09/03/2003
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Attachment A (page 1)
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.. 2003 NC Arboviral SurveWanco
Estimated Risk 01 H\m8n Welt Nile Virus CaMs
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Attachment A
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New Hanover County Health Department
Revenue and Expenditure Summaries for July 2003
Cumulative: 8.00% Month 1 of 12
Revenues
Current Year Prior Year
Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remalnln Amount Earned Remalnln
Federal & Slale $ 1,659,620 $ 130,371 $ 1,529,249 7.86% $1,692,429 $ 1,692,429 0.00%
C Fees $ 570,161 $ 46,348 $ 523,813 8.13% $ 533,044 41,734 $ 491,310 7.83%
Medicaid $ 1,044,080 $ $ 1,044,080 0,00% $1,035,386 $ 1,035,386 0.00%
Medicaid Max $ $ 0.00% $ 0.00%
EH Fees $ 300,212 5.76% $ 312,900 10.44%
Health Fees $ 113,850 11.68% $ 112,850 12.50%
other $ 2,123,669 \ 1.79% $1,208,298 0.33%
Expenditures
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Budgeted
Amount
Expended Balance
Amount Remalnln
%
Budgeted
Amount
Expended Balance
Amount Remalnfn
%
964,585
78,893
241,487
79,255
Summary
Budgeted Actual %
FY 03-04 FY 03-ll4
Expenditures:
Salaries & Fringe $ 9,699,406 $ 964,585
Operating Expenses $ 1,366,405 $ 78,893
Capital Outlay $ 35,000 $ 0
Total Expenditures $ 11,100,811 $ 1,043,478 9,40%
Revenue: $ 5,811,592 $ 245,401 4,22%
Net County $$ $ 5,289,219 $ 798,077 15,00%
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Revenue and Expenditure Summary
For tbe Montb of July 2003
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NEW HANOVER COUNTY HEALTH DEPARTMENT
BOARD OF HEALTH (BOH) APPROVED
GRANT APPLICATION STATUS FY 03-04
Date (BOH) Grant Reauested Pendlna Received DenIed
.?:? "tJO
8/612003 NC DHHS- OPH Preparedness and Response $82,350 $82,350 .,.,
a. 1/
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Smart Start- Partnership for Children (Grant
7/3/2003 Increase for Part Time Nurse Position) $5,523 $5,523
, Cape Fear Memorial Foundation - Diabetes
Today (two-year request; $42,740 annually) $85,480 $85,480
Duke University Nicholas School of the
Environment-Geographic Information Systems
Grant (Env Health) $10,000 $10,000
Safe Kids Coalltlon- Safe Kids Mobile Car Seat
Check up Van $50,000 $50,000
Safe Kids Coalition- Risk Watch Champion\
6/412003 Team . $10,000 $12,500
Smart Start- Partnership for Children: Child
517/2003 Care Nursing Program (Preliminary Approval) $171,977 $172,500
Smart Start- Partnership for Children: Health
Check (Preliminary Approval) $41,035 $41,747
UNC-CH: Child Care Health Consultant $62,849 $84,495
Cape Fear Memorial Foundation (through
Partnership for Children): Navigator Program $178,707 $180,000
4/312003 No activity to report for Aprll 2003.
3/512003 No activity to report for March 2003.
2/512003 No activity to report for February 2003.
1/812003 NC DHHS- OPH Preparedness and Response $115,950 $33,600 $82,350
12/412002 No activity to report for December 2002.
NC Health and Wellness Trust Fund-Teen
Tobacco Use Prevention & Cessation Program
11/6/2002 ($100,000 per year for 3 years) $100,000 $100,000
Safe Kids Buckle Up Program-North Carolina
101212002 Safe Kids $5,000 $5,000
Developing Geographic Information Systems
(GIS) Capacity In Local Health Department In
Eastern North Carolina-Duke University
Nicholas School of the Environment and Earth
Sciences (NSEES) $18,000 $18,000
NO aCDvlty to report fOr :septemoer Z002.
NO 8CUVIlY to report for August 2UO:l:.
NO acovllY to report Tor JUlY Z002.
Totals $936,871 $217,830 $537,842 $187,873
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23.25%
5741%
20.05%
Pending Grants 3 21%
Funded Total Request 7 50%
Partially Funded 2 14%
Denied Total Request 2 14%
Number of Grants Applied For 14 100%
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As of 8/28/2003
. NOTE: Notification received since last report.
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NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda: Consent Meeting Date:
enda:
Department: Health; Health Promotion Presenter: Geoff Zuckerman, Injury
Prevention Health Educator
Contact:Geoff Zuckerman, 343-6636; Elisabeth Constandy 343-6658 (Sr. Health
Educator
Sub' ect: SAFE KIDS Grant A lication for Fire Prevention
Brief Summary: National SK has partnered with US Fire Administration and FEMA to
make grant money available to local SK partn~rships who are willing tQ partner with
local fire agencies. The grant monies are to be primarily used to reduce fire incidence,
death and injuries. There are three levels of available funding, and partnerships are
allowed to apply for two of the three levels. NHC SAFE KIDS will be partnering with
Cit of Wilmin on and NHC Fire Services and a l' for I.evelllI-$2,500.
Recommended Motion and Requested Actions: Approve grant application for $2,500
and budget amendment if funding is received.
_ I Funding Source: National SAFE KIDS, partnering with USFA and FEMA.
Will above action result in:
ONew Position Number of Position(s)
OPosition(s) Modification or change
[gINo Chan e in Position s
Explanation: The funds will be used to provide Life and Fire Safety Education, distribute
safety devices and support exsisting programs.
-Safety Education(Materials, Printing, Evaluation tools): $750
-Safety Devices(Smoke Alann, CO, detector, fire extinguishers): $750
-Su rt existin ro ams 'sk Watch- workbooks and manuals: $1,000
I Attachments:
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Level ill Grants ($2,500) for Fire Prevention in Local Communities
Request for Proposals. 2003
I. INTRODUCTION
The National SAFE KIDS Campaign in partnership with the United States Fire Admini~tration
(USFA) and the Federal Emergency Management Agency (FEMA), announce the availability of
26 grants in the amount of $2,500 each. These grants will support SAFE KIDS coalitions as they
identify a community at high risk and conduct an intervention over a one-year period. The
primary objective is to support and strengthen new or existing coalition programs such as the
purchase and distribution of smoke alarms and fire safety education materials, community
education events and maintenance of fire safety trailers.
These Level III grants are part of a larger grant program including 10 Level I (up to $25,000)
grants and 22 Level 11 ($5,000) grants to be awarded under separate requests for proposals.
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The Problem:
Each year, more than 600 children die in fires. Eighty-five percent of these children are under
age 10 and more than 56 percent are ages 4 and under. In addition, nearly 40,000 children
escape death, but are injured in fires. Despite a dramatic 56 percent decline in the fire death rate
since the launch of the National SAFE KIDS Campaign in 1988, fires remain a leading cause of
unintentional injury-related death among children in the United States.
SAFE KIDS Long-time Partnership with the USFA:
For the last 14 years, SAFE KIDS and USFA have worked together to keep families safe from
the devastating effects of fire. The grant support of the USFA has helped SAFE KIDS coalitions
deliver lifesaving fire prevention programs to millions of caregivers and children. In addition,
firefighters and EMS professionals have worked alongside fellow coalition members to distribute
more than 110,000 smoke alarms and batteries to families in need and to strengthen smoke alarm
legislation. FY 2003 funding from the USFA greatly enhances this partnership.
II. PROPOSAL COMPONENTS
To apply for this grant opportunity, SAFE KIDS local and state coalitions must submit a
proposal with the following: .
A. Fo11tUJlize a working partnership with a local fire department (15 points)
Indicate your partner fire department and provide a general statement explaining what the commitment
entails.
B. Provide a rationale for supporting your new or existing program (30 points)
Based on anecdotal information and the insight of the local fire department representative,
submit a paragraph that explains why the coalition has decided on the intervention. Your action
plan should include target audience, activities, a tinteline, and why the program should continue.
C. DemonstraU coalition capacity (20 points)
SAFE KIDS coalition applicants should exhibit proof of the coalition's capacity to continue
work in the field of fire prevention. This should include:
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IJ List of all members of the coalition's fire committee, and their specific roles and
responsibilities in this program.
IJ Information on the coalition's experience in fife safety. Describe the extent and
documented outcome of past efforts/activities and previous collaboration with fire
departments.
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D. Provide information on how process evaluation will be conducted (30 points)
The means by which you will conduct process evaluation should be included in your proposal. This
type of evaluation indicates how a program is being implemented as planned and quantifies the
effectiveness of a program's methods for reaching the target population (e.g., actual counting of people,
materials, devices, media hits, telephone calls, etc.). Specific variables that could be measured in these
fire grants include:
· NU1Dber of coalition volunteers trained
· Number of homes checked for fire risks
· Number of smoke detectoni and educational materials distributed
. Number of families reached
E. Provide a detailed budget (5 points)
Costs must reflect proposed plan of action and evaluation. Staff time will not be supported under this
grant. An Excel spreadsheet with the required format is provided on the Coalition Extranet under
Forms, Applications and EvallUltions entitled Level III Fire.xls. A sample budget is attached.
Only coalitions in good stllnding with the Campaign will be considered.
III. SUBMITIING THE PROPOSAL
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1&1/ Assemble the proposal with a cover letter indicating the specific grant level for which you
are applying.
1&1/ Proposal must be typed, using single-spacing where possible.
1&1/ All pages should be numbered and preceded by a table of contents.
1&1/ Proposals must include fire department and coalition Statement of Commitment letters.
1&1/ The original and 2 copies of the complete proposal with all attachments should be submitted to:
Carol Kennedy, RN, MA, Program Manager
National SAFE KIDS Campaign
1301 Pennsylvania Avenue, NW, Suite 1000
Washington, DC 20004-1707.
G) To receive consideration, proposals (Including all attachments) must be received by the
Campaign no later than Tuesdav. Sentember 23. 2003. There will be no exceptions.
It is recommended that proposals be sent via commercial carrier for tracking purposes.
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NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda:U Consent Meeting Date: 9/15/03
Agenda: ~
Department: Health Presenter: David Rice, Health Director
Contact: Janet McCumbee, Personal Health Services Director
Sub' ect: Re uest for A roval of Grant Funds- Safe Schools, "U4 Youth"
Brief Summary: Health Department will receive funds from the Early Childhood
component of the Safe Schools' grant, called U4Youth. These funds will support
salary/fringe and operll;ting costs for a Child Find Specialist in the Personal Health
Division over the 3 year grant period. The position will coordinate e~ced Child Find
community activities with the other key agencies serving children birt:h to 5 years, to
identi at risk children and ensure services are rovided to re are them for school.
Recommended Motion and Requested Actions: To accept 49,000 om the NHC Safe
Schools' Grant forFY 03-04 to hire a Child Find Specialist . cation- Program
Coordinator and to a rove associated bud et amendment if ant is awarded.
Will above action result in:
~New Position Number ofPosition(s)
DPosition(s) Modification or change
DNo Chan e in Position s
Explanation: Child Find Specialist (program Coordinator) will enhance Child Find
activities in NHC, working closely with Health Dept. Child Service Coordination
Program, and all agencies represented in Locallnteragency Council, to identify children
in need of earl intervention services.
Attachments: Early Childhood Social and Emotional Development section of "U4Youth" Safe
Schools Grant.
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NEW HANOVER COUNty HEALTH DEPARTMENTu-
Budget for 10/1/03-9/30/04
Safe Schools TolaI Budget Sol. School Req.... Veador Io-KlDcI
United for Youth
EXPENDITURES:
Personnel (nrovide detail)
Child Find SpeciaJist(Pro2l'am CoordinatoilSalaries / Wal!es $31,572.00 $31,572.00
Taxes $2,415.00 $2,415.00
Benefits $9,911.00 $9,911.00
Supervision! Accountinl!! AdministratioD $5,000.00 $0.00 $5,000.00
Total Personnel $48,898.00 $43,898.00 $5,000.00
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Non-Personnel Expenses \
Contracted Services (provide detail)
Teleohone & Postal!e $800.00 $0.00 $800.00
Office SuooJies $910.00 $910.00 $0.00
Travel, Meetinl! & School! 200miles/mo. .$0.36/mile.1l mo. $792.00 $792.00 $0.00
Rent & Utilities $1,600.00 $0.00 $1,600.00
Insurance & Bonds
Other: Eouinment (Personal Computer & Printer) $2,500.00 $2,500.00 $0.00
Technolol!VlTrainingIWorkshOP Materials $300.00 $300.00 $0.00
Printinl!!Pro2l'am Materials $800.00 $600.00 $200.00
Total Non-Personnel Expenses $7,702.00 $5,102.00 $2,600.00
DoUars of Last Resort: (Must meet criteria-provide detail)
Proj1;fam:
TOTAL EXPENSE BUDGET REQUEST $56,600.00 $49,000.00 $7,600.00
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Personnel: PIOQlam Cooldinator /PT03)
Hours / Week 40
Weeks / Year 48 (first year onlv; 52 weekslvear thereafter)
$ Per Hour $16.56
Taxes $2,415
Medical/ Dental $8,348
Other: Describe:Retirement $1,563
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4/11/02 Revision
Safe Schools! Early Childhood psychosocial/emotional
development 11 ()./f- Y"l(-!h '1
Element I: Safe school environment
Goal: Children's early learning environments are safe, healthy and
appropriate for learning and growth.
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Gaps: Safety issues outside of licensed care.( relative care, moms at
" home, unlicensed care)
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Data supporting gap cla~: Estimated 11,045 cmidren 0 to 5 in
NHC '
(Out of a total 0 - 17 population of 36,000 children )
2,800 Receiving subsidy from DSS in licensed child
care (0 - 5)
565 Receiving subsidy in regulated but unlicensed care
(0- 5)
4,132 children in regulatedllicensed child care (OCD)
Children in poverty: Children under five living in
poverty 23.40% (US Census 1990)
Other data: 452 children, birth to 6 substantiated
maltreatment ( rate of 28.15% compared to state rate of
17.21%
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Objectives:
1. Broadly dissem;nAte information regarding quality
care safety
2. Broaden safety information and services to
regulated but unlicensed care provider ( Upgrade
support for the DSS supported PQI that worlcs with
the over 500 child care providers that are regulated
but not li~.)
3. Initiate safety related outreach to those caring for
children in the communities such as unlicensed
care, stay at home mothers and relatives who are not
involved with any service agencies initiate facility
and environment safety checks, emergency plans
etc.
Action Steps! Strategies:
Goal 1 :
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. Participate in CWK Project, an ABC Network
initiative to support local entities in reducing
violence.
. Build bridges on awareness building with local print
and electronic media
Goal 2
. Identify and prepare targeted outreach materials to
specific hard to reach communities (for example
set up training sessions for hair dressers and
manicurists )
Goal 3 and 4
. Establish mechanisms for outreach and safety
checks in collaboration with existing agencies or
programs such as Self Sufficiency ( Housing
Authority), New Hanover Community Action
Program, Parents As Teachers, Child Advocacy PQI
Program, Smart Start and other entities
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Element ll: Alcohol and other drugs and violence prevention and
early intervention
Goal:
. Reduce anti-social behavior in pre-school children.
. Develop awareness of child abuse/neglect signs and
reporting procedures in child serving adults.
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Gaps:
. High rate of early on set of inappropriate social behaviors
(bullying and other behaviors based data from intervention
specialists in the field)
. Lack of training on abuse/neglect indicators for child
serving adults.
(Such as low rate of referrs1s on abuse/neglect from
child care providers as compared with other youth
serving professionals)
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Data: Goall:
Intervention and Inclusion Program of the Partnership:
_ reached 3,668 children via teachers, child care providers
. and parents attending information workshops in 2000-
2002) (Workshops related to identification and services to
special needs)
_ 95 families and children received intensive Intervention
and Inclusion support
. 28 Children received intensive mental health therapy
support
Data: Goal 2:
CAC/Child Care Resource & Referral's Child Abuse
Prevention and Awareness Program:
_ provided over twenty workshops for providers, teachers,
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law enforcement and parents
_ Initiator of the New Hanover County Child Abuse
Prevention Coalition involving over a dozen agencies for
April Child Abuse Prevention month
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Number of abuse reports from child care providers ..l! as
compared with other youth serving professionals:
_ medical 203
_ educational 300
_ human services 842.
Objectives: .
1. Provide abuse prevention and awareness training to adults
who work with children. and distribute appropriate
informative literature relating to abuse indicators
2. Provide "Second Step" violence reduction curriculum and
training to child care providers for use in their child care
homes or centers-
3. Seek and/or develop resources for parents to address
aggressive behavior in their children.
