note: For more i11formation about completing the applieation, see the Guidaneefor
AppIieation/Agreement Addendum that has been developedfor both Certified and non-Certified
counties. The following criteria are based on the specifie information requested in the
appIieations. To avoid delays in aecessing your funds, follow the Guidanee earefully. Ask your
regional health edueation consultantfor help.
I. Evidence that the funding requested will contribute toward Healthy Carolinians:
If your county is not certified, you must use these funds to establish your Heahhy Carolinians
partnership and move toward Certification. If your county received $10,000 last year, and you
apply again this year, you are expected to submit your application for certification by May 2002. e
If your county is certified, you must use these funds to support your Healthy Carolinians
partnership's overall mission, goals, and objectives that have been determined through your
Partnership's community assessment and establishment of priorities.
2. Evidence that your proposed use of these funds has been approved by your Heahhy Carolinians
Partnership Steering CommitteelExecutive Committee. If you are not certified and are just
establishing your Healthy Carolinians, you will need four letters of support that indicate commitment
from the signer that he/she will engage in the Healthy Carolinians process.
3. Evidence that the proposed expenditures reflect activities that will lead to good health outcomes or
support the infrastructure of a community partnership.
4. Description of the 50% ($5000) matching funds or in-kind contributions requirement in your
application.
----,--.---- ~ ---, . .--...----..--.......-.
5. Signed and dated budget requestfjUstification that ~Iearly s~pports the work of the Healthy Carolinians
partnership. The heahh director's signature on the budget page indicates that helshe agrees that the
health department will serve as a fiscal agent for these monies and that monies will only be used for
Healthy Carolinians activities.
6. Counties that ARE Certified: Vour plan to use these funds is based on one or more of the 10 options
listed in the Guidance for Completing Application/Agreement Addendum, or another option approved
by the Office of Healthy Carolinians.
7. Counties that ARE NOT Certified: Vour plan to use these funds reflects how you will move from your e
current status toward Healthy Carolinians certification.
18
NORTH CAROLINA
Department of The Secretary of State
To all whom these presents shall come, Greetings:
I, ELAINE F. MARSHALL, Secretary of State of the State of North Carolina, do
hereby certify the following and hereto attached to be a true copy of
ARTICLES OF CORRECTION
OF
PUBLIC HEALTH FOUNDATION OF NEW HANOVER COUNTY, INC.
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the original of which was filed in this office on the 8th day of October, 2001.
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~~~jJf~
,P.,j4iJA. ~1'1r!~~'-~~
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Secretary of State
Documenlld: 212815108
19
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50510: 0604842
Date Filed: 10/8/2'001 4:16 PM
Effective: 9/20/2001
Elaine F. Marshall
North Carolina Secretary of State
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281
5/08
State of North Carolina
Department of the Secretary of Stale
ARTICLES OF CORRECTION
Pursuant to 955-1-24 or 955A-I-24 of the General Statutes of North Carolina, the undersigned corporation
hereby submits these Arlicles of Correction for the purpose of corre\:.ting a document Iiled by the Secretary
of Stale.
I. The name of the corporalion is: Public Health Foundation of New Hanover Coum:.y, Inc.
2. On lhe 20thday of September
, 20~> the corporation filed:
a. The following described document: Articles of Incorporation
-OR-
b. The attached documenl (Check here _ ifapplicab/e).
3. This document was incorrecl in the following manner (specify the ;nc()rrecl stalement and the re.asoll i(
is incorrect or the manner in which the execution was defective):
'!he applicable line, Section 2, Articles of Incorporation was,
inadvertently, not marked.
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4. The incorrect maners stated in Item 3 above should be revised as follows (the corrected documenll1lo)'
be attachelf):
'lhe corporation is a charitable or religous corporation as defined in
N.C.G.S. Section 55A-1-40(4)
This lhe ~ day of
O::tober
>20~
E\.tllk H%ll.th Ftl.rrlit:im of. l'Bo1ll3ma'~, Ji1::.
~ Name of Corporation
tWc4v. ~
Signature
Warm. M. O:pl.ey, Ch11I:y JIUu..,..y, ]h.\...~tJ:r
Type or Print Name and Title
NOTES:
1. Filin" r~ jl; $10. This dotumenl and one: conformed eopyo(the:se articles must be filed with the Secretary ofStatc.
2. For c:ffc:elivc: date: orthc:sc: Articles o(Corrc:clion, see N.C.G.S, fSS.I-24(c) or ~SS^.1-24{c).
(RellisM Jnnunl)' 2000) (Foml SN-02)
CORPORATIONS DIVISION P.O. BOX29622 RALEIGH,NC 21626-0622
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NORTH CAROLINA
Department of The Secretary of State
To all whom these presents shall come, Greetings:
I, ELAINE F. MARSHALL, Secretary of State of the State of North Carolina, do
hereby certify the following and hereto attached to be a true copy of
ARTICLES OF INCORPORATION
OF
PUBLIC HEALTH FOUNDATION OF NEW HANOVER COUNTY, INC.
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the original of which was filed in this office on the 20th day of September, 2001.
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IN WITNESS WHEREOF, I have hereunto
set my hand and affixed my official seal at the
City of Raleigh, this 20th day of September, 2001
~~J~
Secretary or State
Document Id: 212615051
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State of North Carolina
Department or the Secretary or State
50510: 604842
Date Filed: 9/20/2001 11 :39 AM
Elaine F. Marshall
North Carolina Secretary of State
ZI 261 5051
ARTICLES OF INCORPORATION
NONPROFIT CORPORATION
Pursuant to ~55A.2-02 of the GeIIcra1 Statutes of North Carolina, the undcnigned cOIpOration does hereby submit these Articles of
lncolJlOration for the pUlJlOse of fonning a Donprofit cmporation.
I. The namc of the corporation is: Public Health Fbundation of New Hanover Cbunty, Inc.
2. (Check oiiiy if applicable.) The colJlOration is a charitable or religious cOlJlOration as defined in NCGS ~55A.I-40( 4).
3. The sttcct add=s and counlY of the initia1 regislelcd office of the cmporation is:
Number and Street 2029 SoUth 17th street
City, Slate, Zip Code wilmington ~v #4'01
County New IlanOITer
4. Themailingaddresslfdlffertllltfro..lM _ tuI4r_ of the initial regislelcd office is:
5. The name of the initial regiaIeIcd agent is:
David Rice
6. 1W= r "$Te1 each ha.ot......,doJ is as foUows:
Cbunty Attorney
320 Olestnut street, RoCIII 309
Wilmington, NC 28401
7. (01cck either a or b below.)
a._ Tbe corporation wiD bave memben.
b.X- Tbe cmporation wiD not bave -hers.
8. Attached are provisions regarding thc distribution of the corporation's assets upon its dissolution.
9. Any other provisions wbich the COlI"'.ation elects to inc1wlc are attached.
10. The street addrcas and counlY of thc jlriDcipaI office of thc emporation is:
2029 South 17th street, Wilmington, NC 28401
County
New HarlOITer
II. The mailing address tf dlJ1RM1fro1a 1M _ tuI4raI ofthc principal office is:
Form N-OI
Rcvis,cd January 2000
CORPORATIONS DIVISION
P.O. BOX 29622
llALElGH, NC 27626-0622
22
-..... -_.P-- ____.
12. These articles will be effective upon filing, unless a later time and/or date is specified:
.
This is the~day Of~'
.20~
J1"lJuA .~,j
Signature of Incorpordtor
INCORPORATOR
wanda M, Copley, County Attorney
Type or print Incorporator's na,!,e and title, if any
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NOTES.
1 Filing fee is $60. This document and one exact or conformed copy of these articles must be filed with the Secretary of State.
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Revised January 2000
Form ".01
CORPORATIONS DIVISION
P O. BOX 29622
RALEIGH, NC 27626-0622
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ATTACHMENT
PUBLIC HEALTH FOUNDATION OF NEW HANOVER COUNTY, INC.
A) Specific limitations upon said corporation and other provisions of
these Articles of Incorporation are as follows:
1 The corporation shall not have capital stock and no stock or shares shall be
issued.
2.
No part of the net earnings of the corporation shall inure to the benefit of. or
be distributable to its members. trustees, officers, or other private persons,
except that the corporation shall be authorized and empowered to pay
reasonable compensation for services rendered and to make payments and
distributions in furtherance of the purposes set forth in Article 3 hereof
Except as permitted under Sections 501 (h) and 4911 ofthe Internal Revenue
Code and the regulations promulgated thereunder, as amended from time
to time, no substantial part-ofthe activities ofthe corporation-shall be the
carrying on of propaganda, or otherwise attempting to influence legislation.
and the corporation shall not participate in. or intervene in (including the
publishing or distribution of statements) any political campaign on behalf or
in opposition to any candidate for public office.
3.
Upon the dissolution of the corporation all of its assets, after the payment of
the obligations and liabilities of the corporation, shall be distributed for one
or more exempt purposes within the meaning of Section 501(c)(3) of the
Internal Revenue Code. or the corresponding section of any future Federal
tax code, which, in the judgment of the Board of Directors, are engaged in
activities and/or have purposes similar to the activities and purposes of said
corporation, or shall be distributed to the Federal government, or to a state
or local government, for a public purpose. Any such assets not so disposed
of shall be disposed of by a tourt of competent jurisdiction of the county in
which the principal office of the corporation is then located, exclusively for
such purposes or to such organization or organizations, as said court shall
determine, which are organized and operated exclusively for such purposes.
_________~.___.__________ ._.__ ~m
4.
Notwithstanding any other provisions of these Articles of Incorporation, this
corporation shall not carry on any other activities not permitted to be carried
on by (1) a corporation exempt from Federal income tax under Section
501(c)(3) of the Internal Revenue Code of 1954 or the corresponding
provisions of any future United States Internal Revenue Law or (2) a
corporation to which contributions are deductible under Section 170(c)(2) of
the Internal Revenue Code of 1954 or any other corresponding provision of
any future United States Internal Revenue Law.
24
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5.
The Board of Directors may adopt bylaws, not inconsistent with these
Articles of Incorporation or the laws of the State of North Carolina, for the
management and control of the corporation, and may promulgate and amend
from time to time suitable policies and rules and regulations governing the
work and activities of the corporation, the care and use of its property, the
qualification, duties, performance of work and conduct of its staff and other
personnel and employees and such other matters as may be necessary and
desirable in the judgment of the directors.
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History-
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Rules Governing Tattooing, effective Januaryl, 1995, by North Carolina DENR
. N.H. Co. Board of Health Rules Governing Tattooing Establishments, Effective
November 8, 1995
. N.H. Co. Board of Health Rules Governing Body Piercing Establishments and
Practitioners, effective September 1, 1999
. **General Assembly of North Carolina Session 2001 - House Bill 635 - An Act to
Regulate the Business of Body Piercing, effective date reads:
Section 2. The registration requirements under G. S 66-318, as enacted in section 1 of
this act, becomes effective October 1,2002. The permit requirements under G. S. 66-318,
as enacted in section 1 of this act, becomes effective January 1, 2003 The remainder of
this act becomes effective January 1, 2002.
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STRATEGIC PLANNING PRIORITIES
October 30, 2001 Update
Access to health care
(Issues #7, 11 & 5)
~ Breast Pumps: Nutrition Division now has 25 electric breast pumps. Now able to support
working mothers. 14 new pumps purchased with unspent WIC food dollars.
~ Life Saver' Candace Sancilio, School Health Nurse, recently resuscitated a high school
student. CPR and the AED were used in this life saving effort. Candace was assisted by
school staff and a Deputy Sheriff. The student survived and is recovering. Great Job Candace I
~ Health Choice: State Legislature has budgeted funding for Health Choice. NHC DSS will be
taking applications and pulling names from the waiting list.
~ Oral Health Assessments are currently being conducted for children in kindergarten and fifth
grade classes in New Hanover County Approximately 8000 kindergarten through fifth grade
students are participating in the weekly fluoride mouth rinse program.
~ Public Health Foundation: The Public Health Foundation of New Hanover County, Inc.
Articles of Incorporation were received from the NC Secretary of State Elaine F Marshall.
~
II.
I.
Preventive services & lifestyle-related risks
(Issues #12 & 15)
~ Healthy Carolinians: NHC to receive $10,000 for Healthy Carolinians. Local priorities are
diabetes and access to care.
~ September begins the fall season of outdoor events that usually include food preparation
and sales. The Labor Day weekend Piney Woods Festival heads up the list. This event was
scaled back insofar as the number of food vendors compared to prior years. Seven vendors
were permitted and operated on September 1 and 2. Additionally and of greater impact during
the month was the number of consultations documented by staff in preparation for other events.
Fifty-one contacts were documented where staff provided information and answered questions
about food safety and regulatory issues. These encounters are often lengthy as we make a
strong effort to help prospective vendors solve problems and have a strong understanding of
critical food safety issues well in advance of the event. The goal is to elicit voluntary compliance
with regulations and recognized standards of operation.
~ Flu Vaccine: Anticipate starting through the General Clinic on October 29.
~ TAP' The Teen AIDS Prevention Program received partial funding from the Cape Fear
Memorial Foundation.
~ Hepatitis B Vaccine: Is being administered to 6th Grade students, using volunteers and
nurses from multiple Health Department Divisions.
~ RiverFest: Smaller than past events. EHS worked with approximately 30 temporary food
vendors compared to -50 last year
~ Outreach Flu Clinics: Clinics for high risk population start today, October 9.
~ Flu Shots for NHCHD Staff: Health Department Employees can get flu vaccines through the
General Clinic, beginning October 24
~ The Child Fatality Prevention Team has just completed its annual summary for the state.
This summary will also be provided to the Board of Health and County Commissioners. The
Team took several actions this past fiscal year; however, there were no glaring trends in child
deaths. There were no Sudden Infant Death occurrences this year, possibly due to the Back to
Sleep campaign.
~ ACS conducted a veterinary survey in conjunction with its MAPH group to better determine
the needs of the veterinary community
~ Staff from ACS offered the shelter for housing of animals that may have been aboard the
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downed flights at Wilmington airport after the WTC attacks.
~ Flu Vaccine: Health Department General Clinic opens for the public on October 24.
Approximately 60% of the vaccine orders have arrived. Thanks to the Laboratory and Pam
Horne for assisting CDD with clerical duties More than 300 NHC employees received a flu shot
yesterday
~ Community Health Team will be administering flu and pnemonia vaccines at Solomon
Towers, Cape Fear Hotel, Castle Hayne Feeding Site, and to homebound patients.
~ Community Child Protection Team: Met on October 19. Discussion on improved reporting of
child abuse and neglect by school personnel. Carousel Center will have a new physician in
January for abused children exams.
~ Let's Talk Month: Mailing distributed to approximately 150 local churches on resources to
improve communication between and among adults and teens. Email distributions to NHC
employees continue this month to encourage positive communication.
~ New Hanover County Fair' Event of the Jast1 0 days had well organized vendors,
cooperative and compliant with Environmental Health regulations.
~ Flu Vaccine: Health Department General Clinic administerd 471 influenza vaccines on the
first day, October 29.
~ TAP' The Teen AIDS Prevention Program received the Youth Organization of the Year
Award from Cape Fear Youth Vision, Inc.
~
III. Communication, education & marketing (promotion)
(Issue #1 & 4 in part)
~ Annual Report: Most of the first draft submitted to Division Directors for editing.
~ Greater Wilmington Business: Article on budget cuts and the effects on restaurant
inspections published.
~ NHCTV Mark Boyer, NHC Public Information Officer needs more health related
information.
~ Veterinarians Conference: ACS will hold the 1st Annual Public Health Conference for local
veterinarians on October 11 Purpose is to increase understanding and collaboration between
local veterinarians and ACS.
~ WAAV Radio: October 23 and December 18 slots need to be filled ASAP Please contact
Elisabeth Constandy
~ Airport Displays: Beginning in November, displays will be placed on hold due to security
issues at the Airport.
