01/02/2002
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New Hanover County Health Department
Revenue and Expenditure Summary
November 2001
Cumulative: 41.66% Month 5 of 12
Revenues
Current Yea, Prior Vear
Budgeted Revenue Balance % Budgeted Revenue Balance %
Amount Earned Remainin Amount Earned Remalnln
251 ~5~5 Jl
$ 1,038,n9 1~ 518,513 802,767
216,091 $ 316,953 40.54 149,477 368,976
265,805 $ 747,129 26.24 243,223 599,761
165,n4 100.00 192,301
94,464 30.19 97,269
69,117 61.25 53,546
551 486 36.61 3S1 367
Expenditures
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Budgeted
Amount
Current Vear
Expended Balance
Amount Remainln
%
Prior Year
Budgeted Expended Balance
Amount Amount Remalnln
%
Summary
Budgeted Actual %
FY 01..02 FY 01..02
Expenditures:
Salaries & Fringe $9,007,754 $3,273,054
Operating Expenses $1,634,590 $626,421
Capital Outlay $126,307 $34,985
Total Expenditures $10,768,651 $3,934,460 36.54%
Revenue: $4,768,622 $1,614,292 33.85% ?:J --:t%
Net County $$ $6,000,029 $2,320,168 39. %
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Revenue and Expenditure Summary
Fiscal Year 02
As of November 30, 2001
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NEW HANOVER COUNTY HEALTH DEPARTMENT
BOARD OF HEALTH (BOH) APPROVED
GRANT APPLlCA.TION STATU!':
Date (BOHI Grant Reauested Pending Received Denied
Diabetes Education, Management and
12/5/01 Prevention - CFMF $60,000 $60,000
Youth Tobacco Prevention Project- Robert
11/7/01 Woods Johnson Youth Center $11,800 $11,800 $0
Teens Against Tobacco Use (TATU)-Health
Action Council of NC $350 $350 $0
Healthv Carollnlans- NC DHHS $10,000 $10,000
Family Assessment Coordination- March
9/5/01 of Dimes $16,500 $16,500
Folic Acid Prolect- March of Dimes $16,618 $16,618
Safe Kids Coalltlon- State Farm"Good
Neiahbor" $500 $500
TB Elimination and Prevention - CDC,
8/1/01 NCDHHD, DPH, TB Control Program $10,000 $ 9,2oo $800
Teen Aids Prevention /lAP!- 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 Patlents-NC Medical
6/6/01 Society Foundation $25,050 $25,050 $0
Healthy Homes- Asthma Program - Partnership
for Children (Smart Start) $28,060 $26,000 $2,060
No actlvltv to reDort for Mav 2001
Maternity Care Coordination Expansion Grant
4/4/01 NC DHHS $15,000 $15,000
Wilmington Housing Authortty- Ross Grant -
TAP & Altemative HIV Test Sites for 3 year
funding $192,221 $192,221
Safe Kids Traller-Safe Kids Safe Communities-
NC Govemofs Highway Safety $8,740 $8,480 $260
No actlvltv to reoort for 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
Cape Fear Memorial Foundation-lice
Eradication Program $5,000 $5,000 $0
Healthy Carollnlans- Office of Healthy
Carolinians, Division of Public Health, North
10/4/00 Carolina Dept of Health & Human Services $10,000 $10,000 $0
March of Dlmes- March of Dimes Birth Defects
Foundation Eastem Carolina Chapter $10,000 $6,250 $1,750
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As of 12/11101
. NOTE: Notification received since last report.
GRANT APPLICATION STATUS
Enhanced Counseling Program for HIV / AIDS
9/6/00 E"on John Aids Foundation $48,000 $48,000
Smart Start applying for Cape Fear Memorial
8/2100 Foundation Grant (MOW) $52,000 $50,000 $2,000
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 Ellminatlon- NC DHHS $10,000 $7,200 $2,800
Cape Fear Memorial Foundation (TAP
Prollram)2 year request $55,000 per year $55,000 $35,000 $20,000
Diabetes Today - DHHS DDPH $10,000 $10,000 $0
Totals $955,339 $113,618 $337,615 $504,106
NEW HANOVER COUNTY HEALTH DEPARTMENT
BOARD OF HEALTH (BOH) APPROVED
11.89%
35.34%
Pending Grants 6 21%
Funded Total Request 6 21%
Partially Funded 10 36%
Denied Total Request 6 21%
Number of Grants Applied For 28 100%
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As of 12/11/01
. "InTi:' Nntifi,.J:lflnn received since last report.
52.77%
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New Hanover Countll
Ani11Ull Control Services
Advisory Committee Appointments
The following positions will be vacant per the new rotation scheduling:
Member @ Large - two openings
Humane Society
Applications have been received for Member @Large and Humane Society. A total of four
applications have been received to be discussed at the Executive Committee of the Board of
Health in December 2001.
Updated I2IlllOljpm
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Animal Control Advisorv Committee
ADDointment Rotations
Replacements will occur by rotation of the respective members in the following categories:
GroUD One-1999 appointments
Member @ Large - general public (Jewell Ann Diehn)
Friends of Felines - group representative (Tinuni Evans)
Kennel Operator - general public (restricted selection) (Sylvia Hall)
GroUD Two - 2000 appointments
Hanover Kennel Club - group representative (John Boozer)
Azalea Dog Training Club - group representative (Cheryl Fiste)
Cat Interest - general public (Jeannie Leonard)
GroUD Three - 2002 appointments (to be decided in January 2002)
Member @ Large - general public (Donna Booth-Neal)
Member @Large- general public (open)
Humane Society - group representative (Joyce Bradley)
Note: The veterinarian position on the committee is the veterinarian that serves on the Board of
Health or their designee.
Members in group one will come to the end of their term in December, 1999. Groups two and
three will be replaced in 2000 and 2001, respectively. Anyone currently in a position will serve
until their term expires. If they are serving in their first three year term, they have the option of
serving another three year term before going off the committee.
These positions are subject to approval by the Board of Health. Group representatives are named
by appointment. and that named person is the only voting member of the committee. Another
person may be sent to the meetings in their stead for information to be distnbuted to the group
that they represent.
The selections were made to allow an opportunity for someone from the general public to apply
annually. There is as even a dispersement of group representatives as possible as well.
Revised 12111101 jpm
acadvcom.wp1
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November 5,2001
New Hanover County Animal Control
180 Division Drive
Wilmington. NC 28401
To Whom It May Concern,
I am interested in the position for advisory board
member at large. I have been an Animal Control
Officer for 16 years. I show collies and own my own
kennel. I think I could be an asset on this board with
e my previous experience in this field.
Thank you for considering me for a member.
Sincerely.
rj~4
Lynn Teague
My Contact Information:
5005 Pine Knoll Road
Wilmington. NC 28411
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(910) 395-4104 home
(910) 798-8878 work
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New Hanover County Animal Control Services
180 Division Drive
Wilminl!ton. N.C. 28401
(910) 341-4197
Application for Apoointment to the Animal Control Advisorv Committee
Category Interest:
\ (A l"O. JL
Name:
1q~- ~'b 1 t
Address:
City:
Telephone: Home:
Business:
Why do you wish to serve on the Animal Control Advisory Committee?
'1:: Cit"" (). ~ O~\.:lV - l~~~ ..\c "'" 0 ~
('O""'fV"\~\'~'~ ~(' ~"\L~~\ ~ Q~\'f'i'oC\""
~~\. "\ r6v-\~ \.-~'i? \.'\\\'" iY\v,\ ~LU\~~ O~ G~\f'I'-G.\s.
What areas of concern would you like to see the committee address?
--\'\.-~ ~\.\.~\"ei ~ ~~ * u-~L. 'O~~ UtV\fY'o-.\3
'-
\4~Vl;~ \c-.r,c:,o
-J
Date:---1I- 5 ~D \
~~~
Signature
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October 31, 2001
Jean McNeil
New Hanover County Animal Control
180 Division Drive
Wilmington, NC 28401
Dear Ms. McNeil:
This letter is to express my interest in serving on the New Hanover County Animal
Control Services Advisory Committee. Please contact me at your earliest convenience
with additional information.
Gretchen 1. Colby
637 Grey Squirrel Drive
Wilmington, NC 28409
(910) 796 3255 (home)
(910) 2512315 (work)
Thank you.
~~
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New Hanover County Animal Control Services
180 Division Drive
Wilminl!.toD. N.C. 28401
(910) 341-4197
Application for Appointment to the Animal Control Advisorv Committee
Category Interest: 'T;1.J.M, h u aJ: 1. D.A il ~
Name: ~~ &aeU::t
Address: ~ 23 .s h oc..b tD fl .
City: WJ.."J~ I Nt-
Telephone: Home: t f t -/860 Business:
/V/A
,
Why do you wish to serve on the Animal Control Advisory Committee?
1n ~ Lf:r;-~f 1; ~ ()~IJ t~, ~ Nile
What areas of concern would you like to see the connnittee address?
o lJ-VLO'T" IA.f-;- ~
I )
S-f()~ '
Date: /2 - /1- 0 (
S" r vlkc!-"J
Signature
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NEW HANOVER HUMANE SOCIETY
P.O. Box 12293
Wilmington, N.C. 28405
Phone 910-763-6692
OFFERING
. Animal Sheltering
. Adoptions
. Spay/Neuter Program
. Lost & Found Servloe
. Emergency Servloe
. Cruelty Investigation
Decemberll, 2001
Martha Raynor will represent the New Hanover Humane Society on
the ACS Advisory Committee.
Susan Jackson, President, New Hanover Humane Society
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A NON-PROFIT CHARITABLE ORGANIZATION SUPPORTED SOLELY THROUGH DONATIONS
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Recommendation For Budgeting Medicaid Cost Settlement Funds
Medicaid Cost Settlement Funds
$165,773
I. Various Medical Program Needs
Interpreter Services
Prenatal Vitamins
Vaccine Cost Increases
Client Transportation
SalarieslFringes
Teen AIDs Prevention
Temporary Assistance
To Needy Families
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Indexes for Medical Records
Conversion Services &
Printer Licenses
Fax Machine for Mailroom
2. IT Request for Medical Programs
3. Operable Partitions for Auditorium
4. Child Services Coordination Salary
Total
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$71,036
$15,000
3,000
10,000
3,500
5,906
8,130
9,000
21,000
1,500
$45,700
$22,300
$20,737
$165,713
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Summary of Information Technology (IT) Needs
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Quote for Operable Partitions
For
Health Department Auditorium
1. Modernfold Acousti-Seal Paired Panel Operable Wall
$20,000
2. Modernfold Soundmaster Accordion Partition for
Closing off Kitchen Hallway Area
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$2,300
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CORPORATE OFFICE: P O. Box 33309 · Raleigh, NC 27636-3309' (919) 832-0380 · FAX (919) 839-1402
PANEL PLANT: 3640 Banks Rd.' Raleigh, NC 27603 · (919) 772-3313 · FAX (919) 772-5897
TRIAD: 3721-B W Market St. · Greensboro, NC 27403' (336) 852-7710' FAX (336) 294-1403
SOUTH CAROLINA: 3207 Leaphart Rd. · W Columbia, SC 29169 · (803) 939-9168 · FAX (803) 939-9169
WILMINGTON: 2725 Old Wrightsboro Rd. . Bldg. 5, Suite A-B' Wilmington, NC 28405 · (910) 815-0074' FAX (910) 815-0901
RECISION WALLS. INC..
To: New Hanover County Health Department
2029 South 17th. Street
Wilmington, NC 28401-4946
Attn: Ms. Linda Smith
PROPOSAL
New Hannover County Health Department
Wilmington, NC
Date: December 4, 2001
Sheet Numbers:
Sheet Dates:
Addenda:
Project:
Location:
Architect:
Gentlemen:
We Propose to Furnish and Install the Following:
Scope or Work:
ecification Section 10651 (Modemrold base specification)
odernfold Acousti-Seal 932 paired panel operable wall with # 17 steel track and steel trolleys in a standard
Modernfold vinyl finish. STC Rating of47. (43 STC is no longer available).
1 @39'.10"wx 10'.0" h (hanging weight = 7lbs sq. ft.)
1@43'-6"wxlO'..O"b " """"" "
Total $ 20,000.00
Alternate Bid:
Same wall and dimensions as above except for a 41 STC Rating.
Total $18,000.00
(Existing Steel beam may have to be punched, add $ 875.00 to the above quotation)
Removal of existing ceiling tiles and cut in of new tiles is not included in this quotation.
Exclusions: OVERTIME INSTALLATION. OVERHEAD SUPPORT SYSTEM, OR BEAM PUNCHING.
NOTE: OPENING MUST BE PLUMB AND LEVEL + I - ';4". ORDER MUST SHIP PRIOR TO
612002 TO AVOID A MANUFACTURERS PRICE INCREASE.
CONDmoNS:
(I) This Proposal is based 00 AlA SuboonlnCl Form. cumut
eeclitioa.
) Aa:cptance by your authorized agent "00 the rcvcrac side". within 30 days
tiom Proposal data.
(3) If.... era awarded this Subcontract, this Proposal shall become a binding part of that Su_
Bv:
(4) See...erse side IOJ Pn:cision Wall~ Inc. SlBndanI Rider. Len Rothstein
Commercial Drywall. Demountllblc Partitions. Profit_tad Insulatad Exterior Panel Systems - EIFS - Fireproofing - Pias= - Stucc:o - Opctablc Partitions
Accordian Partitions _ Aluminum Door Frames _ Ceramic Tile. QulUT)' Tile. Natural Stone. Vinyl Walk:ovcring-Composite Panels Systems 23
Respectfully submitted,
Precision Wal1s, Ioe.
Len Rothstein
PWI STANDARD RIDER TO SUBCONfRACf
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Temponll)' filcililies and services (to be supplied by GC or Owner at no dIlIrge to PRECISION WAILS, INC,). .-
A Electrical services: The power source shall be within ]00 ft. of the PWI work area(s) and sufficient to provide full power for tools and equipm.J!!lll'
with GF1 service included.
B. Sufficient heat and ventilalioo for proper drying of joint rompound 8<lOllI"ding to specifications.
C. AdequaIe lighting (not drop or pull lights) to allow for proper drywall hanging and wall finishing.
D. WllIer (within 100 II. ofworic area(s)) and toilet filcilities.
E. Hoisting Facilities.
F T....h and robbish _ cleanup. The Cootraclor shall pay for the removal of trash licm the jobsite or provide a dmnpster aI the jobsite. Precision
Walls, Inc. will cleanup the woric area(s) of its trash and robbish and deposil in . central area 00 jobsiIC floor, or in a dumpster wljacent to the
building designated by the Contractor or Owner.
G. Layout - ~ 18)001 of waIls shall be the responsibility of the Cootraclor or Owner.
H. Sealing ofwaIl penetra1ioos, i.e., MEP, etc., is the responsibility of the trade making the penetra1i00 as it relates to the fire rating of same.
L Any waIl required to be fire ratedlsmoke Illled shall be allowed to be built free of any encumbrances thai may resuIl fian early rough-in by MEP
trades.
D. P8)'IIIents, Progress or Fmal _ The Contractor shall pay the Subcattractor eadI progress payment and the final payrnent under this Subcmtract within five
working d8)ll after he receives payment fian the Owner, exceplas provided below. The amount of eadI progress payrnent \D the Suboontractor shall be
the amount to whidl the Subcattractor is entitled, reflecting the peroentage of rompletion allowed \D the Cootraclor for the Work of this SIAb..u..Il8aor
applied to the CmtnIct Sum of this Subcontraa, and the percentage actually retained, if any, fian p8)1IIenlS \D the Contractor cn lIllClRIIIl of sum
Suboontraalx's Worl<, plus, to the extent permitted by the CmtnIct Documents, the amount allowed for materials and equipma1l sui1abIy stored by ...
Suboontractor, less the aggregate of previoos payments to the Suboontractor. .
The Contractor shall permit the Suboonlra<lor \D request directly fiom the ArdUtecl or Owner information regarding the pcrcenl8I!e5 of oompleticn or the
amount certified cn aooount of Work clone by the soo...,baao-.
If the ArdUtecl or Owner does not issue a Ccrtific:atc for Paymmt or the Contractor does not receive payment for any awse whidl is not the fiwlt of the
Subcattractor, the Contractor shall pay the SIAb..u..b..acr, on demand, a progress payment romputed as above or the final payrnentas fulIows.
Fmal payment, oonstituting the entire unpaid balance of the Cm\raCl Sum, shall be due when the Work desaibed in this Suboontracl is fully oompleted
and I'" ro..ned in IIlXllRIance with the Cootracl Dowments and is satisfildory \D the ArdUtecl or Owner, and shall he payable as above.
If this Cootracl is direct with the Owner, then the Owner shall pay Precision Walls, Inc., any progress or final billing on or befire the tenth of the fullowing
IllOIIIb.