. Second Step is a curriculum that develops language
slcills and other strategies to address and deescalate
potentially dangerous situations.
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Amon steps! strategies
Goal I : Identify outreaCh targets and establish outreaCh and
education delivery systems to raise awareness about child
abuse prevention.
Goal 2 and 3: Train and establish a service schedule for those
working with at risk children to receive training in Second Step
violence reducing program
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Develop strategies for earlier interVention in hard to reach
communities
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Element m: School and community mental health preventive and
treatment intervention services
Goal: Access to Resources. Families with preschool children have
access to mental health and other social service resources
supporting family strengthening factors relating to positive
early childhood growth and development.
Gaps:
. While many services are available in early childhood they
are scattered and often without any comprehensive
coordination \ 'I
. Services available birth to 5 years abruptly end at five
leaving child and family stranded without counselor help.
There needs to be coordination between elementary school
social and mental health professionals and the non-school
based providers of early childhood services. This gap
especially apparent when these families have younger
preschool children who are exposed to the same
environments that may have contributed to the _
social/emotional problems of the elementary school child. _
. Non English speaking families have a special need for
intervention services in support of health, education, and
other strengthening needs as they become assimilated into
our culture.
. Family strengthening outreach to serve at-risk families.
. Lack of assigned person to track data countywide ( possibly
remedied by a fully functioning "Child Find" program)
Data: Care Find is a program that exists but is currently not fully
operating. (See attached re mandates for the Care Find Program.
Last year it served children primarily through UCC's infant
and toddler and pre school consortiums.
We have approximately 2 % non English speAl<ing preschool
children in NBC with over 38 languages spoken in the schools
Objectives:
1. Re-establish "Child Find Coordinator" to identify children in need _
children 3 plus _
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2. Establish a Child Search Specialist to identify children at-risk in
hard to reach communities that are in need of intervention due to
exposure to violence, emotional/social needs or other physical or
developmental delays.
3. Establish a Coordinator position for outreach and administration
to oversee training, second step, monies of last resort and other
contracted services
4. Establish a Training Coordinator to oversee Second Step child
abuse awareness and other strategic training associated with child
safety
Action Steps! Strategies: ( ,~
Goal 1 : Research and strengthen "care finder" program
Goal 2: Establish three positions:
. Child Search Specialist ( searching out hard to
reach children 0-3 who are outside existing
licensed child care)
. Coordinator of Administration and training
. Training Specialist for children 3-5) to address
violence reduction and child safety.
Element IV: Early Childhood Psychosocial and Emotional
development Services
Goals: That children's early learning environments are safe, healthy
and appropriate for emotional and social growth.
Gap:
_ Lack of prevention/early intervention resources
serving pre-school children with exceptional social
and emotional needs (especially those outside of
licensed care such as stay at home mothers, relative
care, unlicensed child care etc.)
_ A lack of financial resources to purchase identified
services needed for families of preschool children.
especially "dollars of last resort.
_ General lack of information concerning
social/emotional development in pre school children
_ Lack of violence reducing techniques and strategies
in adults serving youth or young children
_ Enhancement of identification systems that reach
children in need of social and emotional resources
Data:
High abuse numbers
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High rate of aggressive and bullying behavior in early
childhood
Objectives:
I. Using both print and electronic media, provide information
to parents and others who serve children relating to
children's emotional and social development as related to
their health and safety (For example, information
campaigns relating to early brain development, impact on
young children of exposure to violence, information on
neglect and abuse prevention arid location and contact
information about community resources.)
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2. Establish a special "dollar oflast resort fund". These
"dollars oflast resort would be distributed on an as needed
basis to cover costs when existing fun~ runs out or is
unavailable. \
3. Re-establish "Child Find" to identify children in need and
connect them to community resources
4. Develop connection strategies for hard to reach sectors
(unlicensed care providers, stay at home mothers, relative
care, non English speaking communities).( Child Search
Specialist)
5. Provide "Second Step" violence reduction curriculum,
training's in child abuse awareness and prevention and
strategies to help child care providers and parents to
address and reduce aggressive behavior in their children.
6. Establish training and educational strategies to address
issues of social and emotional health in pre school children.
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Action Steps! Strategies:
Goal 1 : See action steps in Element 1
Goal 2: Establish a fund that will address desperate, "dollar oflast
resort" issues as
related to targeted families.
Goal3: See action steps in Element m
Goal4: See action steps in Elements I and m
Goal 5: see action steps in Element n
Ooal 6: See action steps on Elements I and n
Element V: Education Reform
We have not developed a position on this area other than strengthening
and expanding child development training.
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i;lement VI: Safe Schools Policies
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Goal: That adults who care for chiidren have appropriate procedures
for extreme emergencies relating to children's health and
safety.
Gaps:
Lack of parenting knowledge re emergency
response
Lack of safety procedures or policies re intrusion,
weapons or acts ofterrorism.
Lack of knowledge of law and reporting procedures
for abuse/neglect
Data:
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Objectives: II
I. Broad educational media outreaCh
2. Parenting classes and outreaCh initiatives.
3. Education and training on model procedures in
coordination with school and county emergency
mAnl\gement
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Amon Steps! Strategies:
Goal I : See action steps in Element I
Goal2: See action steps in Elements I , n and IV
Goal 3: Establish a protocol response for child care centers and
providers on how to react should there be a violent intrusion or
circumstance occur in the child care facility.
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Job Descriptions
Safe Schools: E!,lrly Childhood Psychological and Emotional
Development
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Coordinator of Administration and Training; (Child Advocacy's
CCR&R)
BA level with background in early childhood program and
administration.
Duties:
. Coordination of safe schools early childhood services with other
safe school entities
. Oversight and development of "child find" initiative
. Budget management of Safe Schools in early childhood area
. Liaison with other earlyichildhood services in the community
. Staffhiring, mAnagement and development
. Oversight of all outreach and training components
. Chair early childhood healthy start action group
Child Find Specialist. ( Health Department)
BA with background in early childhood education or social work and
marketing -
Duties: -
. Identification of at-risk children in need of intervention services
. Liaison with the Interagency Coordinating Council for Preschool
Children With Special needs
. Research and development of a 'child find' strategy
. Development, with outreaCh specialist, of a multi faceted child find
campaign
. Research and analysis of data relating to regional intervention
priorities
. Coordination and collaboration with school district, Smart Start,
CCR&R, Head Start, Health Department and regional mental
health and other early childhood community programs
Training Specialist: ($40,000 inclnsive of aU henef"rts)
Associates or BA in Early Childhood Education ( Smart Start a,--
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. Lead trainer in Second Step violence education program for
preschool children
. Scheduling and running of workshops __ ~
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. Evaluation plan coordination
. Follow up and resource development and referral
. Liaison with school based Second Step program
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Positions Pg 2.
Outreach Speeialist (Child Advocacy CCR&R and DSS)
BA or equivalent with marketing/media experience and savvy.
Duties include:
. Design of target brochures (non traditional locations such as nail
and hair salons, commuqity activity centers, public housing ,
\. .
community health, on campus student reach
. Write and produce targeted radio spots (education on
developmental stages, parenting skills, abuse prevention,
resources for at-risk children)
. Develop PSA's and speeial media campaign to reach hard to reach
audiences ( Spanish, public housing, tranSitory
populations etc.)
. Coordinate. 8 hours weekly on-site presence in community
businesses and agencies providing information and selective
referrals based on individual needs.
. Record keeping
. Active involvement in local professional associations
. Resource identification and referral
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Rough Budget:
Revised 6/17/02
Early Childhood Social and Emotional Development
Positions: (inclusive of benefits)
Coordinator of adm;nistration and training
Child Find Specialist - fJe4./fh 1)~
Training Specialist
Outreach Specialist (part time)
Pu~hase ohervices from1existing
Agencies: \
(special referrals! special initiatives: on-sight
outreach, mental health, health, abuse awareness,
fiT PQI, SS. CAC etc.)
Dollars of last resort
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45,000
40,000 Sa(~1IFI'"I>'\,J(
40,000
35,000
36,000
25,000
Materials: ~afMy,f;,r q If r"/.~ o.~f!.. e
Print materials and published materials
Second Step materials 50 at $350.00
S ~ S 'F" -A
~I.. b..u .rlIIIIIU
~t'.~ S}J1 ~
"^n
,
Support needs:
Mileage
Phone
Insurance
Space ( 12 x 200)
5,000
17,500
5,000
6,000
6,000
8,000
5,500
-';-!-e< I Eo.rl'1 Ch :tJh""J
pOf'+1;n PF Sa.t'c..
\I U 'f V()<.{~ II
24
$274.000
Sc. '" 0",1.$
bf'CO.
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PUBLIC CONTACT WITH BOARD OF HEALTH
Any written or oral request from the general public to a member of the New
Hanover County Board of Health pertaining to any aspect of program or
operations of the New Hanover County Health Department should be submitted
to the Health Director for follow up and resolution. The Health Director's
response to the request should be reported back to the Board.
This pOlicy is intended to keep the Health Director and Board of Health informed
of such contacts.
New Hanover County Board of Health Policy and Procedures
Draft September 3, 2003 25
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New Hanover County Health Department
Organizational Analysis
Volume 1
Repe;>rt
October 2002
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by
H. Pennington Whiteside, Jr., MSPH
Deputy Director, NCIPH
Charles T. Grubb, PhD
Consultant
William T. Herzog, MSPH
Consultant
Janet G. Alexander, MSPH
Research Associate, NCIPH
Sheila S. Pfaender, MS
Research Associate, NCIPH
The North Carolina Institute for Public Health
School of Public Health
The University of North Carolina at Chapel Hili
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New Henover County HeeJth ~rtment Organizetional Analysis
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Department responses; and positioning the Department to gamer community support
and recognition. As a routine schedule, the Management Team should meet either
every other week or twice monthly.
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Among the manv agenda items for the Management Team. we believe that decisions
regarding service orovision and resource allocation. Darticularlv as thev involve service
exoansion or cuts and staff deolovment. currentlv made within Divisions should be
routinelv reviewed and olaced in the context of the Deoartment Drior to imolementation.
Items for Board of Health for Review, Discussion, and Action
The current working relationship between the Board of Health and the Health Director
appears excellent; still some questions were raised in interviews about the
appropriateness of issues that are taken to the Board for action. This is often a difficult
problem for the boards pf many public and non-profit organizations. Clearly, the role of
an organizational board is to deal with major policy issues, not with the ,management and
operational issues that the organization's exeClirtive is hired to handle. The problem is in
the definition of what are "major policy issues" and what are not. Boards and executives
often disagree on this ~nd the members of many boards do not agree among
themselves. This has not appeared to be a pressing issue in the case of the NHCHD,
but because the issue has been raised we believe that the Health Director. in concert
with the Board of Health. should delineate a demarcation of "DOIiCY" and "ooerationar
decisions in order to dearlv identify the aDDroDriate ranee of decision-makina authoritY.
Generally, The Health Director is responsible for on-going operational decisions
regarding the functioning and performance of the Health Department The Board of
Health is a policy making body that should have extremely limited operational -
responsibility. -
Several years ago the NHCHD began assigning Board of Health members responsibility
for helping Health Department program leaders prepare their budget requests. Although
this process may help get the Board involved in the budget early in the process and
assure that they have greater knowledge of what is involved, it also leads to Board
members developing a certain loyalty to and investment in the particular program area to
which they have been assigned. This process runs the risk of putting the Board
members in an advocacy role for their assigned Division, further reinforcing a partitioned
view of the priorities and services of the Department. Furthermore, the practice does not
contribute to Board examination of the organization's budget as a whole. We believe
that the oractice of Board assistance in develoDina Droaram budaets should be
discontinued. Alternatively, Board members could be "assigned" to different program
areas and become "experts" in those areas. Their expertise would then become a ready
resource to other Board members about the role and function of the Health Department.
At present, the Department budget is more like the aggregation of the individual Division
budgets than a manifestation of Department policies, priorities, and programs.
Many individual leaders and staff in the Department have developed personal
acquaintance and working professional relationships with individual Board members,
sometimes as part of organizational contact and sometimes through community or
church activities. This is appropriate and can often contribute to improved mutual
understanding. However, both groups should be careful to avoid crossing the invisible
line that separates the Board role in policy decisions from organizational leadership and e
The North Carofina Institute for PuMc Heaith 27
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New Hanover County HeeJth Department Organizetional Analysis
staff responsibilities to manage and direct the organization within the overall policy
framework. We suaaest that the Board of Health adoDt a sDecific oolicv that refers anv
concerns brouaht to individual Board members to the Executive Director of the Health
DeDartment for follow-UD and resolution with a "reDort" back to the Board.
Recommendation 3: Promote an internal and external image of
the NHCHD as a single organizational unit.
The Pros and Cons of Strong Divisions
The individual Divisions and programs of the Health Department are unquestionably
among the major strengths of the organization, and the sense of pride and
accomplishment they build among staff and the public they serve must be maintained.
The Environmental Health, Animal Control, anp Nursing Divisions, to name a few, each
have individual staff and community advocates. The image of expertise and public
service that the staff and leadership of these Divisions enjoy contribute to the overall
credibility of the Department To a degree, work group pride and loyalty can build a
healthy element of competition among Divisions and increase the enthusiasm and
productivity of team members, so long as it is accompanied by an even stronger pride
and loyalty in the overall organization. All staff, but particularly the top leadership,. need
to be aware of the importance of strengthening visibility, staff loyalty, and organizational
pride for the Department as a whole. It is only with this broader outlook that the common
aims of greater public support, funding, and resources will be realized. In this respect,
the individual Division-level newsletters emphasize the partitioned nature of the
Department, fail to capitalize on opportunities to widen awareness and knowledge
among both employees and community interest groups, and consume more resources
than are necessary in duplication of effort and costs. We believe that Division-level
emphases should be continued only as sub-sections of a broader Department-level
Newsletter
Although the individual Divisions and pride of accomplishment serve the Department
well, we are convinced that the Divisions in the Health Department have evolved to a
point where the Division lines are demarcations that significantly limit collaboration,
cooperation, and communication across the Department. There does not appear to be
any regular mechanism in place that systematically reviews initiatives and assignments
within individual Divisions in the context of the needs and priorities of the Health
Department. If an individual Division needs assistance and requests it from another
Division, that Division makes a decision to assist or not based solely upon its view of the
situation. Individual employees in one Division have been admonished not to assist
employees in another Division on even routine questions like how computer software
works. On the Staff Survey 60% of respondents disagreed or strongly disagreed with
the statement "Communication between different job levels in this organization works
well."
Significantly, more than 60% of management and more that 65% of supervisors
disagreed or strongly disagreed with that statement.
The North Carofina Institute for Public HeeJth
28
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DRAFT{t~
Ml,.,ion
The mission of the New Hanover County Health Department Is to assure a safe f."3]
and healthy community.
Vision
Healthy people, healthy environment, healthy community
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New Hanover County Health Department
August 19, 2003 Working Session on Mission, Vision, Values
Workina Aaenda. 8/19/03
8:30 - 8:45 am Introductions, "Vision" for the session
8:45 - 9:15 am Review of materials, other ideas, prior work
9: 15 - 10: 15 am "Zeroing In" on Mission
10:15 -10:30 am Break
10:30 - 11 :15 am Vision
11 :15 -12:00 noon "Core Values"
Vision for the session outcome:
A small foldout brochure with four sections;
Mission - What we do.
Vision - Where we are going.
Core Values - What principles will guide us along the way.
Organizational Offices and How to contact us.
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Mission
Existino Statement (from 2001 Annual ReDort and current website)
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''The mission of the New Hanover County Health Department is to
pr9tect the public health and environment, promote healthy living and
optimize the quality of life through prevention, restorative,
environmental, and educational services,"
From ResDonses to Advance Reouest:
Serve the community by promoting "ealthy lifestyles, provi'ding
education related to prevention of disease (esp. emerging diseases)
and promotion of health, protecting the environment, protecting the
public, responding to disasters/emergency situations, and assuring
accessibility to health services.
To provide quality preventive and protective public health services to
the citizens and visitors of New Hanover County.