~ TB Lunch & Learn: Successful session on October 4 for medical providers. Special thanks
to TB Team for providing lunch.
~ Bulletin Board: Check out the new bulletin board in the NHCHD Clinic waiting area. Thanks
to the Child Health Team!
~ Awareness Campaigns: Let's Talk It Over Month and Breast Cancer Awareness Month are
celebrated in October Cut for Cure was a successful event.
~ Due to Family Planning nursing positions being held open and the Family Planning
appointment schedule changing, the Spanish interpreter's schedule had to be adjusted in
October The same number of clients will need to be served in the new schedule, necessitating
some schedule changes for other programs.
~ In the final state budget, Health Choice funds were increased and enrollment has restarted
for this Child Health Insurance program. Staff will refer uninsured children and assist in the
application process.
~ At the HOLA educational meeting, information was received on using the local Spanish
radio station and the local Spanish newspaper for dissemination of health information and for
advertising programs at a low cost.
~ Another positive rabies case put ACS into the media spotlight and emphasizes the need to
continue diligent education in this area.
~ ACS is featured in a continuous airing on NHC-TV, thanks to a taping done by Mark Boyer
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-+ Jean McNeil taught a class at UNCW for honors students regarding the role of ACS in the
community and the laws we enforce.
-+ ACS began its annual Paws to Recycle campaign, which runs from September through
November each year
-+ The Women's Health Care Division is now offering Prepared Childbirth Classes for Latina
women. The classes are held at the health department and consist of a series. They are held
the 2nd and 4th Wednesdays from 2pm to 5pm.
-+ Pender - New Hanover County Medical Society. Requested a public health article for their
newsletter An article on the Reynolds Tribute will be submitted.
-+ Switchboard Calls: Calls on anthrax have decreased; calls on influenza have increased.
Several calls yesterday related to small pox.
-+ Halloween Candy' Press release on safety submitted to the Media on October 22.
-+ UNCW Telephone Directory' Available at the Switchboard. Includes NHCHD advertisement
-+ DSS Foster Parents Training: Nancy Nail spoke to participants to explain how to access
WlC services for foster children.
-+ Annual Report: Is at the printer
-+ UNCW Honors Class: Jean McNeil made a presentation on general pet care and
responsibility
-+
IV. Facility utilization & Information technology
(Issues #6 & 4 in part)
-+ Meeting Room Reservations: LotusNotes room reservations for the Auditorium, Family
Planning Conference Room, Environmental Health Conference Room, and TFW Conference
Room is being worked on. Health-IT is working with Pat Johnson, Marcy Smith, Dianne Harvell,
and Gail Robinson to work through the process.
-+ Lotus Notes Accounts: Are growing. Staff are asked to clean up their accounts. Please
delete any mail in your inbox, sent files, or other folders. that are no longer needed. Email can
be archived. Please contact Health-IT for further information.
-+ Final work was completed by Property Management staff on the generator transfer switch at
the ACS shelter
-+ ACS staff met with HD-IT staff to determine computer needs to operate at top efficiency in
the licensing program.
-+ Email Accounts: Please continue to "clean" your LotusNotes account. Staff who need
assistance with deleting emails, or archiving, please contact Health-IT
-+
V. Water quality, storm water management & drainage; & Air
quality (Issues #3 & 8)
-+ Snow's Cut Project: Earlier this summer, residents of a neighborhood off River Road
expressed concerns relative to mosquito control on an adjoining tract of federally owned
property containing dredge spoil material. Dredge material contains a high content of fine silty
soil and dries very slowly upon removal from a stream bottom. A large number of deep fissures
form as drying slowly proceeds vertically from the soil surface. These fissures collect and retain
precipitation making an ideal hatch site for certain species of mosquitoes. The U. S. Army
Corps of Engineers contracted our Mosquito Control Program to mitigate this hatch site by
moving sandy material over the area retaining water Rental equipment secured at the expense
of the USACOE was necessary to complete this project in a acceptable time frame. Much effort
was placed on planning for potential liability and safety issues. Staff completed this project at an
extraordinarily low cost in eight work days to the satisfaction of USACOE officials and
neighboring property owners.
-+
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VI. Emerging health risks
(Issue #13)
-+ Epidemiology' CDD staff have received increased reports of Salmonella and Rocky
Mountain Spotted Fever during the last two weeks.
-+ In response to the terrorist attacks of September 11, the Laboratory Director and the
Laboratory Supervisor attended an interactive teleconference on October 8, 2001 presented by
the Division of Public Health and the School of Public Health on the current state of Public
Health Bioterrorism Preparedness and Response and linkages to Local Health Departments.
The Laboratory is also working on a plan to address what the Laboratory=s response will be to
the Anthrax problem in Florida and what we will do should we have patients with exposure
-+ NHCHD BTL (Bioterrorism Leadership) Team will meet each Tuesday at 8 am in the TFW
Conference Room. Members of the BTL Team are: Lynda Smith, Beth Jones, Betty Creech,
Dianne Harvell, Susan O'Brien, and Dave Rice. A video of the October 18 teleconference, "CDC
Web Cast on Bioterrorism" is available from Elisabeth Constandy after a copy is made.
-+ A copy of the Local Response Plan Checklist was given to the Management Team.
-+ Zoonotic Connection: to Biological agents (e.g., anthrax) was mentioned by Jean McNeil.
She has contacted the State Veterinarians regarding this aspect of public health response.
-+ Bioterrorism: NHCHD BTL (Bioterrorism Leadership) Team continues to meet each
Tuesday The BTL Team is developing bioterrorism response policies and procedures for
inclusion in the NHCHD Emergency Manual.
-+ Several opportunities for communicating the message of public health response to
bioterrorism have surfaced. On November 5, the Health Director will attend a meeting of the
Pender-New Hanover County Medical Society and will brief the NHC Board of County
Commissioners on the public health response to bioterrorism. On November 10, a Community
Forum on Bioterrorism will be aired by NHCTV and WECT - TV6. A regional training exercise
was conducted by NCDHHS and UNC School of Public Health on October 25. After that
meeting, NHCHD participated at a general operations meeting of New Hanover Health Network.
-+ Mail Handling Procedures: NHC Safety Officer plans to limit the list of current mail handlers
in the County Lynda Smith and Frances DeVane will address the Health Department process.
Last week, NHC distributed its Mail Handling Procedures which limits the possible exposure to
bioterrorism.
-+
VII. Population growth & diversity
(Issue #2)
-+ HOLA Luncheon: On October 2. Radio Alegre - 1180 AM is Southeaster NC's first all-
Spanish radio station. They accept PSAs (email: famradio@bellsouth.net). The newspaper
Mundo Latino accepts informational articles for free publication (email:
mlatin2001@yahoo.com).
-+
VIII. Discontinued services picked up by Health Department
(Issue #9)
-+
IX. Staff Development & continuing education
(Issue # 14)
-+ Training: NHC Human Resources has agreed to provide performance appraisal training to
Health Department Supervisors/Employees. October 1-2, 2001 are the dates for the Supervisors
training. Employees training date to be determined. Management Team will discuss our process
on October 9.
-+ Bioterrorism Training: PHTIN conducted a teleconference on Bioterrorism on Monday,
October 8. Part of the teleconference focused on the recent cases of Anthrax in Florida.
Bioterrorism: October 25 the UNC-SPH and NC DHHS will conduct a table too exercise for
4
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Region 8 Health Departments in our Auditorium from 1-4 pm. This will replace the Epi Lunch &
Learn that day CDC Guidelines on how to handle anthrax and other biological threats were
given to Management Team members. Blood tests for possible anthrax only available to FBI
through CDC. Cultures to be done by NHRMC; confirmatory testing by State Lab. Beth Jones
and Dave Rice attended meetings at New Hanover Health Network and Pine Valley Fire Station
regarding bioterrorism threats in New Hanover County on October 15. They worked on a
statement for NHC Employees to be distributed later today Communicable Disease Staff are
working on a list of commonly asked questions with appropriate answers for Health Department
Staff. Staff will be receiving information to assist in handling calls from public regarding
biological threats. Calls will need to be handled by any division receiving calls. More later
-+ FEMA Training: Dianne Harvell, Beth Jones, Betty Creech, and Dave Rice are scheduled to
attend FEMA Integrated Emergency Management course at Mount Weather, VA on January 28-
February 1, 2002 focusing on man-made disasters.
-+ Eighteen Health dept. staff received training in "Client-centered counseling", a new model
for effectively changing behaviors rather than the traditional information-giving model for health
education and prevention. Will be implemented for HIV counseling and testing and STD
prevention.
-+ Several of ACS were able to attend IT training classes offered at the county training facility
-+ CPR Training: Will be held on November 29 - 30. More information next week.
-+ Teleconference: Elisabeth Constandy attended the teleconference entitled "Immigration,
Cultural Beliefs, Healthcare and the Law" The primary focus was on Latino/Hispanic affairs, but
certainly provided info useful to learning about all cultures. She is planning a Staff in-service
related to this topic.
-+ Human Resources Training: Geographic Information Systems location tracking is a great
tool for ACS Officers to find new addresses.
-+
X. Evaluation of services
(Issue #16)
-+ Budget-Positions: Division Directors received a copy of the County Manager's memo
updating Department Heads on the status of vacant positions.
-+ Super Staff Award: Management Team approved the following recommendations: NHCBH
Executive Committee will continue to select the SuperStaffer The Award will be given twice per
year Individual plaques will be given to Super Staffers. Permanent plaque will be updated. A
Super Staff pin will be given to each recipient. Each year two Super Staffers will be given free
lunch at the Christmas Luncheon. An article on the Super Staffer will be submitted the County
Connection. Will be announced on LotusNotes to all County Employees. PowerPoint
presentation at NHCHD General Staff meeting. Super Staff Parking is available. The
Management Team voted unanimously to pay for the Super Staff expenses.
-+ Medicaid Cost Analysis: Is scheduled for December 5. Carol Chandler will conduct the
analysis.
-+ Pre-July CPT Billing: Still working with State to work through the issues.
-+ Smart Start Funding: Final budget for Smart Start programs reduced by 10% rather than
21%.
-+ Animal Shelter' Proposed shelter for homeless animals cannot be done due to zoning
constraints.
-+ Monthly Report: Beth Jones, Cindy Hewett, and Frances DeVane are preparing draft
revisions of the monthly report format.
-+ Health Promotion Funding: Received notice that NHCHD will be reduced by approximately
$13,000 in State funding.
-+ Vital Records: A new electronic system will be implemented on January 24, 2002.
Hospitals, funeral directors, Register of Deeds, IT, and Health Departments will receive training.
-+ Policies: The Management Team approved the Incident Report Policy The Interpreter
Policy was referred back to the Policy Team.
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-+ Performance Appraisals Process: Following the "Conducting Meaningful and Purposeful
Performance Appraisals" training, the Management Team appointed a Performance Appraisal
Process Team, Members are: Susan O'Brien, Betty Creech, Jean McNeil, Cindy Hewett, and
Nancy Nail), They will present their recommendations on October 30 to the Management Team
-+ Meeting Room Reservations: Lunch & Learn sessions will be held this month for Staff,
Email will be sent to Staff with dates and times, Sign-up sheets will be posted by the
Auditorium,
-+ Medical Director' Dr Phillip Smith, Selected Division Directors, Lynda Smith, and Dave Rice
will meet on October 11 to discuss the physician needs of the NHCBH and the NHCHD
-+ Super Staff Parking: Judy Evonko assigned her parking space to Frances DeVane until the
next Super Staffer is selected,
-+ Restaurant Rules: Recent changes concerning exempt status may affect NHCBH Rules
Governing Temporary Food Facilities,
-+ Budget Update: The state's new half-cent sales tax went into effect today This will become
a local-option in 2003, The economy has a large impact on the budget Sales tax receipts for
the county are down significantly from last year Medicaid expenses are expected to increase,
Next year's debt service is to increase $3,6 million (2 cents on the tax rate), A reduction in the
size of county government was a condition of budget approval. Among the strategies to reduce
the budget: elimination of positions and elimination or reduction in non-mandated services,
-+ 40 positions are targeted for elimination from the county workforce, 28 vacant positions (4
NHCHD Positions) have already been eliminated, 16,5 positions are on hold, 0 (zero) layoffs are
the goal, but not a promise,
-+ ACS staff has had to juggle responsibilities of varying positions to accommodate the
shortage in officer staff, Evening and weekend patrols are most readily affected,
-+ Policy' The Interpreter Policy and the Guidelines for LEP Interpreter Services was approved
by the Management Team,
-+ AEIOU' Subcommittee on on community health assessment met with community partners
last week, NHCHD will develop a list of 10 reasons why public health needs to conduct the
assessment Submit your suggested reasons to Bobby Waters, Mitzi Chappell, Mary Jo
Newton, or Beth Jones by October 30,
-+ Performance Appraisals Process: Performance Appraisals Process Team presented their
recommendations to the Management Team on October 30, The Management Team will
continue its review on November 6,
-+ IT Task Force: Met and is developing an assessment tool for IT planning, The tool will be
distributed to each division,
-+ Multidisciplinary Commillee: Met on October 29, The committee is preparing a plan for
contacting insurance companies to develop a notebook for clinics to use in an effort to reduce
denials,
-+
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~,u'
&:
Public Health Response to
Bioterrorism
. Notification Procedures cJ9
+If a public health official in a local or
state health department is called about,
or otherwise becomes aware of,
apparent incidents or threats of
bioterrorism (BT), they should contact
the FBI and local public safety and law
enforcement partners immediately
.
Ji:r.,'::;;;.,'
(.<To ',jJ
J
Public Health Role
in Bioterrorism
+Leadership through preparedness
+Recognition of threats
+ Threat reduction through awareness
+Respond to events
+Recognition of illnesses
+Consequence management
Communication With Community, Law
Enforcement, Medical Providers, and
Response Teams
1
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.."-"-. - Public Health Goals
.,'.c';;;',
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+Early identification and treatment
+Prompt reporting
+Epidemiologic investigation
+Education
+Preventive medication
+Oevelop outbreak control measures
+Enforce control measures-
Isolation/Quarantine Authority
. ~~
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-'--., 'EPidemiOlogical Surveillance "'V
+Organized process to assess the nature,
characteristics, frequency and
distribution of disease
. Monitor occurrence/trends
. Investigate unusual events
. Determine cause and establish preventive
measures
~~ ~~
~ Reportable Conditions ..-,,;
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~4Jl.I~__t'l~CAIlOUIOA
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Public Health Surveillance @-jJ .
"Disease Detectives" r
+Alert providers to look for index cases
+Receive reports from medical providers
. 61 listed diseases and conditions
. Any unusual symptoms or patterns of
Illness
. Widespread Illness of undetermined cause
Public Health Surveillance fe
+Assimilate and analyze communicable
disease reports
. Identify disease clusters
. Develop case definitions to increase
surveillance and case finding
. Identify outbreaks by comparing to usual
disease occurrence (ex. food borne
Illnesses)
Outbreak Control Fe
+Epidemiologic investigation
. Identify and notify exposed/susceptible
population
+Provlde prophylaxis as indicated
. Antibiotics/vaccines
. National pharmaceutical stockpile
+ Institute control measures - Isolation
and Quarantine Authority
3
Outbreak Control Fe
+Notify health care providers of unusual
cluster/trends - heightened alert
+Notify public of outbreaks - may
activate emergency management plan
for additional resources
+Communicate with health care providers
and public to prevent additional cases
Biological Agents ~.
with Weapon Potential ~
Based on:
./ Ease of dissemination
or transmission
./ Potential for major
public health impact
(morbidity and
mortality)
./ Potential for public
panic and social
disruption
Of Highest Concern:
"'Anthrax
"'Plague
"'Botulism
"'Smallpox (variola)
"'Inhalation
Tularemia
"-Hemorrhagic Fever
~ Define "Suspicious".JiCA..