ID. Fmal cleaning of movable/demountable partiticn rests with the Gcneral Contractor or Owner, provided the cleaning am be clone with regular soap and
wma-.
A 1%''1. MONJ1lLY INTERFSf RATE WILL BE CHARGED ON AU.. DEUNQUENf ACCOUNl'S CARRIED OVER FROM 11IE PREVIOUS
MON11L
ACCEPTANCE
Aa:epted
Approved
CONDmoNS: Respectfully submitted,
(I) This Proposal is based GO AlA SuboonlnCl Form. cumut
edition. Preclsiou Walls, IDe.
(2) Aa:cptance by your authorized agent "00 the....... side", withiD 30 days -
tiom Proposal datil. -
(3) If... are awarded this Subcontrad, this Proposal shall bocomc. binding pan of that Su_
Bv: Len Rothstein
(4) See....... side IOJ Pn:cision Walls, Inc. Slandanl Rider. Leo RothstaiD
Conunen:iaI DlywaJI_ Demountllble Partitions _ Profit_ted Insulated Exterior PancI Systems - EIFS - FiJoproofing - ~ - Stucco - Opctable Partitioas
AoconIiall Partitioos. Aluminum Door Frames _ Cerami<: Tile - Quarry TDe - Natural Slor1c - ViDyl Wallco.uing.composiu: PancIs Systams 24
Name of Company
PRECISION WALLS, INC.
Signature and TItle
Signature and Tille
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Dale
Dale
REV. 3/96
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CORPORATE OFFICE: P O. Box 33309' Raleigh, NC 27636-3309 · (919) 832-0380' FAX (919) 839-1402
PANEL PLANT: 3640 Banks Rd.' Raleigh, NC 27603 · (919) 772-3313 · FAX (919) 772-5897
TRIAD: 372I.B W. Markel SI. · Greensboro, NC 27403' (336) 852-7710' FAX (336) 294-1403
SOUl1l CAROLINA: 3207 Leaphart Rd. · W. Colwnbia, SC 29169 · (803) 939-9168 · FAX (803) 939-9169
WILMINGTON: 2725 Old Wrightsboro Rd.' Bldg. 5, Suite A-B' Wilmington, NC 28405' (910) 815-0074' FAX (910) 815-0901
RECISION WALLS, INC:
I
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To: New Hanover County Health Department
2029 South 17th. Street
W1lmington, NC 28401-4946
Attn: Ms. Linda Smith
PROPOSAL
New Hannover County Health Department
W1lmington, NC
Date: December 10,2001
Sheet Numbers:
Sheet Dates:
Addenda:
Project:
Location:
Architect:
Gentlemen:
We Propose to Furnish and Install the Following:
ScoDe of Work:
&odernfold Soundmaster 80 accordion partition with a 35 STC Rating in a standard Modernfold vinyl finish.
I @6'.0 Vi' x 9'-0" (hanging weight= 3.251bs sq. ft.)
Total S 2,300.00
Alternate Bid:
Modernfold 800 accordion partition in a standard Modernfold vinyl finish.
1 @ 6'-0 Yo" w x 9'-0" h (hanging weight = 2 Ibs sq. ft.)
Total $1,825.00
Header supports are required for either partition. (not included in quotation).
Exclusions:
NOTE:
OVERTIME INSTALLATION. OVERHEAD SUPPORT SYSTEM, OR BEAM PUNCHING.
OPENING MUST BE PLUMB AND LEVEL + /- '1.". ORDER MUST SHIP PRIOR TO
6/2002 TO AVOID A MANUFACTURERS PRICE INCREASE.
CONDmoNS: Respectfully submitted,
(I) This Proposal is based on AlA Subcontract Fonn, cummt
_ edition. Precision Walls, Ine.
_(2) Acceptance by your authorized asent "on the reverse side", within 30 days
fi'om Proposal date.
(3) If we are awarded this Subcontnlc1, this Proposal shall bea>me a binding part of that Su_
Bv: Len Rothstein
(4) See rev_ side fOr PRc:ision Walls, Inc:. Slatldard Rider. Loa Rothstein
Commen:ial Drywall_ Demountable Pamtions. PrclBbricated Insulated Exterior Panel Systems - ElFS - Fireproofing - Plaster - Stu"'" - Operable _... 26
Accordian Partitions. AJuminum Door FI'1lme5. Ceramic Tile - Quany Tile - Natural Stone - Vinyl Walloovering-Composite Panels SystemS
.
PWI Sf ANDARD RIDER TO SUBCONfRACf
L
Tempc6lllY facilities and servi= (to be supplied by GC or Owner 8l 00 charge to PRECISION W ALLS,INc.).
.
Electrical servi=: The power source shall be within I()() ft. of the PWI work area(s) and sufficient to provide full power for tools and equipment,
with GF1 service included.
A
B. Sufficient heal and ventilation for proper drying of joint oomJXllUld acrording to specifications.
C. Adequate lighting (not drop or pull lights) to allow for proper drywall hanging and wall finishing.
D. Water (within I()() ft. ofworkarea(s)) and toilet facilities.
E. Hoisting Facilities.
F. Trash and rubbish _ cleanup. The ContradOr shall pay for the removal of trash from the jobsite or provide a dumpster at the jobsite. Precision
Walls, btc. will cleanup the work area(s) of its trash and rubbish and deposit in a central area on jobsite floor, or in a dmnpster adjacent to the
building designated by the CaItraetor or Owner.
G. La)'out - Engineering lll)<llll of walls shall be the responsibility of the CaItraetor or Owner.
Jl Scaling ofwall penetratioos, i.e., MEP, etc., is the respoosibility of the trade making the penetratioo as it relates to the fire rating of same.
L Any wall mjuired to be fire ratedlsmoke mted shall be allowed to be built free of any encumbrances that may resuIt fiml early rough-in by MEP
trades.
n. Payments, Progress or FIIlIIl _ The CaItraetor shall pay the Subun.b........ each progress payment and the final payment under this Sub.udJad within five
working da)'l after he receives payment from the Owner, except as provided below. The amount of each progress payment to the Subcmtraclor shall be
the amount to which the Sub<mtractor is entitled, reflecting the pen:entage of completion allowed to the Contraelor for the Work of this Suboontractor
applied to the Contract Sum of this Subcootract, and the pen:entage actually retained, if any, fiml payments to the Contraelor 00 IIalOUIIl of such
Suboontraclor's Work, plus, to the extent permitted by the ContracI Documents, the amourtt allowed for materials and equipment suitably stored by"
Subcontractor, less the "B8J'el!8le ofprevious payments to the Suboontrador. .
The Contrnctor shall permit the Subcontractor to mjuest directly from the Architecl or Owner infonnation regarding the pen:entages of oompletion or the
amount certified 00 IIalOUIIl of Work done by the Sub<mtractor.
If the Architecl or Owner does not issue a Certificate for P8)TIlCIlI or the Contractor does not receive payment for any cause which is DOl the fuuIt of the
SuboonIrador, the Contrnctor shall pay the Subcontractor, on demand, a progress pa)1Ilent computed as above or the tinaI payment as fullows.
FIIlIIl payment, coostituting the entire unpaid balance of the ContracI Sum, shall be due when the Wori< desaibed in this Sub.udlad is fully oompleted
and )""&....00 in lICllOTdanoe with the Contract Documents and is satisfilctory to the Architecl or Owner, and shall be payable as above.
If this Contract is dired with the Owner, then the Owner shall pay Precisioo Walls, Inc., any progress or final billing m or before the tenth of the fullowing
month.
Ill. FIIlIIl cleaning of movable/demountable partition rests with the Genc:raI Contractor or Owner, provided the cleaning am be done with reguIar soap and
waI<r.
A )l-)% MONI1lLY 1NTE1U:Sf RATE WlU. BE CHARGED ON ALL DELlNQUENf ACCOUNfS CARRIED OVER FROM TIlE PREVIOUS
MONl1L
ACCEPTANCE
Aa:epted
Approved
Name of Company
PRECISION WALLS, lNC
Signature and Trtle
e
Signature and Trtle
Date
Date
REV. 3/96
27
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Dennis Harrington
<Dennis.Harrington@
nc:mail.net>
Sent by:
Ihd.admin@dehnet.n
et
11/06/01 10:20 AM
Memorandum:
To: Local Health Direc:tors <Ihd@dehnet.net>
cc: Deborah Rowe <deborah.rowe@ncpha.com>, "Ieah.devlin"
<leah.devlin@ncmail.net>, glenn cutler
<glenn.cutler@ncmail.net>, "Penny Lewis (AC)"
<plewis6@intrstar.net>, Libby Stephens
<arizona97@lexcominc.net>, Mitzi Parris
<mparris@coc:entral.c:om>, Dianne Edwards
<aledbe@wnclink.com>, Joy Reed <Joy.Reed@nc:mail.net>, Alicia
Clark <Alicia.Clark@ncmail.net>, Dennis Harrington
<Dennis.Harrington@ncmail.net>, Sharon Pigott
<Sharon.Pigott@nc:mail.net>, Jim Panton
<Jim.Panton@ncmail.net>, Allen Gambill
<Allen.Gambill@nc:mail.net>, Carol Chandler
<CaroI.Chandler@nc:mail.net>, Steven Garner
<Steven.Garner@ncmail.net>, Alicia Clark
<AI icia .Clark@ncmail.net>
Subject: [Lhd] Medicaid Cost Settlement for FFY 2000
TO: All Local Health Directors (Attn: Financial Assistants and Clinical
Staff
FROM:
DATE:
SUBJECT:
Manager/ Medicaid Billing Staff
Dennis Harrington, Chief of Local Health Services
November 6,2001
Medicaid Cost Settlement for FrY 2000
Well, Good News!! ..It is time for some .- isn't it?
In conversation with Allen Gambill, Assistant Director of Medicaid for Financial
Operations, he has gotten the Medicaid Cost Settlement for FFY 2000 released.
The detail paperwork for this is now in the DHHS Controller's Office, and the
funding should flow within the next couple of days. Attached is an Excel File
prepared by Steven Garner in OMR that details your payment amount by program
for you use in depositing funds.
As always, we sincerely appreciate the hard work and dedication of Carol
Chandler and Steven Garner who work with each and every one of you to collect
the data, prepare the individual cost reports by department and prepare the all
inclusive statewide cost report for submission to Medicaid. They are a rare team
and one that we treasure in public health (at the state, and I am sure, locally).
Additionally, Mr. Jim Panton and staff, as well as Mr. Allen Gambill in Medicaid,
28
As always, we sincerely appreciate the hard work and dedication of Carol
Chandler and Steven Garner who work with each and every one of you to collect .
the data, prepare the individual cost reports by department and prepare the all
inclusive statewide cost report for submission to Medicaid. They are a rare team
and one that we treasure in public health (at the state, and I am sure, locally).
Additionally, Mr. Jim Panton and staff, as well as Mr. Allen Gambill in Medicaid,
continue their strong and consistent support in working with us through a
complex and tedious process to allow you recoup your costs as you serve this
important Medicaid population.
If you have questions about your detail amount, do not hesitate to contact
Steven Garner or Carol Chandler.
Thanks, Dennis H
~ . LHD Medicaid Cost Settlement. Oct 99 - Sept 00 . Total By Program1.xls
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Programs Where Medicaid Cost Settlement Funds Were Earned
$165,773
New Hanover Child Health $20,148.621
New Hanover CSC $52,091.681
New Hanover CSHS $6.938.891
New Hanover Familv Plannina $10,008.861
New Hanover General Clinic $1.579.71
New Hanover Immunization $7,493.7i
New Hanover Maternal Health $13,354.6f
New Hanover MCC $47.080.41
New Hanover STD $2,809.1
New Hanover TB $4,269.5
otal $165,773.26
30
Recommendation For Budgeting Medicaid Cost Settlement Funds
Medicaid Cost Settlement Funds
$165,773
1. Various Medical Program Needs $77,036
Interpreter Services $15,000
To cover the cost of client mterpretation services for the remainder of the year for
the nursing division clients. Usage has exceeded budgeted amounts.
5167-3700
Prenatal Vitamins 3,000
To purchase prenatal vitamins for maternal health clients
5162-4210
Vaccine Cost Increases 10,000
To cover increased cost of purchase of various vaccines due to price increases.
5151-4210
Client Transportation 3,500
To pay for transportation of clients to the Health Department for services.
5167-3700
SalarieslFringes
Teen AIDs Prevention 5,906
To provide for shortfall in salary due to grant $ not awarded.
Temporary Assistance 8,130
To Needy Families
To provide for shortfall in salaries due to shortfall in State Grant
Indexes for Medical Records 9,000
Bid proposal for Medical Records Barcoding project came in higher than
budgeted funds. This will cover the cost of the purchase of indexes and the conversion
labor to install indexes in the new file folders during the project implementation. These
items had to be cut from the original bid in order to come within budget. Additional cost
oflicenses for color printers was not included in the bid response as quoted, and must be
added to allow users throughout the building to print color barcoded labels for file
folders. Also, we will use these funds to increase the number of concurrent users able to
access the system.
Indexes- 5151-4210 $9,000
Conversion Services & 21,000
Printer & User Licenses
See explanation above.
5151-3700 $12,000; 5151-6399 $9,000
Fax Machine for Mailroom 1,500
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2. IT Request for Medical Programs
3. Operable Partitions for Auditorium
4 Child Services Coordination Salary
To cover a portion of the shortfall in salaries
Total
$45,700
$22,300
$20,737
$165,773
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NEW HANOVER COUNTY BOARD OF HEALTH
Committee Assignments
2002
Executive Committee:
Mrs. Gela N. Hunter, Chairman
Mr. W. Edwin Link, Vice-Chairman
Dr. Wilson O'Kelly Jewell
Dr. Melody Specie
Mr. William T. Steuer
Budl!et Committee:
Member Division
Dr. Wilson O'Kellv Jewell Chairman Dental Health
Dr. Wilson O'Kellv Jewell Laboratorv
Mr. HenrvV. Esteo Women's Health Care
Mrs. Gela N. Hunter Child Health Services
Mrs. Gela N. Hunter Nutrition
Mr. W. Edwin Link Communicable Disease
Mrs. Anne Braswell Rowe Administration
Dr. Philin Palmer Smith, Sr. Communitv Health
Dr. Melodv C. Soeck Animal Control Services
Mr. William T. Steuer Environmental Health
Environmental Health Committee:
Mr. William T. Steuer, Chairman
Mr. Henry V. Estep
Dr. Wilson O'Kelly Jewell
Dr. Philip Palmer Smith, Sr.
Personal Health Committee:
Dr. Melody C. Speck, Chairman
Mr. W. Edwin Link
Mrs. Anne Braswell Rowe
Animal Control Services Advisory Committee
Dr. Melody C. Specie
Association orNC Boards or Health
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NEW HANOVER COUNTY
HEALTH DEPARTMENT
2029 SOUTH 17TH STREET
WILMINGTON, NC 28401-4946
TELEPHONE (910) 343-6500, FAX (910) 341-4146
Everywhere. Everyday. Everybody.
DAVID E. RICE, M.P.H., M.A.
Health Director
LYNDA F. SMITH, M.P.A.
Assistant Health Director
MEMORANDUM
TO:
FROM:
DATE:
RE:
New Hanover County Board of HeaIth Budget Committee
Wilson O. JewelI, DDS, Chair, Budget COmmitteeijJ~
January 2, 2002
Budget Committee Assignments
The Health Department Management Team has begun work on the Health Department FY 2002-03 Budget
Request.
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Each Budget Committee Member has been assigned a specific division. The Division Director will call you soon
to set up a time for you to meet and review their Budget Request. The Budget Requests are due from the
Division Directors by January 18, 2002. The Division Director will need to review their budgets with you on or
before January 25, 2002. If you have changes or recommendations, these can be included in the budget before it
goes to the County Budget Office on February 15, 2002.
The Board of Health Executive Committee wilI meet to review the Budget Request on the evening of January
29,2002. The Budget Request will be brought to the Board of Health for approval at the Board of Health
Meeting February 6, 2002. You wilI have input in this process through one of the folIowing ways:
(1) Attend the Executive Committee Meeting on Tuesday, January 29, and express any concerns you have
over your particular division's Budget Request.
(2) Let me know by telephone (79I-240Ioffice or 791-6113 home) or e-mail (woiewelIlalao1.com) on or
before January 25, 2002, of your concerns or changes to the Budget Request, and 1 wilIexpress those to
the Executive Committee.
(3) If you approve your program(s) budget as presented, please let me know by 5 p.m. on January 25,
2002.
With your input in one of the three ways listed above, you will provide information to the Executive Committee
regarding the Budget Request.
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If ?jour Aeaft"- _ Our priorit'1lf
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New Hanover County Board of Health Budget Committee
January 2, 2002
Memo: Page 2
Attached are two items:
(1) List of the Board Budget Committee Members with Assignments.