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Vision
From 10/26/02 Meetina:
1. Healthy citizens living in a health environment.
2. Promote, protect, provide healthy living.
3. Health services meeting the needs of the community
4, One healthy county,
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From Advance Reauest ReSDonses:
Healthy People, Healthy Environment, Healthy Community
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Improved access for the communitY through:
Open Access Scheduling for clinical services
Improved access and availability of services
Improved utilization of staff skills
Improved utilization of staff productivity
Increased unity among staff and programs/services
Improved systems for quality improvement
Enhanced systems for staff training and accountability
Achievement of accreditation
Seamless communication among staff and within the community -
engage the publici
--..-------------
Marketed as a quality source of health care... .not only the place to
come when you cannot afford anything else
Being a "heavy hitter" in the community; proactive, prepared,
competent in the eyes of the community (this is really a marketing
issue?)
Being more present in the community, not just in the building
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Core Values
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From 10/26/02 Meetino:
1. Dedication to Service to community
2. Health Protection / disease prevention
3. Strong customer oriented
4. Maintenance of high quality standards and principals
5. Proactive, futuristic, innovative
6. Resilient, determined, will get the job done
7. Importance of friendliness and supportiveness
From Resoonses to Advance Reauest:
guideposts are public health core functions (assessment, policy
development, assurance)
all people have worth - non-descriminatory interaction with "the
public" is paramount for public health
services should be accessible and readily available - customers
should not have to "beg" to be seen
education, education, education (individual patients and community
at large)
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health department customers provide us with a means for
"diagnosing" our community
intemal customers have great worth and are a valuable commodity -
need to be cared for
provision of quality care
Access to care (make accessing our services as easy and streamlined as
possible)
Quality quality quality...we need to ensure that our staff has the most
current knowledge for provision of services
Protecting the public, core public health role of communicable disease
surveillance
Chronic disease prevention education
Treating the "person" and the "family", not the specific body part or
current health condition
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New Hanover County Health Department
Mission, Vision, Values Work Session
August 19, 2003
Summary Report
Facilitator: William T (Bill) Herzog, MSPH
Consultant
Attendees: Betty Jo McCorkle, Elisabeth Constandy, David Rice, Cindy Hewett, David
McDaniel, Nancy Nail, Ellen Harrison, Dina Sarro, Janet McCumbee,
Betsy Summey, Diane Vosnock, Dianne Harvell, Marilyn Roberts, Jean
McNeil, Thomas Morris, Alene Mabry .
Mr. Herzog opened the session by explaining that the group was gathered to finish the
work begun during the NHCHD Strategic Planning Retreat, October 26, 2002. He
further explained the three things he hoped to accomplish during this session:
1. Create a NHCHD "Vision Statemenf
2. Create a NHCHD "Mission Statemenf
3. Try to establish NHCHD "Core Values" (principles that guide along the way)
Mr. Herzog said an organization's vision is similar to "imaging," comparing it to the
game of golf and the importance of looking where you want the ball to land. Get the
image in your mind of where you want to be. Vision is not esoteric - vision is where you
want to go. He suggested creating a small brochure to include the health department's
vision, mission, and core values. The vision and mission are important in organizing
what we do and what we don't do. Ensure clients and staff alike understand.
The public health mission and core functions (see Attachment A) were discussed.
David Rice stated that the Association of NC Board of Health mission is to assess,
address, and assure public health. Mr. Herzog confirmed that public health agencies
should assure services and provide direct care where it relates to public health or playa
supportive role in making sure health services are provided. Mr. Rice commented on
ever-changing health issues such as insurance, home health care, primary care, and
most recently, the jail health.
Attachment B deals with eleven essential public health services that public health
agencies should provide. Mr. Herzog said the CDC has been developing methods of
assessing public health assessment methodology. Mr. Rice said the NC Association of
Local Health Directors is looking into accreditation.
Mr. Herzog reviewed vision and mission statements and core values from other
organizations (see Attachment D). At this point. Janet McCumbee introduced the vision
and mission statement from the North Carolina Smart Start Program (see Attachment
F).
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NHCHO
MIssion, VISion. Values War1< SessIon
August 19. 2003
Page 2 of 5
ZeroinG In Exercise - Mission
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Mr. Herzog reviewed the current NHCHD Mission Statement and asked each participant
to write a new mission statement.
Participant Responses
1. Promote healthy lifestyles, access to care, and disease prevention.
2. Promote and improve the health and quality of life of the people of New
Hanover County.
3. To educate and prepare the public to prevent and intervene against disease
and prof"(lote a healthy community for the common good.
4. Protect, promote, and improve the health and environment and improve the
quality of life t;>f the citizens of New Hanover County.
5. Assured health protection through pr~vention, service, and!education.
6. To promote, provide, and maintain a safe and health community.
7. To protect and provide a healthy environment in NHC and provide education
and healthcare to its citizens.
8. To promote and protect healthy lifestyles by education and prevention of
disease, preparing for disaster and ensuring a safe environment.
9. Serve the community through provision of preventive and protective health
services.
10. Provide quality service to assure a healthy community through protection, _
promotion, and response. -
11. Provide and promote healthy living.
12. To promote healthy lifestyles, access to health care, disease prevention,
protect the environment, and provide services.
13. To promote healthy lifestyles and to protect the public and environment.
14. Protect the people of NHC through health promotion and disease prevention
services.
15. Assure a healthy community by promoting healthy lifestyles, preserving the
environment, preventing disease, and preparing for disaster.
16. To assure a healthy community through prevention, promotion, and response
to individual and environmental needs.
Mr. Herzog went over mission suggestions and pulled out key words. prevention,
promotion, serve, protect, respond, intervene, prepare, and assure. He then collected
all responses, threw them away, and asked everyone to create a new mission
statement based on key elements discussed.
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NHCHO
MisSion. Vision, Values War1< Session
August 19. 2003
Page 3 of 5
e 2nd Round Mission statements
Promoting and providing a safe, healthy and quality assured community.
Assuring a safe, healthy community through protection, prevention,
promotion, and response.
To promote and protect healthy lifestyles, respond to individual and
environmental needs, and provide access to care.
Assure a healthy community by providing services to protect the public and
environment and promote healthy living.
Promoting, preventing, preparing.
Assuring a healthy New Hanover County by promoting, prevention, and
preparing to protect the people of NHC.
Assuring a safe. and healthy community through protection, prevention,
promotion, and response. \ 'I
To protect the health of the citizens of NHC and provide services and
education to promote a clean environment and healthy living.
To prevent, improve, and assure the health of the community and its
environment by assessment and promotion of healthy living.
Assure quality of life through preventive healthcare services.
To protect, promote and improve health, environment, and quality of life.
To promote and protect healthy living.
To assure a safe and healthy community.
Provide a healthy community through prevention and promotion of health and
assuring a safe environment.
Provide quality services that promote and protect healthy people and a clean
environment.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
:e 13.
14.
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15.
Mr. Herzog reminded the group that the mission is what you do and the vision is where
you want to be.
Mission Statement
After group discussion regarding the word "community", Mr. Herzog stated the
"community" should be the area of focus for a health department, and diagnosis and
treatment of the "community" as a patient is key. The group came to a consensus and
chose the following as the recommended New Hanover County Health Department
Mission Statement:
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The mission of the New Hanover County Health Department Is
to assure a safe and healthy community.
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NHCHD
Misslon. VIsion, Values Worl< SassIon
August 19. 2003
Page 4 of 5
Zeroing In Exercise - Vision
Mr. Herzog explained the Health Department's vision statement should give us an
image of "where the Health Department is going." He asked the group if we were able
to accomplish the mission and vision statement, what would New Hanover County look
like ten years from now? Responses as follows:
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1 . Half as many cars on the roads - less sirens.
a. Betsy Summey commented on the "global stress" of New Hanover
County. The tourism and population influx has created a great change in
the ambience of the county.
2. Improved transportation system including access to care.
3. Important to partner with other organizations
a. Health issues are everyone's concem
b. Reduce departmentalization which causes us not to look at the big picture
c. Most problems within communitIes have various facets, i.e., police, health,
environmental, etc.
4. Equal opportunity and access to healthcare
5. See people take responsibility for their health
6. Would like for community to know the health department's role within the big
picture of health.
a. Marketing and education to the community
b. Possible sign .by the road _
7. No unplanned pregnancies .
8. What would the staff look like?
a. Highly skilled, caring, well-trained, big paychecks, adequate staffing,
competent, compatible, united behind mission, every person needs to
know that what they do makes a difference, staff that feels valued by
others and themselves
b. Betsy Summey mentioned that someone once said, "If you're going be a
garbage man, be the best garbage man." In other words, be the best at
what you do.
c. ContinLiing education for staff
d. Quality needs to be a priority - do not tolerate mediocrity
e. Continuing education isn't only about receiving credits it expands into
other areas.
f. People want to a good job and we need to provide those tools so they can
do a good job to get the most from that system and person.
g. People need to have a good sense of value and self-image.
h. Quality and high expectations - people tend to rise to high expectations
9. New facility I building
10. Open access scheduling
It was asked if there a difference between extemal and intemal vision? Mr. Herzog said
yes and asked if we want to make that distinction. Vision is what we tell our _
communities what we stand for and strive for. Mr. Herzog then recounted a story about .
37
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NHCHD
Mission, Vision, Values Woll< Session
August 19, 2003
Page 5 of 5
Chrysler Chairman, Lee lacocca, in which he made a number of commercials. Even
though the commercials were aired nationally, his intent was to motivate and unite the
people in his organization through this public statement.
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Vision Statement
The group reviewed suggested vision statements, both from other organizations and
group solicitation. The group decided to propose the following as the New Hanover
County Health Department Vision Statement:
Heal~hy people, Healthy environment, Healthy community
It was noted that the current New Hanover County Health Department motto, "Your
Health, Our Priority" fits'well with the new mission and vision statement drafts.
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Zeroing in Exercise - Core Values
The group reviewed and added to the core values created during the Strategic Planning
Retreat, October 26, 2002 (see attachment E). The group determined the following
should be key elements in establishing core values:
e 1.
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2.
3.
4.
5.
6.
7.
8.
Dedicated to serve the community (customer orientation both intemal and
extemal customers)
a. Determined to get the job done
b. Friendly, supportive
Quality,standards, and principles
a. Workforce I services - includes education of staff
Proactive, futuristic, innovative
Access to health services should be available without regard to race,
ethnicity, socio-economic status, or disability
Education of public
Community partnerships in collaboration - engage the community
Will be flexible in modifying services to address the needs of the community
Promote health, prevent disease, protect environment, prepare (to respond)
Due to time constraints, it was recommended that a Core Values Subcommittee be
formed to create a Core Values draft for submission to the Board of Health. Elisabeth
Constandy, Betsy Summey, Dianne Harvell, and Jean McNeil volunteered to work on
the subcommittee.
Mr. Rice will present the Vision and Mission Statement Drafts to the Board of Health
Executive Committee Meeting next week for consideration and/or approval. After the
core values are further defined, those statements will also be presented to the Board of
Health for consideration.
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William T, Herzog
P,O. Box 9034
Chapel Hill, NC 27515
(Email: bherzog@intrex.net)
August 21, 2003
Dear Workshop Participant:
This letter includes: A Reauest for your help in preparing for the August 19lh
workshop on Organizational Vision and Mission; A DescriDtion of Attachments;
and, My Concerns and HODes for the workshop.
,
Request:
Please review this letter. the attached materials. and any other resources
available to you and send vour response directly to mv Business Address
(as above) or via Email bv AUGust 8th. It Is vour choice as to whether YOU
identify vourself and unit In YOur response. ). I will summarize your ideas and
suggestions in aggregate form to provide us with a starting point. As a general
rule for your suggestions (as well as our final product), it will be better to be brief
than expansive and better to be practical rather than idealistic.
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1. Organizational "Core Values." What basic principles or standards do
you believe should be most important to the organization?
2. Vision. What is your image of the Departmenfs role and contribution to
the community in the future?
3. Mission. How would you state the primary purpose of the Department in
a way that can be easily understood by staff, board, and the community?
4. Concerns and Suggestions. What are your major concerns about this
process? What are your suggestions for dealing with these?
Description of Attachments:
A. Mission and Core Function Statements from the 1988 Institute of
Medicine Study of the Future of Public Health. Most of you are familiar
with the three core functions of "assessment, policy development, and
assurance" outlined in this report. but it is worth reviewing the detailed
recommendations related to these functions.
B. Public Health Foundation "Essential Public Health Services." These
eleven "essential services" are often quoted and are integral to the
proposed COC performance standards for state and local health
departments.
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C. List of New Hanover County Health Department Services. (as
displayed in the organizational website). These are more familiar to you
than to me and. along with the above "essential services" and state and
local mandated services, provide a broad view of the range and
complexity of departmental operations.
D. Sample Values, Vision, and Mission Statements. These samples are
not presented as positive examples that you should strive for or negative
examples of what you should avoid. You can make your own judgment on
that. They are simply examples of what others have attempted.
E. Summary of October 26th, 2003 Discussion of Organizational Core
Values and Vision. (Excerpted from meeting report). This is presented
so that we don't lose the benefit of the previous discussion. but our effort
that day was incomplete and there were a number of other agenda items
that day.
My Concerns and Hopes:
To be honest, I have a number of concerns about the value of many
organizational "core value, vision, and mission statements," Too often the
process and results become artificial, fUzzY,lpretentious, irrelevant, and so full of
compromise they become meaningless. What starts with a well meaning and
genuine effort to improve organizational focus gets bogged down in wordiness,
the drive to seem profound, and the need to be all-inclusive. In my opinion a
review of the mission statements of many organizations, public and private,
health oriented or production oriented is not impressive. I believe that the field of
public health is particularly vulnerable in this regard. It is, by nature, a highly
complex, ambiguous endeavor that calls upon a divergent group of professionals
with little common language or perspective. The task of finding common ground
and unifying principles is at the same time more difficult and more important.
Despite these concerns, I am idealist enough to have the "vision" that your group
can develop a clear statement of the principles that are most important to you,
the kind of organization you would like to see in the future, and the primary
purpose of the organization. At least I am willing to tilt toward that "windmill" if
you are.
I look forward to working with you again and hope that we can collaborate to
finish this task.
Please let me know if you have any questions.
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Cordially,
Bill Herzog
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ATTACHMENT A
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Institute of Medicine, Committee for the Study of the Future of Public
Health, Dlvisi9r1'of Health Care Services, "The Future of Public Health,"
Washington, DC: National Academy Press,196a.
(Statement on public health mission and core functions, pages 7-8. )
"THE PUBLIC HEALTH MISSION, GOVERNMENTAL ROLE, AND LEVELS OF
RESPONSIBILITY
Mission
. The committee defines the mission of public health as fulfilling
society's interest in assuring conditions in which people can be healthy.
Its aim is to generat,e organized community effort to address the public interest in
health by applying,scientific and technical knowledge to prevent disease and
promote health. The mission of public heal8i' is addressed by private
organizations and individuals as well by a~ public agencies. But the
governmental public health agency has a unique function: to see to it that vital
elements are in place and that the mission is adequately addressed.
Governmental Role in Public Health
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. The committee finds that the core functions of public health agencies at
all levels of government are assessment, policy development, and
assurance.
Assessment:
. The committee recommends that every public health agency regularly
and systematically collect, assemble, analyze, and make available
information on the health of the community, Including statistics on
health status, community health needs, and epidemiologic and other
studies of health problems.
Not every agency is large enough to conduct these activities directly;
intergovernmental and interagency cooperation is essential. Nevertheless each
agency bears the responsibility for seeing that the assessment function is
fulfilled. This basic function cannot be delegated.
Policy Development
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. The committee recommends that every public health agency exercise
its responsibility to serve the public interest in the development of
comprehensive public health policies by promoting use of scientific
knowledge base in decision-making about public health and by leading
in developing public health policy. Agencies must take a strategic
approach, developed on the basis of a positive appreciation for the
democratic political process.
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Assurance
. The committee recommends that public health agencies assure their
constituents that services necessary to achieve agreed upon goals are
provided, either by encouraging actions by other entitles (private or
public sector), by requiring such action through regulation, or by
providing services directly.
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. The committee recommends that each public health agency involve key
policymakers and the general public in determining a set of high-priority
personal and community-wide health services that governments will
guarantee to every member of the community. This guarantee should
include subsidization or direct provision of high-priority personal health
services for those unable to afford them.