I Mail or Package ~-
"'Excessive postage
"'Handwritten, poorly
typed address
'" Incorrect titles
"'Misspelling of
common words
"'Oily stains,
discoloration, odor
'" No return address
"'Excessive weight
"'Lopsided, uneven
envelope
"'Protruding wires or
aluminum foil
"-'Excessive tape,
string
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4
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Potentially Threatening Letters, Packages,
and Parcels
~'
+Place package in secure location
. Wash hands and other body surfaces potentially In
contact with parcel with soap and water
+Call 911 - loca' law enforcement; If
body, clothing, or environmental
surfaces have been contaminated,
insure that police notifies HAZMA T
Potentially Threatening Letters, Packages,
and Parcels
~
. Law Enforcement to contact the New Hanover
County Health Department
. Based 00 dl'C1Jmstances ~nd/or laboratory findings,
surveillance activities may be Initiated
. Reassure the recipient that the risk of exposure
is extremely low
. NC State Public Health Laboratory will process
and report results
. Tumaround time for samples is 2-3 day5 following receipt by
l:t1eLab
Threat Analysis
~
~--
,,---
-
--
1
--
-~-
r~o
5
NHCHD Preparedness
. NC Center for Public Health Preparedness
. New Hanover, Cumberland, Edgecombe, and Wake
. NHCHO Bloterrorlsm leadership Team
. Weekly meetings with New Hanover Health
Network
. NC OHHS and COC Teleconferences
+ Health Alert Network
+ FEMA - IEMC Terrorism Course
State Bioterrorism Budget Proposal -
Local implications
~
. The budget proposalsuppom developin& a statewide
network of Public Health Units (regional
infrastructure) to be In local health departments with
current Hum_t siles
. Buncombe, Cumberland, Durham, Guilford, Mecklenburg, New
HanovCT,andPin
. Hamlal Region: Brunswick, Cmere!, Columbus, Duplin, Jones,
New HlUIover, Onslow, lIfld Pender
. Medical Epidemiologist, administrative support.
laboratory support and equipment, genenl supplies
and equipment (IT as needed)
NHCTV and WEer - 1V6
Community Forum on Bioterrorism
. "Protecting The Homefront"
+Saturday, November 10th, with a live panel
program at 6:30 PM
+ Panel Members: Dr. Art Constantinl, Agent
Tim Flynn, Dr. Janelle Rhyne, Dan Summers,
and Dave Rice
+ Moderator: Dr Bill Atkinson
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blIStey wants Jltj,O IDUllon to ngm tenur
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Brown enters Oem.
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news I News Shortcuts J Place a DisF
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Published: Thursday. November 1, 2001 3:47 a.m. EST
Easley wants $13.6 million to fight
terror
By JAY PRICE AND WADE RAWLINS, Staff
Writers
STORY TOOLS
~ printer friendly version
a.. send this story to a friend
Gov Mike Easley on Wednesday said the
state needs to spend $13.6 million right away
to better prepare North Carolina for terrorist
attacks, including establishing seven regional
public health bloterrorism teams.
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The federal government is expected
eventually to reimburse some of money, but
it's unclear how much and when. Easley said
It is important to move soon.
"I wanted to get funding in North Carolina," Easley said. "If the federal money
comes through, fine, but right now, we've got people to protect."
Lawmakers appeared to be in a mood to give Easley what he was asking for
On Wednesday, the state House of Representatives tentatively approved a bill
11B-0 that would specifically give the governor $1.9 million to pay for
emergency-management needs, including proposed urban search-and-rescue
teams,and allow the administration to spend up to $30 million more from the
state savings reserve if necessary for other terrorism prevention and response
efforts. The bill now goes to the Senate.
"What we are trying to do Is respond to any terrorism or bioterrorlsm act that
might occur in North Carolina," said Rep. David Redwine, a Democrat from
Ocean Isle Beach, and co-chainman of the House Appropriations Committee.
"We are probably not a state that is high on the list of terrorist activity However,
you never know what Is on the minds of terrorists."
Some members questioned appropriating money without a specified purpose.
Easley wants $13.6 million
to fight terror "Even in a time of emergency, we should not forgo our responsibility to provide
Security doesn' bedevli fiscal oversight," said Rep. Art Pope, a Raleigh Republican.
panygoers
Museum mixes art,
chemistry
But the House Appropriations Committee rejected an amendment that would
fund $11.6 million in requests and require the governor to declare an
http://www.newsobserver.comlthursday/news/Story/834359p-823105c.html
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4th anthrax fatality
Citizens group breaks tie,
backs Meeker in Raleigh
mayoral race
.AJternative~sentencing
program gets a reprieve
Ad criticizes Meeker on
Outer Loop issue
Security vote faces delay
Killing lessens Halloween
fun
Wake Forest mayor enters
race with write-in bid
Flipping through a guide
to the 'other half
High school help often not
enough
Man guilty in 'free' rentals
Drill checks readiness
Losses leave Duke
grieving
Drivers face tighter
scrutiny to get licenses
FBI agent taken off loan
probe
Inmate account at Durham
jail used in swindle
Fighting agencies not
easy
Briefs
Death notices
Deaths. by community
emergency to tap the remaining monies, And all members voted for the bill on
the floor.
The bioterrorism teams would cost a total of $3.3 million over the current budget
year and the next one, and more in future years. Among other things, they
would be charged with looking for patterns that could provide an early indication
of a bioterrorism attack, said Leah Devlin, acting state health director The
teams would investigate whether the cause was bioterrorism. In an attack, they
would identify victims and determine measures to control the problem, such as
proper treatments and whether to set up a quarantine.
The teams also would be charged with getting the proper information about the
attack to the public, Devlin said.
There are many details about the teams that haven't been decided, such as
whether they would be hired as state workers. or perhaps set up under
contracts with outside agencies. she said. The teams would be small, perhaps
four people each.
It is likely that the regional teams would be based in county health departments
in the same cities as the state's regional hazardous materials teams, she said.
There are now six hazardous materials teams: in Asheville, Durham,
Fayetteville, Williamston, Wilmington, and Greensboro. The seventh would
probably go in Mecklenburg County
There also would be a central bioterrorism team with similar duties statewide.
The bioterrorism teams and the other measures Easley proposed were based
on recommendations from a state terrorism task force headed by the secretary
of crime control and public safety, Bryan Beatty
Among the measures listed were:
. An electronic communications system that would link hospitals, health
departments and pharmacies to allow health officials to detect possible signs of
an attack, such as outbreaks of unusual diseases or significant increases in
caseloads, The system would include a central office and necessary upgrades
to local county health department computer networks, at a cost of $2.9 million
spread over the two budget years.
. Additional security to prevent cyberterrorism against the state computer
networks, $3.4 million.
. Seven search-and-rescue teams capable of responding to collapsed
buildings in urban areas, $1 4 million.
. Additional training and equipment for law enforcement, $1 million.
. Expansion of an agriculture lab so that ~ could be used for testing for anthrax
and other dangerous chemical and biological agents, $1 1 million,
. A reserve fund for cleaning up debris from destroyed or contaminated public
facilities, $2 million.
. Equipment for Division of Air Quality to assess and track dangerous chemical
http://www.newsobserver.com/thursday/news/Story/834359p-823105c.html
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Staff writer Jay Price can be reached at 829-4526 or jprice@newsobserver.com
Feedback II Parental Consent II Privacy Policy II User Agreement
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21.-.. .
T"'"'
I ANN TAYLOR
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C Copyright 2001. The News & Observer. AJI material found on nevJ$observer.COI11 is oopyrighted The
News & Observer and associated news services. No material may be reproduced or reused Y.tthout
explicit permission from The News & Observer.
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NEW HANOVER COUNTY HEALTH DEPARTMENT
Medical Consultant
ADMINISTRATION
A. Medical consultant to New Hanover County Board of Health (BOH).
B. Advisor to BOH on public health policy
C. Serve as liaison to medical community.
o Provide medical input and advice regarding health information to the
public.
E, Attend monthly BOH meetings and BOH Committee meetings when
appropriate.
F
Provide medical consultation to New Hanover County Health Department
programs and services.
II. NURSING PROGRAMS
A. Communicable Disease Medical Consultant
1 Primary supervising physician to physician extender providing
direct clinical services to patients.
2. Approve and sign physician standing orders for routine nursing
activities requiring physician order. Ex.: Administering
immunizations, HIV counseling and testing, and post-exposure
prophylaxis.
3. Provide medical consultation and physician orders to staff
regarding surveillance and outbreak control activities.
4
Sign standing orders for collection of specimens and treatment
protocol for sexually transmitted diseases, tuberculosis, general
communicable disease outbreak control according to appropriate
CDC and state guidelines and treatment protocols.
a: medlcalconsuftant-1 (NHCHD 10101)
.
'.
."
"
B.
Child Health/Community Health Medical Consultant
1. Primary supervising physician to physician extender providing
direct clinical services to patients (ex: Kindergarten Health
Assessments). .
e
2. Approve and sign physician standing orders for routine nursing
activities requiring physician order (ex: Ipecac, community nursing
orders.
3 Serve as medical consultant to staff in Child Health and Community
Health programs.
4 Provide clinical supervision of registered nurses in Lead program
and Child Health clinics.
5. School Health medical consultant - sign standing orders and
provide consultation and advice to staff providing School Health
services.
C Women's Health Medical Consultant
1
Primary supervising physician to physician extenders in Women's
Preventive Health program.
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2. Approve and sign standing orders for routine nursing activities that
require physician's order
3. Approve protocol for providing Women's Preventive Health
services.
o Laboratory Clinical Consultant
Provide consultation regarding the appropriateness of the testing ordered
and interpretation of test results~ The clinical consultant must:
. Be available to provide clinical consultation to the lab's clients.
. Be available to assist the lab's clients in ensuring that appropriate tests
are ordered to meet clinical expectations.
. Ensure that reports of test results include pertinent information
required for specific patient conditions.
. Ensure that consultation is available and communicated to the
laboratory's clients on matters related to quality of the test results
reported and their interpretation concerning specific patient conditions.
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a: medicalconsuftanl-2 (NHCHD 10101)
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SCHEDULE A
Scope of Services
1 The physician shall provide treatment and diagnostic services in accordance with
approved methods and standards of practice of the North Carolina Medical
Practice Act, North Carolina Board of Medical Examiners and the code of ethics
of the American Medical Association.
2. Shall provide medical/clinical services and serve as primary supervising
physician to physician extenders in programs under Communicable Disease,
Community Health, Child Health, and Women's Health Care Divisions. Clinical
services include review of historical data, diagnosis, and treatment as indicated
in specific clinical setting. Supervising physician includes being available for
consultation with physician extenders for patient management, quality assurance
and problem reviews as required by North Carolina Board of Medical Examiners.
3. Shall serve as Clinical Consultant to the NHCHD laboratory
4
Shall refer to medical facility or private physician for extended treatment or
diagnostic measures not managed by this agency.
5.
Shall document and appropriately sign findings and treatment course in patient
medical record in accordance with agency policy
6. Shall dispense medications according to agency pharmacy policy.
7 Shall perform clinical duties in accordance with OSHA Bloodborne Pathogens
Standards.
8. Shall observe agency policies regarding confidentiality.
,
.: medicalconsullant-3 (NHCHD 10101)
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North Carolina Department of Health and Human Services
Division of Public Health. Epidemiology Section
1912 Mail Service Cemer. Raleigh, North Carolina 27699-1912
Te1919-733-3410. Fax 919-733-9555
Carmen Hooker Buell, Secretary
Michael F Easley, Governor
October 3,2001
To
() '/If4/(
From
Posl-il' Fax Note 7671
David Rice, Health Director
New Hanover County Health Department
2029 South 17th Street
Wilmington, North Carolina 28401-4946
Co.fDept.
Co.
Ph,
Fax"
Dear Mr Rice:
Thank you for your letter of 9/13/01 with the enclosed data for the Blue Clay Rdjail
construction site. I have asked one of my staff toxicologists, Dr. Ken Rudo to review the
document. I will summarize Dr. Rudo's comments below'
e
The firm of Catlin Engineers and Scientists (Catlin) evaluated the possible presence
of methane gas at the site, and as with previous tests, no methane gas was detected.
The two suggestions by your environmental management director, Ray Church, to put
in an interceptor ditch and to install methane detectors in the finished jail should
address the concerns we had about methane gas in the facility
OEEB would recommend additional monitoring of groundwater both onsite and
offsite. Previous sampling by the contractor laboratory used detection limits for the
volatile compounds (benzene, carbon tetrachloride, tetrachloroethylene,
trichloroethylene, vinyl chloride, EDB, DBCP, and chloroform) and inorganics
(chromium, arsenic and nickel) that were 5 to 100 times the NC groundwater standard
or EP A maximum contaminant level. These high detection limits makes it impossible
to detect these compounds, which are routinely found in unlined landfills in NC. In
addition, no lead analysis was done. These concerns, along with the detection of
xylenes and cadniium (which in at least one monitoring well exceeded the NC
groundwater standard of I 75ppb), indicate that a further, more detailed look at this
site should be done.
e
No offsite monitoring has been done within 200 yards of the facility As a result, we
do not have any information about possible offsite groundwater contamination.
Because the hydrogeological data is still preliminary, with Mr. Church recommending
more data points to confirm flow direction, offsite monitoring takes on an added
importance in order to understand which of the II wells within V. mile of this site
may be in the future pathway of groundwater flow from the landfill and jail facility
OEEB recommends offsite monitoring at this site.
@ Location: 2728 Capital Boulevard. Parker Lincoln Building. Raleigh, N.C. 27604
An Equal Oppormnity Employer
,\
,
'-
David Rice Letter
October 3, 200 I
Page Two
Because groundwater contamination of the landfill was evident on the west, east and
south sides of the landfill, further information on the direction of groundwater flow is
needed. In addition, if the flow direction is north/northwest as the preliminary data
suggest, OEEB recommends putting 2-3 monitor wells at the North end of the landfill
to detect any contamination in this direction, because at the present time there are no
monitoring wells in this area. Future decisions about where to put off site monitoring
wells (and how many) to assure the protection ofthe nearest offsite private wells
carmot be made until we have a better understanding of the nature of the onsite
contamination, direction of groundwater flow, and possible extent of offsite
contamination within 200 yards of the site.
I look forward to discussing this matter with you in greater detail as we work together
to protect the health of all the residents living next to this site. I appreciate your
assistance in this matter. Should you have any further questions, please feel free to
contact me at 919-715-6425
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Sincerely,
~
~~
William Tynan, MD, MPH, Head
Occupational and Environmental Epidemiology Branch
WT:pd
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I.
II.
New Hanover County Child Fatality Prevention Team
Year End Summary 2000-2001
(Deaths reviewed occurred during fiscal year 1999-2000)
Introduction
The New Hanover County Child Fatality Prevention Team (CFPT) is a group comprised of
community representatives from diverse agencies and disciplines who meet on a regular
basis. Their mission is to promote the development of a community wide approach to
understanding the causes of childhood deaths, identify deficiencies in the service delivery of
public agencies to children and families, and to make and carry out recommendations for
changes to prevent future child deaths as dictated by the NC General Statute, Chapter 7B.
Team Activities and Accomplishments
The New Hanover County (NHC) CFPT wrote two letters to the local hospital. The first one
was in regard to the explosion in growth of the Hispanic population. Spanish speaking
pregnant women and new mothers are not receiving the type of care to which they are
entitled because of the lack of interpreting services. The second letter was written regarding
"rollover" deaths. It was brought to our attention while reviewing in-home rollover deaths
that our hospital was not providing adequate staffing overnight. Babies were often observed
in bed with their mother. We expressed our concern that newborns were not being properly
supervised and that a "rollover" could occur The hospital responded to our team. The
Director of Women's and Children's Health Services came to our quarterly meeting to
address our concerns. She stated that they were satisfied using the AT&T phone line for
interpreting, and that they would try to incorporate teaching about the dangers of "roll over"
They were also becoming better staffed.