(2) New Hanover County Board of Health Budget Committee! Health Department Program Review Form
for use in reviewing your specific program.
The Budget Committee wilI not meet as a committee. Each Budget Committee member wilI receive their line
item Budget Request from the Division Director for the program( s) the Board member is reviewing. The Fiscal
Year 2002-2003 Budget Workbook wilI be presented only to the Executive Committee, but a copy of the Budget
Workbook wilI be available to other Board members in Frances De Vane's office if you wish to review the entire
Budget Request.
We encourage each Board member to participate directly in the completion of their Budget CommitteeIHealth
Department Program Review Form.
Since this memo is also copied to Health Department Division Directors, I am encouraging staff not to ask for
budget items to be included, if we anticipate we can obtain these items through other funding.
LFS:fd
c: Health Department Division Directors
David E. Rice, Health Director
Attachments
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NEW HANOVER COUNTY BOARD OF HEALTH
BUDGETAS~GNMENTS
Dr. Wilson O. Jewell, Chairman, Budget Committee
January 2, 2002
Administration
Ms. Anne Braswell Rowe
Animal Control Services
Dr. Melody C. Speck
Child Health Services
Ms. Gela N. Hunter
Communicable Disease
Mr. Edwin W. Link
Community Health
Dr. Philip P. Smith, Sr.
Dental Health
Dr. Wilson O. Jewell
Environmental Health
Mr. William T. Steuer
Laboratory
Dr. Wilson O. Jewell
Nutrition
Ms. Gela N. Hunter
Women's Health Care
Mr. Henry V. Estep
NHCBH/Ol/2002
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NEW HANOVER COUNTY BOARD OF HEALTH
BUDGET COMMITTEE
HEALTH DEPARTMENT PROGRAM REVIEW
Name of Budget Committee Member
Division Name
Division Head
Program (if more than one in Division)
Organization Budget Code
REVIEWED THE FOLLOWING: CHECK BELOW.
Yes No Comments
Staffing - Number
Staff Classifications
Line Item Increases or
Decreases from Current Fiscal
Year
Capital Needs:
Current and/or Future
Revenue Sources
Revenue Increase/Decrease
from Current Fiscal Year
e
01/2002
Funding Level and source for
Mandated Programs
Non-Mandated Programs
Funding Level and Source for
Non- Mandated Programs
e 01/2002
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Fiscal Year
TotalImpds
Total Adopt
Total Relocd
Total Bites
Total Eued
New HaDover COUDty
ADUnaICoDuoISe~
Statistical InformatioD
94/95 95196 96/97 97/98 98/99 99/00 00/01
4288 4557 4021 4682 4511 4467 4693
417 732 546 626 690 736 638
89 192 182 107 98 138 213
380
507
497
440
3138 3013
2798 3339
438
445
419
3068
2895 3061
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New HanOW1l' County Aninull Control Services
Aninull Adoption Contrad
New Hanover Animal Control Services (ACS) hopes that you will be satisfied with and enjoy your new family i
member. At the same time, we are concemed about the welfare of the animal This contract is for the purpose e
of adopting an animal from ACS. The following procedures are conditions to this contIact
.
,
I The adoption deposit is a $60 non-refundable fee.. You must also pay the $10.00 County License fee
which is payable at the time of the adoption.
2. Owner is required to pick up their pet from the below named veterinary hospital.
3. ACS retains ownership of the pet until it is retrieved from the veterinarian.
4. Failure to retrieve your pet from the hospital at the specified time results in loss of the pet and the
adoption deposit The animal will return to ACS to be handled appropriately according to
county policy
5. Dogs, cats and ferrets four months of age or older will be given a rabies vaccination at the point of
surgery
6, Dogs, cats and ferrets under four months of age must receive a rabies vaccination when they reach four
months of age. (See Rabies Certificate)
7 Ownership is transferred to you when the animal is picked up from the veterinarian.
8. All applicable laws governing control and custody of animals must be followed.
9 ACS will be allowed to visit the premises to ensure that the terms of this agreement have been met.
10. New Hanover County will be held harmless for any veterinary fees, and claims incurred by or damage
caused by the animal while it is in my care.
11. As adopter, I acknowledge that the adopted animal may have contracted a contagious condition, and I
hereby agree to indemnify and hold New Hanover County, its Boards, Agents, and Employees,
harmless against any claims, demands, causes of action, or other liability or account of personal injuries
or deaths, or on account of any other damages arising out of or relating to the adopted animal.
Breed: DOMESTIC SH Sex: F Color: BRN TABBY Animal #. A088136 Weight: 0.00 e
Veterinary Hospital:
Address:
Phone No..†
Note: Ple2Se contact the veterinary hospital by 3pm the day you a.e to pick up your pet.
.Exceptions to non-refundable fee:
1 The animal dies under anesthesia, or from complications during sugery.
2. The pet has a life-threatening disease, and must be returned to the shelter. The animal should be
returned to the shelter within 15 days with a statement from an attending veterinarian as to the condition
diagnosed.
In these instances, the fee may be retained for another animal to be chosen, or a refund may be
forwarded through the Finance Department
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New Hanover County Animal Control Services
Animal Adoption Contract
NOTE: INDIVIDUAL PARTICIPATING VETERINARIAN MAY HAVE FEES FOR SERVICES
UNSPECIFIED BY TInS CONTRACT THAT THEY CUSTOMARILY CHARGE IN
CONNECTION WITH SPAYINEUTER SURGERY, LE., BOARDING OR HOSPITALIZATION
FEES. ADOPTERS ARE ADVISED THAT THEY ARE LIABLE FOR SUCH CHARGES AND
ARE ENCOURAGED TO INQUIRE BEFOREHAND WHETHER OR NOT ADDITIONAL
CHARGES WILL BE MADE.
Animals adopted from New Hanover County Animal Control Services may have been exposed to
various diseases from contact with other animals. Wildlife rabies is currently prevalent in this area of
North Carolina. A dog, cat, or other animal which is bitten (exposed) by a rabid animal may not
develop symptoms of rabies for up to six months. During this time (the incubation period), the exposed
animal may appear to be totally healthy. Since the vaccination history of shelter animals is usually
unknown, many of these animals are not protected against rabies. Although aD animals offered for
adoption have been carefully screened for signs of exposure to rabid animals prior to adoption, the
possibility exists that your adopted pet could be infected. It is, therefore, very important that you know
that these symptoms could be rabies in your pet: change in behavior, vicious or nervous activity,
difficulty swaDowing, excessive drooling, difficulty walking, or paralysis. If your pet develops any of
these symptoms, immediately separate the animal from people and other animals until it can be
examined by a veterinarian. Newly adopted pets shaD be examined by a veterinarian and vaccinated
for rabies. However, a rabies vaccination may not protect the animal from previous bite or other
exposure to rabies. In addition, the physical condition of some animals may be less than ideal due to
conditions the animal may have suffered before arriving at the shelter.
a New Hanover County Animal Conrol Services. strives to screen animals and to inform prospective adopters of
_ any perceivable problems, but some problems may not be evident to them at the time of adoption. Animals
may be returned to the ACS shelter during regular working hours on weekdays if the adopter decides it is in his
or her best interest or in the best interest of the animal. All paperwork must be returned with the animal.
.
Adopter verifies that he or she is 18 years of age or older and fully understands the contractual obligations set
out above, and agrees to accept all risks. Failure to comply with these obligations will be a breach of contract,
which gives A C S the legal right to reclaim the animal.
C?M,t:~
dopter Si
P066948
~~ bJa~tk?41Z-
cs Authorized Signature
10\3\ \0 \
Date . . .
/:;.- g/-rJ (
Date
revised 0912112000 dsb
e
:
A088136 O.OOLBS CAT BRNTABBY F DOMESTICSH
1213112_
-.
NORMAL VACCINATE
CAT APPEARS HEAL mY OK TO ADOPT
QTY
0.00
Cycle #Day
o 0
Medication
Dose
0.00
T",ated by: NAR
VACC/DW 12117/01
.
IF YOU OR YOUR VETERlNARIAN HAVE ANY QUESTIONS ABOUT THE MEDICAL TREATMENT YOUR ANIMAL HAS RECEIVED
PLEASE CALL US AT (909) 243-3790
MEDHIST: JUIT
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New Hanover Coun~ Animal Control Services
180 Division Drive, Wilmington, NC 28401
(910) 341-4197 (910) 341-4349 FAX
Receipt Number: R01-'134847
Person Information: CHERYL JACKSON
9183 BALD EAGLE OR
LElAND. NC 28451
Receipt Date: Monday, December 31,2001
PIO: P066948
0"
Rp.rpivprf F'rnm" IA~K5;nN c;l-IF=RYt
Check No:
Reference No:
Price: Each:
Phone: (910) 383-'1907
Amount:
Item:
L1C CFNO
AOOPTCA T
Animal 10:
A088136
A088136
L01-098983
$.00 1
60.00 1
Total Fees Due:
Payments: Cash:
Check:
Credit Card:
Total Payments Received:
Thank You!
Change:
Balance Due:
nimallnfonnat/on:
A088136 A088136 - 1
License Infonnat/on:
Tag Number: expires: Anlmal#
L01-098983 12/31/01 A088136
Vacc Date: Term:
12
Expires:
01/02/02
Amount: Type:
$0.00 L1C CFNO
TAL LICENSE FEES: $0.00
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SheltIIr HoUI8
Monday - Friday 8:00AM - 4:45PM' Saturday 10:00AM - 1 :45PM'
Shelters CLOSED Sundays and Holidays
Clerk: MCHARLES
Transaalon Date: 12131101
Print Date: 12131101
$.00
60.00
$60.00
$0.00
$60.00
$0.00
$60.00
$0.00
$0.00
a:~pl.flIl
..
00
_'.Il,
New Hanover County Aninull Control Servkes
Rabies Certificate
Breed
Sex
Color
Impd. No.
Wt.
Veterinary Hospital
Address
Phone No.
r agree to have the above ~nim" I vaccinated for rabies according to the adoption contract dated
r understand. that r must return to the above named veterinary
hospital to receive my "free" vaccination. r further understand that failure to have my pet rabies
vaccinated and county licensed by constitutes a breach of contract, which
gives Animal Control Services the legal right to reclaim the ~nnn,,1
Adopter Signature
Date
ACS Authorized Signature
revised 9/1/99 jpm
Date
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North Carolina Department of Health and Human Services
Division of Public Health. Epidemiology Section
1912 Mail Service Center. Raleigh, North Carolina 27699-1912
Tel 919-733-3410 . Fax 919-733-9555
Carmen Hooker Buell, Secretary
Michael F Easley, Govemor
December 20, 2001
Mr David Rice
Health Director
New Hanover County Health Department
2029 South 17th Street
Wilmington, North Carolina 28401
Dear Mr Rice:
We have reviewed the offsite private well water sampling data for the Jail/Landfill
site. The results indicate no significant levels of organic or inorganic chemical
contaminants in these private wells. Continued use of the well water at these sites
should not pose any health risks based on these sampling results. In addition, your staff
has informed us that increased monitoring will occur at this site, with an emphasis on
offsite monitoring around the landfill perimeter
At this time, Occupational and Environmental Epidemiology Branch (OEEB) does
not believe current construction activities pose any increased health risk via
contamination of any private drinking water supplies, and the additional offsite
monitoring will allow us to keep a close watch on any possible well water contamination
in the future.
Thank you for your assistance in gathering data at this site and your cooperation
in designing a plan that assures healthy drinking water supplies in this area.
I look forward to continuing our close working relationship in the future. Please
feel free to contact me if you have any further questions at 919-715-6425.
Sincerely,
~~
William Tynan, MD, MPH, Head
Occupational and Environmental Epidemiology Branch
WT:pd
Post-it" Fax Note
To
7671 oatail
From
Co.
Phone #
Phone #
Fax #
Fax>
@ Location: 2728 Capital Boulevard . Parker Lincoln Building. Raleigh, N.C. 27604
An Equal Opporrunity Employer
NEW HANOVER COUNTY
HEALTH DEPARTMENT
2029 SOUTH 17TH STREET
WILMINGTON, NC 28401-4946
TELEPHONE (910) 343-6500, FAX (910) 341-4146
Everywhere. Everyday. Everybody.
DAVID E. RICE, M.P.H., M.A.
Health Director
LYNDA F. SMITH, M.P.A.
Assistant Health Director
December 18, 2001
Michael U. Rhodes, Chief
Environmental Health Services Section
NC Dept of Environment and Natural Resources
1632 Mail Service Center
Raleigh, NC 27699-1632
Courier Number: 52-01-00
Dear Mr Rhodes:
e
We have been a partner with your organization in the Restaurant Pilot Grading
Project since its inception during the fall of 1998. As early details of this project were
made available during its developmental stages, we quickly recognized the potential
benefits, endorsed and sought approval to participate.
As you prepare to update the North Carolina Commission for Health Services
on its status, we ask that our very positive experience be strongly considered. This
project has been unequivocally successful in "raising the bar" and strengthening the
level of food safety practiced by restaurants in New Hanover County Employees and
managers are much more focused on achieving a high numerical compliance rate,
whereas in the past, a prominent letter grade masked a ten-point interval of differential
infractions and thus, inherent risks to the public's health. The public has been highly
receptive to this change and seems to be much more discerning in making their
selections of eateries. We believe other counties must have had similar experiences
and strongly desire to see this new method of posting scores implemented statewide.
If we may be of any assistance in this process, please feel free to contact David
Rice, Health Director at (910) 343-6591. We appreciate your efforts to better serve
and protect the public's health through the assurance of a safe food supply
Very truly yours,
/ita Pt~
Gela N. Hunter, RN, FNP, Chairman
New Hanover County Board of Health
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" '/jour .JJeafth - Our priorit'j "
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STRATEGIC PLANNING PRIORITIES
December 18, 2001 Update
I. Access to health care
(Issues #7,11 & 5)
.. Janet McCumbee is representing the Health Department on a new task force called More at
Four This group has applied for funding for New Hanover County to add four year old preschool
classrooms for at risk children. The members of the task force are aware of over 100 four year
olds already determined eligible for preschool who are on waiting lists. There will be 10-25 pilots
funded in January statewide and if New Hanover County is chosen, the school system and
Smart Start will oversee this project. The Health Department will continue to be involved to
monitor the inclusion of health and developmental needs of these children.
.. On December 3 and 4, Lens Crafters completed eye exams and provided glasses to
students who had not been able to receive them with their family's resources. The effort was
coordinated through the efforts of School Health nurses, Board of Education staff and Lens
Crafters
.. Oral Health Assessments are currently being conducted for children in kindergarten and fifth
grade classes in New Hanover County 2187 students have been screened for dental disease
so far th is school year
..
II. Preventive services & lifestyle-related risks
(Issues #12 & 15)
.. TAP Program: Received the Governor's Award as Volunteer Organization of the Year as
part of World AIDS Day Celebration. TAP led the AIDS Walk in Raleigh on December 1
Congratulations!! !
.. Influenza Surveillance: The Influenza Surveillance System has 43 providers across NC
reporting weekly to the CDC on Influenza- like illnesses seen in a wide variety of practice sites.
The most recent report shows an increase in cases from 7% to 1.3 % of total patient visits were
for Ill. It's not too late to get the vaccine!
.. Hepatitis B Vaccines: Special thanks to nurses in all divisions who assisted with Hepatitis B
vaccines for sixth graders in the schools. Second doses in series have been provided.
.. Influenza vaccine campaign underway, vaccine available. State Influenza Surveillance
System shows increase in patients being seen by providers for influenza-like illness.
.. Earlier this year, the dental varnish program was started statewide. Medicaid will reimburse
physicians' offices and Health Departments for varnishing the teeth of children under age 3
years, while they are receiving their well child care. This is an important preventive service not
being offered widely in New Hanover County Janet McCumbee has discussed this with some of
the Pediatricians and has prompted the Pediatric group to have a person from the state dental
office to come speak to them on 12/18 regarding the program.
..
III. Communication, education & marketing (promotion)
(Issue #1 & 4 in part)
.. NHCBH Department Focal: A sign-up list was circulated. January and December 2002 are
available.
.. Monthly Report: Starting in January 2002, reports will have monthly narratives with
quarterly statistical reports.
.. General Clinic Bulletin Board: Sign up for the month in 2002 to reserve the Bulletin Boards
in the General Clinic waiting area. Notify Nikki Todd (6677).
.. Pink Ribbon Plus: The Pink Ribbon Plus Coalition (of the Women's Health Care Division)
decorated a Christmas tree for the Hospice Festival Of Trees. It not only included beautiful
1
ornaments, but also early detection and prevention messages throughout. The tree is being
displayed throughout the holiday season at the office of Wilmington Surgical Associates.
.. WAAV Radio: NHCHD will be scaling down our WAAV radio participation to once per month.
Dates have yet to be decided. If you want to reserve a particular month, please contact
Elisabeth Constandy (6658).