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ATTACHMENTS
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Public Health Foundation -1220 L Street, N.W., Suite 350,
Washington, DC 20005
Essential Public Health Services
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. Monitor health status to identify community health problems
. Diagnose and investigate health problems and health hazards in the
community
. Enforce laws and regulations that protect health and ensure safety
. Inform, educate and empower people about health issues
. Mobilize community partnerships to identify and solve health problems
. Link people to needed personal health services and
,
. Assure the provision of health care \When otherwise unavailable
. Evaluate effectiveness, accessibility, and quality of personal and
population-based health services
. Assure a competent public health and personal health care workforce
. Develop policies and plans that support individual and community
health efforts
. Research for new insights and innovative solutions to health problems
Source: Essential Public Health Services Work Group of the Public Health
Functions Steering Committee
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ATTA~~MENT C
New Hanover County Health Department Services (as listed on
Departmental Website)
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Animal Control Services
Rabies Control
Animal Licensing
Animal Control Services Shelter - Adoptions
Bite Investigations
Child Health
Child Care Nursing
Child Lead POisoning Prevention
Child Services Coordination
Health Check I Health Choice
Navigator
Sickle Cell Testing
Sudden Infant Death Syndrome Counseling
Communicable Disease
HIV Counseling, Testing, and Prevention
Immunizations
Sexually Transmitted Diseases
Surveillance and Outbreak Control
Tuberculosis Control Program
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Community Health
Adult Day Health Monitoring
Adult Health Clinics
Adult In-Home
Child In-Home
Jail Health
Kindergarten Health Assessment
Neurology Clinic
Orthopedic Clinic
School Health
Well Baby Clinics
Dental Health
Access to Care
Adult Dental Program
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Community Water Fluoridation
School Preventive Dental Program
e Environmental Health
Food and Lodging - Food Safety
Soils and Water
Vector Control
Health Promotion
General Health Education
Tobacco Prevention/Project ASSIST
Injury Prevention
Women's Health Education
Laboratory
Technical and Testing Support Services to Health Department Programs
State Approved Laboratory for Water Bacteriology Examinations Testing
Resource for Private and Community Health Programs
Licensed by the Federal Govemment to Provide Medical Laboratory
Testing
Nutrition
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General Nutrition
Women, Infants, and Children
Women's Health Care
Baby Talk
Breast and Cervical Cancer Control Program
Birth Control Options
Breastfeeding Resources
Childbirth Classes
General Clinic
High Risk Home Visiting Program
Intensive Psychosocial Counseling
Matemal Outreach Worker Program
Matemity Care Coordination
Matemity Clinics
PostpartumlNewbom Home Visiting Program
Pregnancy Testing
T ANF Program
Vasectomy Program
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\ \
ATTACHMENT D
Sample Values, Vision, and Mission Statements
United States Air Force: Core Values
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Integrity First
Service Before Self
Excellence in All We Do
Marriott: Core Values & Culture
The core values established by the Marriott family over 75 years ago have
served our company well and will continue to guide our growth into the
future. Foremost 'of these core values is the enduring belief th~t our
associates are our greatest assets. !' '
Core values
There is a 'Marriott Way.' It's about serving the associates, the customer
and the community. Marriott's fundamental beliefs are enduring and the
keys to its continued success.
Marriott culture
It's the Marriott experience. We do whatever it takes to provide our
associates with the utmost opportunities, and our customers with superior
service.
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American Academy of Pediatrics
Core Values, Vision, and Mission Statement
Core Values. We believe in the inherent worth of all children. They are our
most enduring and vulnerable legacy. Children deserve optimum health
and require the highest quality health care. Pediatricians (primary care
pediatricians, pediatric medical subspecialists, and pediatric surgical
specialists) are the best qualified of all health professionals to provide
child health care. A dynamic organization is necessary to advance these
values. The American Academy of Pediatrics is that organization.
Vision. The American Academy of Pediatrics exists to prepare its
members with the tools, skills, and knowledge to be the best qualified
health professionals 1) to advocate for infants, children, adolescents, and
young adults and provide for their care; 2) to collaborate with others to
assure child health; and 3) to ensure that decision-making affecting the
health and well-being of children and their families is based upon the
needs of those children and families. The American Academy of Pediatrics
also exists to support members professional satisfaction and personal
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growth. By providing these services, the American Academy of Pediatrics
will be the most valuable professional organization to which those eligible
for membership can belong.
Mission. The mission of the American Academy' of Pediatrics is to attain
optimal physical, mental, and social health and well-being for all infants,
ST. LOUIS COUNTY DEPARTMENT OF PUBLIC HEALTH
MISSI,ON:
The mission of Public Health is to promote and improve the health and
quality of life of the people of St. Louis County.
VISION:
'.
,
The vision of Public Health is: Healthy\people in healthy cornrriunities
through Public Health leadership.
Grand Forks Public Health Department
VISION
Healthy People, Healthy Environment, Healthy Community
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"
MISSION
The Grand Forks Public Health Department is committed to serve the
community by promoting healthy lifestyles, protecting the environment,
preventing disease, responding to disasters, and assuring accessibility to
health services.
Core Functions
The Department's Strategic Directions together with public health core
values are its guideposts. We want to keep on top of health issues,
respond effectively, and engage the public.
NC Association of Local Health Directors Mission Statement
The mission of this Association shall be:
"To promote health, prevent disease, protect the environment in order to
ensure the public's health in North Carolina through leadership, vision,
advocacy, and commitment to the principles of public health practice in
our local communities and throughout the state.'
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47
ATTACHMENT E
Summarv of October 26. 2003 Vision Exercise
Discussion of Oraanizatlonal Core Values. Vision. and Mission (excerpt
from 10/26/02 meeting repprt)
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Vi"ioDin!! I Mission Exercise
Participants broke out into table groups to work on the Vision / Mission Exercise.
Participants were asked to write down possible accomplishments of public health
by the year 2022 and then create a vision. Following are some suggested vision
statements for the Health Department:
"Vision"
1. Healthy citizens living in a health environment.
2. Promote, protect, provide healthy living.
3. Health services meeting the needs of the community.
4. One healthy county.
Core values
1. Dedication to Service to community
2. Health Protection / disease prevention
3. Strong customer oriented
4. Maintenance of high quality standards and principals
5. Proactive, futuristic, innovative
6. Resilient, determined, will get the job done
7. Importance of friendliness and supportiveness
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48
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A7Ilratllf€tfJT F
"Building Bridges to the Future"
Our Vision-
The New Hanover County Partnership' Cor Children envisions every child entering school
with the health, Camily support, and early education necessary to succeed.
. All families will receive the support that they need in order to have healthy children
with necessary preventive and routine health care;
. Every child will grow up in an environment that is free of abuse, neglect and
violence;
. Families and their children will have necessary assistance in their efforts to reach
their full potential;
. Affordable, quality early education and care will be available to all families, as
appropriate, meeting individual child and family needs;'
. New Hanover County cOrporate, philanthropic and community leaders will make
quality early childhood services for children and their families a priority.
Our Mission-
The New Hanover County Partnership Cor Children seeks to build bridges to develop,
sustain and enhance health, Camily support and early education services Cor all children,
ages birth to fIVe.
Beliefs:
. The well Demg and sucCess ot' every child is critical regardless of race, ethnicity,
socioeconomic status, or developmental and learning disabilities;
. The quality oflife for young children is basic to adult well being and the future
economic vitality of our community;
. Parents are a child's first and most important teachers;
. A broad community-based partnership committed to young children should be
available to assist parents in their role as primary caregivers;
. The community has the responsibility to provide effective strategies to support early
education as well as the development ofmenta11y and physically healthy children.
Partnership Principals:
. Program and fiscal accountability are key to producing appropriate, measurable and
qua1ity outcomes;
. Collaborative and cooperative efforts with community partners working on behalf of
children are most effective and essential;
. The planning, allocation and evaluation activities of the Partnership significantly
involve key stakeholders- parents, community members, agency representatives,
business and political leaders, and representatives of the faith community- is
strategically important;
. Our resources will be maximized by developing human and fiscal supports;
. The concept of Smart Start and the Partnership's locally funded programs is promoted
within the community at large.
49
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NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda:U Consent Meeting Date: 09/15/03
Agenda: ~
Department: Health Presenter Cindy Hewett, Business
Manager
Contact: Cindy Hewett, Business Manager, ext 6680
Sub'ect: Medicaid Cost Settlement Funds - Bud et Amendment $273,333
Brief Summary: Medicaid Cost Settlement Funds were received in FY02-03 in the
amount of$273,333, The Office of Medicaid Reimbursement conducted a Medicaid
Cost Analysis (examining services provided, cost of services, staff time spent in
programs, etc.) comparing actual medicaid renhbursement for services provided at local
health departments during a given timeframe. The cost settlement funds noted here
($273,333) were additional reimbursement to the New Hanover County Health
Department for services provided from July 2001 - June 2002. These funds must be
spent in the programs that provided these services, or programs that are part of the
Women's and Children's Health Pro or su rt ro s for an of these,
Recommended Motion and Requested Actions: To approve rollover of Medicaid Cost
Settlement Funds received in FY 02-03 and associated budget amendment as submitted
for expenditure of these funds,
I Funding Source: Office of Medicaid Reimbursement
Will above action result in:
[]New Position Number ofPosition(s)
DPosition(s) Modification or change
~o Change in Position(s)
I Explanation:
I Attachments: Budllet amendment and proposed breakdown of expenditures.
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NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda:U Consent Meeting Date: 09/15/03
Agenda: C8]
Department: Health Presenter Janet McCumbee, Personal
Health Services Director
Contact: Cindv Hewett, Business Manager, ext 6680
Subiect: Addition of 5 School Health Nurse Positions.
Brief Summary': Request from New Hanover County Schools to hire (5) school health
nurses (each will be a '0 month position but will be pro-rated to 8 months for the
remainder of the school year) and funding for such to the New Hanover County Health
Departmem. \
Recommended Motion and Requested Actions: To approve the addition of(5) school
health nurse positions to the Health Department School Health Program as funded by the
New Hanover County Schools for the 03-04 school year. Also, to approve the associated
budget amendment.
I Funding Source: New Hanover County Schools
Will above action result in:
C8]New Position (5) Number ofPosition(s)
Dposition(s) Modification or change
DNo Chan e in Position s
Explanation: The New Hanover County Board of Education would like to increase the
contribution to the Coun to fund 5 additional School Health Nurses.
Attachments: Budget Amendment and supporting documentation identifYing award of$90,358
(amount needed above original budgeted amount for FY 04) to fund (5) additional school health
nurse positions.
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APPENDIX F
~ltl:l~44"~:l
"'-">AN
r""HoX. tJ.L
CONTRACT
.... HI"",, Countr Maal.
M,O CInIlIn8 ......Ild.
W1bn1..... NC ..fa
AND ,
NIw HaMwr County ....Ilh De,.,......
20.1.11" .....
Wllml........ NO JMI1
'I1dI ClOIIlnIclt wID IIegln GIl Jul)' 1, 2003 Md IIld on.June 30. 20041l1llW8111 New HInD_ County 8dloalo Ind ""'"
~ ~ ...... Olplrtmert 1lolIl..... do"'" ..-to tile ~,,_
A.
New If.- Cou~ 8clIooIa WIll:
" Pey 11.SI2,242,oo (1159,224,20 per IllOIIth rvr 10 monlN) lbr ,,,,,,-.
:z. PnMa IlId eppIIlPlIlIltIy *IufppecI .-n for lIle nurse wilen the II ~ It her cIeIIGna\ICllCllool.
"
NIw tt.lGJeK CounIr ....... OIp II1mInt wit
"
..
1, Develclp IIld IllIintJinl'nt Aid guldellneund nunlnll /lid JIJ ID lie 1lI8CI1n,.a.choaIJ.
II "
2. Pmlde 4 Mene run. 8IIIpecI to loaN., HIGh SChoo~ HotIIllIt HWI8dloa1. N8W HlnDYIt HgIl
ScIIool, IIld LIMy HIgh SdIooI,IIId _ _ _., per__1I Labf.... HIgh SclloclI.
3. PnMdt T M-41me..- Ullgned to tile 7 middle IlIhaoIL
PreWle 21l1l11111M _ Md1 half tlml _to blllllgned an l1li_ nllded Ileais to lIII
...........ylClloal..
PnMde IUppllelllllr __ MedloII seroll~ II
..-..... In 'cc.r.~wllltIle'NoItIl c.dIlI NulII ~klllnd""~dL...
_bhIIllI by tile N8W ~ CounI1 HIdh 0IpI1lmenl
PnMde nanInt lupervIJian IhtaurlIItIle PItIOllII HlllIIl8eM_ 0irecIDr mid thI PublIc Heellll NIne
lup lI\4IOI.
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CCInIrlIct Is con\lngwIt the Ipprvvet ofthl MImorIndum ttf AgJ...m by baIh .....'
.dIng lIwuglIlhIIr dlb 8\IlIIOIlZ8d ollIc:IItI "- ell' i.t\od 11111 COIllI8d.
~~/
NHC8
tlllIlMlrUIIIenI .... beIflllldilld III the
Mlnllll' NqUINcI by lIIelalloolludelt
And ..... CcwdnlI M
1 !8"'311~ 4342.057.00
2 &810.. 311~ 41111.093.00
:2 11810 ~11 GOIHIOll .. _.012.00
DATE
COH1'RACTOR
DATE
.
~U./:J
t/~L
DATE
DRAFT
NEW HANOVER COUNTY
ORGANIZATIONAL CHART
DRAFT
.
J -,
CmzENS
I I
SHERIFF II COUNTY REGISTER OF DEEDS
... COMMISSIONERS ..,
...1 COUNTY ATTORNEY I......................... COUNTY MANAGER .........................1 CLERK TO THE BOARD I..!
PIO - EXECUTIVE
ASSISTANT
ASSIST ANT COUNTY ASSISTANT COUNTY II
MANAGER MANAGER
I I
-I AJRLlE GARDENS I BUDGET AGING l-
e COOPERATIVE II FINANCE ELECTIONS
- EXTENSION -
-II EMERGENCY II I J~
MANAGEMENT 'II nUIVlAN RESOURCES HEALTH
-II ENGINEERING & WATER INFORMATION I HUMAN RELATIONS I~
& SEWER TECHNOLOGY
~I ENVIRONMENTAL I TAX ADMINISTRATION 1 JUVENILE DA Y I~
MANAGEMENT REPORTING CENTER
-il FIRE SERVICES I i ,---------, I UBRARY ]~
.................., COURTS I
.----------
-il INSPECTIONS I I MUSEUM 1-
-I PARKS I II SOCIAL SERVICES -
-I PLANNING I VETERANS SERVICES -,
-- PROPERTY r-SOUTHEASTERN -l l
MANAGEMENT CENTER ....
L_________..I
PUBLIC SAFETY
L- COMMUNICATIONS
e
North Carolina Department of Health and Human Services
2001 Mail Service Center' Raleigh, North Carolina 27699-2001
Tel 919-733-4534 . Fax 919-715-4645
Michael F Easley, Governor
Carmen Hooker Odom, Secretary
e
I
e
August 2S, 2003
Mr David Rice
New Hanover County Health Director
2029 South 17th Street '
Wilmington, NC 284081
Dear Mr. Rice:
Thank you for agreeing to serve on the Public Health Task Force 2004. Your
contribution in this critically important initiative is much appreciated.
We wanted to get the dates of the Task Force meetings to you as soon as possible.
Please hold:
September 29th -
November 19th -
February 2Sth
April 20th
l-Spm
l-Spm
l-Spm
l-Spm
The location will be announced as soon as we have identified a place but most if not all
of these meetings will be in Raleigh.
We look forward to working with you to create an innovative plan that will have
significant impact on public health.
Thank you again for agreeing to join us in this exciting effort.
.~
Sincerely,
armen Hooker Odom, Chair
Public Health Task Force 2004
Baluss, President
ation of Local Health Directors
*
Location: 101 Blair Drive' Adams Building' Dorothea Dix Hospital Campus' Raleigh, N.c. 27603
An Equal Opportunity / Affirmative Action Employer
~~
-
1-
c..
MAKING A DIFFERENCE IN DIABETES WITH TIMEt V INFORMATION FOR THE CITIZENS OF NEW HANOVER COUNTY
best level for you -- less than 130/80 if pos-
sible.
. Have your urine checked for protein, Protein
in urine is related to diabetic retinopathy.
. Do not smoke..
. Have a Qilated eye exam every year. Damage
to your eyes may have no symptoms in the
early stages wh!ln it j~ most -treatable. Laser
surgery can't bring baCk vision thathas already
been lost. That is why it is so important for you
to have an annual eye exam.
You're invited to be a DUe.
Take a Look:
Why Eye Care Is Important
As someone with type
Z diabetes, you may
/ulve read that diabetes
is the most common
cause of blindness in
adults. But blindness
doesn't /ulve to /ulppen because you have diabetes.
You can greatly reduce your chances-of getting eye
disease by taking care of your diabetes. If detected
early, diabetie eye disease can be treated and msy
never cause trouble,l
With your vision. Read $
on to find out how ~
diabetes affects the
eyes and what you can
do to help prevent eye
problems in the future.