The NHC CFPT made recommendations for Spanish signs to be posted at the beaches
warning of "danger/no life guards" to prevent drowning. The committee has since been
informed that Spanish signs have been erected.
The NHC CFPT purchased car seats given out to low income health department clients. The
team also purchased smoke detectors which were supplied to the fire department for low
income families with children.
III. County Child Fatality Statistical Information during the Fiscal Year 2000-200 I
18 deaths occurred (1999-2000) and were reviewed during the fiscal year 2000-2001
Perinatal conditions
Homicide/GSW
Accidents - vehicle
Choking
Drowning
Illnesses
(newborns)
(ages 12, 16, 17)
(bike) (age 15)
(age 3 yr.)
(age 17 yr.)
(ages 4 mo., 7 yr., 11 yr., 13 yr)
8
3
1
1
1
4
.
New Hanover County Child Fatality Prevention Team
Year End Summary 2000-2001
Page Two
-
Three cases were reviewed that had been held over from prior fiscal years due to legal issues,
i.e. prosecution of offender and obtaining all family records. (2 GSW ages 9, 17) (I
asphyxiation due to self hanging, age 11 yrs).
IV Analysis & Recommendations:
A. There were no trends identified in New Hanover County in the deaths occurring
1999-2000.
The increased Hispanic population causes concern due to lack of bilingual
information and interpreting services.
The good news for New Hanover County is that there have been no SIDS deaths in
the past 2 years.
B
Recommendations
The State needs to put pressure on hospitals and physicians to provide face-to-face
interpreting for Spanish clients. Health departments have complied with federal
laws, but our local hospital and physicians have not. Our team views this as a risk
of death to children of Spanish heritage.
e
V Training Needs Identified
Since most members cannot travel for CFPT training, it would be beneficial to have Brenda
Edwards come to a local team meeting to review guidelines and rally our members to be
more committed to the team.
VI. Resources
Local counties need assistance from State staff to get cooperation for mandated team
positions to be filled. We have been unable to recruit and maintain a Medical Examiner on
our team for several years.
VII. Conclusion
NHC observed that 45% of the deaths that we reviewed were due to perinatal conditions.
In all of these deaths, the mothers had obtained appropriate prenatal care. Our team was
unable to identify any known prevention and has no local recommendations.
NHC was also unable to identify any local action to influence the deaths due to homicide and
accidents.
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New Hanover Diabetes Today Coalition
2029 South 17th Street, Wilmington, NC 28401
October 22, 2001
,f/
0vt9'V.{l
Dr. Michael Goins
5030 Randall Parkway
Wilmington, NC 28403
Dear Dr. Goins,
Thank you so much for your support of the Lions ClublDiabetes Today vision
screening on October 17th. We couldn't have done it without you. Along with
your direct help at the site, your recruitment efforts paid off with the volunteer help
from Doctors Tracey and Chris Glendenning. All three of you were key in
providing the professional expertise that was essential.
The staff with the See the 21st Century Vision Van was impressed. Throughout the
day, there was a steady line of people. No one waited too long and everyone was
seen _ all without appointments! We exceeded expectations; 125 people were
screened over a 6 hour period. We were told that any amount over 120 is
considered excellent. We will be receiving data from the screening regarding
problems identified and follow-ups scheduled, but I'm sure you already have a
fairly good idea of the types of problems that were discovered.
With the help of so many, we had the perfect mix - student nurses from Cape Fear
Community College and UNCW, the Community Health Center staff, the Lions
Club and Diabetes Today volunteers, the Star News and WW A Y TV, and three eye
doctors from the private sector.
On behalf of the New Hanover Diabetes Today Coalition, thank you for being part
of the perfect mix.
Trish Snyder
Diabetes Today Coordinator
c: David Rice, New Hanover County Health Department
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CHILD CARE NURSING
NEW HANOVER COUNTY HEALTH
DEPARTMENT
~
~
{{
The New Hanover County Health Department employs two full-time Qualified Child Care Health
Consultants, a Community Health Assistant and an Administrative Support Technician to provide
training and consultation to all child care facilities in order to enhance the health and safety of the
child care environment. The program provides ongoing health and safety consultation and techni-
cal assistance, health screenings, on-site immunizations, maintenance of health records and assis-
tance in the development of health policies. Health and safety education is provided to child care
facilities and target providers, parents and children through in-service calls, newsletters, confer-
ences, puppet shows, etc.
~ ~
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2000-2001 Successes
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. 531 young children received speech/language and/or other developmental screenings
. 198 young children received hearing screenings
. Over 1,400 children received health/safety education and training in a child care setting
. 479 child care teachers/directors received health/safety education, training and/or consultation
***************************************************************
-: The Child Care Nursing Program worked with a child care center this past year to increase their sanitation rating. -:
-: Environmental Health Specialists make unannounced inspections of child care centers at least once every six months. -:
* A classification of Superior, Approved, Provisional, or Disapproved is given. This facil ity received more than 46 de- *
-: merits giving them a Disapproved Sanitation rating. -:
* Child Care Nurses worked with this facility on sanitation issues, educating staff on proper sanitation practices, and *
-: developing an On-site Technical Assistance Plan. This plan consisted of solutions to the problems and a time line for -:
* completion. *
-: Child Care Nurses received a great deal of cooperation and willingness to comply with child care sanitation rules :
* and regulations. The majority of demerit issues were corrected. Upon the return of the Environmental Health Spe- *
: cialist, this facility was issued a Superior Sanitation rating. :
***************************************************************
OlllClalti 11"0111 VUlt:! U:::VCJ~ V1 gU...CUUU....UL.
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Nice going,
lIealth Departn1ent
e
Cheers to the New Hanover County Health Depart.
ment for going out of its way to get enough flu vac-
cine in time to protect vulnerable people. That will
help many residents avoid misery and expense, and it might
even save some lives.
This year, like last, vaccine makers were slow to pro-
vide enough vaccine to meet demands. For some of us,
that's a relatively minor matter; if we get the flu, we'll
feel rotten, but we'll get over it.
For others, particularly those who are old or weakened
by other infirmities, the flu can pose a serious threat.
The sooner they get vaccinated, the better.
The Health Department decided not to be patient this
year. In addition to arranging for. the usual shipment of
vaccines from the state's supplier, i~ made deals with two
private outfits - and paid a higher price. Medicaid is ex-
pected to pay most of that difference.
But money aside, this is what public health is all about.
It's heartening to see that New Hanover's department is
eager to meet its responsibilities.
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NEW HANOVER COUNTY
HEALTH DEPARTMENT
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ANNUAL REPORT
2000/200 1
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New Hanover County Health Department
Board of Health
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The Board of Health IS appointed by the New Hanover County Board of Commissioners as the
governing body for the Health Department.
Wilson O. Jewell. DDS
Chairman
Dentist
Robert G. Greer
County CommiHioner
Phillip P. Smith. Sr., MD
Phvsicitlll
Gela N. Hunter, RN, FNP
Via-Chairman
Regis/ernl NUrJ('
W Edwin Link, Jr., RPH
Pharmacist
William T. Steuer, PE, RLS
Profcssiolltll Enginar
Henry V. Estep, RHU
Public Alember
Anne B. Rowe
Pub/ic Member
Estelle G. Whitted, RN
Pub/it !vfnnher
2 NE\X/ HANOVER Cl)UNTY HEAI.TH DF,[',\RTJ\lENT
Michael E. Goins, 00
Optometrist
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Melody C. Speck, DVM
lleterinarian
Frank R. Reynolds, MD
Aledioll Consu!tmlt
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Directors Message
We are pleased ro provide you with rhe New Hanover County
Health Department Annual Rl:port for fiscal year 2000-01 It
represents the provision of public health programs and services
for people in New Hanover County. The core concepts that guide
our efforts arc: it is better to prevent disease than to have to treat
disease, and controlling health risks is one of our best disease
prevention strategies.
David E Rice
The mission of the New Hanover Counry Health Department
is to protect the public health and environment, promote healthy living and optimize
the quality oflife through preventive, restorative. environmental, and educational ser-
vices. In fulfilling our mission, the Health Department provides preventive health ser-
vices, environmental protection programs and health enhancement activities. An em-
phasis on health promotion and education embraces all of our programs, services and
activities.
During fiscal year 2000-0 I, the Healrh Department experienced many challenges and
opportunities. Among the most notable highlights were:
. Strategic Planning R<:treat
. NCPHA in Wilmington
CO . Animal Cruelty Cases
. Folic Acid Grant
. Guard Your Smile
. Salute To Teens
. Enhanced Mosquito Surveillance
. Jail Accreditation
. 'I()bacco Merchant Education
. Laboratory Accomplishments
This dommem fOcuses on most of our progrmns, seroices and activities. 71Je breadth of our Health
Departmem, however, prf'vmts us ftom C(wering aU our promotion, prelim/ion, find protation
endealJOrs. f'or (1 more detailed aavunt of our past and current effirts, ple/lSe llisit our web site at:
http://www.nhcgov.com/HLTH/HCI.Hmain.htm
"From the Northeast River to Federal Point, and from the Cape Fear (0 the Sea~C:iry,
Suburb, Village and Farm-we arc one people striving for healthful and useful living. "
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David E. Rice, MPH, MA
Health Director
Division Directors
Assistant Health Director
Lynda F Smith
Animal Control Services Director
Dr. Jean P. McNeil
Child Health Director
Janet B. McCumbee
Communicable Disease Director
Beth W Jones
Community Health Director
Betty B. Creech
Dental Health Director
Dr. David W McDaniel
Environmental Healtb Director
Dianne M. Harvell
Laboratory Director
Susan M. O'Brien
Nutrition Director
Nancy R. Nail
Women" Health Care Director
Betty Jo McCorkle
Mission Statement
The mission of the New Ha-
nover County Health Depart-
men t is to protect the public
health and environment, pro-
mote healthy living and optimize
the quality oflife through preven-
tive, restorative, environmental
and educational serviees.
Motto
"Your Health - Our Priority"
zooa /01 ANNllAI. REPORT 3
Highlights
STRATEGIC PLANNING RETREAT
In an dl(m ro prioritize the health needs of New Hanover CountY,
the Board o[Hcalrh and Health Department Managemem Team
participated in a Srraregic Planning Retreat in Ocwber 2000.
facilitatcd by William Herzog. A"sociare Protessor Emeritus from
UNC C1upd Hill's Schuul uf Puhlic Health, the two-day ses-
sion provided Board, Management and StatY members an op-
porruniry ro review the health status of the county's ciri'lcns. A
dcraikd list ofprioriries, goals and objectives was developed and
shared with the full Health Department Staff This unique re-
treat provided a positive atmosphere to share inf()rmation, ideas
and concerns. The established priorities afC continually revis-
ited through momhly updates which are shanxi with the Board
and Stafl
NCPHA IN WILMINGTON
Wilmington was the proud host of tht: Nonh Carolina Public
Health Associ;uion's Annual Meeting, held Septl'mber 20-22,
2000. NHCHD received awards recognizing the outstanding
achievements and accomplishments of staff members and the
programs in which they work. Awards or scholarships were
presented to the Community Health, Communicable Disease,
and Environmental Health Divisions. Having the meeting in
Wilmington prt:sented a uniqw.: opponunity to share the rich
history of public health in N<.:w Hanover County. Many meet-
ing attendees panicipated in a (Our of the downwwn area, his-
toric Oakdale Cemetery, and NHCHD facilities.
ANIMAL CRUEI:JY CASES
Aninlal C(lnrnl! Services was successful in rescuing three sets of ani-
nuls filllll three separate locations in the counry. Each resclI<.: re-
quired mlllripk hours of preliminary work and f()How up carl' for
the animals brought into the shelter. These cases have increased
4 NEW H A NO\' ERe 0 U N T \ H E.\ I.T H n I': 1'.\ R T 1\1 EN T
public awarmcss about animal cruelty cases in the area, and they
encourage those who witness mistreatment to share their tl.'Stimony
to capture future offenders.
FOLIC ACID GRANT
The Women's Health Care Division embarked on a new venrure wim
the March of Dillles ;md community parmers to provide educational
intormation on the importance o[taking a daily vitamin mat includes
fulic acid. A grant w:t<; received hum me March ofDimcs to purchase
and distribute rnultivit;Ullins and information to women of child-
bearing age. Partnerships with NHC Register of Deeds and UNCW
Student Hl':.dth, in addition to NHCHD effons, will ensure broad
distribution in the community. Folic acid, when taken prior to con-
ception, has been proven to gre.uly reduce the risk of ccnain binh
defect.., and has als<) lx:en linked to lower incidenc~ of he an diSC'.l'ie,
stroke, and sOl11e f(m11S of cmcer.
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GUARD YOUR SMILE
In celebration of Public Health Month, the Dental I-Il'alth Divi-
sion sponsored a regional initiative to increase the use of
mouthguards as a method of injury prevention. Results of the
~ GUilrd}our5ilni/(.'c:.unpaign were impressive with over 1 ,O()() adults
~ and children receiving informalion. Additi(mally, many V(lllngsoc-
~ cer players were professionally fined tor mourhgll3rds free of charge.
i Co-sponsors offhe evenr were the Y1\.1CA, Cape rear Community
~ College, and the North Carolina Oral Health Section.
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SALUTE TO TEENS
The Communicable Disease Division sponsored Sdlltt' to 'Ii'em
as part of the Public Health Month celehration. Adolescenrs n..'-
ceived immunization aSSl'ssmenrs and updates and inf(lfI11ation
on healthy lifi.:stvle choices. Door prizes were purchased with
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money raised by the Division and induded a grand prii'.c of a per-
sonal computcr <lnd printer.
ENHANCED MOSQUITO SURVEILLANCE
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The Cl'Ilters for Disease COlUro] Fay-Prince'lrap is currenrly being
implcmcmed in the Vector Control Program to enhance mosquito
sllrv<.:illance effons. Designed 3S a daytime trap, it fenures a bold
colUrasr of gloss V black and white panels. "I'his unique visual dement
attract~ day tlicr mosquitoes. The ([ap fcatlln:,~ a wind orienting cover
~U1d a slIction motor, which hlows the mosyuiwes into a collection
cup. 'Ii) increa.<;e the traps Guch, sraffwilluse C02 and scented water
buckers place_xl near each trap. Gral'id Cuux mosquitoes find water
scenrL"l1 with alfulfu ideal for egg laying. The traps will be set at com-
plaints and other container-breeding sllSpici{)ll~ sites to quantitY the
population of these difficult to trap species. Our goal is (() monitor
Aerh1- a!bopictus, Cu!exquinquefitciatus. ;md ocher Cit!exspccic.~, which
may prove significant to the spread of West Nile Virus.
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JAIL ACCREDITATION
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The Jail Health Program, pan of the Community Healrh Di-
vision. received notification in J--:ebruan' 2001 from the Na-
tional Commission on Correctional Health Care that rhey had
met all standards and achieved national accreditation. New
Hanovl'l" County's program is one or tcw in Nonh Carolina
that have been accredited. The reputation of the lail Health
Program results in frequent requests from otha counties for
assistance in program development.
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TOBACCO MERCHANT EDUCAnON
The Proiect ASSIST Tobacco Prevention Coalition co-sponsored
a Merchant Education campaign in partnership with a local youth
empowerment organii'__ation. Coalition members and aR"a youth
canvassed the College Road, Wrightsville Beach. and downtown
Wilmington areas, targeting stores where tobacco products are
sold. The youth presented pledges to store owners and manag-
ers, asking them not to sell tobacco products to people under the
age of 1 ~-L Of the') 1 stores visited, 96(~'h signed pledges to check
identification and not to sell to underage buyers. The youth also
noted the number of tobacco advertisements posted in and
around the stores.