.. Annual Report: NHCHD Annual Report for 2000/2001 is available in pdf format and will be
placed on the website.
.. Pregnancy Report: Pregnancy Nutrition Surveillance Report for 1999 is available in the
Nutrition Division and Women's Health Division. The report now has county-specific data.
.. A new segment (psa) was taped for NHC-TV regarding adoption of pets during the holiday
season. It will air by the hour throughout the next few weeks.
.. The ACS MAPH group was awarded the green ribbon for most fundable project at the
November session in Durham.
.. Friends of Animals formed as a new group of citizens interested in the animals of NHC.
They held a raffle to raise funding for the shelter, specifically targeted for a wall mural in the front
office.
.. Entire issue of November 2001 EPllnfo (newsletter for medical providers) was on Public
Health Response to Bioterrorism
.. Due to the additional state funding of Health Choice this year and the lift on the freeze on
enrollment, the local coalition is back in operation. This group, including Health Department
representation, will look at ways to get the word out to low income families with uninsured
children. The coalition is also applying for a grant to hire a part time outreach/marketing
coordinator If received, the person will be housed at Smart Start.
.. NHCTV. NHC-TV is featuring a segment on ACS regarding adoption of pets during the
holiday season. It will air each hour for the next few weeks.
..
IV. Facility utilization & Information technology
(Issues #6 & 4 in part)
.. Mail Handling Procedures: Mike Winebar (NHC Safety Officer) provided training to mail
handlers on Wednesday, November 28, 2001 The new door to the mail room has been
installed. Beginning immediately, postal mail will be opened in the Mail Room. Sign will be
placed on the door - Please do not enter, knock or disturb (door will be locked until mail opening
is completed).
.. Help Desk: NHC IT has indicated that testing a new product will begin in January 2002.
.. ACS received word that the Chameleon upgrade to 32 bit will soon be available for all users.
Cost is included in the yearly maintenance fee.
.. VideoPhone Technology. The TB program is using videophone technology (equipment
purchased with grant funds) to directly observe an active case taking her medicine in her home
while the staff sees her on a television in the office. A device is installed in the patient's home on
her television, and at a prearranged time the nurse telephones the patient and observes her
taking her TB medications.
..
V. Water quality, storm water management & drainage; & Air
quality (Issues #3 & 8)
.. Enhanced Drinking Water Well Permit Procedures: A new step has been added to this
permit process to assure proper placement of drinking water wells. Site plans and property
locations are now forwarded to the New Hanover County Engineering Department for
preliminary review Engineering Department staff identify the locations of any subsurface sewer
mains in vicinity of proposed well sites. With this information, Environmental Health Specialists
assure compliance with minimum separation distances, and better protected drinking water
wells.
.. On November 21, Keith Studt was visited by Howard Varnum and his manaQement team.
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Previously we had agreed to attempt two 1000 feet lateral across center cell right in the wettest
most likely to hatch mud flats. Howard estimated four months to place these laterals. The Army
COE were pleased with find 2000 feet lateral finished within the first thirty days. I attribute this
progress to capacity of the Daewoo with oversize crane mattes to "f1oaf' our excavator in
adverse environment plus the skill level of our operator and the team support of all Vector staff.
Howard requested an additional major lateral and Keith continues to make excellent progress
with drying hatch mud. Next meeting on November 30 th will have COE engineers to measure
grades and final elevations.
.. Equipment Supports Improved Drainage: Vector Control Program staff have constructed
more extensive drainage features through dredge spoil material on Eagle Island. Equipment
purchases two years ago of a new trackhoe, large capacity dump truck and wheel loader made
this a feasible project;. Dewatering these fine silty materials dredged from the river bottom
reduces the potential for these areas to function as prolific mosquito breeding sites next spring
and summer It also makes these areas more accessible for the warranted level of larvicide
treatment from the ground. Without access, aerial applications of larvicide would be required
and would increase cost logarithmically The skill level of operator Keith Studt is continuously
tested as he uses oversized crane mats to essentially "float" the excavator through this adverse
environment;. Representatives of the US Army Corps Of Engineers made a preliminary
assessment of the first 2000 feet of ditching on November 21, 2001 and gave a very favorable
report.
..
VI. Emerging health risks
(Issue #13)
.. Bioterrorism: NHCHD BTL (Bioterrorism Leadership) Team continues its review of the
draft policies and procedures submitted to the BTL Team on November 20,2001
.. NACCHO web site on bioterrorism materials:
http://www.naccho.org/files/documents/explanatory.html
.. NC DHHS/DPH has scheduled weekly teleconferences on implementing the regional
bioterrorism teams. First teleconference was held yesterday On Friday December 7, Dave Rice
will attend an all-day work session in Raleigh.
.. North Carolina's best defense against Bioterrorism is detecting the release of an agent of
Bioterrorism as early as possible and taking aggressive action to prevent deaths. The control
measures to prevent illness and deaths must be undertaken at the local level. However, it is not
affordable to provide additional resources in today's economic environment to each of the 86
local health departments. Therefore, DPH is implementing a regional approach working through
local health departments located strategically across the state. The terrorism defense funds will
support the development of 7 regional (Buncombe, Cumberland, Durham, Gilford, Mecklenburg,
New Hanover, and Pitt) Bioterrorism Risk Reduction and Response Teams - referred to as NC
Public Health Defense Teams. The bulk of the funds will be used to provide four (4) FTEs per
each of the 7 teams across North Carolina to provide the regional expertise to support the
counties in each of their respective catchment areas (Brunswick, Carteret, Columbus, Duplin,
New Hanover, Onslow, and Pender). Not having this capacity in place puts our NC citizens at
risk should a Bioterrorism event occur The Urgency is clear based on the environment of war
at home and abroad.
.. The teams placed in the 7 host local health departments will consist of the following:
Physician (MD)/Epidemiologist, Field Investigator (Disease Investigation Specialists or Nurse
Epidemiologist), Environmental Health Staff (Industrial Hygienist or Occupational Environmental
Specialist), and an Administrative Assistant. Operating Expenses will be needed for space and
daily ongoing functionality for staff: phone, utilities, travel, communication devices (pagers, cell
phone, satellite phones etc.). Equipment needs will be one time in this year' satellite phone,
furniture, computers, lap top computers, reference manuals! guides etc.
.. Tuberculosis: TB staff are continuing to conduct massive contact investigation related to a
recentlv reported case of infectious TB. Clinic staff are administering lots of PPDs (-500).
3
.. NC DHHS/DPH continues the weekly teleconferences on implementing the regional
bioterrorism teams. Third teleconference was held on December 17 Dave Rice listed the
projects included in the Bioterrorism Implementation Plan:
Development of Regional EPI BT Teams
Develop Active and Passive Surveillance Plan - regional focus
Develop and Implement recruitment plan for Physician EpidemiologistlBioterrorism
resources
Define Regional Catchment Areas
Identify Training needs of local teams and local health department counterparts in that
region
Develop inventory of minimum equipment necessary for regional team functionality
Develop detailed plan (MOU) between Regional Teams and the State (DPH) for redirection
of resources during an emergency
Develop the Agreement Addenda and budget documents to document the Regional BT
deliverables and expectations for receipt of the Aid to County funding to the respective local
health departments.
Develop the standard connection/coordination mechanism between Regional BT Teams and
the State BT Team
Develop Environmental Health capacity at the state and Regional level to support actual
local response effort
.. Tuberculosis: The TB program continues to analyze information related to the most recent
case of infectious TB. Thus far, over 100 contacts have tested positive for TB infection, many of
whom will begin preventive therapy to prevent development of disease.
..
VII. Population growth & diversity
(Issue #2)
.. The Health Department received the HOLA Achievement award on December 4, for our
outstanding service to the Latino community
..
VIII. Discontinued services picked up by Health Department
(Issue #9)
..
IX. Staff Development & continuing education
(Issue # 14)
.. In-Service for Nursing Divisions: WHC is planning an In-Service for Nursing Divisions (and
other interested employees) on Juvenile Legal Issues. Janet Mason and Jill Moore from the
Institute of Gov't will present on this topic., and a local panel is planned to answer questions
from staff. The In-Sevice will be January 14, from 1-5 pm in the Auditorium. More info will
follow We will need an RSVP for set-up purposes.
.. Holiday Celebration: The time is drawing near (Thursday, December 13,12 - 2 pm). At this
point we have 180 folks scheduled to help us celebrate the HOlidays. We are looking forward to
a wonderful time.
.. Judy Evonko and Jean McNeil completed the Frontline Leadership Supervisory Training
series offered by Human Resources.
.. Standard First Aid wi AED Class: Jean McNeil taught the Standard First Aid w/ AED class
for NH County this past Wednesday Be sure to check your schedules for availability of future
classes.
..
X. Evaluation of services
(Issue #16)
.. Bioterrorism: NHCHD BTL (Bioterrorism Leadership) Team continues its review of the
4
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draft policies and procedures. The final three components to be completed are: Communication
Plan, Building and Grounds Plan, and Contact Telephone numbers.
~ Ground Rules: Management Team approved the following ground rules: Attendance,
promptness, meeting time (Tuesdays, 8:30 - 10:30 am), participation, conversational courtesies,
assignments, interruptions, and minutes. Management Team members will email a list of items
to the Health Director on Mondays, prior to the meeting.
~ Pre-CPT Billing: Will be submitted this week for July 1999 through June 2000. We are
estimating $45, 000 in back billing revenue.
~ Mileage: Mileage reimbursement increases to 36.5 cents on January 1, 2002.
~ Medicaid Maximization: Medicaid Cost Settlement Funding amount received of $165,773.
Budget amendment to be presented to the NHCBH Executive Committee on December 18.
Includes the following: Various Medical Program Needs, IT Request for Medical Programs,
Operable Partitions for Auditorium, and Child Services Coordination funding.
~ FY 2002-03 Budget Update: We have received information from the NHC Budget
Department. Our budget process for FY 2002-03 is underway We will develop an in-house
schedule for deadlines. There will not be any "training" provided this year for budget support
staff. Manuals have been distributed to Division Directors. Please copy as needed for Budget
Support Staff. More to come on Budget.
~ Holiday Celebration: Congratulations to Cindy Hewett, Chair, and Christmas Committee,
entertainers (staff, retirees, Board of Health members), decorators, donators of prizes and
deserts, to those who helped make the event successful, and to fund raisers. -200 plates of
food were served!
~ Pre-CPT Billing: Pre-CPT billing has been denied by EDS due to a system error (the date
over-ride was not handled correctly). The State will re-bill these services- no further action is
required by the county- this re-bill will be completely handled by the State and EDS.
~ Merit Increase Process: Due to the conflict with the Performance Appraisal Process Policy,
the Merit Increase Process Policy was referred to the Policy Team for revision.
~ Refrigerated Packages: All refrigerated packages coming into the Health Department that
are not clearly marked to go to a specific division or person are required to be delivered to a
general clinic nurse. This item was referred to the Policy Team.
~ ACS Pre-Citations: ACS has been sending out multiple months of pre-citation letters to
bring licensing status up to current status. This effort was to bring citizens through the holiday
and tax season with ample opportunity to pay their license fee without penalties.
~
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Contributions Received
Expenditures
Vendor
Wilmington Academy of Music
Dock Street Printing
Kenny Barnes
Dock Street Printing
4 Seasons Trophy Shop
Party Suppliers & Rentals
Pat Johnson
Elisabeth Constandy
Lynda Smith
Gallo's Florist
Linprint
Port City Sign Works
Pitney Bowes/US Postmaster
Kenny Barnes
Total Expenditures
Balance Unspent
New Hanover County Health Department
Dr Frank Reynolds Tribute
Item Purchased
Musical Entertainment
Invitations
Balance Owed on Portrait
Cards and Envelopes
Plaques
Table & Chair Rentals
Supplies
Supplies
Art & Frame
Flowers
Programs
Plaques
Postage
Portrait Deposit
As of 12/14/01
PV
5131-2257
5131-2261
5131-2267
5131-2268
5131-2273
5131-2274
5131-2279
5131-2280
5131-2281
5131-2282
5131-2285
5131-2287
5131-2299
$9,675.00
Amount
$775.00
$92.06
$1,344.00
$123.60
$38.20
$140.00
$1.99
$29.80
$48.99
$250.00
$1,118.20
$165.00
$102.00
$1,200.00
$5,428.84
$4,246.16
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e
NAME:
PRESENT
POSITION:
CURRICULUM VITAE
Charles John Schleupner, M.s., M.D.
Professor ofInternal Medicine
University of North Carolina School of Medicine
Head, Department of Medicine
Coastal AHEC Director, Residency in Internal Medicine
New Hanover Regional Medical Center
2131 So. 17th. Street
Wilmington, North Carolina 28402
Telephone (910) 343-0161 (244) FAX. (910) 762-6800
E-Mail: Charles_SchIeupner@med.unc.edu
DATE OF BIRTH: February 12, 1945
PLACE OF
BIRTH: Baltimore, Maryland
SECONDARY
EDUCATION:
Loyola High School
Towson, Maryland 21204
_OLLEGE EDUCATION:
School
Dates
Del!:ree
Loyola College of Maryland
9/63 - 6/67
B.S. Biology
GRADUATE EDUCATION:
University of Pittsburgh 9/67 - 8/68
Graduate School of Public Health
Pittsburgh, Pennsylvania
M.S. (Hygiene)
Microbiology
University of Maryland 9/68 - 6/72
School of Medicine
Baltimore, Maryland
M.D.
PROFESSIONAL TRAINING:
Johns Hopkins School of
Hygiene and Public Health
Dept. of Epidemiology
Research Asst.
~~;uversity of Utah
~ledical Center
Dept. of Medicine
Medical Intern
(Revised 08/28/2001)
1
Date of Del!:ree
06/04/67
08/15/68
06/02/72
June - August,
1969-70
7/1/72 - 6/30/73
~
PROFESSIONAL TRAINING (continued):
University of Utah
Medical Center
Salt Lake City, Utah
Dept. of Medicine
Medical Resident
7/1/73 - 6/30/75
e
University of Utah
Medical Center
Salt Lake City, Utah
Dept. of Medicine
Division ofInfectious
Diseases
Fellow
7/1/75 - 8/15/77
MANAGEMENT TRAINING:
Selected for "Leadership Roanoke Valley" program sponsored by Roanoke Valley Chamber of
Commerce, 1990-91.
Selected Participant, Management Training sponsored by Department of Veterans Affairs and American
College of Physician Executives, 8/31-9/3/92, Boston.
Selected Participant in "Clinical Manager's Institute" 2 week program sponsored by the Veterans Health
Administration and run by FOCUS Consulting Group, January (San Francisco) and May (Denver), 1993, (dealt
with issues of self evaluation, conflict resolution, strategic negotiation, continuous quality improvement,
managed health care, etc.)
TQI and Baldridge Management System Retreat, March 7-8, 1996; Kit Management Consultants, RegiOn_
Medical Education Center, Durham, N.C.
Participant and Discussion Group Leader, Association of American Medical Colleges Meeting on "Implications
of the Evolving Health Care System for Academic Medicine: Defining the Role of the Clinical Department
Chair", Washington, D.C., 01/29-30/98.
BOARD CERTIFICATION:
Diplomate of the National Board of Medical Examiners, July 2, 1973
(Certificate # 126194)
Diplomate of the American Board ofInternal Medicine, June 18, 1975
(Certificate # 052398)
Diplomate of the American Board of Internal Medicine, subspecialty examination in Infectious Diseases, June
27, 1978 (Certificate # 052398)
Diplomate of the American Board of Pathology Exam for Special Qualification in Medical Microbiology, May
30, 1984
e
2
r
~. ".
Published for Members of Local Boards of Health
President's
Message
Harvey A. Wallace, PhD
~-
;,.
,~ ~
The events of September
11 are still too recent to i ...
fully comprehend. The
evening following the
terrorist attack, I was
having dinner with a
colleague, a professor of I
clinical dietetics who was c
born and raised in Cairo and is a Muslim, Early in the evening, he
received a telephone call from another university professor who
asked my friend to speak to his intro to sociology classes; a group
of over SOO anxious, angry and somewhat frightened students.
CltiPIY that by the millions of Americans who were also seeking
""ers to the unanswerable. My Egyptian friend could only hope
, "plain to our students that they had nothing to fear from true
Muslims. The fact that they were a thousand miles away from the
tragedy doesn't really matter in today's world. We all know some-
one - a relative, a friend, a neighbor, a colleague, or a loved one -
with some connection to these events. There's no doubt in my
mind that this tragedy will make us stronger.