It .doesn't matter if you have Type 1 diabetes
or Type 2, whether you are newly diagnosed
or have lived with diabetes for a while - you
are invited to become a DUC. That's the name
chosen for our Diabetes Support Group. It
stands for Diabetics Under Control - and con-
trol is what it's all about..
Experts agree that when it comes to diabe-
tes, you're in charge, Most of the day-to-day
care is up to you. You choose what and how
much to eat. You also decide whether to take
your medicine, to check your blood sugar and
whether to be active. Luckily, you have help
and support.
Join us on the third Thursday of each month
from 1:30 - 3:00 PM at the New Hanover
Senior Center, 2222 South College Road. Our
program begins at 2:00 PM. We're on sum-
mer break; there is no meeting scheduled for
August.
The September meeting is set for Thursday,
September 18, Our focus this month - man-
aging stress. Certified laugh leader Stephanie .
Carr, M.Ed. - will lead us in chuckles, belly
laughs and stress busters. Come for fun - and
leam a new technique for managing your blood
sugar and blood pressure.
Future programs include talks by a podiatrist,
an endocrinologist and a certified diabetes edu-
cator. Call 343-6758 for more information.
You should seek
care right away
if you have:
. Severe pain in the
eye
. Sudden vision chang-
es such as light flashes,
dark spots, floating
objects in your vision,
partial blindness or
blind spots. These
changes may mean
serious problems _ that
could lead to blindness
if not treated at once.
Mark your Calendar
"'
September 4 and 11
Di.a~etes Seif.Management Class
9:30 -11 :30 AM at New Hanover Community
Health Center.
Details at 343.6758
,CJ
Preventing
diabetic eye
disease
September 8. 15, 22
Dining with Diabetes
5 to 7 PM at Cooperative Extension Service
Phone 452.6393 for info
To protect your!
vision, it's important (
;,
to keep your blood )1
I
sugar level in the ['
best control you ~ September 18
can. The closer your I DIABETES SUPPORT GROU~
hemoglob'n Alc \ 1:30 - 3:00 PM at New Hanover Semor Center
't I al (I 1 Certified Laugh Leader Stephanie Carr
IS 0 norm ess" 'II . k
th ) I M~N
an 7.0 ,Percent, ~ Phone 343.6758 for info
the more hkely you ,I
are to prevent orl
limit eye disease. I
Here are some other J
important steps to !
take:
; ~
. Have your blood :1
pressure checked I
often. Talk to your :1'
doctor about the
The American
Diabetes Association
recommends that you
let your eye doctor
. know if you have:
. Any loss of sharpness
in your vision -- either
up close or at a dis-
tance
. Any double vision
. Any pressUre in your
eye
FREE ViSION SCREENING
October 9, 12 Noon - 2 PM at Carolina Beach
Elementary School
October 10, 9 AM - 4 PM at the New Hanover
Community Health Center
October 11,9 AM - 5 PM on Hwy 17
in Hampstead
(-
. ..
DUCS Go Shopping
Registered dietitian Pam DiBiase leads a grocery stofe tour for members of
the Diabetes Suvport Group. Here she explains that a serving of meal should be
about the same size as a deck of cards.
Diabetes Today is a special publication of the New Hanover County Diabetes Today Coalition which provides the editorial content. The Diabetes Today Coalition was fonned in 1999 to advocate
for
diabetes care and prevention in New Hanover County. The Coalition operates under the auspices of the New Hanover County Health Department and is funded by a grant from Cape Fear Memorial
Foundation, Wilmington, North Carolina.
Diabetes Today, August 2003
I have been told I have
diabetes. What kind do
I have?
The most common types of diabetes are 1YPe
1 diabetes, 1YPe 2 diabetes and gestational
diabetes.
Type 1 Diabetes is present in about 100/0 of all
those with diabetes. Type 1 usually occurs during
childhood or adolescence, though it can occur
at any age. Unlike people with Type 2 diabetes,
people with Type 1 diabetes tend to be thin or of
normal weight and Caucasian. They also usually
do not have other associated conditions such as
high blood pressure or high cholesterol at, the
time of diagnosis. The cause of type I diabetes
is not entirely clear, though it is felt to be caused
by an autoimmune process in which the body's
immune system attacks the pancreas and destroys
the .cells that produce and secrete insulin. Since
insulin is important in helping glucose get into
the body's cells, this lack of insulin results in a
buildup of glucose in the bloodstream, which can
then affect the other organs of the body, including
the heart, kidneys, eyes, nerves and blood vessels.
Since the main problem in Type 1 diabetes is
the lack of insulin, the main treatment is insulin.
Type 2 Diabetes is the most common form
of diabetes and present in about 900/0 of all
those with diabetes. Although it can develop at
any age, it usually occurs after the age of 35.
The risk for getting Type 2 diabetes increases
with age. People with Type 2 diabetes tend to
be ovelWeight and often have associated high
blood pressure and abnormal cholesterol. Type
2 diabetes is more common in _ certain ethnic
groups, including African Americans, Hispanics,
Native American Indians, Asian Indians, and
Pacific Islanders. The cause of Type 2 diabetes is
related to insulin resistance, in which the body's
insulin is unable to adequately lower the glucose
in the bloodstream. The pancreas responds by
secreting more insulin, leading to excess insulin in
Type 2 diabetes. mtimate1y, the pancreas "burns
out" and is unable to produce enough insulin
to meet the body's needs. Hyperglycemia, or
elevated blood suwrr, results. The treatment for
Type 2 diabetes not ouly includes a balanced
meal plan and exercise, but also oral medications
and insulin to overcome the insulin resistance.
Gestational Diabetes refers to the
development of diabetes during pregnancy. Like
Type 2 diabetes, it is thought to be due to insulin
resistance. The cause of the insulin resistance
is likely related to fluctuating female hormones
during pregnancy. Management of gestational
diabetes includes close monitoring, a balanced
diet, and sometiriles insulin to keep the blood
sugar under normal control and prevent problems
with the fetus and the delivery. Gestational diabetes
usually resolves after pregnancy, but women with
a history of gestational diabetes are at increased
risk of developing Type 2 diabetes later in life.
Can diabetes be prevented?
The diabetes prevention program (0 PP) is a long
term study designed to find out whether diabetes
could be prevented or delayed in people who had
a risk for developing Typ_e 2 diabetes. More than
4000 people were studied at 25 research institu-
tions around the United States.
Participants had blood sugar levels that
were above the normal range but not
quite yet in the diabetic range (in medi-
cal terms it is called impaired glucose
tolerance or IGT). The participants
were put into one of four treatment
groups. The first group was the inten-
sive lifestyle group which exercised
at least 120 minutes a week and lost
10-15 pounds over the three year dura-
tion of the study. The other three groups
were put on medication or a fake pill
(placebo) with only minimal lifestyle changes.
-
,
Page2
The opp was ended one year early because of the
remarkable results. Compared to the group that
received a placebo, the intensive lifestyle group
reduced their chances of developing Type 2 dia-
betes by 58%! The individuals who were given
medication with minimal lifestyle changes showed
a reduction in the development of diabetes by
31010 over the three years study, compared to the
placebo group.
")
'"
The OPP is ouly one of several prevention trials
recently completed demonstrating that intensive
lifestyle can reduced the incidence of Type 2 diabe-
tes in individuals who are at risk. The risk factors
for Type 2 diabetes include having a family of his-
tory of Type 2 diabetes, being ovelWeight, having
high blood pressure or abnormal cho1estero11ev-
els, having gestational diabetes, or having a baby
over 91bs, and being a member of an ethnic group
that has a very high incidence of diabetes (Native
American Indians, Latinos, Pacific Islanders, Asian
Indians and African Americans). The bottom line:
know your risk factors for Type 2 diabetes. If you
already have diabetes, let your relatives
know that they should be tested
and that life- style change is the most
powerful tool to prevent Type 2
diabetes.
120
minutes of
exercise per
week and moderate
weight loss reduced
the risk of develop-
ingdiabetes by
58%!
Controlling Diabetes ISn't a Piece of Cake e =~~
IF YOU ARE 18 YEARS OR OLDER, SrECIAUSTS, PA.
AND HAVE BEEN DIAGNOSED WITH and the Division of Endocrinology
TYPE 2 Diabetes Mellitus, then you may Paul C. Whitesldes,Jr. M.D,
be eligible to participate in a medical Michael S. McGarrity, M.D,
research study of an investigational drug announces the association of
for diabetes. - John C. Parker, M.D.
For more information call in the practice of Endocrinology
N H M d'ca1 R h at 1515 Doctor's Circle, Wilmington. NC 28401
eW anover e 1 esearc TELEPHONE OFFICE HOURS
910-799-5500 ____ _ .(910) 763.6332 BY APPOINTMENT
Medical Center 908 S. 16th Sl
~. j{. :~~~:
Home Care www.m~-dicakmkmoml'l.We.fom
:J
foOT & ANKLE SURGERY' DIABETic FoOT CARE 0
SPRAINS & FRACTURES' AMBULATORY SURGERY
INGROWN NAiLS . ENoOSCOPIC SURGERY
SECOND OPINION CONSULTATIONS' X-RAY FACIUllES
&o~!2~sl~j .~Q!t~~~!~~
Y!s~~~AS~l~~~1. C2~~~
m Insuranceocceotedand#led_a_~__
Diabetes Today, August 2003
Spending 'Less at the
Supermarket
By Ellen Davis, RN, MS, CDE, Duke University
You can eat healthfully without spending big bucks
at the supermarket There's no reason to buy expen-
C. ~ "diet food." A healthy, balanced diet focuses
on wholesome
. foods that tend
to be relatively
inexpensive
- whole grains,
beans, vegeta-
bles and fruits,
lean protein
sources and
low-fat dairy
products. You
can save money by preparing more of your own
meals and going light on the amount of meats,
sweets and snacks.
Although you've heard it before, planning ahead is
the most important step you can take. You could
write out menus for a week, and then make a
shopping list of what you'll need. While planning
ahead, take advantage of advertised specials and
try to get everything you'll need in one trip. You
can always keep a master list of family favorites
Ct can be put together quickly and require few
;edients. It's a good idea to keep some shelf-
staple basics on hand like pasta, rice canned toma-
toes, frozen vegetables and canned tuna.
You can save money by using coupons, especially
if the store offers double or triple coupon days.
However, remember that the price of a store-
brand food may still be less than the discounted
price of a brand-name item. In-store specials lire
another way to save money.
It is interesting to note that where you shop and
how long it takes you to shop may affect your
spending practices. The longer you spend in a
grocery store, the more you spend. The exception
to this rule involves super centers. They are larger
to navigate but generally offer lower prices.
Here are some items to avoid in the supermarket:
Single serving items
~~((
North Ci1rolll1ll Di.betn Advlaory Council
,
Foods dressed in fancy packaging
Food stocked at eye level. The better buys are on
the lower and higher shelves. -
"Diet Food: These items usually cost a lot and are
not necessarily better for you.
In addition to planning ahead, become a label
reader. Then you can tell if what you are thinking
of buying is good for you.
Dining with Diabetes
The good news about diabetes meal planning is that
things have changed. There are no such things as good
foods and bad foods. Many people think they know all
about what people with diabetes should or should not
eat. But some of the ideas you may hear are out of
date, not quite right or just plain wrong. You can enjoy
mealtime and still reach your blood sugar goals.
If you or someone close to you has diabetes, join us.
September 8, 2003
Desserts (carb9hydrates, sugar, artificial sweet-
eners)
Managing diabetes
September 15, 2003
Main Dishes (fats, oils, salt)
lowering cardiovascular risks
September 22, 2003
Side Dishes (calcium, fiber)
Diabetes meal planning
Classes will be led by Allison Block Registered
Dietitian; food preparation will be demonstrated
by Dianne Gatewood, Extension Agent Everyone
gets to taste!
All classes will be held from 5 - 7 PM at the New
Hanover Cooperative Extension Center, 6206
Oleander Drive in Wilmington. Fee.
Contact Dianne
Gatewood
at 452-6393.
Registration
deadline:
August 22, 2003.
Diane Gatewood (left) shares informa-
tion
llJ1
1 cup
2 tbsp
1 packet
1/3 cup
1 packet
2 eggs
1/2 cup
1/4 cup
2tsp
2 cups
1 con-
tainer
Page3
Luscious
Lemon Squares
Recipe makes 9 Servings
"_l
graham cracker crumbs
reduced-fat margarine, melted
Equal (equivalent of 2 tsp sugar)
cold water
unflavored gelatin
well beaten
lemon juice
sugar
grated lemon peel
thawed frozen fat-free nondairy
whipped topping
(8 ounces) lemon-flavored
nonfat sugar-free yogurt
.'
1. Spray 9-inch. square baking pan with non" .
stick cooking spray. Stir together graham crack:
er crumbs, margarine and sugar substitute in
small bowl. Press onto bottom of pan with fork;
set aside.
2. Combine cold water and gelatin in small
microwavable bowl; let stand 2 minU,tes.
Microwave at High 40 seconds to dissolve gela-
tin; set aside.
3. Combine eggs, lemon juice, sugar and i
lemon peel in top of double boiler. Cook, stir- I
ring constantly, over boiling water, about 4 min:.1
utes or until thickened. Remove from heat; stir I
,
in gelatin mixture. Refrigerate about 25 minutes i
or until mixture is thoroughly cooled and begins i
to set. I
,
,
i
4 Gently combine lemon-gelatin mixture,
whipped topping and lemon yogurt. Pour into
prepared crust. Refrigerate 1 hour or until firm.
5. Cut into 9 squares
ington Health Associates
NEW WCATlON:
1501 Medical Center Drive
Wilmington, NC 28401 I'
Our Board Certified
docrino/,'II,I1i#$'>Are Here To; HelP
$. BrysonL~~J_~~,.-_::o,1 DeDe warfg, M'J).
~.Wl.:6375 L
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:~. ... _.~,,",_..
SUMMIT
PODIATRY
Glaser Foot &
Ankle Clinic
1717 Shipyard Blvd.
791-1300
Get Real! You don't have to eat like this
to prevent diabetes.
Over 45 and overweight? Talk to your health care
provider about the small steps you can take to prevent
diabetes. For free information about preventing diabetes,
call 1-800-438-5383.
State of North Carolina
Department of Health and Human Services
Division of Public Health. Diabetes Prevention and Control Branch
~www.niiCdiabeleSO~~;.
. o,,~ '.~~i~
-"'-'-
If you're diabetic,
your feet need special attention.
. INFECTION' mar ULCERS' NEUROPATIIY -
.' VASCULAR DISEASE . BONE PROBLEMS
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TIiabetes Today, Aug 2003
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FREE VISION 'SCREENING
Page4
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The NC lions VISIOJlJ VAN is coming to town, Equipped with the latest
"state of the art" medical equipment, the Vision Van travels throughout the
state offering free screenings to test visual acuity, field vision and eye pres-
sure. When these tests have been completed, an eye doctor evaluates the
l'esults of the screening and recommends when the participant should have a
complete eye examination.
Over 31,000 people have taken advantage of this free community service.
You can, too. In Wilmington, stop by the New Hanover Community Health
Center at 925 North Street between 9 AM and 4 PM on Friday, October 10.
Appointments are not necessary. See page 1 for other locations and times.
This screening does not take the place of the annual dilated eye exam by an
ophthalmologist recommended for every person with diabetes. Rather, it is a
screening to identify eye diseases and other ocular problems that may other-
wise go unchecked.
1-.'"'1-
Stress affects blood sugar. YOu can learn to control it
Proven Stress Reducers
1. Get up fifteen minutes earlier in the morning. The inevitable morning mis-
haps will be less stressful.
2. Don't rely on your memory Write down appointment times, when to pick
up the laundry, when library books are due.
3. Procrastination is stressfuL
Whatever you ,want to do tomorrow, do today
Whatever you want to do today, do it now,
4. Plan ahead. Don't let the gas tank get below one-quarter full, keep a well-
stocked "emergency shelf" of home staples, don't wait until you're down to
-~.'
. ~_,Mina
7 oA.-~..:;.t--~
. ..........,,,.. "{J!T "V" ~'" "',
Meter Conversion Day
Call (910) 686.2988 to find out how
~_ you can get a free meter
"frPPQvle- Sept. 18t11
-.~~J , Retirement Living Showcase
, World s Smali<St Sampl. 511 Coastal Convention Center
. Approv.d for Ait"nat. Sit. Wilmington, NC
T<Stin .., Sept,l9th
.s>~. Johnson Home Medical
'" Porters Neck Shopping Coo.