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LABORATORY ACCOMPLISHMENTS
This year marked another inspection ot the NHCHD Labora-
tory by the NC Division of Facilitv Services to ensure compli-
ance with the rederal Clinical Lahoratory Improvemenr Acts.
These acts govern the way laboratories function in every aspect
from personnel and testing, to quality assurance. The Labora-
tory was fi:nll1d to haw no deficiencies on this inspection. The
Lahoralory was also instrumental in assuring that NHCHD
would be ready for a voluntary OSHA inspection of countv El-
cilitie.... from the NC l)epartlllent of Labor. The Laboratory and
the Health Departmcnr had no deficiencies on this inspection.
either. This again demonstrates the excellent quality of service
provided bv the Laboratory.
lOOO /01 ANNU.\L RFJ>llRT 5
Administration
The Administration Division is responsible for the administra-
tion, opl'rarion and fiscal management of the New Hanover
County Health Department.
GOALS
. Assure a positive public image and serve the citizens of New
Hanover County
. Provide assistance in administrative. financial, personnel and
vital records
. Support rhe Board of Health, Health Director, Assiscant
Health Director, Division Directors and Health Deparrmem
Staff
. Monitor, maintain, and purchase computer equipment. and
provide Information 'technology expertise to staff
. Prepare Property Management work orders and assist with
scheduling of Health Department maintenance
PERSONNEL
GOAL
. Providl' personnel services for approximately 189 Health
Deparrmem employees and serve as liaison between the New
Hanover Coumy Dcpartmc:m of Human Resources and the
Healdl Departme:nt
Pt.'rsonnel services include processing payroll and personnel ac-
tion forms; orientation to new employees regarding policies
and procedures; annual open enrollment for county personnel
bcndits; and the maintenance of personnel records and the
New Hanover County and Health Department Personnel PoliLY
and Procedure manuals.
VITAL RECORDS
North Carolina General Statutes 130-A requires the Health
Department administer the Vital Records Program under the
direction of the Health Director.
GOAL
. Assure vital records are filed as required by Chaprer 130-A
of North Carolina General Starutes and are submitted to
the North Carolina State Division of Vital Records and
New Hanover Coumy Register of Deeds within the
required time period.
Deputy Registrars are appointed by the Health Director to pro-
cess birth and death cenitlcates for New Hanover County. The
hospital is responsible for filing birth cenificares and funeral
directors arc responsible for filing death certificates with local
Health Department Deputy Registrars.
Certified copies of birth and death certificates are available at
the New Hanover County Register of Deeds or from the North
Carolina Office of Vital Records. Fees are charged for certified
copies of certificates.
Vital Records for Fiscal Years 1996/97 - 2000/01
New Hanover County FY1996/97 FY 1997/98 FY1998/99 FY1999/00 FY 2000/01
Birth Certificates
Death Certificates
3,071
1,583
3,549
1,795
3,604
1,972
3,446
1,923
3,592
1,939
Animal Control Services
Animal Control Service:s (ACS) is responsible for surveillance of
rahil.'s exposure sitlJations and protects our communitys citi-
Zl.'ns and their companion animals from this viable zoonotic dis-
e:asc through prevention dTorrs, raising public awareness, and
diligl'nt e:ducation methods.
GOALS
. Inerl.'ase the positive public image: of the dutil'S performed
hy ACS in sl.'rvice to the community through increased
mcaSlll"t's of education
6 NEW HANOvER COUNTY HEALTH DEPARTMENT
. TncreJ.Se adoption rates and decre;lse euthanasia rates of
surrendered animals
. Build an on-site spay/neuter facility J.nd outdoor exercise/
play J.rea
. A"sess J.nd improve methods of rabies exposure prevel1tion
THE YEAR IN REVIEW
Animal Control Services experienced a bJ.rrJ.ge of head-liner cru-
clrv cases in FY 00/01 Each case required hours of intensive
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investigation and dedicated manpower to care fin rhe
numerous pets contiscated from the homes. In Oc-
tober 2000, 68 animals wen: seized from a residence
on Rose Avenue. These 66 dogs and two cats re-
mained at the shelter until a December court date
and a final release (0 the Humane Society on Janu-
ary 2, 2001 The case was appealc:d from its original
determination, but the offender chose to ren13nd the
case back to the original dl:cision, when they were
found harboring pets at a Brunswick CountY address.
A second problem wa.<; solvl..'tl in January afier momhs of
collabor.uion with the NHC Shcrilf's Department. MlJ-
riple wild dogs were removed rr()ll1 a home on Sill Harbor
in the southcm portion of the COllll[y. lbis owner was
allow\.;'(.l to kL'L"'{J two neutered dogs as personal pelS. A
third situation was handled in conjunction with the
Wilminb'1nn Polio: Dcpattmt:nt. 111e MaidesAvetlue 10-
Cltion was inside me city limit~ ;md wa.~ the home for mul-
uple inbred, semi-wild dogs. ACS was able (0 clPture the
majorirv of these dogs and relocate several t(l a Bmmwick
County shcltcr.
Another unwanted stray kitten awaits a new hOHlt,. More than
Of the nnirnals left ilt the shelter are owner surrendered.
Thrce positive rabies cases were identitled in PY 00/01 Two
occurred in October 2000, one of which involvt:d a raccoon at-
tacking an eight year old child. The third cast:, in April 2001,
was particularly discouraging because the cxposcd individual...
were nonchalant in their handling of a rabid fox. It was difficult
to track them down to inform thcm that the tl.lX was rabid, so
that tht:y could receive post-exposure vaccinations if they de-
sired to do so. This emphasizes tht: continued need to raise pub-
lic awareness of tht: danger associated with tht: lite-threatening
virus, as it continues to maintain a hold on our community.
~
The Chamelcon sottware system cominues to prow itself as a
viable resource f<H upgrade and maintenance of the ACS li-
ccnsing program. Service has bcen expanded through this pack-
age by cnabling staff to send electronic rcminders, pre-citation
letters, citations, and consolidated tiles to a collection agency
for people in noncomplianct: with the counry ordinance. It
has also given ACS thc capabilitv to place phows of pets avail-
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able for adoption on the internet (www.petharbor.com) for
general public viewing without visiting the ~hdter. This served
as a catalyst tot staff to upgrade the ACS web~ite, which was
markedly improwd in the last months of FY 00/01 A kiosk is
availablt: in the from otlice area of the shelter to review listings
of the animals kt:nnded in the facility. Staff enjoyed a week of
training from a sohware representative, which has increased
till' ability (0 urili'/,l: additional porrion.\ ot the system.
Despitt: numerous power and water failures due to construc-
tion on Division Drive for the months of March through May,
ACS was able to ~ponsor a number ofevellts at the shelter loc1-
tilln. On March 17,2001, an Opcn I-louse was held from 10
a.m. - 2 p.m., using a Saint Patrick's Day theme. April's Public
HM/th Month acrivitil's included voluntl:er orientations, a frt:c
rabies clinic at the shdtt:r on Aptil21, discounred rabies vacci-
nations offered at area vett:rinarians from April 23-28, and thret:
WAAV radio spots. One of the WAAV spots was an hour long
forum, which gave citizens an opportunity to call in (0 rill'
station with questions. The annual Pet Adopt-a-than was held
the weekend of May ';-6, with the usual array of
activities and displays.
Staff continues to raise public awareness of ACS ac-
~ tivitics and services by going into the community {()
.
Z conduct educational presematiolls. A display was
.
~ available at the airport in February with information
~ on general pt:t cut: and rabies. ACS wa~ preselH at
~ Town Hllll at t/)t' NIall and the anllual Hurriulnc E'<po
~ to showcase services. Sever;}l schools were visited for
~ individual da~ses {() tell the ACS story. A UNCW
~ honors class met at the she her seeking understand-
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U ing of the human-animal bond. Hurricane floyd
relief workers Illt:t at Wal-Marr (0 advertise the avail-
ability of animals for adoption at the facility
(.ity (~rU?ilmington police officer downed by two iltttlt'kingpit bulls as he
tlttempts to protect schoolchildrt'11 fom the chmging dogs.
2000/01 ANNUAL REPORT 7
June 2001 marked the end of one full year of biweekly morn-
ing radio spotS on WAAV Radio. (These are continuing into the
next year.) 2000 marked the seventh year for the free Inner City
Rabies Clinic, held in November. We experienced greater suc-
cess with our annual Paws to Recycle campaign, possibly due to
the lack of hurricanes during the September through November
months of the event.
StaA-' participated in a weekend strategic planning retreat coordi-
nated by the Board of Health and Health Department Manage-
ment Team. This has served [0 focus staff on targeted channels
of operation to improve functions of the division in identified
areas. One area of direct improvement was the development of
a Spanish manual of translations pertinent to our area of exper-
tise. Clerical staff and officers in the field will be able to converse
with our culturally diverse community utilizing this tool.
ACS presented a Department Focal to the Board of Health in
October 2000, which highlighted an update of ACS licensing
activities. The entire process has been developed to a fine-tuned
machine, from the initial reminder notices through the final
outcome of the electronic file sent to the collection agency. A
Hearings Examiner comes to the shelter about twice a month to
hear appeals cases. This framework has instituted accountahility
and consequences to enforcement of the ordinance, which is
necessary to provide a means of rabies prevention surveillance.
Child Health
The Child Health Divi.sion provides a variety of preventive health
services in homes, child care facilities and weekly clinics. The
~ivision is a multidisciplinary team of nurses, social workers,
nursing assistants and administrative support staff.
GOALS
. Increase community awareness of children's preventive
health, safety, and development
. Incn.:ase number of children receiving rourine testing f{>r
lead poisoning with appropriate follow-up
. 80% participation in Health Check well screenings
(Medicaid-eligible children)
. Early detection of health and developmental problems
leading to early intervention and treatment
. bmilies are ,Supported in parenting young children and in
their utilization of community resources through case
management and home visiting services
PROGRAMS AND ACTIVITIES
Child Service Coordination (CSC), a statewide program since
1990, provides home visiting and coordination of services f{)r
families with children ranging from birth CO five years of age
identified through a referral process. Nurses and social workers
provide health, safety and developmental follow-up CO over 400
f.."1milies in the county. The program receives approximately 50
referrals per month. Staff is trained in developmental screen-
ing, parent-child interaction assessment and the early interven-
tion system. Luino families comprise 7% of the CSC cascload.
which necessitates the w..e of an interpreter. The CSC program
is supported by Medicaid billing. Parenting dasses were also
provided eo the general community this year.
The Health Check Clinic provides well check~lIps for
Medicaid-eligible and Health Choice insured children, who re-
8 Nr"w llANO\' ER COUNTY HEALTH DEPARTMENT
ccive a health history, immunizations, laboratory testing, devel-
opmental screening, measurements, hearing and vision screen-
ing, physical exams, education, counseling and referrals. The
clinic provides kindergarten health screening, and Head Start
and preschool/child care/sports physicals upon request. All
Health Check screenings are shared with the child's physician.
Health Check Coordination, a Smart Start funded service, as-
sists families with Medicaid-eligible children in making doctor
and demal appointments, arranging transportation and mak-
ing referrals for other health and social services. The Health
Check Coordinator assists clients in the application process tor
enrollment or re-enrollment fot Health Check or Health Choice
child health insurance. The Health Check participation ratio
increased fmm ')4.8% (FY 1997/98) to 69% (FY 2000/(1).
The Health Check Coordinator works with physicians' offices
to follow-up on no show appointments, chronic medical COIl-
ditions and referrals. With her bilingual skills, she also assists
many Latino families with accessing community resources.
The Lead Program is a coordinated effort of the Child Health,
WIC, L1.boracory and Environmental Health divisions. Dur-
ing FY 2000/01 there were 1,881 lead tests completed in the
Laboratory. Child Health nurses are presently following 60 chil-
dren with elevated blood lead levels, including providing home
visits, cducuion, additional testing, follow-up with doctors, as-
sessment of hazards, developmental testing, school planning sup-
port, and referrals. New state guidelines have increased the num-
hers of children being followed, but the couney continues to
meet and exceed minimum requirements. Collaboration with
local private providers and housing officials has improved
through workshops and meetings. Lead histories and monthly
statistics are morc complete, up-eo-date, and accessible, which
has increased screenings otdered by other divisions and helped
statl' respond mote quickly to inquiries from both in and out of
the Health Department. A new local Lead Program protocol
has been implementi.:d, along with facilitating voluntary envi-
ronmental investigations.
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The Child Care Nursing Program is funded by Smart Starr
and a UNC Chapel Hill grant. The Child Care Nurses (Child
Care Health Consultants) provide services to all child care fa-
cilities including preventive health services, health education,
consultation and technical assistance upon request from direc-
tors, teachers, parents, Environmental Health statE and regula-
(Ory cOllsulcants. The UNC grant-funded nurse performs as-
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111mi'll Hl'tlth, Child Gur Nurse. pnfimns a hearingscrecJl on a preschooln:
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sessmencs ofa facility's needs, assists in applying t{)r state money to
improve the' facility, and participates in research on the effective-
nes,''i of the Child Care Health Consul tams. This year, a tempo-
rary Community He-J.lth Assistant performed ')00 hearing screens
on preschoolers in child c..'1re [tcilitics. The nurses are continuing
to follow children identified with problems during screening.~.
The NAVIGATOR Program is a prenatal and early childhood
nurse honK' visitation program. The program bl'gan accepting
diems in November 11)99 The target population for the pro-
gram is first time moms at or below 100% of the federal poverty
level. funding for the program is through the state Division of
Women's and Children's Health, Smart St3rt,Cape ~ear Memo-
rial foundation, and Mcdilaid. The program is initiated during
pregnancy and continues until the baby is two years of age. Nurses
Communicable Disease
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The mission of the Communicable Disease Division is to pro-
mote health and quality of life by preventing and controlling
communicable disea..<;es. Stratt'gies co accomplish this are early
idenriflcation and treatmenr, prompt reponing, contact investi-
gations and partner notitlcation, encouragemenc ofhealchy be-
haviors that prevcnt acquiring or transmitting disease, and pro-
viding preventive medication during incubation. Communi-
cable disl'ase control protects citizens hv providing immuniza
tions for children and adu\cs co diminJ.te vaccine-preventahle
diseases, screening and tn.:atment for early identification of cer-
tain illnl'ssl's, monitoring case reports, implementing outbreak
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provide hcalch assessments, education, life course guidance, and
access [0 community resources through weekly or bimonthlv
home visits. Home visitors instruct moms in techniques [0 en-
hance their parenting skills, which leads co improvement in their
child's development. The three nurses in the NAVIGATOR
program have small casdoads to provide intense services.
The Family Assessmem Coordinator is a new position in the
NAVI(JATOR program. The nurse has developed a universal
screening tool for all pregnant women and new moms who de-
liver in New Hanover Regional Medical Center. The screening
(001 is heing distribuc('d at New Hanovcr Regional Medical Cen-
ter and by local obstetric offices. This rool addresses topics
ranging from financial needs, information about breastfeeding,
domestic violence, and depression. Referrals to existing ser-
vices are made for identified prohlems and requested informa-
tion is given to moms with follow-up made if needed.
Organized in Fehruary 2000, the New Hanover County Asthma
Task Force (NHCATF) strives [0 improve the quality oflife f{>r
asthmatics in thl' community by engaging in activities that en-
courage the use of the National Institutes of Health Guidelines
fi)r Asthma Diagnosis and Management; increase the level of
asthma education ro families, health cJ.n,' personnel, and the gen-
eral public; help identitY and reducc environmental triggers; and
assist in data collection ro determine the extent of the prohlem
in the community. Undiagnosed and under managed, asthma
results in tremendous loss of productivity, school absenteeism,
skyrocketing medical costs, and decrcased quality of lite.