As many of you who have read my previous messages know, I
have been representing NALBOH at several CDC-sponsored work
group sessions regarding local public health's levei of
preparedness for bioterrorism. Thankfully, several years ago our
leaders recognized the inadequacy of the current public health
infrastructure and began planning for the time when we'd be giv-
en the tools to improve the structure. It appears that the time is
near. Just this morning (10/03/01), I heard Senator Ted Kennedy
on the Today Show tell us he and Senator Frist would be speaking
to the Senate Hearing on Bioterrorism that
afternoon. Senator Kennedy indicated that he would be asking for
$1.4 billion to fund the Public Health Threats and Emergencies
Act. This money would be dedicated to the improvement of the
local response to bioterrorism. Programs would be developed to
train medical personnel to make rapid and early detection of dan-
gerous diseases. The public health system would be prepared to
detect, respond, and contain the event. Much has already been
done to get us ready. However, much more needs to be accom-
plished. Overnight the world order has changed dramatically. Per-
haps we are on the threshold of a better world, one dedicated to
r- 'er cooperation and greater peace.
,
Tt1e NALBOH board of directors came together in Atlanta a few
days before the opening of the annual conference of the American
Public Health Association where over ten thousand of our closest
Continued on Page 2
'Unitt''' -"W~ Sfand
IIlIIIlI
November 200 1
U.S. Surgeon
General to Boards
of Health:
You Can Make The
Difference
David Satcher, MD, MPH,
U.S. Surgeon Generai
Dr Satcher;s a Lifetime NALBOH
Member and has served as Keynote
Speaker at NALBOH's Nationai
Conference
More than 20 years ago, the Nation
embarked on a significant journey to
make our communities healthier and happier places. Using the Healthy
People Initiative, which began in 1979, we have learned that we can
make a differenre. The current phase, Healthy People 2010, is a set of
health objectives for the Nation to achieve over the first decade of the
new century. It can be used by many different people, States, boards
of health, communities, professional organizations, and others to help
them develop programs and policies to improve health.
Healthy People 2010 (HP 2010) has two overardling goals: to increase
the quality and years of healthy life of all Americans and to eliminate
disparities in health status. Its vision is deceptively simple: Healti1y
People in Healthy Communities. But to reach these goals, to achieve
ti1is vision, we must all wor1< together - individuals and communities
alike.
HP 2010 builds on initiatives pursued over the past two decades.
The 1979 Surgeon General's Report, Healthy People, and Healthy Pe0-
ple 2000: National Health Promotion and Disease Prevention Objec-
tives both established national health objectives and served as the
basis for the development of State and community plans. Uke its pre-
decessors, HP 2010 was developed through a broad consultation pre-
cess, bui~ on the best scientific knowledge and designed to measure
programs over time.
The 28 focus areas of HP 2010 were developed by leading
Federal agencies with the most relevant scientific expertise. The
development process was informed by the Healthy People
Consortium - an alliance of more than 3S0 national membership
organizations and 2S0 State health, mental health, substance
abuse, and environmental agencies. Additionally, through a se-
ries of regional and national meetings and an interactive website,
more than 11,000 public comments on the draft objectives were
received. The Secretary's Council on National Health
Promotion and Disease Prevention Objectives for 2010 also
Continued on Page 4
NALBOH Nev.'sBrief
President's Message...Continued from Page 1
friends gathered. The Executive Director of APHA is Dr.
Mohammad N. Akhter and the President is Michael E. Bird.
Together they have asked the public health community to
consider the following five propositions:
1) War is the enemy of public health;
2) Diversity is our strength;
3) Funding for public health must be bolstered;
4) Promote reasonabie protections for civil liberties; and,
S) Discover what you can do to aid in this crisis.
As members of your iocal boards of health, I urge you to reflect
on these important propositions and then act to improve the
health of your communities. 0
DeKalb - Fulton County (GA)
Bioterrorism Response Plan
As you read about in our last NewsBrief (August 2001, page 4,
"DeKalb County Board of Health's Center for Pubiic Health
Preparedness), DeKalb and Fulton Counties have produced a
blueprint for formulating a comprehensive plan and set of
procedures to guide all agencies in metropolitan Atlanta that are
responsible for detecting and responding to bioterrorism events.
The following is from the introduction of this plan document.
"Recent worldwide events have forced all levels of government
in this country to address the issue of domestic preparedness
and their own respective capacities to respond to terrorism.
Terrorism is the threat or use of force or violence against per-
sons and property to achieve political and social ends and is
usually associated with community disruption, injuries and death."
DeKalb County has generously shared a limited number of cop-
ies of its pian document for distribution to interested NALBOH
members. The guide is for those who would like an introduction
to bioterrorism, for those who are interested in reviewing
response protocols, and for information on speCific biological
agents. For a free copy of DeKalb and Fulton Counties
Bioterrorism Response Plan CD, please contact NALBOH at
Phone: (419) 3S3-7714, Fax: (419) 3S3-7714 or E-mail
<nalboh@nalboh.org>
NALBOH Officers
The NALBOH NewsSriefis published by the
National Association of Local Boards of Health
1840 East Gypsy Lane Road
Bowling Green. OH 43402
Phone: (419) 353-7714
Fax: (419) 352-6278
Email: <nalboh@nalboh.org>
Website: <www.nalboh.org>
President
Harvey A. Wallace (MI)
President-Elect
Phil Lyons (UT)
Secretaryffreasurer
Stephen Papenberg (N])
The production and distribution of this publication are
supported by funds from the Centers of Disease Control
and Prevention.
Page 2
November 2001
New Jersey Award Given to
Annette Kovacs, Keyport Board of
Health Cd)
The New Jersey Local Boards of Health Association (NJLBHA) held
its Annual Training conference September 29 at the
Paramus NJ High School. More than ISO members of local boards
of health and health officers attended the day-long session. One of
the highlights of the session was the presentation of the
Christopher Saccenti Award to Annette Kovacs, President of the
Keyport Board of Health. This award is the highest award
presented to a member of a New Jersey Local Board of Health and
is given for exceptional service to publiC health.
Annette has been active in iocal public health issues in Keyport NJ,
Monmouth County, for 10 years. She served on the Keyport Board
of Health since 1990 and serves as its president for the last 3 years.
Additionally, Annette has served selflessly as Treasurer of the New
Jersey Locai Boards of Health Association since its inception in 1991.
Annette epitomizes the commitment of local board of health mem-
bers.who perform their responsibilities and tasks behind the scenes,
doing whatever it takes to get the job done. She has not only
served her community but the entire state through her contribu-
tions to many of our statewide projects. She saw in the beginning
of our efforts to create a state association, the great potential for
common growth and assistance for board of heath members in
joining together to better serve our communities and the citizens of
the state as a whole. []
Requests for Articles and Meeting" )
Announcements
NALBOH wouid like to receive announcements and articles for
future issues of the NewsBrief. If you have a topic which wouid
be of interest to other local boards of hea~h, please let us know.
We are aiso interested in publishing upcoming
conference announcements and meeting dates. The next publi-
cation deadline is January 10, 2002
Pieasemail your articles and/or announcements 10 NALBOH at
1840 East Gypsy Lane Road, Bowling Green, OH 43402. Or fax
to (419) 352-6278. or email us at <nalboh@nalboh.org> []
NALDOH Trustees
North AtJantic
Shepard Cohen (MAl
Mid Atlantic
John C. Saccenti (NJ)
Southeast
J. FrederiekAgel (GA)
East Great Lakes
Jim Recchio (OH)
West Great Lakes
Ken Hartke (IL)
Midwest
Diane Wartgow (CO)
West
Connie Tatton (UT)
State Affiliate
Barbie VanderBoegh (ID)
State Affiliate
Ronald Burger (GA)
NALDO" Staff
Executive Director
Marie M. Fallon, MHSA
Director of Liaison &
Governmental Relations
Edwin "Ted" Pratt, Jr., MPA
Tobacco Control Consultant
Rebecca Edwards, MPH
Project Director~ Tobacco
Sylvia Beck, MPA
Project Director-Training
Sarah Chard. PhD
Project Coordinator
Jennifer O'Brien, MPH
Administrative Assistant
Grace Serrato
NewsBrief Editor
Fleming Fallon, MD, DrPH
-"
.J
r
i NALBOH NewsBrieJ
,
C)
~"".
Report from Washington
Edwin "Ted" Pratt, Jr., MPA
Director of Liaison and Governmental Relations
Everything has changed here in DC
since the horrible events of
September 11'" and yet, in many
ways, things are just the same. There
is increasing talk of public health in-
frastructure and
preparedness. Between the
existing Frist-Kennedy Public Health
Threats and Emergencies Act of 2000 and the
newly introduced Edwards-Hegel bill The Biological and
Chemical Weapons Preparedness Act, billions of dollars are be-
ing put into place. There has never been anything like this in
the recent history of public health in this country - we have to
go back to the turn of last century when the massive
investments in sanitation and public health infrastructure blazed
the path to astonishing improvements in the health status and
life expectancy for most Americans to see similarities.
This is potentially good news for local boards of health as they
grapple with the combined problems of developing greater pre-
paredness within the jurisdictions they serve while facing often
drastic cuts in funding as many states confront
substantiai budgetary shortfalls. As I write this, the Governor of
California, Grey Davis, is asking for 15% cuts in
departmental budgets. Local governments now find
themseives in the all-too-familiar situation of needing to do more
with less.
On the face of these difficulties, the Frist-Kennedy process offers
the real possibility of additional resources for local public health
agencies. However, local boards of health and health depart-
ments are going to have to be proactive if they are to participate
in the decisions regarding distribution of these funds. The fed-
eral agencies making distributions, primarily the
Centers for Disease Control and Prevention (CDC), will be work-
ing directly with the 50 states and 7 territories. Except for a few
of the nation's larger cities working directly with federal agen-
cies, it will be at the state and territorial level that local public
health agencies will need to work to insure their involvement in
the decision-making process.
There are two stages to the Frist-Kennedy process.. The first,
referred to as 319B, is to fund state-wide preparedness
capability assessments. This has been described to us by
senior CDC officials as being essentially assembling an inventory
of needs suitable for developing a grant application requesting
funding for specific state public health system preparedness ca-
pacity and capability enhancement. The states then
prepare these applications for competitive grants under the sec-
ond stage 319C process. CDC maintains a web page on bioter-
rorism and preparedness which can be accessed through its main
web site <www.bt.cdc.gov>
i
I
II
II
I
:1
It must be remembered that the Public Health Threats and Emer-
gencies Act of 2000 envisioned an orderly, long term, systemat-
r;c process for developing preparedness capability and capacity
~ ,t ail levels of the public health infrastructure. This has all
changed with the urgency forced upon us by the
attacks on our country. While there have yet to be changes
made to the legislation, it is hard to Imagine that the actual
disbursement of funds will follow a long evaluative
-- - - - -- -N~vemb~;2001l
--- - - ~"~
process, let alone a competitive one. Boards of health and local
health departments must be forceful in making their voices heard.
The first step in insuring that local boards of health playa role in
this process is to be certain of good communications with other
elements of local government. In particular, boards of health
should work to insure that they and members of the local health
department are properly represented on any local government
committees or task forces that work on emergency
preparedness and response issues, and that the governing body,
county commission, selectmen, mayor, etc., are updated on pub-
lic health issues. Dispatch and response protocols need to be
reviewed and assessed in light of the need to protect first
responders. Including non-governmental public health and health-
care agencies is critical as the first cases of bioterrorist-event
illness willlikeiy show up in emergency rooms or other ambulato-
ry care facilities. In the end, because of the scarcity of funds
even with these new federal grant programs, there will be com-
petition for funds. The more that local agencies within a jurisdic-
tion can work together, and the more that neighboring jurisdiC-
tions can as well, the more likely receiving funding will be.
Finally, local agencies should consider making use of state public
health organizations to press for adequate representation in the
State's response to the 319B and 319C grants process. State
associations of boards of health, state health officers'
associations, public health associations, municipal associations
or others can be important allies and spokespersons at the capi-
tol. It is clearly essential to have good communications with your
state's health and emergency response departments. Don't wait
to be contacted, go and meet with them, put faces to names and
let them hear directly the concerns and needs of your communi-
ty.
As I wrote in the beginning, everything has changed,
everything remains the same. Even with this unprecedented na-
tional emergency, even though it is clear that preparedness for
bioterrorist incidents is a public health infrastructure issue first
and foremost, you will still have to use those tried and true lobby-
ing and political techniques to assure that local publiC health gets
what it needs. One of the most important roles for local boards
of health is advocacy, advocating on behalf of the people they
serve for the resources, information, and training needed to pro-
tect their health. As always, it is trying to do more with less - but
maybe this time we'll have a little less of less
Note: NALBOH is developing bioterrorism and emergency
preparedness information for the use of local boards of health.
Check our website at<www.nalboh.ora>! []
Check out our Website!
<www.nalboh.org>
If you have not checked out our website, then now is the
time. Our website has really expanded. We are trying to
meet the needs of all NALBOH members. We welcome
suggestions on how to improve our site. Email your
feedback to <nalboh@nalboh.org> Remember, our goal is
to assist local boards in providing up
to date information and training. []
~
Page 3
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I NALBOH NewsBrieJ
u.s. SUrgeon GeneraI...Continued from Page 1
provided leadership and advice in the development of national
health objectives.
Healthy People objectives have been specified by Congress as the
measure for assessing the progress of the Indian Health Care Im-
provement Act, the Maternal and Child Health Block Grant and
the Preventive Health and Health Services Block Grant. H~althy
People objectives also have been used in performance
measurement activities. For example, the National Committee on
Quality Assurance incorporated many Healthy People targets into
its Health Plan Employer Data and Information Set (HEDIS(R))
3.0, a set of standardized measures for health care purchasers
and consumers to use in assessing performance of managed care
organizations in the areas of immunizations, mammography
screening, and other clinical preventive services.
The success of a Healthy People initiative (national, state, or
local) depends on sustaining the process, particularly as
leadership, administrations, and policymakers change. Initial
commitment and energy of community partners in identifying needs
and setting objectives or targets is only the beginning of the pro-
cess. Sustainabillty and institutionalization of Healthy People in
day-to-day activities of many people in diverse organizations is
necessary in order to achieve objectives. Commitment is not a
one-time event, but must grow throughout the next decade.
Individuals, Boards of Health, and organizations are encouraged
to integrate HP 2010 into current programs, special events,
publications, and meetings. Businesses can use the framework,
for example, to guide worksite health promotion activities as well
as community-based initiatives. Schools, colleges, and civic and
faith-based organizations can undertake activities to further the
health of all members of their community. Health care providers
can encourage their patients to pursue healthier lifestyles and to
participate in community-based programs. By selecting from among
the national objectives, individuals and organizations can build an
agenda for community health improvement and can monitor
results over time.
vested communities created a strong demand for continuing the
2010 objectives. Virtually all states and 70% of iocal communities
participated in the year 2000 initiative. A critical mass of
participation and positive peer pressure fuel partners' continued
desire to be "on board" this popular initiative.
Another reason for the sustainability of the Healthy People
Initiative is the many Consortium members from the private and
voluntary sectors who have used and promoted the objectives as
a framework for their constituents' action. As an example, the
American Hospital Association developed Healthy Peopie 2000:
America's Hospitals Respond, a resource kit for hospital
administrators to help mobilize health promotion initiatives. The
American Dietetic Association (ADA) developed Call to Action to
inspire its more than 64,000 members to pursue the nutrition ob-
jectives. These and other initiatives of Consortium members con-
tinue to sustain Healthy People at multiple levels.
All states and territories identify Healthy Peopie state action
contacts. Among these, four have appointed staff solely
devoted to Healthy People Coordination. These four state action
contacts have been instrumental in establishing a development
plan early and sustaining the effort throughout the decade. A cur-
rent listing of the state action contacts is included in the
Toolkit and available at: <http://www.health.gov/healthy
people/Contact/StateContact.htm>
r
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I
November 200 ~
You may be wondering how to use the HP 2010 objectives after
you've determined which issues are most important in your
community. ("\'\
\.dJ1
Here are four simple steps you can take:
Step 1. Decide on which issue your community wants to focus its
efforts. How: There are many ways to determine which issue to
address. For example, you can talk to your neighbors and friends
about what is important to them, or get information about health
problems from local health agencies.
Step 2: Get a copy of HP 2010 and identify the objectives that
relate to your issue. How: Contact your local health department
or library or search on the Internet at <http://www.health.gov/
healthypeople>
Step 3: Use the objectives and background data in Healthy Peo-
ple 2010 to set goals for your community efforts. How: Pick
objectives and information based on your group's understanding
of the conditions in your neighborhood or community. Using the
help of a health professional, such as a public health officer, is
strongly recommended for this step.
Step 4: Begin to design your board's action plan, based on the
objectives you have chosen. How: Design programs, policies, or
activities so that they will help make improvements in the health
of your,community.
Here's how the Healthy People initiative has been implemented in
several states and communities:
o In Polk County, Iowa, Healthy Iowans 2010 informs businessO
government, nonprofit and citizen leaders about local performance
on Leading Health Indicators. Based on available data, leaders
have mobilized disparate groups to work together on priorities.