8207 Market St. .
Wilmington, NC ~
(910) 686-2988
A
T
Diabetic
Retinopathy
Board Certified In Ophthalmology
Igor Westra, MD . Erik van Rens, MD
n
I'
11301 Nt"lw Hanover' Medical Park Dr. . Wilming1on, NC
1703 CountryClub'Ad. SUIte 104' Jucksonville. NC
400Q.Hlgt\woy.9E, Suito24Q . lillie River, NC
WWW.retlnl;(fcoastalcarotlna.com
the last postage stamp to- buy more
5. Don't put up with something that doesn't work right. If your alarm clock,
wallet, shoelaces, windshield wipers are a constant aggravation, get them
fixed or get new ones,
6. Be prepared to wait. A paperback book in a post office line can be almost
pleasant.
7. Pollyanna - power' For every one thing that goes wrong. There are Ht.'),~
50 or 100 blessings. Count 'em! )
8. Turn "needs" into preferences. Our basic needs translate into food, w'fter
and keeping warm. Everything else is a preference. Don't get attached to
preferences.
9. Simplify, simplify, simplify.
10. Make friends with non-worriers. Nothing can get you into the habit of
worrying faster than associating with chronic worrywarts.
11. Create order out of chaos. Organize your home and workspace so that you
always know exactly where things are. Put things away where they belong and
you won't have to go through the stress oflosing.things.
12. Add an ounce of love to everything you do.
13. Become more flexible. Some things are worth doing perfectly and some
issues are well to compromise upon.
14. Eliminate destructive self-talk: "I'm too old to..." "I'm too fat to. ." etc.
15. "Worry about pennies and the dollars will take care of themselves." That's
another way of saying, "take care of today as best you can and the yesteraays
and tomorrows will take care of themselves."
16. Do one thing at a time. When you are with someone, be with that person
and no one else or anything else. ...
When you are busy on a project, .
concentrate on doing that project and t>
forget ahout everything else that you
have to do.
17. If an especially unpleasant task
faces you, do it early in the day and
get it over With.
18. Learn to delegate responsibility to
capable others.
19. Forget about counting to 10.
Count to 1,000 before doing some-
thing or saying anything that could
make matters worse.
20. Have a forgiving view of people
and events. Accept the fact that we
live in an imperfect world.
21. Learn to laugh. Learn to enjoy life
independent of where you are and
the stresses that surround you.
Sourca: UVin9 with Diabetes, North Carolina Diabetes Advisory Council
II
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"
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\ \'hen \ \uunds hon't Heal
THE
Ghobad Azizi,MD
~L~INGTON
Endocrinology, PA.
Specialized Medicine. PerSOl'1alized Care
Board Cemfied in
Internal Medicine, Endocrinology,
Diabetes and Metabolism
Welcoming Existin~ Patients, New Patients and
PhYSician Referrals
For Appointments (9101 254.9464
1776 Wellington Avenue. Suite 2
Wilmington, NC 26403
~
WOUND CARE
Cf NT E.1l
'17.., WfWNGTON AVENUE W'U1INGfON
91o.8iS.OOO5
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I NEW HANOVER COUNTY
I HEALTH DEPARTMENT
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I ANNUAL REPORT
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I 2001/2002
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New Hanover County Health Department Board of Health
Gela N. Hunter, RN, FNP
Chair
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Melody C. Speck, DVM
Veterinarian
W. Edwin Link, Jr., RPH
Vice Chair
Wilson O. Jewell, DDS
Dentist
Henry V Estep, RHU
Public Member
Anne B. Rowe
Public Member
Edward Weaver, Jr.
Optometrist
2 NEW HANOVER COUNTY HEALTH DEPARTMENT
Phillip P Smith, Sr., MD
Physician
Janelle Rhyne, MD
Medical Consultant
. Director -s Message
All of us at New Hanover County Health
Department believe that we can make a dif-
ference as we strive to become the healthi-
est county in North Carolina. Our mission
is to protect the public health and environ-
ment, promote healthy living and optimize
the quality of life through preventive, re-
storative, environmental, and educational
services. It is accomplished through as-
sessing the health needs of the community
. and establishing health objectives to maintain essential personal,
family, community and environmental health services.
. We are pleased to present the New Hanover County Health De-
partment Annual Report for fiscal year 2001-02. It represents
the provision of public health programs and services for people
. in New Hanover County Due to limited resources, our annual
report format has changed from paper to electronic.
. During fiscal year 2001-02, the Health Department experienced
many challenges and opportunities. The visibility oflocal public
health increased in 2001 as a direct result ofthe unthinkable acts
. of September 11, and the anthrax events that followed. Those
acts and events lifted our Health Department to higher levels of
involvement, collaboration, and performance. Fortunately, we
~ well positioned for a response to bioterrorism. In addition,
~ Hanover County Health Department was selected as one of
seven health departments in North Carolina to host public health
. regional surveillance teams.
It would be misleading, however, to conceal the many achieve-
. ments of200 1-02 by only focusing on bioterrorism. A great deal
of important work was done during the year, and is described
throughout this report. Our annual report focuses on programs,
. services and activities. The scope of our Health Department, how-
ever, prevents us from covering all the promotion, prevention,
protection and provision activities. For a more detailed account
. of our Health Department, please visit our website at:
http.llwww.nhchd.org
. "From the Northeast River to Federal Point, and from the
Cape Fear to the Sea-City, Suburb, Village and Farm-
. we are one people striving for healthful and useful living. "
~
David E. Rice, MPH, MA
Health Director
Division Directors
Assistant Health Director
Lynda F Smith
Animal Control Services Director
Dr. Jean P McNeil
Child Health Director
Janet B. McCumbee
Communicable Disease Director
Beth W Jones
Community Health Director
Betty B. Creech
Dental Health Director
Dr. David W McDaniel
Environmental Health Director
Dianne M. Harvell
Laboratory Director
Susan M. O'Brien
Nutrition Director
Nancy R. Nail
Women's Health Care Director
Betty Jo McCorkle
Mission Statement
The mission of the New Hanover County
Health Department is to protect the
public health and environment,promote
healthy living and optimize the quality
of life through preventive, restorative,
environmental and educational
servICes.
Motto
"Your Health - Our Priority"
3 NEW HANOVER COUNTY HEALTH DEPARTMENT
I "On September the 11th, the world learned how evil men can use airplanes as weapons of terror.
Shortly thereafter, we learned how evil people can use microscopic spores as weapons of terror.
Bioterrorism is a real threat to our country."
President George W. Bush
June 12,2002
Ie
Ion June 12, 2002, President Bush signed H.R. 3448 - The Public
Health Security and Bioterrorism Response Act of 2002. Across
I North Carolina, seven Public Health Regional Surveillance Teams
(PHRST) have been formed in response to the nation's Bioterrorism
preparation effort. These teams are funded by a $22.9 million grant
from the and a $3.4 million grant from the U.S. Health Resources and
I Services Administration.
The Public Health Regional Surveillance Team - Region 2 or PHRST-2,
hosted by New Hanover County, serves the following seven counties
I in Southeastern North Carolina: New Hanover, Brunswick, Carteret,
Columbus, Duplin, Onslow, and Pender.
Based out of the New Hanover County Health Department, PHRST-2 will
I work with the seven counties to strengthen public health infrastructure
within the region in order to detect, identif'y, investigate, and control
illness due to biological, chemical, or nuclear terrorist attacks. The
primary responsibility ofPHRST-2 is to help these counties prepare for
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and respond to chemical, nuclear, or biological terrorism events. infec-
tious disease outbreaks, and other public health threats in Southeastern
North Carolina through elaborative planning, education, investigation,
and surveillance.
Each Regional Surveillance Team will consist of a Physician Epide-
miologist, Nurse Epidemiologist, Industrial Hygiene Consultant and
Administrative Support Technician. Three ofthe Regional Surveillance
Teams will have an additional Laboratory Technician to supplement the
State Public Health Laboratory's evaluation of suspect samples. In addi-
tion, a central team under the North Carolina Division of Public Health
Bioterrorism Branch is being formed to coordinate the teams and set
policy for statewide preparedness and response. Future plans include
organizing a Regional Bioterrorism Steering Committee to share infor-
mation, establish contacts, enhance communication, and build Public
Health infrastructure within Region 2.
Public Health Regional Surveillance Team - Region 2
PHRST-2
North Carolina Department of Public Health
Q ~(. -~ cartere.<<4o/
~~. Onslow ~~
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( Pender \
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. Columbus / \
. f~ 4 Aliew Hanover
'. :r:SWICk I r PHRST-2
. r '.J ' New Hanover County Health Department
.--~ ~d 2029 South 17th Street
Wilmington, North Carolina 28401
/
North c...IN ,.... MNIth
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~
Phone: (910) 343-6760
Fax: (910) 342-2528
Web Site: www.nhcgov.com
Click on Departments, Health, Bioterrorism
4 NEW HANOVER COUNTY HEALTH DEPARTMENT
I
PHRST-2 Vision
A region in a state of readiness to respond to and recover
from significant public health threats and/or events.
~ PHRST-2 Mission
The Public Health Regional Surveillance Team-2
llRST-2) is a multidisciplinary team acting as a state
I resource that serves the Southeastern region of North
Carolina and the State of North Carolina. The team works
with seven counties to strengthen public health infrastruc-
ture within the region in order to detect, identifY, inves-
I tigate, and control illness due to biological, chemical, or
nuclear terrorist attacks.
I Plans for establishing the Regional Bioterrorisrn Surveillance
Teams began early in the year 2002. By May 2002 three team
members were in place--the Nurse Epidemiologist, the In-
dustrial Hygieni.st, and the Administrative Support Technician.
I While the recrUItment process for a Physician Epidemiologist
is underway, David Rice, Health Director, has assumed the role
of Director for the team in the interim.
I The North Carolina Department of Public Health facilitated a
statewide meeting of all the Regional Surveillance Teams in
Raleigh. Presentations were made by State and Federal alli-
ances including the Centers for Disease Control (CDC), the NC
I State Laboratory, the NC Department of Justice, the FBI and
SBI, the NC Department of Agriculture, the NC Department
of Emergency Management, the Office of Emergency Medical
I Services, the United States and North Carolina Departments
of Health and Human Services, Special Operations Response
Te~ (SORT), and ~~ .~azmat Regional Response Team (RRT).
MIssIOns, responslblhtIes, and challenges were summarized
~he te~rns. .. .
Durmg this meetmg It was reahzed that a close relationship with
the North Carolina Department of Agriculture and Consumer
I Services (NCDA&CS) was necessary for the successful
prevention, detection, and response to potential Bioterrorism
events. Subsequently, a cooperative agreement between the
NCDPH and the NCDA&CS has been formed. Locally, Dr.
I Daniel Wilson, DVM, Field Veterinarian (NCDA&CS), has
partnered with PHRST-2. He participates in many of the
meetings, exercises, presentations, and training sessions with
I PHRST-2.
Each county Health Department submitted its Bioterrorism
Emergency Response Plan to the State. After review by
I the State, guidelines regarding the Bioterrorisrn Emergency
Response Plans were given to each respective county and
corresponding PHRST Team to review and update according
I to the State guidelines. It is anticipated that this ongoing
collaborative process will be completed by year-end 2002.
PHRST-2 is working closely with the Health Departments and
Emergency Management in each of its seven counties to review
I their Bioterrorism Emergency Response Plans according to the
directive from the State.
Electronic reporting and surveillance of diseases is a critical
I issue across the nation. The CDC is working to create the
4ft ~ompre~ensive technology solution to this issue. Faster
rtmg ?f disease outbreaks is key to reducing vulnerability
terronst attack as well as enabling a quicker response in
I the control and spread of the incident. The PHRSTteams will
be working closely with the Department of Public Health to
help facilitate this process.
I
The PHRST-2 Team will be working to build public health
infrastructure and bridge the gap between the stakeholders in the
community who may respond to an event related to Bioterrorism.
Training .exercises are an important part of preparing for a
BlOterronsm ~vent and an excellent vehicle for helping network
s~ke~older~ m the process. PHRST-2 attended the City of
Wllrnmgton s Annual Emergency Response Exercise and the
Onslow County Bioterrorism Preparedness Exercise. Events
on the calendar for the coming year include the Bioterrorism
Tabletop Exercise at New Hanover Regional Medical Center,
!he Onslow County Terrorism Capability Exercise including
mvolvement from Camp Lejeune, and the annual Brunswick
Nuclear Plant Exercise.
The three "R's" of Bioterrorisrn preparedness are: Readiness,
Response, and Recovery. Training is an essential element in
addressing the three "R's", and PHRST-2 will participate in
extensive training. In addition to the state mandated training
for the teams, PHRST-2 will participate in the following
trai~ing sessions: Epidemiology and NEHA, Minneapolis;
Incident Command System, HAZWOPER, Epidemiology
Surveillance; CDC Sponsored Trainings; Ingestion Pathway;
FEMA Bioterrorism Preparedness Training.
PHR~T-2 will als? work withi~ its region to provide training
and gIve presentahons to the vanous stakeholders. Bioterrorism
Preparedness and Epidemiology Training will be held in each
county. A special Smallpox Training session has been designed
to address the growing concem over this issue in the nation.
Presentations have been created and will be delivered to several
groups within the region as well. PHRST-2 is also scheduled
for a live "on-air" interview with Don Ansell on "Talk of the
Town" (980 AM WAAV). Additionally, an Internet web site
is available for the team. This site will be a resource tool as
well as a means for information dissemination in the event of a
Bioterrorism incident. The site is available at www.nhcgov.com.
Departments, Health, Bioterrorism.
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Cammie Marti, RN, provides background infonnation during an initial
PHRST-2 infonnational training.
5 NEW HANOVER COUNTY HEALTH DEPARTMENT
I
I Administration
e Administration Division is responsible for the admin-
I istration, operation, and fiscal management of the New
Hanover County Health Department.
I GOALS
Assure a positive public image and serve the citizens of
New Hanover County
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Provide assistance in administrative, financial, personnel,
and vital records
Support the Board of Health, Health Director, Assistant
Health Director, Division Directors, and Health Depart-
ment Staff
Monitor, maintain, purchase, computer equipment and
provide Information Technology expertise to the staff
Prepare Property Management work orders and assist
with scheduling of Health Department maintenance
I Personnel
.AL
rovide personnel services for approximately 189 Health
Department employees and serve as liaison between the
I New Hanover County Department of Human Resources
and the Health Department
Personnel services include processing payroll and person-
I nel action forms; orientation to new employees regarding
I
policies and procedures; annual open enrollment for county
personnel benefits; and the maintenance of personnel records
and the New Hanover County and Health Department Per-
sonnel Policy and Procedures manuals.
Vital Records
North Carolina General Statutes 130-A requires the Health
Department administer the Vital Records Program under the
direction of the Health Director.
GOAL
Assure vital records are filed as required by Chapter 130-
A of North Carolina General Statutes and are submitted
to the North Carolina State Division of Vital Records
and New Hanover County Register of Deeds within the
required time period.
Deputy Registrars appointed by the Health Director to pro-
cess birth and death certificates for New Hanover County
The hospital is responsible for filing birth certificates and
funeral directors are responsible for filing death certificates
with local Health Department Deputy Registrars.
Certified copies of birth and death certificates are available
at the New Hanover County Register of Deeds or from the
North Carolina Office of Vita! Records. Fees are charged
for certified copies of the certificates.
New Hanover County FY 1997/98 FY 1998/99 FY 1999/00 FY 2000/01 FY 2001/02
IBirth Certificates
3,549
3,604
IDeath Certificates
1,795
1,972
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3,446
3,592
3,547
1,923
1,939
2,045
6 NEW HANOVER COONTY HEALTH DEPARTMENT
I September 11, 200 I, was a devastating day for our entire nation.
ttACS responded immediately by approaching airline personnel to
f any animals needed assistance from the grounded planes
I r airport. Additional changes and updates were instituted in
the ACS Emergency Policy through meetings with Dan Summers
ofNHC Emergency Management and Dr. Daniel Wilson, the
state veterinarian overseeing CART and SART (County and State
I Animal Response Teams) in our area. Information regarding
7 NEW HANOVER COUNTY HEALTH DEPARTMENT
IAnimalCon"oISe~kes
I Animal Control Services (ACS) is mandated to do surveillance
A"ollo:-v-,up ~~ rabies expos~re situati~ns. ACS protects our
Wmumty s cItIzens and their companion animals from this
I viable zoonotic d.i~ease throug? prevention means, raising public
awareness, and dIlIgent educatIon methods. Successful adoptions
I and proper pet care are also other areas of keen interest to the
diVISion, though they are not mandated functions.