NHCATF ha,~ sponsored a variety of community events, most
notably a health care providers' luncheon, asthma screenings,
Open Airways classes f{)f elementary school students, and a local
asthma camp tor 2'5 children. Other services have included hOl11e
visiting co providc asthma education and environmental inter-
Vl'nrions to Fdmilies, and coordination services and financial schol-
arships for seven childn.:n attending an asthma camp in Parbon,
Noreh Carolina. Although largely depcndent on grant funding,
NHCATF has also engaged in fundraising this year.
comrol measures and emphasizing prevcncion of disease trans-
miSSIon.
GOALS
. Minimize val inc-prevenrable diseases by providing immu-
nizations to childrcn and adults
. Provide counseling and treatment for Scxually Transmitted
Diseases, HIV testing, and use client encounters as OppOftll-
nlCles to encourage prevention strategIes
. Provide tuberculosis treatment (including preventive medi-
cations) to reduce tuberculosis in Ncw Hanover County
2000/01 ANNUAL REPORT 9
. Ensure required reporting of communicahle diseases and
respond appropriately to reduce transmission and prevem
outbreaks
. Serve as communiry resource for prevention of communi-
cable diseases
Immunizations should begin in infll1cy and continue as a life-
long practice to protect citizens from diseases which can seri-
ously compromise individual and community health. Some vac-
cines arc required by law (childhood vaccines), while others such
as influenu, pneumonia, and tetanus boosters are recommended.
Children and adults received 20,724 doses of vaccine during
15,5~:) visits. New Hanover County Health Department
(NHCHD) monitors vaccine compliance for children up to 24
months of age. The Division provided the above in addition to
immunizations n:quired for specific employment such as Hepa-
titis H and rabies vaccines. Havrix protects against Hepatitis A
and is recommcnded for food handlers and O(hers. The Senior
Vacciwltion Smson campaign n'ached popub.tions at high risk
for complications, with 473 flu vaccines administered in 11 off--
site locations. A total of 6,lJ84 influenza and ')00 pneumonia
vaccines were given. Despite delays and shortages in inflm:nu
vaccine supplies, there was a 2Yl'h increase from last year.
Tuherculosis (TB) is a disease transmitted through the air that
poses a puhlic health threat, especially ifactive cases are not iden-
tified and trcated early. All acrive TB cases in New Hanovcr
(:ounty received direcdyobscrved trl'atment, requiring that staff
be presem when medications were taken. Early identification of
TB intection hy a positive tuberculin skin test (PPD) is critical
(0 preventing new cases. rrequently, prl'ventivc medicine is rec-
ommended for individuals cxposl'd (0 TH. Comact investiga-
tions, case follow-ups and home visits assure adequate treatment
to prevent communiry outbreaks. Tuberculin skin tests, clinical
l'valuations, and tuberculosis medications an: available at
NHCHD ()f'),6'J3 PPDs administered, 262 indicated latent
infection and 279 individuals wen~ provided preventive therapy.
H IV positive and foreign-born individuals receiving TB services
are mcreasing.
Sl'xually'lransmitted Diseases (S'I'Ds) arc a threat to individuals,
their sexual panners and unborn ("hildren. The STD program
provides ("ounseling, testing, l'xamination, treatment, and educa-
tion about STDs including gonorrhea, syphilis, herpes, chlamv-
dia, human papillomavirus (condyloma), and others. Prevention
and risk reduction cducation are ("omponents of each clinical visit
and condoms arc available. Thl're were 2,831 visits made for
STD services during the year.
Testing fClr HIV antibodies provide~ an opportuniry for early
identification and referral tor medical care before symptoms of
HIV/AIDS appear. Medical advancements provide many treat-
ment options which can prolong and improve quality of life.
HIV antibody testing encourages individual risk assessmem and
behavior changes to reduce risk of transmission. Thcre were
10 NEW HANOVER COUNTY HEA.ITH DFP.\RT,\'1F.N'J
2,018 HIV tests done. It is noteworthy that reports of AIDS
cases among African Americans indicates they arc being diag-
nosed late in the infection, rather than in the early stages when it
is reported as HIV
North Carolina requires 61 diseases and conditions to be re-
ported. NHCHD monitors and responds to case reports to pre-
vent further cases. In addition to the reportable illnesses, physi-
cians and the general population are encouraged to be diligent
about prompt reporting of unusual conditions which may pose
a threat to public health. ror the second consecutive year, there
was an increase in the number of Shigella cases. There were 119
cases reported involving outbreaks at five local child care facili-
ties. There was also an increase from cwo (0 six cases of Rocky
Mountain Spotted rever, a disease transmitted by ticks.
Reportable Communicable Diseases
AI OS 25
Campylebacter 10
Chlamydia 518
E. coli 0157:H7 1
Gonorrhea 421
Hepatitis A 1
Hepatitis B (acute) 8
Hepatitis B (chronic carrier)14
HIV 34
Lyme Disease 5
Rocky MIn. Spotted Fever 6
Salmonellosis 60
Shigellosis 119
Streptococcal Group A Invasive 1
Syphilis 56
Tuberculosis 12
Vancomycin-Resistant Enterococci 6
HEALTH EDUCATION AND OUTREACH ACTIVITIES
Etlective ("ol1lmunicable disease control requires an alert staff
viewing potential outbreak.. as opportunities to educate the public
about prevention methods. Health education and outreach as-
sure prevention messages and treatment reach the community.
Staff provides individual and group education in clinic;].1 and
community settings. Two newsletters arc written and distributed
by the Communicable Disease Division. tPI "~fi)rmation is a
himonthly newsletter sent (0 all medical providers in the county
;].nd ~)'('xutllly SjJt'tlkingis a quarterlv newsletter distribuled to agen-
cics working with populations at risk for STDs and HIV
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TAP par educfl/or leads discwsioll tl/ Salllte to Hens,
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'Eugeted outreach services provided screenings, immunizations,
and education at various sites in the community. One of the
highlights of the year was the Salute to Teens event designed to
educate teens on various adolescent issues. Activities included
immunization assessment, classes on healthy lifestyle choices, and
discussions related to college preparedness. Hepatitis education
and prevention was promoted with special events during May,
National Heptltitis Month.
The Teen AIDS Prevention (TAP) program trains adolescents as
peer educators to teach other young people the skills of HIV
prevention, healthy decision-making, and how to resist peer pres-
sure. TAP consists of30 trained peer educators who give regu-
lar pn:semations to teenagers at the Juvenile Detention Center,
Wilmington Treatment Center, recreational centers oflocal hous-
ing developmems, and other communiry settings. Four TAP
educators won scholarships to attend the National Ryan White
Youth Conference on HIV I AIDS in Denver, Colorado. By con-
ducting small group presentations and ont'-on-one sessions with
their friends, the TAP teens arc showing their peers that it's
"cool" to be healthy and safe. TAP, funded by the Cape Fear
Memorial Foundation, has reached 8,927 adolescents through
presentations, outreach events, and one-an-one outreach.
Community Health
The Community H<:alth Division provides [;unily oriented health
promotion, disease and injury prevention and disease manage-
l11ellt services in clinics, homes, schools and other sites through-
out the counry. Services are provided throughout the lifespan.
GOALS
. Promote hcalth and saferyofindividuals and [1Il1ilies through
the provision of preventive, curative and rehabilitative health
servICes
. Enable individuals and families to access needed community
resources through identification, referral and coordination with
local, state and fednal agencies
. Promote a healthy environment through identification, reso-
lution and/or referral of conditions that threaten the health
and safety of residl'nts
. Promote puhlic health and the Health Department's image
in the communirv through: collaboration with other agc:n-
cics; serving on local and state boards, committees and other
related organizations; exercising media and public speaking
opportunities; and coordination of care with other providers.
CHILDREN'S HFAITH
Newborn visits provided int~u1t care assessment and intorma-
tion ahout normal growth and development, injury prevention,
and thc importance of well-child care and immunizations, poi-
soning prevention and rderral to communitv rl'sources. Public
hl'alrh nurses identified and coordinated services for health proh-
lems of other family mcmhers. Nc:wborn visits declined by 69%
dul' to the establishmenr of an appointment systl'm, necessitaled
by socictal changes and growth in other programs.
Well Baby Clinics provided ,ervices throughour the county. The
clinics offered physical exams, developmentalcvaluations, im-
munizations, Iaboratorv resting, TB screening, nutritional and
injury prevention information and referral, and t{)llow-up as
nCl'dc:d. Clinic visits decre;t~c:d .10% overall, with evcning clinics
bl'ing the most utilized. This reduction in clinic attendance is
attributed to increased Health Choice insurance, as families with
Health Choice arc now taking their children to private provid-
ers.
Child In-home Service visits increased ')8% and provided he-J.lth
a.';sessment, dise-ase management, access to equipment and supplies,
hL';uth promotion and injury prevention information and referral
and fi)llow-up;Th needed. Outre-J.ch on topics including health and
safety was provided in churches, dubs and other community sitt'.<;.
The Kindergarten Health Assessment Clinic provided physical
examinations, laboratory testing, immunizations, TB screening,
hearing and vision screening, counseling and rderrals. The clinic
served non-Medicaid patienrs, following the mandate that indi-
gent have access to this service.
Statistics for the School Health Program rdlected a 117% growth
in the number ofsrudenrs screened during fY 2000/01 School
Health services consist of: assessing and monitoring student
Ill'alth problems; physical assessments; dl'velopment of emer-
gcncy care plam; coordination of care; education for providers
of care; consultation with personnel regarding health issuc:s and
the school environment; mass screening; health education for
students and faculty; first aid; medication and trcatment ad-
ministration; monitoring delivery of care and medical supplics.
Six new public healrh nurses were employcd to accommodate
the increascd demand fl.)r serviccs, cnabling NHCHD to in-
crl':lSe School Hcalth hours and provide more comprehensive
care in elcmentary, middle, high, and Lakcside schools. Thc
most critical arca of School Health, the development of emcr-
gl'IlCY cue plans, incrl'asl'd by 69% rhis year. Health education
sessions increased 191 (rh. Mass screenings fl.)!. vision, scoliosis
and lice infcst<ltioll werc completed.
Vollllltcers, including thc Amcrican A~sociation of University
Women, plavcd a major role in Sch(xll Health accomplishmcnts
this ycar, assisting with scoliosis and vision screenings and infirmary
duties. Special schoo] activities induded healrh displays,
200n /01 ANNUAl. REPORT
11
Smoking is Not Your Friend,
Media Review Committee, Se-
nior Project Board, Opn! Air-
ways, spons physicals, coordi-
nation of services with srudent
nurses, and health r.?ducarioll
sessions for students and staff
A grant from New Hanover
Regional Medical Center's
CH I P Program enabled the
Division to fund additional
dental health services. A grant
from the Cape ~ear Memorial
Foundation provided lice
combs (0 needy students and
educational materials (0 all el-
ementary school students.l..cns
Crafters donated $64,500 III
vision care and glasses.
Orthopedic and Neurology
Clinics provided diagn()sis and
treatment of rdated diseases,
care coordination and healthy
lifestyle counsding. Physicians
volunteered their services ordonatl'd their
payment to further program activities.
The purpose of these dinics is (0 snvc in-
dividuals unable (0 access service~ else-
where. The Rotary Club of Wilmington
established the Orthopedic Clinic and
continued to support it both in funding
and member volunteers. funding by the
Rotary Club increased this year due to cuts
in state funding. Overall program activi-
ties increased bv 22cYcl.
ADULT HEALTH
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nit McSwtlin, PHN II, prepares medictition fOr patients to enable them to manage their chronic diseases
tltiJome.
Adult Health Clinics af(: IOLatcd in areas
of the county where there are huge num-
bers ofclderly individuals. The clinics of-
tcred health assessment and monitoring,
care coordination, treatment, immuniza-
tions, disease management and healthy
lifestyle counseling. Clinic attendance in-
creased 71J1tJ during the year.
Changes in Medicare coverage, early
hospital discharges and increased lon-
geviry create thL' nel'd for taking health
carl' (0 homebound adults. The Adult
In~home Services Program provided
health assessment, disease and disabil-
ity management, cnvironmental as-
scssments, immunizations, treatment,
care coordination and healthy lifestyle
counseling. Administered by program
staff, the Ministering Circle Chore
Program was a valuable re~ource for
homebound patients.
Adult Day Health Monitoring is a statt:
mandated service for adult day health
celuers. Each center was evaluated on
a quanerly hasis for provision of health
care. Public health nurses provided as-
sistance with compliance issues. No
new centers opened this year.
Dillbetl's Today, a state initiative to ralse
awareness about diabetes and promote
mobilization in dealing with the disease,
was funded again this year. Thc coalition
;lctivitics consisted of: educ;ltion of health
care providers through sessions with Dr.
Joseph Konen; distribution of nztterns of
rare to providers; hlood sugar, blood pres-
sure and toot screenings in the commu-
nity; and distribution of diabetes preven-
tion and management information to the
public.
N HCHD, thnl\.lgh an agreement with the
Sheriff's Department, is responsible for the
health care of jail inmates. Jail Medical
Pcogram services included primary and
preventivc health care, dental health care,
12 NEW HANOVER COUNTY HEAl.TH DFI'ARTI\lENT
health education, consultarion and train-
ing of jail personnel and consultation with
the court system and other detention cen-
ters. Sraff provided consultation and train-
ing to other jail health providers. Volun-
teer assistance wa.<; a valuable a.<;set to pro-
gram, and on-site staff was able to reduce
care accessed outside the jail by 13% dur-
ing FY 2000/0 I
Disaster planning continues to be a year-
round activity. The Shelter Manual was
completed and will eliminate many con-
cerns of the past, reduce confusion and
misunderstandings. and expedite set-up
and delivery of care_ full power generator
hookups will reduce health and safetY haz-
ards for evacuees and stan: Requests for
teaching and consul ration throughout the
state have continued. The UNC Office
ofPuhlic Hcalth Nursing's Immduaio1J to
Public Health Nun-ing includes a module
on the puhlic health nurse s role in disas-
ter management, which is taught by Divi-
sion .'leaf[
Division awards this year induded the 2000
L/Jild Ht'lllth Iel1m Awtlrd, Clzss Act AWl1rd,
recognition hy Glaxo Wellcol11e, national
;lccreditation for the Jail Medical Program
and the Marg(/ret B. Dolan Award.
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Dental Health
GOAL
. To promote, prmeC(, and assure the
optimal oral health of the citizens of
New Hanover County.
The New Hanover County Dental Program
continues to demonstrate the cooperative
effons of the North Carolina Oral Health
Section. the New Hanover County Hc-a1rh
Department, rhe Wilmington TriCounty
Dental Society, the North C...arolina Dcnral
Society, Cape Fear Community College
Demal Programs, the New Hanover Com-
munity Health Center and many other com-
munity groups. The Dental Health Divi-
sion utilizcs numerous strategies to improve
Dental Hm/th F:.dumtion in the community.
the oral health of our citizens which involve:
increased lIse of Demal Sealants; periodic
Dental A'isessmenrs with Referral; Dental
Health EduG.uion; (.ommunity \XI;ucr Huo-
ridation; School Huoride MOllthrinsc; and
promotion ofcommuniry efforts to improve
access to dental c.are.
F'i 2000/0 I was an exciting Jnd pro-
ductive period for the Division. Ap-
proximately 10,000 children and
adult~ received dental health nlucation
from staff Additionally, over 3.200
children received denral assessments
and over 7,900 children participated
in the weekly tluoride mouth rinse pro-
gram.
During Spring 2001, the Division par-
ticipated in a regional campaign entitled
Guard YOur Smile 200 /, to increase aware-
ness and use of mourhgu:uds as an im-
portant pan of injury prevention forchil-
dren and young adults in New Hanover
County. Local sponsors and partners werc
the North Carolina Oral Health Section,
the Wilmington 'IriCounty Dental Soci-
ery, the YMCA, and Cape Fear Commu-
nity College Dcntal Programs. The re-
sults of the campaign were quite impres-
sive. Over one thousand adults and chil-
dren received information concerning
orofacial injury prcveTlrion during athletic
activities. The adults and children learned
about the benefits of wearing a
mouth guard during participation in ath-
letic events. Additionally, on April 21,
sixty young soccer participants were pro-
fessionally fitted for mourhguards at no
charge" In all, GWlrd Your Smile 200 1 was
a tremendous success.