Healthy Iowans 2010 will allow them to track performance and
hold leaders accountable for resuits.
o North Carolina established an Office of Healthy Carolinians that
is responsible for keeping the initiative on track. Staff are
available to North Carolina counties for support and training,
particularly coalition building. There is also a Governor's task force
that certifies counties in the Healthy Carolinians project. The coun-
ties do an assessment and then implement an action plan.
o After the Columbine High School shootings, concerned
citizens in Lafayette, Louisiana, formed a community task force on
the prevention of violence in schools. In concert with local school
officials and psychologists, the task force proposed closer moni-
toring of cases of anger and early intervention with
professional help to defuse potentially dangerous situations. HP
2010's Focus Area on Injury and Violence Prevention has been
helpful as a guide for assessing workable solutions.
o The Iowa State Department of Health is working with the Har-
din Library for the Health Sciences and College of Medicine at the
University of Iowa in establishing listservers by teams, by team
leaders and facilitators, and for all chapter team members with e:--
mail addresses, so they can interact via the Internet. This is a kf \
component in the communication process. J
o An urban core neighborhood of Kansas City, Missouri, had
become concerned about crime and safety. The neighborhood
Contin~ on Page 5
NALBOH NewsBrief
u.s. Surgeon GeneraL.Continued from Page 4
decided to do something, but wanted to know when its efforts
. made a difference. They decided to use HP 2010 objectives for
IC.ssaUlts as their measure of progress, and they began to collect
~..:-.~nme reports for their neighborhood.
o The Benchmarks Project was a part of Oregon's strategic plan
and is therefore supported by the Governor. State Healthy
People objectives infiuenced the selection of Oregon benchmarks.
The Oregon Progress Board monitors the benchmarks and
reports on progress toward long term performance targets.
Oregon Benchmarks are part of the biennial budget process.
Agencies must identify benchmark links and report on progress
toward achieving the performance targets. Results are reported in
a biennial report to the legislature.
The road to improving health for all is wrought with obstacles. We
cannot let our resolve fail We must continue to work
together to make certain the benefits of health are available to
all. 0
Nationwide Toll-Free Poison
Center Number
Americans now have a free and easy way to access poison
control services. A toll-free, nationwide hotline proVides callers
across the country with reliable information and advice in the
event of a poison exposure. The service is available 7 days a
week, 24 hours a day.
Ohe toll-free number is the result of a cooperative effort
between the Centers for Disease Control and Prevention the
Health Resources and Services Administration and'the
American Association of Poison Control Centers (AAPCC). The
effort was made possible through the Poison Center
Enhancement and Awareness Act of 2000, which provided
$20 million in FYOl to enhance poison prevention and
treatment services. With that funding, AAPCC has also
developed an education campaign to increase awareness about
the toll-free number and about poison prevention.
In 1999, health care facilities treated 570,000 people for
poison exposures. That same year, poison control centers in
the United States reported approximately 2.2 million poison
exposures, 873 of which resulted in death. The majority of
these poison exposures occurred at home and among children
under age 6. At home, children and adults are exposed to
numerous potential poisons such as pain relievers,
antidepressants, cardiovascular drugs, stimulants, alcohois, gases
and fumes, and chemicals. Potential exposures on the job
include inhalation and other contacts with chemicais. 0
r.
Li
Nationwide Poison
Information Center
(800) 222-1222
November 2001 :
Public Health Needs Harmony in
System Interaction
Gayle Judd, President, Utah Association of Local Boards of Health
o We need to view the whole picture with all parts, big and small.
o We need to emphasize patterns of change over time rather
than static and repetitive discussions of behavior or activity.
o We need to focus on integration interconnectedness and on
interrelationships rather than on accusational cause-and-effect
behavior.
System thinking indentifies the interdependencies of public health
at all levels and shows the need for interconnected, interdepen-
dent health boards and health departments to work as one. The
concept of being a system must be our way of thinking and
acting so that the system becomes the focal point rather than
anyone subsidary organization or individual.
Becoming a system thinker can be a difficult transition because
traditional loyalty to our own local boards and health
departments must be set aside and replaced with loyalty to the
entire system. Board members or leaders who cannot see the
bigger picture but rather remain focused on their own local or-
ganizations may not be focusing on improving health care but
rather protecting their turf.
System thinkers know that doing the same things better is no
longer good enough. Doing new things, and continuously doing
them better, is the way to create a new and functional reality
statewide. System thinkers place the best Interests of the sys-
tem above those of the institution from which they come.
It is easier to talk about public health than it is for health care
leaders to protect and improve it. According to recent study by
the Healthcare Forum, the critical determinants of a healthy com-
munity include the following:
. Low crime rate
o Good place to raise children
o Not afraid to walk late at night
o Good schools
o Strong family life and a low level of child abuse
o High environmental quality
o Good jobs and a healthy economy
o Affordable high quality health care
Health care leaders know that public health is not a single event
or issue, and that everything is reiated to everything else.
System thinking, including c011aboration with other systems, is
absolutely critical.
More progress in funding public health will be made for all local
public health organizations if it is approached as a statewide
system rather than anyone local organization or individual. Once
a meaningful and clear legislative plan has been developed for
the statewide system, all components and parts of the system
must work toward the goals of the plan. We need to merge with
one focus as a united public health system. 0
Page 5
!
L~~;;ewsBrieJ
November 2001
NAlBOH AdbrI1i~
Director of Liaison and
Governmental Relations Visits
West Virginia
The west Virginia Association of Local Health Departments
is in the final stages of formation. In West Virginia, local
health departments are overseen by governing boards of
health appointed by county commissioners, They receive
one-third of their funding from local taxpayers directly, the
county commissioners, and from the West Virginia
Department of Health and Human Services respectively,
State funding is based on a per-capita formula, The
meeting was chaired by John Bertram from the Brooke
County Health Department.
Ted Pratt, Director of Liaison and Governmental Relations,
was the lead speaker where he shared information about
NALBOH and the National Public Health Performance
Standards, NALBOH will continue to provide assistance in
the development of a West Virginia State Association of
Local Boards of Health,
The attendees were very focused on a number of funding
issues before the West Virginia Legisiature, 0
NALBOH Representative Attends
Annual Symposium for UT Boards
Ted Pratt attended the Utah Association of Local Boards of
Health (UALBOH) Steering Committee where the
discussion centered on the problems of finding nursing and
other qualified public health staff, especially for the more
rural counties and the upcoming consequences of state
budgetary problems.
Ted Pratt was the luncheon speaker and gave an update
on NALBOH activities and projects, a brief summary of
NALBOH history, and then discussed NALBOH's future
priorities, emphasizing the importance of successfully
establishing itself on the national scene, as well as, assisting
the state associations in their efforts to establish and
sustain the promotion of public health. 0
NALBOH Representative and the
Task Force on Community
Prevention Services Meeting
Regional Trustee, Fred Agel (GA), attended this meeting
dealing with the Violence Prevention Chapter (VPe) and
discussed Firearms Legislation, Also reviewed was the
Sociocultural Environment Chapter, The Cancer Chapter
discussion dealt with social and behavioral changes and the
numerous methods of treatment intervention available to
make informed decisions, The task force agreed to further
review the 6 studies now availabie. The VPD Chapter dis-
cussion targeted Vaccine Strategies, and after considerable
discussion, suggested that follow-up is necessary for high
risk because of medical conditions under 65 years of age.
o
~;6
NALBOH Representative Visits
Colorado
()I'
Ted Pratt, NALBOH Director of Liaison and
Governmental Relations, attended the EI Paso County (CO) Board
of Health meeting to brief the board and senior health depart-
ment staff in preparation for their pilot testing of the National
Public Health Performance Standards Program (NPHPSP) Gover-
nance Instrument.
Ted Pratt presented the background on the NPHPSP
Rosemary Bakes-Martin, EI Paso County Health Department
Deputy Director and former CDC NPHPSP Project Director, also
contributed to this presentation, Members of the board asked
questions about the process and applicabiiity of the instrument
to their special circumstances. It was explained that each
jurisdiction had unique circumstances and issues, and that their
input into how we could make the instrument better capture this
uniqueness would assist NALBOH in improving the entire tooL
Martin Thrasher, attorney for the board, and Ted Pratt
discussed the possible participation of NALBOH in working
together in developing policy and operational guidelines for the
EI Paso County Health Department based on the NPHPSP 0
President-Elect and Executive
Director Train in Boston, MA
o
Phil Lyons, NALBOH President-Elect and Marie Fallon, Executive
Director attended the Seminar for Non-Profit Board Chairs and
CEOs held in Boston, MA. Each board chair was asked to briefly
describe the greatest governance challenge their organization
faces.
The attendees had an opportunity to work on case studies and
to help solve the problems in the studies, After each
session there was time to work together on issues that were
presented, Eight nonprofit boards were represented. It was
helpful to interact with other boards and to hear first-hand the
problems that they face. This seminar was very helpful and the
many things learned will be used within NALBOH to make it a
more effective and efficient organization to better serve its
members. 0
NALBOH Representative on the
Council on Linkages
Regional Trustee, Fred Agel (GA), attended this meeting
reviewing the action pian for Core Competency with
discussions on PRjMarketing, examples, tools, and technical
assistance, There was a session on this at the American Public
Health Association's Annual Conference. A combined report dealt
with the activities of Public Health Services Research and
Research America. RA is in the process of identifing partners '\
for forums and state polls, The strategy will be to present to J
nonscience groups. The Association of Schools of Public Health
Academic Public-Health Centers Workforce is in the process on
working on its agenda. NALBOH is a member of this steering
committee. 0
~
November 200 1 1
]J
, NALBOH NewsBrieJ
!
d
, .
~ A Look At NALBOH Membership
There are approximately 3,22S local boards of health across the country. In six years, NALBOH membership has increased seven-fold
from 3% to 21%. The three states with municipality-based boards: New Jersey (S41); Massachusetts (322); and New Hampshire
(233) represent one-third of all local boards of health.
Voting:
NALBOH has two voting and five non-voting membership classifications:
Non-voting:
800
700
600
500
400
() 300
200
100
0
Institutional
Affiliate
Associate
Retired
Lifetime
Sponsor
Student
=
Local, Tribal, or State Board of Health
State Association of Boards of Health
Individual or organization (i.e., State DPH)
Former board of health member
Board-granted honor
Sponsoring entity
Currently enrolled student
=
=
=
=
=
D Spon sor
. Lifetime
D Retired
D Associate
III Affliate
Din stituti onal
1993
1994
1995
1996
1997
1998
1999
2000
2001
There is a clear correlation between a strong state association of boards of health and NALBOH membership, making the support and
strengthening of existing associations and the establishment of new ones a key part of NALBOH's membership development strategy.
Current 2001 accomplishments include:
1. Live telecast of the second Ned E. Baker Lecture Series presented via satellite to boards of health across the country
2. Refining the Governance Standards in collaboration with our public health partner organizations as part of CDC's National
Public Health Performance Standards Program
3. Continuing efforts to control the use of tobacco in our communities
4 Maintaining a Government Liaison Representative in Washington, DC
S. Developing an environmental health primer for local board of health education
6. Working on CDC's Task Force on Emergency Public Health Preparedness and Response
7 Convening the 9~ Annual NALBOH Conference in Cleveland, OH
8. Developing a public health resource guide to the Internet, available through the NALBOH website
Current NALBOH members will be receiving their membership directories this month with a membership drive letter from NALBOH
President Harvey A. Wallace. This is the kick-off of our 2002 Membership Drive. In the current state of heightened public health
awareness, now more than ever, Americans depend on their local health departments and local boards of health. As a NALBOH
,1('11ember, you can be assured that we represent your concerns and interests at the highest levels of government. Through your
llembershiP, you have access to a national network of other board of health members as well as access to programs and materials
designed speCifically for boards of health.
You will soon be receiving an invoice for 2002 membership in NALBOH. An application is also provided on page 14 of this publication.
Don't be left out - this is the time to be involved, informed and active in promoting and protecting the health of your communities.
We look forward to your membership and active involvement in NALBOH. D
Page 7 l
~______________~____.....-.......-J
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NALBOH NewsBr;~f
Public Health Response After the
Attack on the World Trade Center
New York City, September 11,2001
Ronald C. Burger
Senior Emergency Response Coordinator,
Centers for Disease Control and Prevention (CDC),
NALBOH State Affiliate Trustee
Reporting from the scene in New York City
September 28, 2001
Just after 8:30 am on Tuesday, September 11, 2001, in the midst
of a typical New York City lower Manhattan rush hour, out of the
sky came not one, but two jumbo jets crashing into both of the
World Trade Center giant towers. The rest is history in New York
City and all across America.
I was notified of the first plane crash on my pager. I immediately
thought that it was a terrible accident caused by a medical
emergency in a light aircraft. Then reports came in on a second
plane crashing into the southern tower. I knew it was an act of
some sort of terrorism. I immediately flashed back to the mid-70s
and early-80s when I used the World Trade Center subways
commuting to my position as the Deputy Director of the New York
City Department of Health's (NYCDOH) Bureau of TB Control. It
hurt badly.
Our Emergency Response Operations Center was immediately
opened as we contacted our Response Team. At the same time
we made telephone (cellular) contact with officials at the
NYCDOH. By 2:00 pm, CDC officials approved the deployment of
our National Pharmaceutical Stockpile "push package" to be sent
by truck to New York City. At 5:00 pm with only the clothes on my
back, I joined 6 members of the Stockpile Technical Support Team
and 4 medical epidemiologists from CDC to charter an
airplane to head for laGuardia Airport in Queens, New York.
As we aligned for our approach into laGuardia, we flew right
beside the vacant land, which once stood the massive Trade
Towers. It was so very sad to see the pile of rubble at ground zero
still smoking. I said a little prayer as we speeded in for a safe
landing. I was very excited yet very emotional. New York City
was my town for 8 years at one time in my 30 years in public
health.
By g.OO pm, I was at the Mayor's Office of Emergency
Management then headed downtown to the NYCDOH
headquarters just 5 short blocks from ground zero. Our stockpile
team headed for the warehouse to await the materiel. Our
medical epidemiologist joined their NYCDOH counterparts and
headed to the local Manhattan hospitals that took care of the im-
mediate injuries. They were going to collect the numbers and
extent of the immediate injuries.
Even though the NYCDOH has many public health workers, they
needed additional outside assistance from CDC as well as the
National Disaster Medical System including Disaster Medical
Assistance Teams, Veterinary Medical Assistance Teams, Disaster
Mortuary Assistance Teams, and Disaster Mental Health Assistance
Teams. There have been over 600 US Department of Health and
Human Services staff on-site.
The NYCDOH has been responding outstandingly. Its staff and
command center has been up and running 24 hours a day 7 days
a week. I am so very impressed with this local health department.
I am so proud to be here assisting them.
Page 8
November 2001
Some of the public health issues that are being worked on by the
NYCDOH staff and CDC are as follows: collection of the injury
information of people injured at the time of the attack and some
days later; enhanced syndrome surveillance system at 1m '
hospital looking for any unusual medical occurrences; rescue work~)}
injury/illness surveillance system at the Disaster Medical Assis-
tance stations in and around ground zero and 4 nearby Emergen-
cy Departments. The Environmental Health issues have been
massive: providing recommendations for personal
protective equipment to be worn by the responders working on
the rubble and in other areas; sampling the ash and the air in the
area as well as the air at the responders breathing zone;
inspecting all of the food services being provided to all of the
responders at the scene, in the Red Cross shelters, all of the Emer-
gency Operations Centers and the restaurants in the area; and
many other issues concerning potable water and lots of personal
sanitation and hygiene.
These activities will continue for days, but rest assured, local pub-
lic health is there to protect all. We will survive and we all owe a
lot to local public health. The public health work
necessary to respond to this terrible attack is grass roots publiC
health: surveillance, epidemiology, and environmental and
worker safety and health. I am very proud to be an American and
very proud to be serving this great New York City
Department of Health. We can all count on local public health to
be there.
The NYCDOH is a proud member of NALBOH. They have my ut-
most respect.
God Bless America 0
o
Local Public Health Agency
Infrastructure: A Chartbook
The National Association of County and City Health Officials
(NACCHO), in cooperation with The Robert Wood Johnson
Foundation, releases this new publication which provides an
extensive look at the infrastructure of our nation's local health
agencies.
The Chartbook can be used in many ways; to compare a health
department to the nationwide picture, to educate others about
local public health agencies, to learn what local publiC health
agencies feel are their strengths and challenges, and to help
develop programs and policy for the community.
The results of this study will help guide programmatic and policy
decisions. It identifies some of the critical areas of need, such
as workforce development and funding, as well as identifies the
strengths of public health.
If you are interested in ordering the Chartbook, please contact
Anjum Hajat at NACCHO, (202) 783-5550 ext 253 or
<ahajat@naccho.org> The cost is $30 per book for those or-
ganizations and individuals who are not members of NACCHO
and $15 for active NACCHO members. You can also download it)" ,
from the we at <www.naccho.org> for free.