GOALS
I Increase .th.e .pos~tive p~blic image of the duties performed
by the dIVISion In servIce to the community by increased
measures of education and raised public awareness
I
Increase successful adoption rates and decrease euthanasia
rates of surrendered animals
'I
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Build an on-site spay/neuter facility and outdoor exercise/play
area
Assess and improve methods of rabies exposure prevention
The Year In Review
I ACS began the fiscal year with fee schedule changes to help
supplement the deficient budget needs. This has proven to
.-rate.an increase in revenue, when coupled with the entire
~ty lIcense fee process. Upgrades and fine-tuning to the
procedures surrounding this machine have taken a toll on staff,
despite the reduction in statT of two officer positions. The postal
I address of the shelter became official the first week of September,
causing additional workload on statT to alter all paperwork and
computer documents. However, we have been able to maintain
I the integrity of all functions by diligent and exceptionally hard
work of the ACS statT
I NHC- TV went live in the month of August 200 I ACS has
aired a video segment throughout the fiscal year that was taped
to educate the public on animal control practices. An additional
I segment was done as a "commercial" during the Christmas holi-
day season to discourage impulse buying of pets for holiday
gifts. In January 2002, Eric Peterson from NHC Public Rela-
I tions began taking weekly photos of adoptive animals to air on
NHC- TV The ending of the fiscal year marked the end of two
years of biweekly radio spots on WAAV Radio, a local station.
I This included another hour-long question and answer segment
done in April 2002 for public health month.
animals was collected in the event ofbioterrorism attacks through
an animal route. Animal issues were included in the discussions.
StatT also underwent radio training through Wilmington Police
Department, and discussed radio upgrades in a meeting with Dan
Summers.
Three department focals were prepared and presented to the Board
of Health (BOH) this fiscal year. The first was done in August
2001, with a topic of "Animal Cruelty Trends in New Hanover
County" This highlighted the numerous successful cruelty cases
that the division handled the former fiscal year. The second focal
was done as a fill-in in January 2002. It covered animal adoptions
done at the facility. The third focal was completed at the end of
the fiscal year, as the formal request by statTto gain permission to
build an on-site spay/neuter facility with adoption play area as an
addition to the existing building. A favorable vote was obtained
from the BOH, and plans to pursue the add-on will be done in
the 2002-2003 year.
ACS organized the first animal control group to attend the
Management Academy of Public Health in Chapel Hill. The
group consisted of Daisy Brown, ACS Administrative Support
Supervisor, Barbara McClure, Assistant Finance Director, David
Howard, Health Educator, Dr. Robert Weedon, area veterinarian,
and Jean McNeil, ACS Director. The group's business plan,
"Sterilization Protects Animals and You" (SPAY), won the team
green ribbon for most fundable project. Their plan is described
in the above paragraph as the June BOH department focal.
NHCACS Adoption StatlsUc:s
5.000
4.500
4.000
3.500
3.000
2.500
2.000
1.500
1.000
500
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.' 'I
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t _: j, - ::~: :: : :: - - ::::
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1995 1996 1997 1998 1999 2000 2001
Ie Anmals Accepted DArimals Adopted "ARmsls El.thaBzed I
New Hanover Humane Society Adoption Statistics
5000
4500
4000
3500
:5000
2500
2000
1500
1000
500
o
2000
2001
1998
1999
1995
,...
1997
IDAnlmalS Accepted DAnlmnls Adopted I
I Staff pursued better methods of education by hosting the first
annual Public Health Conference at the shelter in October 200 1
~The conference was designed to educate area veterinarians and
. r employees about ACS vision,
, policies, and procedures. A I '
lic Forum on Animallnforma-
I tion was well received in April,
earmarking a collaborative effort
between four animal groups in New
I Hanover County. Both conferences
may become annual events as a
means of educational marketing
I for the general public and special-
ized areas of the community.
I A fund-raiser conducted by vol-
unteers in the county generated
enough income to place a mural
Ion the wall just inside the entrance
to the shelter's front office. The
picture creates a warm and welcom-
ling environment for staff and general public to view. Our intent
is to show the community our dedication to meet their needs and
to provide a positive area for prospective adoptive "parents" to
I make responsible ownership choices.
BeginningJune 1,2002, ACS was forced to close its doors to the
"ral public on Saturdays. The shelter had been open for six
~nuous years prior to this date. Loss of two officer positions
also caused reduced services in other areas, including reduced
i lfield coverage for weekends and evenings, decreased ability to
enter rabies data in the system, which ultimately could result
in reduction ofrevenue, and an inability to pursue educational
opportunities, as examples of some decreased services.
I Several severe pit-bull attacks in the downtown area prompted
city council to consider banning the breed from inside city
I Child Health
limits. The controversy opened up an avenue to discuss other
changes in the county ordinance that ACS enforces. One change
has already been activated as an inter-local agreement between
Wrightsville Beach (WB) and
NHC ACS. The WB police
will handle enforcement of the
new dog control laws at Mason
Inlet, and NHC ACS will handle
administration of the citations
generated from his patrols. In
June 2002, the BOH passed a
resolution against breed specific
legislation. This determination
resulted from discussion that pet
owners are the ones responsible
for their pet's behavior, good or
bad. Dangerous dog laws have
been enforced since October
1990 as a means of policing
behind those owners that are
not responsible. As another part of
the countywide advance in technology, ACS initiated an active
web-site this past fiscal year. Citizens are able to view pictures of
animals available for adoption by visiting the site. It is linked with
other animal groups, both local and national. Continual upgrades
have been done to the site throughout the year.
~
This beautiful mural now decorates a wall at the ACS facility.
I The Child Health Division provides a variety of preventive health
services in homes, childcare facilities and weekly clinics. The
I Division is a multidisciplinary team of nurses, social workers,
nursing assistants, administrative support staff and a health
educator.
I GOALS
Increase community awareness of children's preventive health,
I safety, and development
.crease number of children receiving routine testing for lead
~isoning with follow-up
I 80% participation in Health Check well screenings (Medicaid-
eligible children)
I
No hurricanes or positive rabies cases threatened our community
this past fiscal year, but there will always remain a great need
to educate our residents about the risks involved in exposure.
The ACS mission statement exemplifies all that we as a division
endeavor to achieve for the people we serve, "to protect the
public from the threat of rabies virus exposure, and to ensure
proper animal care, through prevention, public perception, and
education. "
Early detection of health and developmental problems leading
to early intervention and treatment
Families are supported in parenting young children and in their
utilization of community resources through case management
and home visiting services
Programs and Activities
Child Service Coordination (CSC), a statewide program since
1990, provides home visiting and coordination of services for
families with children ranging from birth to five years of age
identified through a referral process. Nurses and social workers
provide health, safety and developmental follow-up to over 400
families in the county, with 25-50 referrals per month. Staff
are trained in developmental screening, parent-child interaction
assessment, the early intervention system and local resources.
8 NEW HANOVER COUNTY HEALTH DEPARTMENT
1 Latino families comprise 7% of the case load, necessitating the
use of an interpreter. The CSC program is supported by Medicaid
1 billing. Each CSC caseload increased this year, due to the loss
I.*.ne staff position; however, client numbers and initial visits
. up 9.5%, and monthly contacts were up 5.5%
1
1
CSC Referrals 504
Initial Home Visits 360
Tracking Visits 688
Follow-up Contacts 4527
1 The Health Check Clinic provides well check-ups for Medicaid-
eligible and Health Choice insured children, who receive a health
history, immunizations, laboratory testing, developmental
1 screening, measurements, hearing and vision screening, physical
exams, education, counseling and referrals. Since most children
have primary care physicians, the clinic primarily fi lis a gap
1 during the spring and fall when Headstart and kindergarten health
screenings have to be done. Therewere 158 clinic visits this year and
all Health Check screenings are shared with the child's physician.
1 The Health Check Coordination Program has been a Smart
Start funded program since December, 1997 The goals of this
program are: to implement a county-based outreach plan aimed
1 at increasing enrollment in Health Check and Health Choice;
and to improve the system for coordination of Medicaid services
to reduce morbidity and mortality of children in New Hanover
-anty, by assuring that eligible children receive appropriate well
~ exams and recommended follow-up care from public and
private health care providers. The Health Check participation ratio
increased from 62.7% (FY 99-00 ) to 71.3% (FY 00-0 I ).The Health
1 Check Coordinator recently received a Certificate of Recognition
for having the greatest percentage increase in the 2000/200 I
participation rates for the Southeastern Coastal Region. She also is
1 a member of the New Hanover County Health Choice Coalition,
and she continues working with providers and other agencies to
assist families with accessing community resources and services
1 available to them. The Health Check Coordinator can also help
families with obtaining a medical provider for their children and
finding dental services. The Health Check Coordinator made 1704
1 phone contacts and sent out 3421 mailings to clients this year.
The Childhood Lead Poisoning Prevention Program (CLPPP)
lis a coordinated effort of the Child Health, WIC, Laboratory
and Environmental Health Divisions. During FYO 1102, the
Lab performed 1728 lead tests. Currently, CLPPP staff follow
130 children with elevated blood levels, providing home visits,
education, additional testing, follow-up with physicians,
assessment of hazards, developmental testing, school planning
I support and referrals. Collaboration with private providers,
_ing officials, and community agencies continues to increase
_extend the CLPPP's outreach efforts. A computerized
1 tracking system is efficient and effective, providing easy access
to up-to-date client information. Child Health staff also work
with regional Environmental Health Specialists for voluntary
1
investigations. The local CLPPP protocol continues to be
reviewed and refined to meet or exceed State recommendations
and the legal requirements of NC lead-related laws.
The Child Care Nnrsing Program is a Smart Start and UNC
Chapel Hill grant funded service that promotes safe and healthy
childcare throughout New Hanover County The program serves
all licensed childcare facilities, including centers and family
childcare homes. Child Care Nurses (Qualified Child Care Health
Consultants) perform health screenings and immunization audits;
provide ongoing health and safety consultation and technical
assistance; assist with the maintenance of health records, the
development and implementation of medical action plans and
written policies for the prevention of illness and injury; and
provide health education to children, providers, and parents.
This year, an additional service has been available with a part
time Health Educator who has provided asthma management
services including: surveying child care centers for the prevalence
of asthma, educating child care providers, parents and children,
offering home visits to child care facilities and families to identifY
environmental triggers, and assisting with the development of
Asthma Action Plans. These plans describe a child's diagnosed
condition, what worsens the condition, what kind of symptoms
to look for, and what medication or action should be taken.
Scientific evidence has indicated that as many as lout of 10
children (10%) have asthma, with prevalence and mortality
being highest in the birth to five populations. This estimate
supports the need for asthma education, Asthma Action Plans,
and environmental assessments within our child care facilities.
In existence for only 5 years, the Child Care Nursing Program
remains an exemplary program across NC. The Child Care
Nurses were the first nurses in the state to become Qualified
Child Care Health Consultants, completing an extensive training
and field study as part of the Healthy Child Care NC Campaign.
Center and Childcare Home
Visits 315
Health and Safety Education 96 sessions; 1,680 total
Sessions participants
Developmental Screenings 271
Referrals for Other Services 556
Immunization Record Reviews 2,923
Follow-up for Delinquent
Immunizations 404 children
Statistics for the Child Care Nursing Program for FY01/02.
The NAVIGATOR Program is a prenatal and early childhood
nurse home visitation program, which began accepting clients
in November 1999 The target population for the program is
first time mothers with incomes at or below 100% of the Federal
Poverty Level. The program has been funded through the state
Division of Women's and Children's Health, Cape Fear Memorial
Foundation, Smart Start, and Medicaid. Services are initiated
9 NEW HANOVER COUNTY HEALTH DEPARTMENT
1
------...
..
1
1
1
,
1
Beverly Bass, RN, with NAVIGATOR Graduates.
1 during pregnancy, continuing until the baby is two years of
age. Nurses provide health assessments, health and parenting
1 education, life course guidance, support group meetings, and
access to community resources through weekly or bimonthly
home visits. Home visitors instruct mothers in techniques to
1 enhance their parenting skills, leading to improvement in their
child's development. The three nurses in the NAVIGATOR
program are serving 88 clients (moms and babies). In April,
.aVIGATOR graduated six families, who had participated
~ the inception of the program. This year, three nurses
made 973 home visits with 562 other visits at alternate sites.
1
Communicable Disease
1 The mission of the Communicable Disease Division is to pro-
mote health and quality of life by preventing and controlling
1 communicable diseases. Strategies include early identifica-
tion and treatment, prompt reporting, contact investigations
and partner notification, encouragement of healthy behaviors
1 that prevent acquiring or transmitting disease, and providing
preventive medication during incubation. The two most sig-
nificant challenges presented to the division this year were the
1 loss of staff positions forcing the reduction in essential services
and the emerging threat of bioterrorism. Without the assistance
of volunteers, cuts in services would have been more severe.
1 GOALS
Minimize vaccine-preventable diseases by providing
1 immunizations to children and adults
AProvide counseling, screening, and treatment for Sexually
~ransmitted Diseases, HIV testing, and use client encounters
1 as opportunities to encourage prevention strategies
Serve as community resource for prevention of communicable
diseases
1
Family Assessment Coordination (FAC) is a program within
the NAVIGATOR program, It involves distribution ofa universal
screening tool (survey of needs) to pregnant women, through OB
offices, and new mothers who deliver in New Hanover Regional
Medical Center (NHRMC). Examples oftopics addressed are:
financial needs, information about breastfeeding, domestic
violence, and depression. Referrals to existing services were
made for identified problems, and requested information was
given to mothers. With results of 2300 surveys (80% return
rate), the FAC nurse is analyzing responses and has concluded
that concerns about general parenting issues are common among
families from all income levels. A volunteer nurse is presently
doing phone follow up to determine whether survey participants
found their referrals and resource information helpful.
Child Health staff coordinate the state mandated New Hanover
Connty Child Fatality Prevention Team, with child deaths
being reviewed quarterly. The team reviewed 26 deaths for
FY01-02. This community team focuses on preventing future
child deaths, by reviewing the circumstances surrounding local
child deaths and making recommendations at the local and state
level for systems or service changes. Prevention efforts also
include distribution of car safety seats (in cooperation with
Health Promotions) and smoke detectors (in cooperation with
fire departments) to low income families. The number of car seats
distributed, with instructions, during the 01-02 year was 226.
Sudden Infant Death Syndrome (SIDS) counselors are available
to serve families who experience a SIDS death and to provide
Back to Sleep education in the community New Hanover County
only had one SIDS death reported this year.
Provide tuberculosis screening and treatment (including
preventive medications) to reduce tuberculosis in New
Hanover County
Ensure required reporting of communicable diseases and
respond appropriately to reduce transmission and prevent
outbreaks
Provide Medical Records services to five divisions
Programs and Activities
Immunizations should begin in infancy and continue as a
lifelong practice to protect citizens from diseases that can
seriously compromise individual and community health. Some
vaccines are required by law (childhood vaccines), while
others such as influenza, pneumonia, and tetanus boosters
are recommended. Children and adults received 17,562
doses of vaccine during 13,968 visits. New Hanover County
Health Department (NHCHD) monitors vaccine compliance
for children up to 24 months of age. The Division provides
immunizations required for specific employment such as
10 NEW HANOVER COUNTY HEALTH DEPARTMENT
I Hepatitis B and rabies vaccines. Havrix protects against Hepatitis
A and is recommended for food handlers and others. A total of
..5,976 influenza and 212 pneumonia vaccines were given.
State Immunization Branch conducts an annual review in all
nties to evaluate the rate of age-appropriate immunizations for
I children under age two.
All children age 0-2 '
years who receive any
I service in the department
are monitored by staff
for imm un ization Testing for HIV antibodies
I compliance. New provides an opportunity
Hanover County for early identification
received a 77% and referral for medical
I immunization rate for care before symptoms of
the 2001 review, a 5 HIV/AIDSappear. Medi-
% increase over last cal advancements provide
I year's rate of 72% and many treatment options,
9% above the State which can prolong and
average of 68%. The improve quality of life.
I initial review reported HIV antibody testing en-
by the Immunization courages individual risk
Consultant indicated a assessment and behavior
165% compliance rate. changes to reduce risk of
Staff challenged the transmission. There were
accuracy of the data Kathy Bundy, LPN, provides care to a client in the General Clinic. 2,119 HIV tests done.