Exciting work occurred this year in the
area of dental health education and pre-
vention. During February, the New
Hanover County Dental Staff celebrated
National Children's Dental Health Alonth
with various dental activities conducted
throughout the community. Educational
information concerning Dental Sealants
w~s sent to all New Hanover County em-
ployees. Staff produced an interesting dis-
play located in the NHCHD clinic re-
ception area entitled Sport A Winning
Smile. In addition to the display, Staff
answered patients' questions :md distrih-
uted sealant literature. On numerous
dates throughout h'bruary, the DeIHal
SufI' conducted eduGlrional sessions at
preschools, daycare centers, and after
school enrichment programs on various
topics such as nurrition, brushing, Hoss-
ing, and the benefits of sealants. Cel-
ebrating NatioJlal Children's LJent,zl HMlth
Nlonth is another imponant way to en-
courage both children and adults to keep
a terrific smile.
Other programs and activities conducted
by the Division during FY 2000/0 1 in-
cluded: Delltal Health fOr a Lifttime
parenting programs; Let's Tizlk Teeth pro-
grams at Head Start, preschools, and
daycare centers; Don't "!tzke a Vacation
From Good Dental HMlth after school and
summer enrichment programs for at-risk
children; and Tilke (/ I.ook at Dentistry
Dental Careers Program for New
Hanover County students.
Important work has occurred this year
concerning improving access to dental
care in the community. There are thou-
sands of children and adults in New
Hanover County who lack rhe resources
to receive much needed dental treatment.
On January 18. 2001, Dr. Wilson Jewdl.
Chairman of the NHC Board of Health.
and Dr. David McDaniel. NHCHD
Dental Health Director, mer with the
New Hanover Communiry Health Ccn-
ter Dental Advisory Committee to dis-
cuss the critical issue of access to dental
care in New Hanover County. Ideas for
building additional resources for provid-
ing dental care in rhc community were
discussed. Suggestions considered ranged
from hiring an additional dentist at the
Community Health Center, expanding
hours at the Tileston Dental Program, to
establishing a Children's Restorative Den-
tal Program at the Health Department.
Continued discussions have resulted in
the possibility of a volunteer program
involving local dentists and the New
Hanover Communiry Health Center
Dental Program. Further work is pro
ceeding in .this area of access to dental
care in New Hanover County.
"l'he GUtzrd Your Smill' 2()() I Mouthguard
Program and other demal health educa-
tion, prevention, and access to care pro-
grams continue to demonstrate how the
New Hanover County Dcntal Program
collaborates with various community
groups and organizations to assure opti-
mal oral health for the citizens of our
commul1lty.
2000 IOl ANNU-\L REPURT 13
Environmental Health
Many aspects of human well-being are
influenced by the environment, and many
diseases can be initiJ.ted, promoted, SU.~-
rained, or stimulated by environmental
factors. The interactions of people with
their environmcm afC critical components
of public health. The Environmental
Heahh Division (EHD) prorcns rhe pub-
lic health and environment through the
II,
"
provision of a diverse group of services in
thl: communicy, including evaluation of:
all types of food operations; body an es-
tablishments; child care facilities; toster
care homes; institutions including hospi-
tals, nursing homes and private and pub-
lic schools; lodging facilities; public swim-
ming pools; recreational waters; wastewa-
tef systems; and water supplies. The Divi-
:-;ion assesses air quality, identifies/mitigates
environmental hazards including lead and
applies control methodology for potential
disease vectors such as mosquitoes and
ticks. During disaster response and recov-
ery, many services and supports are offered
to Facilitate the restoration of normalcy in
the everyday lives of citizens.
FOOD SAFETY
Achieving a 100% coverage rate of estab-
lishments/facilities under inspection by
EHD is critical to assuring food saFety prac-
tices and reducing the risk of foodborne
illness in the population. This translates as
conducting an evaluation of each restau-
rant on at least a quarterly basis or four times
yearly. A minimum frequency of
inspection is established for the vari-
ous type.~ of establishments/facili-
ties in the North Carolina Leneral
Statutes and Administrative Code.
Increasing the coverage rate has
been an ongoing objective, how-
f ever, continuous growth in the lo-
cal food service industry has had a
,>: major impact on the Division's ca-
pacity to accomplish this perfor-
nlance nleasun:.
Through a joint venture with Cape
I'ear Communirv (:nllege (CI'CC),
EHD staff instructed flY\: sessions
(164 students) of the National Res-
taurant Association's Serving Sift'
Food Ccrtificrztion Course. More
than 90%, 148 student.s, ohuined
the certification credential. Plaqucs
were awarded to Elijah's Restaurant,
the Pilot House Restaurant. Holi-
day I. m Sunspree Resort, Diamond
FoOl. Enterprises and the Dockside
Restaurant for having at least tlve certitled
employees in their operations. Represen-
tatives of these establishments were giver
special recognition hy the Health Director
and CfCC Dean of Continuing Educ.."1-
tion at New Hanover County Board of
Health meetings.
PUBLIC SWIMMING POOLS
Like eateries, swimming pools have a
strong presence throughout the county.
Public swimming pools include virtu-
ally every kind of constructed recre-
ational water facility except those
found in residential backyards. Pro-
gram growth in FY 2000/01 led to a
14 NEW HANO\; I.:R COUNTY HEALTH DEPARTMENT
record setting issue of 340 permits and
')78 inspections.
To meet the same proficiency standard es-
tablished for po()1 operators, EHD staff com-
pletes Cerrit1ed Pool Operator training, con-
sisting of formal classroom instruction and
an acceptable score on written examination.
Staff must also demonstrate application and
knowledge in the field to obtain authoriza-
tion from the North C..a.rolina Dt:parrment
Of Environment and Natural Resources to
enforce state laws and rules.
In October 2000. tht: New Hmover County
Board UfHealth Rules GOllerning Primte Pools
was revised to more cumprehensively address
safety. Prior to study hy the Environmental
Health Committee, staff conducted exten-
sive research of practices and standards ex-
isting in other states. Requirements were
expanded for fencing and securing above
ground private swimming pools.
VECTOR CONTROL
Sentinel chicken flocks began (0 test posi-
tive for Eastern Equine Encephalitis vi-
rus by mid-July and continued into Sep-
tember 2000. Neighboring counties and
coastal South Carolina documented
record infection rates, but extremely lim-
ited morbidity. EHD staff generated the
strongest mosquito adulricide effort in
program history to minimize the risk of
human exposure. An upgraded boat pur-
chased in FY 1999/00 was used exten-
sively for surveillance and application of
larvicide on small dredge disposal islands
in the Cape Ft:ar River and Intracoastal
Wat<:rway, including the successFul dewa-
tering of 300 acres of Eagle Island mud.
Heavy equipment excavated and main-
tained perimeter ditches to lesson the im-
pact zone of these potential mosqulto-
hreeding sites.
A $400 million project to deepen the
Wilmington Harbor again made Eagk
Island a control focus by March 2001
Increased water depth including routine
maintenance along the Cape Fear River
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and Intracoastal Waterway hrought
many challenges. Staff vigilamly moni-
tored and tceared 600 acres of the project's
spoil deposition with larvicide product.
prompted implementation of a new per-
mitting procedure for on-site wastewater
systems. Initiated by examining the n:-
quirement.<; for developing new subdivisions
in New HanoverCounry,
including stare standards,
the resulting process is a
dramatic change from
prior practice. The fee
schedule was adjusted to
shift focus from the I m-
provcments Permit ro the
Aurhorizarion (0 Con-
struct Permit. All forms
underwent major design
and layout changes. Col-
laboration with me NHC
Inspections and Planning
Departments were essen-
tial to this endC'J.vor.
,..
Representatives of local restaurants accompanied by Isobel
Olarltoa ofCFCC display their awards from the NHC Board
ofHelllth jOr stafJ-particiPiltioll ill food safety edUCiltioll.
Enhanct:d collaboration with City of
Wilmington (,ode Enforcemt:nt otlicials
reduct:d tht: number of tire piles serving
as mosquito-breeding habitats. Busi-
nesses were enlisted to implement han-
dling practices that minimize the poten-
tial for collection of stormwater in tires.
Transplanting Gambusia a./fillis, a mos-
quito-eating fish, to low-lying areas still
proves (0 be a desirable and effectivt: bio-
logical control method. Newly con-
structed stormwater retention ponds and
changes in the landscape that allow stand-
ing watt:r arc annually evaluated to verify
the presence of Gambwia.
WASTEWATER-WATER QUALITY
A hallmark On-Site Wastewater Program
in North Carolina, this EHD section con-
tinued the trend-setting pace in FY 00/01
Application (If cutting edge technologies
brought n:sollltion to wastewater tn:atment
issues. E.x~X'rimt:ntal and innovative options
address many of the limitatiolls inherent
to coastal geography for properly function-
ing septic systems. Components otTering
pretreatment of wastl.:water dHlIel1t pri(lr
to disposing into the soil is given strollg con-
sideration so as to better assure protection
of groundwatcr resources.
Added dllciency and reduction {lliabiliry
Throughout the year, a
variety of individuals or groups typically
make contact with EHD to secure in-
formation about drinking water quality.
A strong intl'fest recently has been the
availahility of geologic data recorded by
drillers as they construct drinking water
wells. Local rules require submittal of a
construction log upon completion of a
well. In addition to valuable geologic
data, this documents materials and pro-
cedures used by the driller to develop a
potable source of drinking water, all of
which must be evaluated when degrada-
tion of an aquifer and loss of a valuable
natural resource occurs. Saltwater in-
trusion has rendered many drinking wa-
ter wells along the coastal edge of north-
eastern NHC unusahle. As a long-term
remedy, the county is planning construc-
tion of a well field to provide a commu-
nity source of drinking water along
Highway 17, north of the Ogden area.
Construction methodology and geologic
data relative to existing drinking water
wells was sought as Dickson Engineer-
ing began to work with the NHC Engi-
neering Depanment Oll a plan for this
water system. Staff researched and sup-
plied this information. Another contact
was by a researcher at Woods Hole
Oceanographic Institute in Massachu-
setts, who was .~pecifically interested in
geologic data. Administrative support
staff with the assistance of volunteers has
subsequently compiled files of available
well logs to be better prepared to respond
to similar request... in the future.
Laboratory
The Laboratory provides technical sup-
pon and testing for Health Department
programs and serves as a support service
to community health programs and pri-
vate health care providers. The Labora-
tory has established written policies and
procedures for a comprehensive Quality
Assurance Program to monitor and evalu-
ate the quality of rhe total testing pro-
cess. The Program evaluates the effec-
tiveness ot policies and procedures, iden-
titIes and corrects prohlems, evaluates the
accuracy, reliability and prompt report-
ing of test resllIrs, and assures competency
of testing personnel. Proficiency testing,
quality 3ssurance programs, testing qual-
ity control and competent personnel ell-
abies the Division to continue to provide
the bl.:st of services.
GOAL
. Provide quality assured medical and
environmental laboratory services
to public and private health care
providers responsihle for thl.: pro-
tection of the health of the citizens
of New Hanover County and sur-
rounding areas.
LICENSING
The Laboratory is governed by the Fed-
eral Clinical L3boratory Improvement
Amendments (CLlA) that place all medi-
callaboratories under the control and li-
censing of the.: federal government. The
Nonh Carolina Department of F3ciliry
Services is the inspecting agency for the
20 () 0 / () 1 ANN U ^ l. REI' () R T 15
Health Department Ltborawry and issues
the CLlA Laboratory Ccrtificate of Com-
pliance allowing the \abora(Ory to perform
testing. During the bi-annual inspection,
the Laboratory receivcd a rcport of no de-
ficiencies. The Water Bacteriology Pro-
gram is licensl.'d by the North Carolina
State Laboratory of Public Health to per-
form hactl.:riological testing of potable
water samples and is subject to yearly on-
site inspections. This year, as in the past
26 years, the L,borarory received no defi-
ciencies on the inspection.
ten priori tics that the Laboratory, along
with rhe othcr Divisions, has been work-
ing to fulfill. In August OSHA inspected
the Health Deparrment as part of a vol-
untary inspection of county facilities.
The Laboratory and the Health Depart-
ment had no deficicncies. In September
the North Cat'olina Public Health Asso-
ciation Annual Educational Lonferencewas
held in Wilmington. The laboratory staff
helped plan the meeting and attended
some of the cducational scssions. During
April the Laboratory celebratcd Public
Health Month by attcnding numerous
Lunch and Learn programs to expand their
knowledge and participated in the annual
Ernployce Appredtltioll l.uncheon. The
Laboratory also celebrated Ntltional Medi-
cal Labortltory Week with shirrs, pens, mag-
nets, pads and posters displaying the theme
of Labortltory Professiontlls: Solving Todavs
Medhtrl Mysteries.
SERVICES
The Laboratory performed 119585 pro-
cedures during FY 2000/01, including:
22':;97 fot the STD Program; 46,38'; for
Women's Preventive Health; 3r;,014 for
the WIC Program; \ ,443 for the jail
Clinic; 5,470 fot' Child Health programs;
1, \82 for the Neurology Clinic; 4,337 lor
the Tuberculosis (TB) program and 4C) 1
for thl.: Water Bacteriology Program. Test-
ing includcd but wa~ not limited to gon-
orrhca and wct smears; urine, throat and
gonorrhea cultures; urinalysis and micro-
scopic tcstS on urine; pregnancy testS; he-
matology proEles; glucose, cholesterol and
liver panels in clinical chl.'mistry; testS for
thc HIV virus, qualitativc and quantita-
tive tests for syphilis; lead testing on chil-
dren; stool cultures (0 control shigcl\a out-
bre;1k; and water coliform testS.
Q)
~
"
,
,
,
/'
The Ltlboratory poformed over 6, 100
Hematology profiles il1 FYOO/O]
Nutrition
The Nutrition Division providcs a vari-
cty of servie<:s for the residents of New
Hanover CountY. The programs within
this division are the Supplemental Nu-
trition program for Womcn, Infants and
Children (WIC) and the General Nutri-
tllm program.
WlC PROGRAM
During FY 2000/01, thl.' Laboratory stafF
volunteered t<H the NHCHD co-spon~
sot'ed Asthma Ctlmp, workcd at the
NHCHD booth at HealthFestllt RivaFest,
providcd phlebotomy services for CURE
AIDS at an HJV/Syphilis Fair, performed
hl.:moglobin and lead testing at Well Baby
Clinics, and provided the Laboratory por-
tion of tWO Ll.:ad Lunch tmd Learn pro-
grams. Once again, NHCHD monitored
an on-going outbreak of shigella in local
daycarr..: facilities and the laboratory pro~
cessed the mon: than 600 stool cultures
that were sent to the State Laboratory.
W1C sl'fvicl.:s are providl.:d to low-income
prl.:tlatal, postpartum, and breastfeeding
women; infants and children up to 5 years
of age. WIC participants reccivc indi-
vidual nutrition education and vouchers
for nutritioUS foods to usr..: at area gro-
cery and drug stores. WIl nutritionists
stay up-to-date in arcas of nutrition im-
portant for women of childbearing age,
infants and children. All WIC mothers
are counseled on the importance of ad-
equate folic acid intakc during childbear-
ing years to decrease the chance of an in-
fant born with ncural rube dcfl.:cts. Preg-
nant women are inf<)f!ned of the danger
of listeriosis to the unborn baby, and are
counseled on avoiding certain foods that
may be contaminated with listl.'ria.
In October the Health Department Man-
agement'leam and Board of Health par-
ticipated in a Stratcgic Planning Retreat.