\ ~
NALBOH NewsBrief
From Urban Sprawl to Health for All
Howard Frumkin, MD, DrPH
, Professor and Chair of Environmental and Occupational Health, Rollins
I ((0 School of Public Health of Emory University, GA
\ .,,,
for centuries, we have known that the way we build cities and
towns has a great impact on our health. The early cities of the
New World were centers of commerce and culture, but they were
also incubators of infectious disease-typhus, typhoid, cholera,
yellow fever, and others-because clean water, sewage treatment,
and trash disposal had been overlooked. In fact, the original boards
of health, in the 1790s, were a response to these urban
problems!
But in the last half century, a new sort of urban challenge has
emerged, commonly known as "sprawl." Cities expand in a
low-density, "leapfrog" manner. Different land uses-housing, re-
tail stores, offices, industries, recreational facilities, and public spac-
es such as parks-are kept separate from each other, enforced by
both custom and zoning laws. Extensive roads need to be
constructed. Newly built suburbs are relatively homogeneous in
both human and architectural terms, compared to the diversity
found in traditional urban or small town settings. Capital
investment and economic opportunity shift from the center to the
periphery, sometimes to a series of "mini-downtowns."
Regional planning and coordination are relatively weak.
A cardinal feature of sprawl is driving. With large home lots and
great distances between activities, people rely heavily on their
cars. A quick enrand for a newspaper or milk turns into a car trip.
_ Indeed, studies show a close relationship between lower density
~ttevelopment and more automobile travel. In sprawling metro
~~tlanta, the average person drives 35.1 miles each day. Denser
cities have far lower per capita driving figures: 16.7 for Philadei-
phia, 19.7 for Chicago, 21.1 for San Francisco. The metro Atlanta
population drives a total of 100,460,000 miles each day, enough
to reach from Peachtree Street to the sun and part way back.
All of this driving contributes to air pollution. It also means less
walking and bicycling, and more chance of car crashes, and more
hassle. In fact, we are becoming increasingly aware that sprawl
affects health in a number of ways, such as:
. Air oollution: Even with automobile and truck engines that have
become far cleaner in recent decades, the sheer amount of
vehicle miles driven results in large releases of carbon monoxide,
carbon dioxide, particulate matter, oxides of nitrogen (NOx) and
hydrocarbons into the air. NOx and hydrocarbons, in the presence
of sunlight, form ozone. In various combinations, these pollutants
account for a substantial part of the air pollution burden of
American communities. And air pollution is hazardous to health,
causing respiratory tract irritation, decreased lung function,
aggravation of asthma, visits to emergency rooms and
hospitalizations, and even increased mortality.
. Contributions to climate chance: Not only do cars and trucks
release air pollutants, but they are also a major source of carbon
dioxide-approximately 20 pounds of CO, for each gallon of
gasoline burned. This goes a long way to explaining the U.5:s
(f"eading global role in contributing to climate change. And climate
Il~hange, in turn, has a wide range of potential health effects: more
infectious diseases, more "severe weather events" such as
hurricanes and floods that cause injuries, death, and dislocation,
interruptions in the food supply, and, of course, the direct effects
of heat.
c
,
I
November 2001
. The urban heat island: Sprawl also contributes to heat in a
more direct fashion. On wanm days, urban areas can be six to
eight degrees Fahrenheit warmer than surrounding countryside,
an effect known as the urban heat island. This effect is caused by
the loss of trees (which provide cooling) and by dark surfaces
such as roadways and rooftops that absorb and reradiate heat. As
cities sprawl outward, the heat island expands, both in
geographic extent and in intensity. This is especially true if the
pattern of development features extensive tree cutting and road
construction. And excessive heat is dangerous to health, causing
a cascade of effects from the relatively benign (heat syncope, or
fainting; heat edema; and heat tetany) to heat cramps, heat ex-
haustion, and the potentially fatai heat stroke.
. Decreased ohvsical activity: Sprawl decreases physical activity,
as we replace walking and bicycling with driving. And low physical
activity threatens health both directly and indirectly. A sedentary
lifestyle raises the risk of cardiovascular disease, stroke, and
all-cause mortality. And a sedentary lifestyle contributes to the
epidemic of overweight and obesity, which in turn raises the risk of
ischemic heart disease, type 2 diabetes, hypertension, stroke, dys-
Iipidemia, osteoarthritis, gall bladder disease, and some
cancers.
. Car crashes: When we drive a lot, we crash our cars a lot.
fortunately, mortality from car crashes has decreased in recent
years, thanks to safer cars and roads, laws that discourage drunk
driving, and other measures. But car crashes still claim more than
40,000 lives each year. Car crashes are the leading cause of death
among young people 1-24 years old. They account for 3.4 million
nonfatal injuries, and cost an estimated $200 billion annually.
Interestingly, data from the National Highway Traffic Safety
Administration (NHTSA) show that denser cities where people walk
more tend to have far lower automobile fatality rates than sprawl
cities: 2.65 per 100,000 population in New York, 6.98 in Philadel-
phia, 5.57 In Chicago, 2.54 in San Francisco, and 4.17 in Portland,
compared to g. 97 in Houston, 12.55 in Phoenix, 11.53 in Dallas,
10.65 in Tampa, and 11.21 in Atlanta.
. Pedestrian fatalities: On roads designed more and more for
cars, and less and less for pedestrians, people who do walk take
their lives in their hands. The most dangerous stretches of road
are not hard to guess: multiple lanes, high speeds, no sidewalks,
and long distances between intersections or crosswalks, and lined
with commercial establishments and apartments. Across the
country, the pattern seen for driver and passenger fatalities is re-
peated for pedestrian fatalities, with lower rates in denser
cities: 2.21 per 100,000 population in New York, 2.40 in
Philadelphia, 2.25 in Chicago, 3.49 in San Francisco, and 2.98 in
Portland, compared to 4.21 in Phoenix, 3.99 in Dallas, 5.72 in
Tampa, and 5.72 In Atlanta.
. Threats to water: As we clear forests and cover large areas with
impervious surfaces, rainfall tends to run off into streams instead
of soaking into the ground and recharging groundwater aquifers.
And with a heavy storm, the runoff can swell stream flows to
destructive levels, undermining and eroding the banks. Moreover,
the runoff picks up "non-point source pollution" such as oil, grease,
and toxic chemicals from roadways, parking lots, and other sur-
faces. Not only is groundwater not recharged, but surface water
is sullied by silt and pollutants. Both water quality and water
quantity-two essential pillars of public health-can be threatened
by sprawl.
From Urban Sprawl...Conlinued on page 12
Page g
NALBOH NewsBrief November 2001
I TOBACCO-FRE~ USA
............................... ..
Join Other Local Board of Health Members for
Tobacco Control Conference Calls
Mondays: February 11, 2002 & May 13,2002
12 noon-1:00 p.m. Eastern Time
Toll-free bridge number 1-800-713-1971 and
conference code #430064
NALBOH will moderate discussions on various tobacco use
"prevention and control issues relevant to local boards of health.
. .
................................ .
JUST THREE
David Brumagin
Mr Brumagin is a member of the Barberton, Ohio Board of Health, a
Past President of the Ohio Association of Local Boards of Health, and a
former Barberton City Councilman
There were many high points for those of us in public health as
we attended the outstanding NALBOH Annual Conference in
Cleveland. Out of the two sessions at which I had the privilege
to present, three ideas need recounting: studying State Code,
understanding a politician's mindset, and becoming acquainted
with politicians as "real" people. These three points will serve
you not only in tobacco control issues but in all the public health
areas in which we deal.
The State Code is what governs each health entity. therefore, if
savvy health board members will study their own State Code
carefully, many pitfalls, shortcomings and embarrassments can
be avoided. In one city, for example, a mayor tried to fire the
health commissioner. Ultimately, even though a court battle oc-
curred, the State Code clearly defined the separation of the health
district from the city, leaving the mayor powerless in his attempt
to "overrun" the health district. In the final analysis, by knowing
the State Code, the health entity can function as it should.
Next a health board member must understand a politician's
mindset. Reelection, decisions on many unrelated pending
issues, and very limited study time are constant factors that play
in that mindset. Along with these, a politician receives
pressure from lobbyists, special interest groups, and constitu-
ents who demand a response. Bottom line, what is the priority,
a new bridge or the health issue?
The thought. It must be remembered that a health board
member must communicate with politicians. Brevity, facts,
timing and a good, friendly spirit are necessary because messag-
es that do get through must be meaningful. It is, however, al-
ways necessary to communicate (even if it is testimony before a
house or senate committee).
Lastly, ask yourself, "How many elected officials do I know who
know me?" It takes time, planning, and some "costs", but there
are dividends. When that elected official is able to call you by
name, you become a potential public health expert. Your thoughts
are appreciated and do have influence.
Please take time to ponder these three simple suggestions and
dare to try them. 0
Page 10
NALBOH Tobacco Scholarship
Winner Reports on TUPTI 2001
Conference
@
Walter A. Stein
Mr Stein is Secretary of the N.J. Local Boards of Health Association
and Vice-Chairman of the ManaJapan Township Board of Health (N))
I had the privilege of attending the annual national Tobacco Use
Prevention Training Institute (TUPTI), held in Portland, Oregon in
August, as the recipient of a NALBOH Tobacco Scholarship. This
was not your average conference or convention. My participation
had a very specific aim: to empower board of health members
nationwide to act constructiveiy, both individually and through their
boards, in the ongoing struggle against the tobacco
menace, particularly, but certainly not exclusively, among
America's youth.
Hundreds of activists in the anti-tobacco movement from every
state and territory were joined by successful and creative leaders
who functioned as their faculty and guides. The faculty spent five
days in conveying what does and does not work in the drive to cut
youth smoking. However, I was in a unique position as
probably the only "volunteer," the only board of health member, the
only person who did not represent a heaith department,
corporation or state agency.
My role in Portland was to attempt to glean, from an absolute mul-
titude of ideas and programs, those that would be of value to us as
local health board members, as public representatives
responsible for our communities' public health. Any idea I might
have had of focusing exclusively on the youth problem w~,\\
shattered when Greg Connolly, Director of the Massachusef..dg;
Tobacco Control Program, told us not to believe in kids-only
programs. As he stated, If you don't involve their parents, their
peers, locai authorities and other institutions, you'li get nowhere. A
light went on in my head: local boards of health can be
instrumental in linking with the community, in rallying support for
anti-tobacco measures, and much more.
I recently attended a statewide Board of Health Members Training
Institute, sponsored by the NJ Local Boards of Health Association.
At the tobacco control session, many board members asked what
publications existed relevant to a board's involvement in tobacco
control. Were there materials that boards could use as guidelines
for involving their members directiy in the fight against youth and
adult smoking? Were there programs that worked? Everyone knew
that I had just attended TUPTI so they turned to me.
I pledged to the attendees, members from over 50 New Jersey
boards, that I would work qn a booklet or brochure aimed directly
at local boards of health members, that would encourage and en-
able our boards to take constructive roles in the multi-faceted war
against tobacco. I hope that the publication might be of value to all
of our boards across the country. Despite the
increasing need for programs at the local level, and the
responsibility of our boards for the public's health, too often we are
simply rubber stamps for initiatives at higher levels, despite the fact
that circumstances vary widely from state to state, even county to
county. I was enormously privileged to be able to atte~,\\
TUPTI in Portland and I would like to use what I learned to try ~.)
give new tools to our boards in this vital, continuing effort. ~
Walter, a member of NALBOH's Tobacco Control Advisory
Committee, may be consulted at (732) 446-3220. 0
NALBOH NewsBrief
Health Care the Big Winner of
Tobacco Funds
Q,.'
'"'.,1
Lee Dixon
Mr Dixon is the Director of Health Policy Tracking 5elVice of the
National Conference of State Legislators
Members of local boards of health have been asking what is
happening with the tobacco settlement dollars and where does
their state stand. State lawmakers have appropriated over $21.3
billion over the past three fiscal years - 2000 through 2002. More
than 45% of these funds - $9.7 billion - went for health care
including tobacco-use prevention, Medicaid services and
reimbursements, Children's Health Insurance Programs, training
of health care professionals, school nurses, charity care,
biomedical research pharmaceutical assistance and home-and
community-based waivers. In many of the states where tobacco
funds have been utilized for public health purposes including
tobacco control, local boards of health have been instrumental in
interacting with their state government officials to bring this about.
A significant amount - $5.6 billion - was placed in endowments
and budget reserves as state lawmakers sought to leave a legacy
of funding in perpetuity for tobacco use prevention and health
care services. Seventy-five percent - $4.2 billion - of the
endowment funds are devoted in statute to health care
programs. When added together, the $13.9 billion to underwrite
current and future health care activities represents 66% of the
tobacco funds.
Tobacco-use Prevention
ntates collectively appropriated $1.1 billion dollars on tobacco
U,essation and prevention - more than three times the amount
. that the Centers for Disease Control and Prevention (CDC) spent
during the same period. This is new money for school- and
community-based programs, cessation and media campaigns since
previously, states were dependent on grants from the CDC for the
funding of tobacco-use prevention.
I
I
\
Health Care Services
Initially, governors and state legislatures were concerned that,
despite the robust U.s. economy, some 44 million people are with-
out health insurance. Now that the country's economy is turning
downward and state revenues have fallen sharply, people without
health insurance or access to health care services may be even
more vulnerable than before. State legislatures continue to place
a high priority on allocating tobacco settlement revenue for health
services. States are seeking to use the tobacco
settlement funds for indigent care programs, primary care,
expanding insurance coverage to the working poor, hospital
charity care, State Children's Health Insurance Program (SCHIP),
community health centers, and numerous other health purposes.
Lono-term Care
Eighteen states allocated some of the tobacco settlement funds
specifically to long-term care programs, including home- and
community-based care designed to keep the elderly in their homes,
long-term care insurance, and pharmaceutical assistance to the
elderiy and disabled.
/'e
\~!t~hildren and Youth
Kentucky is one of twelve states to appropriate tobacco
settlement revenue to non-health activities directed at helping
children and youth. Kentucky appropriated 2S% of its tobacco
revenue for early childhood development activities, including an
expansion of the Healthy Start
development.
November 200~
program and childhood
Tobacco Growers and Communities
Ten tobacco growing states-Alabama, Georgia, Indiana,
Kentucky, Maryland, North Carolina, Ohio, South Carolina,
Tennessee and Virginia-have enacted legislation to assist
tobacco growers and communities that already have been
affected by the reduced quotas from tobacco companies. The
programs vary in scope, but most offer education and training for
tobacco growers or people employed by the growers and
tobacco warehouses to seek new employment opportunities.
Future Outlook
Initially, opportunities existed for creating new programs,
increasing funding for existing programs, and experimenting with
bold new financing strategies. In 2001, the nation's economy has
slowed and states are facing fiscal situations that are dramatically
different than two years ago. in January 2001, there was
concern that states would turn from supporting new or existing
services to using the funds to cover the shortfall in revenue they
are experiencing; with a few exceptions-Tennessee and
Wisconsin-this did not occur. However, recent events have accel-
erated the fall in state revenues-Washington State could be facing
a shortfall of up to $1 billion. Governors are freezing travel and
personnel actions and proposing current fiscal year budget cuts of
up to 5%. Many policymakers are expecting
governors and legislators to seriously consider using tobacco
settlement revenue for current services funding, divert the
tobacco funds to the general fund or consider selling bonds against
the tobacco funds and receive a single initial payment against
future payments.
The pamphlet, " The Concerned Board of Health Members' Guide
to Tobacco Control Advocacy" outlines ways in which you can work
with your state legislatures. This is available upon request from
the NALBOH office.
Information about your state can be found in the new
publication, "State Management and Allocation of Tobacco
Settlement Revenue - 1999 to 2001, published by the Health Pol-
icy Tracking Service (HPTS) at the National Conference of State
Legislatures. To find out about your state or order a copy,
contact Maryellen Harvey at (202) 624-576 or
< maryellen.harvey@ncsl.org>.
ALLOCATION OF TOBACCO REVENUES BY CATEGORY,
FY 2000-2002 (Dollars in thousands, OOOs).
N"mh", nl ~"tA" "'"""""'- Am<wnl P""rpnl nl Tn!..i
6 Tobi:XXXIGrowersand $687,110 3.2"'1",
Communities
9 O1ildrell and Youth $685,140 3_2%
14 Education $1,339,308 6.3%
16 long-Term Care $948,412 45'%
17 ,.,.,,,h $949,015 4.5%
20 Endowments and $5,552,023 26.1%
Budget Reserves
20 Other $3,329,258 15.6%
40 Health Services $6,728,169 31.6%
40 Toba::c:o Prevention $1,064,000 5.0%
49 Total Slates with $21,282,505 100%
Approprll:ll.lon
Source: Healthy Policy Tracking Service, National Conference of State
Legislators, August 2001. 0
-- - ------- -- - "- -1
Page 11
----.-
NALBOH NewsSrie!