Thc outCOmc of the Il1l.:eting was a list of
16 NEW HANl)VER CUUNTY H~:AI.TH DFI'ARTMFNT
The WIC Program encourages
bn:astfeeding as the feeding of choice for
inEl11ts. Breastfeeding cquipment and
supplies arc available ~or breasdeeding
mothers and their babie~. During fY 00/
01, more than 50 mother-baby pairs bor-
rowed one of the program's clecuiL
breastpumps. Mothcrs with infants in
the neonat;1\ intcnsive care unit and
mothers who want to conti nul.' to
breastfeed their babies after returning to
work benefit greatly from this service.
f:\"",
VJj
On-site printing ot tood vouchers bl.'gan
in November 2000. This change has al~
lowed the staff to work morc efficiently
to sr..:rve the more than 1000 participants
enrolled in the WIC prognm.
Most participants arc noW issued vouch-
crs to USI.: for three months and only need
to come to the WIC office four timl.'s a
year for continuous WIC servicr..:.
The WI(~ Program collaborates with other
programs within the hcalrh department
and communiry. WIC staff refer children
for lead testing and immunii'.ations as needs
0_
c
(()
c
WIC dients without ad-
equate food supplics arc
rcfcrn:d to food Stamps
and arca food banks.
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GENERAL
NUTRITION
Two nutritionists in the
Cencral Nutrition Pro-
gram provided individual
nutrition counseling and
presented nutrition pro-
grams to many groups
throughout the commu-
nity, including: churches,
senior cenrcrs, school classes from Pn:-K
through college, proh.:ssional organiza-
tions, local businesses, child care facilities.
and social service agencies. During FY 00/
01 individual conraC(s included)1? 5":5-
.'lions at Coastal OB/GYN prenatal clin-
ics, 142 sessions at the NICU follow-up
clinic. 38 sessions at community well bahy
dinics, and 18'5 sl'ssions at the Health f)e~
parrmcnr. Referrals for individual nutri-
tion counseling come from other Health
Department programs, area physicians,
and self-referrals. New Hanover C:ounty
Nutrition Ambassadors {Torn Blount Elementary School
arc identifil'd. Children without a
I1H:dical home arc rderred to Health
Check and Health Choice. Pregnant
women are encouraged to seek prena-
tal care early in their pregnancies. WIC
clients arc referred to the Child Health
Navigator Program, Child Servicc Co-
ordination, and Maternity Care Coor-
dination. Pregnant women interested
in breastfeeding or new breastfeeding
mothers are referred [() the North Caro-
lilla Cooperative Extension In-Home
Sllpp<lrt Breastfeeding 11rogram.
ouzens call and ask questions about
many different nutrition topics. Health
department nutritionists must stay cur-
rent on the latest nutrition research find-
ings and nutrition recommendations for
a wide variety of nutritional problems.
The Nutrition Division recognized 42
fourth gradcrs at Blount Elementary
School as "Nutrition Ambassadors"
;"h1e A Day is a national health campaign
(0 encourage consumption of at least five
fruits and vegetabks each day for good
nutrition. These students performed a
Fiw A Day rap and dance program, com~
plcte with creative costumes, to the other
classes at the school. 'I'heywere also cho-
sen to prescnt this progr;Im at the Best
Foot FOrWtlrd program, which showcases
innovative perf(lrmanCes from all county
schools.
The Nutrition Division is committed to
serving thc citizens of New HarlOVL'r
County hy promoting good nutrition
throughout the life cvde. Good nurri~
tion is the foundation for good health
and a healthy community.
WOmens Health Care
'Ih.: Women'~ Hcalth Care (WHC) Di-
vi.~ion is comprised of Women's Preven-
tiw Health, Maternal Health and Hcalth
Promotion,
GOALS
. Ptevent unwanted pregnancies
. Improve pregnancy outcomes
. Reduce inf~U1t mortality
. Improve the health status ofdisadvan-
taged women and women of diverse
culrures
. Provide he;Ilrh education for women
ill the community
. Provide brea~t and cervical cancer
screening and rderrals
WOMEN'S PREVENTIVE HEAlTH
New Hanover COUiHV Health Depart-
ment (NHCHD) provides womens pre-
velHive health (WPH) services which in-
clude health screenings, comprehensivc
physicals, Pap smears, breast exams,
mammograms, and health education.
WPH services are thl' only source of pre-
Vl,lltiVl: cue for mallY womcn, and help
prevent unwanted pregnancies, prevent the
spread of sexually transmitted diseases,
provide valuablc preVL'lllion education,
rcduce health C;Ire costs anJ save lives, For
every $1 spent on WPH services, an aver-
agl' of$4.40 is saved in health, welfare and
nutritional expenditures. 'WPH provided
4,1 ')') clinic services to women during rY
OO/O!
A prioritY goal of the WI-IC Jivision IS
improved birth outcomes through early
idelHification of pregnancy with timely re-
krrals for prenatal care. Among the tecn
population in New Hanover CountY in
1999, there were1() I ['regnancies in tht'
10-19 age range. 'lcen;Ige mothers art'
more likely to hear sub~equent children
more rapidly and to have more unwanted
alld ollt-of-wedlock births, Unplanned
children are ;It greater risk for ahuse and
neglect, which increases with family size.
Women who have unintended prcgnan-
cies are more likely 10 live in povertY, Teen-
agers are more likdy to deliver low birth
wt'ight inf~nts due to poor nlltrition and
inadequatc prenatal care. Low hirth wei-
gilt inbnts are ;It greater risk for physical
and developmental disabilities throughout
childhood. The cost t()f this long-term
care is insurmolllHabk and is often fundcd
by taxpayers. The Division provided 446
pregnancy tests among the teen popula-
[ion during the year and provided coun-
seling and refcrrals f(lr V;2 positive preg~
nancy tests among teens and adults.
The WHC Division supports a nurse out-
2000/01 ANNUA1. RFf'ORT 17
posted to the NHC Department of Social Services to reach young
women seeking public assistance. The goal is to explain and
offer contraceptive services and reduce the number of our-of-
wedlock births in the county. This nurse. through outreach ef
forts, increased by 81 thi.: number of unserved or underserved
women who have received WPH servici.:s. Outreach efforts have
also brought in donations of incentive items to encourage women
to keep their appointments and follow-up with instructions. Over
2.000 phone contacts were made to remind patients of sched-
uled appointments.
Since 1960, breast cancer has claimed more American lives than
World War II. Vietnam, and the Gulf Wars combined. and is
the second leading cause of cancer deaths among women in North
Carolina. Nationwide North Carolina ranks ninth for cervical
deaths, fourth highest for African American women, and twd-
&h for white women. These cancers arc prevcntabk and cur-
able. Routine breJ.st exams and Pap smears lead to early diagno-
sis and treatment. Every woman is at risk, but some women arc
less likely to obtain screening services. NHCHD provides breast
and cervical cancer screening free of charge to qualifk.d women
through the Breast J.nd Cervical Cancer COlHrol Program
(BCCCP). WPH conducted 132 mammograms (44 abnormals)
and 132 Pap smears (16 abnormals). The Division also empha-
sizes outreach to Latino women in New Hanover County.
Male sterilization is the birth control method of choice for some
couplt:s. The Health Department provides education, counsel-
ing, and scheduling for vasectomies through arrallgeml'nts with
a local urological group and the Regional Vasectomy Program in
Greensboro, NC. This service is provided free or at a reduced
rate based on income. Services were provided (0 19 men during
FY 00/0 1
MATERNAL HEALTH
Early and consistent use of
prenatal care provides early
idl'ntification of high-risk
concerns, improves birrh
outcomes and decreases
low-weight birrhs and in-
fant monality. North
Carolina's infant mortality
rate continues to be among
the top lOin the nation.
Prevention of one high-risk
pregnancy can save over
$250,000. Adolescents and
unmarried women have a
greater likelihood of poor hirth outcomes. The Maternity Care
Coordination program assists potentially eligible clients in ap-
plving for Medicaid, develops a strong referral network, and in-
creases community awareness of expanded Medicaid coverage
and benefits for pregnant women. The program determines cli-
ents' strengths and needs including psychosocial, nutritional,
Alaternal Outreach Worker vis-
its with mom and new baby.
18 NEW HA"NOVER CUUNTY HEALTH DEPARTMENT
medical, educational. and financial factors. The goals are aimed
at reducing infant mortality and improving the health status of
women and their newborns. A new service, the Maternal Out-
reach Worker program, was added to provide intensive home
visiting for pregnant women who are at risk for poor pregnancy
outcomes. Recruitment of at-risk women through extensive
community networking ensures early and continuous prenatal
care. Reinforccmem through health education assists partici-
pants in adopting healthful behaviors and lifestyles. The Mater-
nal Health Team generated 6,050 contaC[s and provided coun-
seling and referrals for 947 new prenatal patients.
Psychosocial assessment, clinical observation and counseling for
at-risk pregnant women is essential in cases of domestic violence,
emotional crisis, family dysfunction, impending incarceration.
substance use/abuse, negative feelings about a current or previ-
OllS pregnancy, and emotional stress associated with HIV/AIDS
diagnosis during pregnancy. A licensed clinical social worker
addresses these issues among this population and provides in-
tensive counseling and referrals.
Mothers who deliver newborns in hospitals today receive little
rl'cuperation time or instruction prior to discharge. Issues such
as breast-feeding and newborn care o&en need reinforcement to
prevent problems. Postpartum home visiting provides in-home
physical assessments, education and referrals for mother/infant
pairs within 72 hours following discharge from the hospital, an
opportune time for early problem identification and interven-
tion. Last year Maternal Health provided nursing visits to 308
mother/infant pairs.
Women's Health Care provides quality options for women seek-
ingcontraceptive care, routine women's health care services, pre~
natal care and cancer screening. Services are provided free of
charge or on a sliding fee scale based on income. Medicaid and
private insurance are accepted. Protection of confidentiality is a
priority. The Division has the opportunity and responsibility to
provide factual, accurate and current information on wpics such
as sexuality, birth control, ahstinencc, sexually transmitted dis-
eases and parental involvement, which are crucial (0 the health
and maturity of young women and could save lives. Preventive
education is provided on osteoporosis, folic acid's role in the pre-
vention of neural tube defects in newborns. pre-conceptional
health education, breast and cervical cancer screening and pre-
vention, childhood obesity and depression. Staff invites oppor-
tunities to share information about services with parents, civic
groups. churches, and other interested organi7,ations.
HEALTH PROMOTION
Health Promotion strives to improve the community's health
by providing educational programs to prevent disease and in-
jury and to enhance the community's ability to solve health
problems through informed decision making. The section pro~
vides programming in the areas of injury prevention and to-
bacco prevention and control, and promotes state initiatives to reduce chronic disease. Health Promotion provides health edu-
cJ.tion consultation (0 all Divisions of NHCHD and coordi-
c
0)
2
c
nates events such as public awareness cam-
paigns, outreach activities, community
health a..',>ses..<;ments, and corrc.<;ponding me-
dia coverage. A highlight of FY 00101 was
the compilation of health status and ser-
vice provision data for the Board of Health
Strategic Pumning Retreat.
The Project ASSIST ~Iobacco Prevention
Coalition works to reduce death and dis-
ability related to tobacco use. Local coali-
tion initiatives tocus on youth prevention,
youth and adult cessation, and dean indoor
air. The coalition re-impk:menred the
Commit to Quit cessation contest during
FY 00/0 1 While registration numbers were
not as high as in the past, thl' overall suc
ccss rate of 27% was comparable (0 other
cJ.mpaigns. Another successful endeavor
was the third annual lbbtlcco Awareness
U7eek, which included prescnrarions to ap-
proximately 1,400 students and the sign-
ing of tobacco-free pledges by 1,650 middle
and high school srudems. The 'week was
highlightt:d hy the Mayor's attendance at
the Ug(y Face Contest at Bradley Cn..-ck EI~
ememary School, in which students made
faces rdlecting their interpretations of to-
bacco use and its effects.
The Injury Prevention program focuses on
major risks for injury and coordinates the
local Safe Communities/SAFE KIDS Coa-
lition, partncring with local and state agen-
ci('s, law enforcement and schools to en-
courage safe environments and behavior
change. A primary foclls was the Child Pas-
senger Safety Program, which provided op-
portunities to increase and improve the use
of child safety scats. Through the Governor's
Highway Safety Pmgr,-illl (GHSP), approxi-
mately 320 seats were distributed (0 low-
income f.lmilies and to agencies mat serve
them. Three Child Passenger Safety Train-
ing classes were offered, rcsulting in me cer-
tification of30 pi.:ople by the NC Depart-
mem of Insurance. Ten child safety seat
clll'cks were held, with approximately 250
seats examined for proper installation, po-
sitioning and recall status, revealing that
95% of seats examined were incorrecdy
used.
Parts of the Basics of Bicycling Program
were implemented during FYOOIO 1, with
schools and agencies conducting bicycle ro-
deos and presentations mat reached over
700 children in schools, churches, daycare
and public housing. Another GHSP grant
provided 200 bicycle helmets, which were
distrihuted at these events. The coalition
advocated for passage of the Child Birycle
,)iifety Act and to defeat the relaxation of
mowrcycle helmet laws in the state. Driver
distraction became an issue during FYOOI
01, and at the request of the Board o[Health
a resolution W3.'i drafted to support action
to reduce car crashes due to driver distrac-
tion or inattention. The coalition contin-
ues to addrcss this issue, and developl'd a
billboard to display current crash rates in
NHC and a simpk' safe driving message.
c
Financial Management
The New Hanover County Health De-
partment Amended Budget (Adopted
Budget plus ;lny amendments during the
fisc;:d year) for FY 00/01 was
$10,763.762. The Health Department's
budget is composed of}!) individual pro-
grams. Division DirectOf.s submit a line
item hudget for each program within the
division. Budget requests an: reviewed
by the Health Director, Assistant Health
Director and the Business OHicer. Bud-
get hearings are conducted and a Budget
Workbook including all programs with
linc item narrative justitlLations is pre-
pared and submitted to rhe Board of
Hcalth for approval.
Figure 1 illustrates how the expenditure
budget is divided among Salariesl Fringes,
Operating and Capital Omlay items.
c
Figure 2 illustrates the hreakdown of the
Health Department s total revenue
(S4,70050(,) through Health Fecs, Med-
icaid, Environmental Health Fees, Ani-
mal Control Fees, and Other (including
miscellaneous grants J.nd school contri-
hurions). It also shows Federal and State
Crams through the North Carolina De-
partment of Health and Human Services
($1337,)83 which is included in the
above toral revenue figure) and County
Appropriations ($6,063,2)6).
Fig. 1
Total Expenditures:
$9,703,334
Operating
$1,964.198
18%
Capital
Outlay
$534,236
7%
Salaries & Fringes
$8,245,328
74%
(NOle: Of the $l,O~5,37q Medicaid
Revenue, $1 )3,479 is Medicaid Cost
S<:trlemenr Funds.)
The Health DepartlllcIH's Business Officer
is responsible for preparing expenditure
reports to ensurl' billing and receipt (If the
Health Department s state grant funds.
The Health Department complies with
N<:w Hanover COUIHY Financial Policies
and Procedures that includes an annual
audit.
Fig. 2
Total Revenue:
$9,703,334
Environmental
Health Fees:
Health Fees. $312,900
$~12,015 3%
1%
Federal & State
$1,337,583
12%
Medicaid
$1.095.379
10%
Animal Control
Fees-$523,044
5%
Other
$1.319,585
12%
2000/01 AN:-':UAL REPURI 19
2029 South 17th Street. Wilmington, NL 2H40 I
(910) 343-6')00 . fax (910) 341-4146
The New Hanover County Health Departml'nr's 2000-01 Annual Rcpon is published with assistanct'
from the Coastal Area Hcahh Education Cemer, Wilmington, NC.
o
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