From Urban Sprawl...Continued from page 9
. Mental health: Suburban life offers an important
benefit-access to trees, birds, and flowers. But first you have to
get there. For years psychologists have studied automobile
commuting as a source of stress, stress-related health problems,
and even physical ailments such as back pain and cardiovascular
disease. In recent years, we have seen an increase in road rage,
defined by the AAA Foundation for Traffic Safety as "events in
which an angry or impatient driver tries to kill or injure another
driver after a traffic dispute." Even lawmakers may be involved;
in one highly publicized account, a prominent attorney and former
Maryland state legislator knocked the glasses off a pregnant
woman after she had the temerity to ask him why he had bumped
her Jeep with his. And surveys reveal a high prevalence of
aggressive driving behavior across the country. Could these
findings reflect threats to mental health related to the extensive
driving required by sprawl?
. Social caoital: All this anger and frustration can't just vaporize
when people get out of their cars. When angry people arrive at
work or at home, what are the impiications for work and family
relations? Robert Putnam, in his recent book Bowling Alone,
argues that the nation is suffering a decline in "social capital," the
network of trust, reciprocity, and conviviality that helps society
function at its best. Many board of health members know how
difficult it is to get people involved in civic life. And while this is a
complicated problem, part of the blame may lie with sprawl. The
simple fact of more driving time means less time with family or
friends, and less time to devote to community activities, from
neighborhood barbecues to PT.A. meetings. And it may not be
too much to hypothesize that this, in turn, contributes to the ris-
ing prevalence of depression.
As in many aspects of public health, the potential health effects of
sprawi do not impact us all equally. From infections to obesity,
from car crashes to malnutrition, the poor and disadvantaged are
disproportionately affected. To begin with, when jobs, stores,
good schools, and other resources migrate outward from the core
city, poverty is concentrated in the neighborhoods that are left
behind. And poverty is bad for health. But there are also speCific
examples. One is air pollution, which disproportionately affects
minority populations for at least two reasons. First, they are more
likely to live in areas with unhealthy air. Second, they are more
likely to have diseases, such as asthma, that make them
susceptible to the effects of air pollution. Heat is another
example. In the 1995 Chicago heat wave, blac~ had a 50 per
cent higher heat-related mortality rate than whites. Similar
findings have emerged following heat waves in Texas, Memphis,
St. Louis, and Kansas City, and in nationwide statistics. And
pedestrian fatality rates show iarge racial and ethnic disparities.
In Atlanta, for instance, pedestrian fatality rates during 1994-1998
were 9.74 per 100,000 for Hispanics, 3.85 for blacks, and 1.64 for
whites. In the Virginia suburbs of Washington, Hispanics com-
prise eight per cent of the population but account for 21% of
pedestrian fataiities. Indeed, while the heaith effects of sprawl
affect many of us, the less fortunate among us seem to bear
some of the greatest risks.
If sprawl is a publiC heaith problem, it is indeed a pressing prob-
lem. The Census Bureau predicts that our national population will
nearly double in the next 100 years, from about 275 million
peopie to almost 600 miliion. Where will we put all these people?
In addition to the pressure of a growing population, we face a
range of health challenges in the 21" century. Our population is
Page 12
November 200 I
aging. We face a growing burden of mental illness and disability,
including depression. Chronic diseases such as asthma, diabetes
and obesity are on the rise. We continue to struggle with
disparities in health; the poor are sicker than the well off. Can w~
help control some of these problems by addressing the challeng"'~
of sprawl? If so, how might boards of health help?
We need to think broadly about how to protect health and
Improve livability. We need to design and build human-scale,
livable communities. We need to make walking safe, practical,
and attractive-as a way to decrease air pollution, increase
physical activity, conserve scarce resources, perhaps even improve
mental health. We need to rethink zoning, returning to "mixed
use"-siting homes, stores, workplaces, and recreation close
together, so people can easily walk or bike among them. In some
circumstances, we will opt for greater density-more homes per
acre, to consume less land-balancing this with preservation of
greenspaces. These and similar strategies are part of an approach
known as "smart growth." Importantly, many of the health
benefits that could fiow from smart growth would also yield
collateral benefits such as a cleaner environment and more livable
neighborhoods.
Smart growth isn't just the concern of planners and developers. It
is a health issue. Exciting new initiatives at the Centers for Dis-
ease Control and Prevention are exploring the public health di-
mensions of land use and transportation. But it is at the local
level, exactly where boards of health do their work, that these
decisions are debated, adopted, and implemented. Local publiC
health leaders need to talk with planners, architects, engineers,
and developers. If the Zoning Board is making public health
decisions-and this article argues that it very much is-then lo"'l~
boards of health need to be at the table. 'v.!:)
Public health historian John Duffy wrote that during the 19th
century, "probably no single subject so occupied the attention of
public officials, newspapers, and citizens as that of general
nuisances....the enormous manure piles, slaughterhouses, dairies,
stables, obnoxious trades, overfowing privies and cesspools, and
filthy gutters common for that time...." Future historians may well
write of the present era that "probably no single subject so
occupied the attention of publiC officials, newspapers, and
citizens as that of general nuisances....the interminable commutes,
enormous traffic jams, streets without sidewalks, disappearing
green spaces, mind-numbingly ugly strip malls-and their contribu-
tions to asthma, obesity, heart disease, depression, anger, and
social isolation." Let's hope that better design-wiser decisions about
land use, transportation, construction, and resource
use-will leave our grandchildren with a healthier, more livable world.
And let's hope that boards of health can help lead us in that direc-
tion.
Dr Frumkin, is currently working with CDC's National
Center for Environmental Health on urban sprawl, livability and
related issues. 0
If your board of health has dealt with urban sprawl or is currently
facing urban sprawl publiC health issues, we'd like to hear from you.
Please e-mail, fax or mail your contact information and the l~~
challenge you have faced or are facing to: (
National Association of Local Boards of Health . ~
1840 East Gypsy Lane Road
Bowling Green, OH 43402
Phone: (419) 353-7714; Fax: (419) 352-6278
E-mail: <nalboh@nalboh.org>
r NALBOH NewsBri=-==~~=_
Tech Tips
By Jennifer M. O'Brien, MPH
C;
I-
In the August Tech Tips, I discussed
using various Web-based communication meth-
ods. In this column, I address issues that
board of health members should
consider when creating a web site.
Before beginning, you will need to answer some questions, such
as: What is the purpose of our web site? How will a web site
support our health department's goals? How much time and money
do we have to spend on the web site
design? How much time and money do we have for its
maintenance? Who is our target audience?
The answers should be used to create a plan for the content and
design of your web site. Such a plan will help ensure that
resources and staff time are used cost-effectively and that the
goals of the web site are reached. For example, if one of your
goals is to communicate immunization information and the publiC
is unable to easily find the information or does not know that it is
available on-line, the time and money have been wasted. The
same process that you would use when creating a new program
should be used when designing your website. If, for instance, you
consider the above questions when designing a health
education program to reduce youth smoking, then good project
management requires that you use a similar process with your
web site. This means that there should be a project leader, input
from various stakeholders (e.g. employees, board
C.i11embers, the community, and web designers), a budget of time,
;'ersonnel and monies, a written plan for the stages of develop-
iI1ent, and objectives for evaluating success.
Unless you have some experience with web design already, it is
unlikely that you will be responSible for ieading the project.
However, you should be aware of some basic web design
principles so that you can assist in making sure that the goals of
the project are met.
To familiarize yourself with the basics of web design, you may
want to visit your local library and check out books on web design.
In addition to print resources, there are numerous
on-line resources that are available regardless of your
technical abilities (see Resources at the end of the next
column).
Another way to research web design is by surflng the Internet to
see what you like. Pay
attention to how long
pages take to load, how
easy it is to navigate
through the site and find
the information for which
you are looking. Keep a
list of what you like or
do not like. Take the
time to look at state and
local health
department web sites. If
you like a particular site,
try to contact the person
in the health department
or on the board of health
who is responSible for
Internet Surfing Tip
If the font size on your
Internet browser is too
small, you can increase the
size by:
Internet Explorer: Go to
View -> Text Size -> Select
(C~~Larger or Largest
Netscape Navigator: Go
to View -> Select Increase
or Decrease Font
November 200l I
the web site. He or she may have some real life tips to share.
Take your notes and lists with you when you are discussing the
health department's web site with the board.
If it is likely that a web design company or Internet service
provider will be responsible for the actual design of your web pag-
es, ask to see examples of their work and to speak with
clients to determine if the company's abilities are compatible with
your goals. For example, if the design company's specialty is
complex graphic laden pages, which may have a long
download time, but you serve a community whose average
connection speed is 28.8K, you will need to either look for a new
company or be firm that the web site needs to be quickly
accessible to the clients of your community.
It is easy to be overwhelmed by the issues related to
designing a web site. The most critical issue for you as a board of
health member to remember is that a web site is as much a
communication tool as a letter, pamphlet, regulation or annual re-
port that is published by the health department. Additionally, be-
cause a web site requires an ongoing investment of money, time
and personnel, it needs to be managed like any other project in
the. health department. This means a strategic plan, goals and
mission, assessment, and evaluation must be in place for the web
site.
A good web site can be an extension of the health department and
a great way for public health to reinforce its presence at the local
level. If you would like to share your experience with
establishing or operating a web site, please contact me by
e-mail at <jennifer@nalboh.org> or by phone at (419) 353-7714.
I will post (anonymously) any suggestions or comments on the
Tech Tips page <www.nalboh.org{Bohti{techtips.htm>
Resources
. Build Your OWn Web site <http:{{build-website.com{>
. Coolhomepages.com <www.coolhomepages.com{>
. Efuse <www.efuse.com{5tart/>
. Information Networks and Other Information Sources
<www.cdc.gov{other.htm>
. Plan Your Site < http:{{builder.cnet.com{webbuilding
{0-7307. htrnl?tag=st.bI.3881.dir2. 7307>
. State & Territorial Health Departments <www.nalboh.org{
WebHealth{statehealthdepartments.htrn>
. Webbery and Nettery <www.strum.co.ukjwebbery{>
. Webpagesthatsuck <www.webpagesthatsuck.com{index.html>
(NOTE: apoiogies to those who may be offended about the
title of this page, but it has great resources and examples on
what not to do when designing web pages)
. Web Site 101 <www.dspinner.com{website101{index.htrnl>
. Web Site Audit Checklist <www.ivanhoffman.com{audit.html>
. Web Style Guide <http:{{info.med.yale.edu{caim{manual/
contents.html> (NOTE: This is an on-line book that should aiso
be available in a library. It is a very useful guide regarding the
principles of web design without being too technical.) 0
Page 13
i'
NALBOH NewsBrie!
November 2001
NALBOH Needs You!
NALBOH is In the process of searching for new committee members for the year 2002. Below is a list of all NALBOH committees and
summary of their objectives for the coming year. Please indicate which committee(s) you have an interest in serving on by checking the
box and completing the information below. Fax (419) 352-6278 or mail to NALBOH, 1840 East Gypsy Lane Road, Bowling Green, OH
43402. Please return your response no later th,lI' December 15, 2001. 1I1ank you for your ~~PP!l!L .~ .~._.
~~--------------------Applicatlonfor~ern-berShlp---------------------,
,
,
'Date:
,
: Board of Health/Organization/Name:
, Address:
'City:
,
I Phone:
I Contact Person:
, Check type of Membership:
LI Institutional ($120) Any local board of health or other governing body that oversees local public health services or programs
($95) A of local board of health that is a member of its state association
LI Affiliate ($300) State associations of local boards of health
LI Associate ($60) Any individual committed to NALBOH's goals and objectives
LI Retired ($12) Any former member of a board of health, state board of health, local governing body, state, territorial or tribal
board of health
LI Sponsor ($60) A non-profit organization, agency or corporation committed to NALBOH's goals and objectives
($300) A for-profit organization, agency or corporation committed to NALBOH's goals and objectives
LI Student ($20) Any full time student committed to NALBOH's goals and objectives
o Awards Committee
Directs the search for award nominations through the NewsBrief
and the Regional Trustees. Reviews nominations and selects re-
cipients for Execulive Board approval. Coordinales awards and
presentations at annual conference.
o Board of Health Training Institute (BOHTI)
Works 10 assist state and local boards of heallh 10 understand the
importance of state associations and helps in Ihe development of
establishing a state association. Coordinates and reviews all
educational efforts.
o Budget Committee
Oversees Ihe development and implementation of financial policies
and procedures. Explores additional income opportunities. Re-
views and approves quarterly and annual financial statements.
o By-Laws Committee
Annually reviews NALBOH By-Laws and submitted draft and
proposed amendments. Presents revisions to the Executive Board
and the association membership for vote at the annual
conference.
o Communications Committee
Directs, promotes and develops modes of communication for
training and education in support of NALBOH's mission, goals and
objectives.
Name
Add~
Fax
Membership Year. 20\12
o Legislative Committee
Develops procedures for proposing legislation and programs 10
keep nalionallegislators informed on public health issues. En-
courages legislative efforts at the state level 10 promole local
public health advocacy efforts.
o Membership Committee
Plans and organizes Ihe annual membership drive and all fol-
low-up aclivities. Establishes largeted membership drives and
explores joint membership ventures.
o Nominating Committee
Provides a slate of candidates for open Executive Board posi-
tions and presents ballots for voting.
D. Program Committee
Plans, organizes and initiates the annual conference; reviews
past evaluations: presents draft conference schedules to Ihe
Executive Board for approval.
o Tobacco Control Advisory Committee
Guides Ihe development of NALBOH's tobacco conlrol policies
and advocacy efforts on a national level. Promotes anti-tobacco
efforts, oversees grants, works with NALBOH Tobacco Fello~~
and olher national public health and anti-tobacco organization0
Board of Health
"'one
E-mail
State:
Fax:
Zip Code:
E-mail:
Title:
/L.
J
Mail this portion, along with payment of dues to: NALBOH, 1840 East Gypsy Lane Road, Bowling Green, OH 43402
Page 14
,-----------------------------------------------------------------_/
NALBOH NewsBrief
November 200 t
Q
Mal'll Your Calenda~
National Kick Butts Day 2002
April 3, 2002
The nation's largest initiative to protect children from tobacco addiction and exposure to secondhand smoke. Your Board ,
! may get a free Planning Activity Guide, contact the National Campaign for Tobacco-Free Kids @ (888) 839-3869 or visit '
< www.kickbuttsday.org>.
3rd Annual Ned E. Baker Lecture in Public Health
Board Member to Board Member: Issues to Consider
Featured Speaker: Susan Scrimshaw, PhD
Dean, School of Public Health
University of Illinois at Chicago Circle
Friday, April 5, 2002
1:00 p.m. Eastern Time
MARK
YOUR
CALENDAR
Th/s lecture will be broadcast by satellite for /ocal boards of health throughout the country!
Visit <www.nalboh.org> for more information 0; call NALBDH at (419) 353-7714
I
MARK
YOUR
CALENDAR
NALBOH's 10th Annual Conference
The Foundation of Local Public Health:
Boards of Health, Health Departments, and Health Officers
July 10-13, 2002
The Astor Crowne Plaza Hotel
New Orleans, Louisiana
Co-located with the
National Association of County and City Health Officials
--i
I
For more information, visit <www.nalboh.org>orcall NALBOH at (419) 353.7714
Important Information:
The National Immunization Programs at the Centers for Disease Control and Prevention (CDC), for copies of new
immunization-related education and information materials available through the National Immunization Program website
<www.cdc.gov{nip> or call (404) 639-8375 for.information on how to obtain printed versions.
"Anthrax: What Every Clinician Should Know" single copies of this live satellite broadcast of October 18th are available free
of charge on VH5 tape by calling (877) 252-1200 or e-mail <info@phf.org>.
CDC Public Health Emergency Preparedness and Response website contains bioterrorism fact sheets, guidelines,
notification protocols, news and links at <www.bt.cdc.gov>.
!: CC
II
1.1
I'
Contact the Office of Homeland Security by writing:
The Honorable Tom Ridge
Assistant to the President for Homeland Security
The White House
1600 Pennsylvania Avenue, NW.
Washington, DC 20500
or call (202) 456-1414.
Page 15
[NALBOH'S 10th Annual conferenc~d
The Foundation of Local Public Health: Boards of Health, Health
Departments, and Health Officers
July 10-13, 2002
The Astor Crowne Plaza Hotel
New Orleans, Louisiana
Co-located with the
National Association of County and
City Health Officials
For more information contact the NALBOH office at phone: (419) 353-7714; fax: (419) 352-6278
e-mail: <nalboh@nalboh.org>, or visit our website at <www.nalboh.org>
NON PRom ORG.
U.S. Postage
PAID
Bowling Green, OH
Permit No. 47
National Association of Local Boards of Health
1840 East Gypsy Lane Road
Bowling Green, OH 43402
Website: <www.nalboh.org>
o
~