.Arequested a second review, which resulted in an increase in There was an increase in 2001-2002 in HIV and AIDS cases in
~ Hanover County's compliance rate from the initial 65% to New Hanover County. This increase is related to the efforts to
77%! As a result of New Hanover County's challenge, compliance increase testing and reporting and to an increase in people previ-
I rates of 20 other counties were corrected, increasing the overall ously diagnosed with the virus in other locations living in New
200 I immunization rate for North Carolina from 66% to 68%. Hanover County.
New Hanover County was recognized for the rate as well as the
I accountability by the Regional Immunization Consultant and
staff in the North Carolina Immunization Branch. Achievement
of this rate reflects a cooperative effort between Communicable
Disease, Child Health, and WIC staff.
I Tuberculosis (TBl is a disease transmitted through the air that
poses a public health threat, especially if active cases are not
I identified and treated early. For all active TB cases in New
Hanover County, staff is required to observe medications being
taken. The TB program is utilizing the Infoview, which is new
I technology that allows patients to take their medication at home
while being observed by the nurse in the Health Department
through a camera and television screen. Early identification of
I TB infection by a positive tuberculin skin test (PPD) is critical
to preventing new cases. Frequently, preventive medicine
is recommended for individuals exposed to TB. Contact
I investigations, case follow-ups and home visits assure adequate
Amentto prevent community outbreaks. Tuberculin skin tests,
wPcal evaluations, and tuberculosis medications are available
I at NHCHD Of 5,930 PPDs administered, 391 indicated
latent infection and 40 I individuals were provided preventive
therapy
I
Sexually Transmitted Diseases (STDs) are a threat to individuals,
their sexual partners and unborn children. The STD program
provides counseling, testing, examination, treatment, and
education about STDs including gonorrhea, syphilis, herpes,
chlamydia, human papillomavirus (condyloma), and others.
Prevention and risk reduction education are components of each
clinical visit and condoms
are available. There were
2,586 visits made for STD
services during the year.
Assuring compliance with public health laws and rules requires
significant effort and time. Violation of public health laws is a
Class I misdemeanor, punishable by up to two years in prison.
Providing follow-up on reports of violators involves contacting
violators, issuing written control measures and isolation orders,
specific to the disease and method of transmission. Providing
support and treatment options for individuals needing assistance in
obeying public health laws is complicated by other problems, such
as substance abuse and mental health problems. More resources
are needed to develop treatment plans that protect public health by
offering long-term treatment options as alternatives to prison.
North Carolina requires 61 diseases and conditions to be reported.
NHCHD monitors and responds to case reports to prevent further
cases. In addition to the reportable illnesses, physicians and the
general population are encouraged to be diligent about prompt
reporting of unusual conditions, which may pose a threat to
public health. There was an increase from six to twenty cases
of Rocky Mountain Spotted Fever, a disease transmitted by
ticks. Bioterrorism moved public health to the forefront as a
national emergency response network. Training for the medical
community and first responders was a priority after the anthrax
events in October 200 I
II NEW HANOVER COUNTY HEALTH DEPARTMENT
IReportable Communicable Diseases
34
18
499
288
5
7
16
45
3
20
79
4
32
9
pylobacter
mydia
Gonorrhea
Hepatits A
Hepatitis B (acute)
Hepatitis B (chronic carrier)
HIV
I Lyme Disease
Rocky Mountain Spotted Fever
Salmonellosis
I Shigellosis
Syphilis
Tuberculosis
I Vancomycin-Resistant
Enterococci
3
Iprogress was made toward conversion of patient records to a
new terminal digit filing system. Once completed, records will
be barcoded for tracking purposes. Policies and procedures
Iwere revised to comply with privacy regulations and increase
the protection of patient health information. Results of system
changes will be greater accountability and record security,
"oved efficiency and enhanced customer service.
IZth Education and Outreach Activities
IEffective communicable disease control requires an alert staff
viewing potential outbreaks as opportunities to educate the public
about prevention methods. Health education and outreach assure
Iprevention messages and treatment reach the community
Staff provides individual and group education in clinical and
Icommunity settings. Two newsletters are written and distributed
by the Communicable Disease Division. EPI Information is a
bimonthly newsletter sent to all medical providers in the county
land Sexually Speaking is a quarterly newsletter distributed to
agencies working with populations at risk for STDs and HIV
ICommunity Health
The Community Health Division provides family oriented health
Ipromotion, disease and injury prevention and disease management
services in clinics, homes, schools and other sites throughout
the county Services are provided throughout the lifespan.
leLS
I
I
The Teen AIDS Prevention (TAP) program trained adolescents
as peer educators to teach other young people the skills of HIV
prevention, healthy decision-making, and how to resist peer
pressure. TAP consisted of 30 trained peer educators who gave
regular presentations to teenagers atlhe Juvenile Detention Center,
Wilmington Treatment Center, recreational centers oflocal hous-
ing developments, and other community settings. TAP received the
Youth Organization of the Year award for New Hanover County
from Cape Fear Youth Development Visions, Inc. TAP was cho-
sen to receive the 200 I World AIDS Day Governor's Volunteer
Award by the North Carolina Department of Health and Human
Services and the HIV /STD Prevention and Care Branch. TAP
peer educators led the 2001 AIDS walk and raised $700, which
was donated to organizations that treat people with HIV / AIDS.
Three TAP peer educators were selected as national online peer
educators for the My Sistahs project sponsored by Advocates for
Youth. Two TAP educators received national scholarships to at-
tend the Ryan White National Youth Conference for HIV peer
educators in Washington, D.C. The TAP program ended June
30,2002 due to loss in funding, but not before having significant
impact on many young lives in our community.
. ,_-=::' .02-
Maureen Lamphere, RN, administers medication.
Enable individuals and families to access needed
community resources through identification, referral and
coordination with local, state and federal agencies
Promote a healthy environment through identification,
resolution and/or referral of conditions that threaten the
health and safety of residents
Promote public health and the Health Department's
image in the community through: collaboration with
other agencies; serving on local and state boards,
committees and other related organizations; exercising
media and public speaking opportunities; and
coordination of care with other providers.
12 NEW HANOVER COUNTV HEALTH DEPARTMENT
Promote health and safety of individuals and families
through the provision of preventive, curative and
rehabilitative health services
I Statistics for the School Health Program reflected a 19%
growth in the number of students screened during FY 2001/02.
School Health services consist of: assessing and monitoring
I student health problems; physical assessments; development
of emergency care plans; coordination of care; education for
providers of care; consultation with personnel regarding health
~s and the school environment; mass screening; health
l'!IIII'.'ation for students and faculty; first aid; medication and
treatment administration; and monitoring delivery of care and
medical supplies. Mass screenings for vision, scoliosis and lice
I infestation were completed. Two full time and one half-time
new public health nurses were employed to accommodate the
increased demand for services, enabling NHCHD to increase
I School Health hours and provide more comprehensive care in
elementary, middle, high, and Lakeside schools. Having nurses in
schools more hours per day increased medication administration
I by 9% and first aid by 63%. Over all services increased 41 %.
Volunteers, including the American Association of University
I Women, played a major role in School Health accomplishments
this year, assisting with scoliosis, vision screenings and infirmary
duties. Special school activities included health displays, health
I fairs, Smoking is Not Your Friend, Media Review Committee,
Senior Project Board, Open Airways, sports physicals and health
education sessions for students and staff. A grant from New
I Hanover Regional Medical Center's CHIP Program enabled the
Division to fund additional dental health services. A grant from
the Cape Fear Memorial Foundation provided lice combs to needy
I students and educational materials to all elementary schoo I students.
. Crafters continued providing free vision care and glasses.
Orthopedic and Neurology Clinics provided diagnosis
I and treatment of related diseases, care coordination and healthy
lifestyle counseling. Physicians volunteered their services
or donated their payment to further program activities. The
I
13 NEW HANOVER COUNTY HEALTH DEPARTMENT
I Well Baby Clinics provided services throughout the county
The clinics offered physical exams, developmental evaluations,
I immunizations, laboratory testing, TB screening, nutritional
I'njury prevention information and referral, and follow-up
eded. Clinics are offered in the evenings to accommodate
ling parents and volunteer physicians staffing the clinics.
Clinics had to be cancelled early in the year due to physician
retirement. Demand for services has increased waiting periods.
I Child In-home Service provided health assessment, disease
management,accesstoequipmentandsupplies,health promotion and
injury prevention information and referral and follow-up as needed.
I The Kindergarten Health Assessment Clinic provided
physical examinations, laboratory testing, immunizations,
I TB screening, hearing and vision screening, and counseling
and referrals. The clinic served non-Medicaid patients, fol-
lowing the mandate that indigents have access to this service.
I Clinic attendance decreased from 123 to 85 and can be at-
tributed to increased participation in Health Choice insurance.
purpose of these clinics is to serve individuals unable to
access services elsewhere. The Rotary Club of Wilmington
established the Orthopedic Clinic and continued to support
it both in funding and member volunteers. Funding by the
Rotary Club increased this year to cover cuts in state funding.
Two Adult Health Clinics were eliminated this year due
to loss of staff. The clinics offered health assessment and
monitoring, care coordination, treatment, immunizations,
disease management and healthy lifestyle counseling.
Clinic attendance increased 29% during the year
The Adult In-home Services Program providedhealthassessment,
disease and disability management, environmental assessments,
immunizations, treatment, care coordination and healthy lifestyle
counseling. Administered by program staff, the Ministering Circle
Chore Program was a valuable resource for homebound patients.
Adult Day Health Monitoring is a state mandated service for
adult day health centers. Each center was evaluated on a quarterly
basis for provision of health care. Public health nurses provided
assistance with compl iance issues. No new centers opened this year.
Penny Raynor treats an inmate through the Jail Health Program.
NHCHD, through an agreement with the Sheriff's Department, is
responsible for the health care of jail inmates. The Jail Medical
Program services included primary and preventive health care,
dental health care, health education, consultation and training of
jail personnel and consultation with the court system and other
detention centers. Staff provided consultation and training to
other jail health providers. On-site staff was able to reduce
care accessed outside the jail by 14% during FY 2001/02.
The Division lost a PHN 11 position this year. This forced staff
to discontinue newborn visits and two Adult Health clinics.
During the summer staff was able to provide health fairs at
the sites where Adult Health clinics had previously been held.
I Dental Health
I The New Hanover County Dental Program continues to
Aonstrate the excellent cooperative efforts of the North
_Iina Oral Health Section, the New Hanover County Health
I Department, the Wilmington TriCounty Dental Society, the North
Carolina Dental Society, Cape Fear Community College Dental
Programs, the New Hanover Community Health Center, as well
I as many other community groups. The Dental Health Division
utilizes numerous strategies to improve the oral health of our
citizens which involve a) Increased Use of Dental Sealants, b)
I Periodic Dental Assessments with Referral, c) Dental Health
Education, d) Community Water Fluoridation, and e) Promotion
of Community Efforts to Improve Access to Dental Care.
I Fiscal Year 2001 - 2002 was an extremely productive period
for the Dental Health Division. Over 9,300 children and adults
I received Dental Health Education from our staff. Additionally,
3,200 plus children received Dental Assessments with over 7,600
children participating weekly in the Fluoride Mouthrinse Program.
I
I
Out 2002" was a local Dental Health initiative to prevent tooth
decay by the increased use of Dental Sealants. "Seal Out 2002"
took place at the Cape Fear Community College Dental Program
on Friday, February 22, 2002. Local Dentists volunteered
their time in order to serve as instructors and supervise the
placement of Dental Sealants by Dental Assisting and Dental
Hygiene Students. In total, 45 local elementary students
received 226 Dental Sealants free of charge. Over $10,000
of Dental Treatment was provided to needy area children at
no charge. In all, "Seal Out 2002" was a tremendous success.
Exciting work has occurred this year in the area of Dental Health
Education and Prevention. During February 2002, the New
Hanover County Dental Staff celebrated National Children's
Dental Health Month with various dental activities conducted
throughout the community Educational information concerning
Dental Sealants was sent to all New Hanover County employees.
The Dental Staff produced an interesting display located in
the Health Department clinic reception area entitled "Seal
A Winning Smile" In addition to the display, the Dental
Staff answered patients' questions and distributed sealant
literature. On numerous dates throughout February, the
Dental Staff conducted educational sessions at preschools,
daycares, and after school enrichment programs on
various topics such as nutrition, brushing, flossing, and
the benefits of sealants. Celebrating National Children's
Dental Health Month is another important way to
encourage both children and adults to keep a terrific smile.
I
I
I'
\.--
11- ~\. ,
I .J'
"
Ik ,~ 7-~-~
IL {,.. .." ~
I - .~~._'\
Avoung client ;s "all smiles" during the Seal Out 2002 Campaign
.. Important work has occurred this year conceming Seniors' Dental
I In honor of National Children's Dental Health Month, the New Health in our community During July and August 2001, Dr.
Hanover County Dental Program, the North Carolina Oral Health David McDaniel and Staff conducted Dental Health Education
Section, Cape Fear Community College, and the Wilmington and Oral Health Assessments for approximately 300 Senior Adults
I TriCounty Dental Society sponsored "Seal Out 2002" "Seal at 6 nutrition sites in New Hanover County. These assessments
14 NEW HANOVER COUNTY HEALTH DEPARTMENT
,
~"I'
"
.,
Other programs and activities conducted by the New
Hanover County Dental Staff this year included "Oral
Health Care F or You and Your Baby" Parenting Programs,
.-....-..
, \. "
""'~."""~ '.
~
P"" '
I "
J
i .'\
,Xy
..
"Community Smiles" After School and Summer Enrichment
Programs for At-Risk Children, "Let's Talk Teeth" Head
I Start, Preschool, and Daycare Programs, and "Take a Look
at Dentistry" Dental Careers Programs for New Hanover
County Students. In addition, the New Hanover County
Dental Program was pleased to serve as a Dental Public
Health orientation site for 26 Dental Assisting and Dental
Hygiene Students from Cape Fear Community College.
The Dental Assisting and Dental Hygiene Students were
introduced to the Public Health Department as well as
completed numerous experiences in Dental Public Health.
land education were major components of a program for Senior
Adults entitled "Senior Smile 200 I" sponsored by the New Hanover
iunty Dental Program, the New Hanover County Department of
. g, and the North Carolina Oral Health Section. In addition to
or Smile 2001 ", during November 200 I, Dr. David McDaniel
I the guest speaker at the Brightmore Center located on 41"
Street in Wilmington. The title ofthe presentation was "Diabetes
and Oral Health" The program was designed to inform Seniors
about current concepts involving diabetes and oral health. The
Iprogram explored the etiology of diabetes, the link between diabetes
finvironmental Health
Many aspects of human well-being are influenced by the
lenvironment, and many diseases can be initiated, promoted,
sustained, or stimulated by environmental factors. The interactions
of people with their environment are, therefore, critical components
tf public health. The Environmental Health Division (EHD)
rotects the public health and environment through the provision of
a diverse group of services in the community. Services include the
.valuation of: all types offood operations; body art establishments;
.hild care facilities; foster care homes; institutions including
hospitals, nursing homes, and private and public schools; lodging
.facilities; public swimming pools; other recreational waters;
.astewater systems; and water supplies. The Division assesses air
quality, identifies/mitigates environmental hazards including lead
.Plies control methodology for potential disease vectors such
osquitoes and ticks. During disaster response and recovery,
many services and supports are offered to facilitate the restoration
10f normalcy in the everyday lives of citizens. The following
highlights some of the past year's environmental health activities.
IFOOd Safety Program
Achieving a 100% coverage rate of establishments/facilities
under inspection by the Division is critical to assuring food
Isafety practices and reducing the risk of foodborne illness in the
population. This translates as conducting an evaluation of each
restaurant on at least a quarterly basis or four times yearly A
minimum frequency of inspection is established for the various
Itypes of establishments/facilities in North Carolina General
Statutes and Administrative Code. Increasing the coverage rate
Ihas been an ongoing objective, however, continuous growth in
the local food service industry has had a major impact on the
Division's capacity to accomplish this performance measure.
IHigh demand from the local food service industry for training
and certifying their employees continues as a strong indicator of
the value placed on compliance with regulatory standards. Food
lservice establishments with at least one full-time employee in
Aervisory status who has attended an accredited course and
.een certified through successful completion of a written
lexamination are awarded two bonus points on their sanitation
score. A perfect score plus two bonus points means that the
sanitation score could actually exceed the 100% mark to 102%.
I
and oral health, as well as the oral manifestations of the disease.
Participantsgainedathoroughunderstandingofguidelinesfordental
treatment as well as the principles of prevention of oral disease.
"Senior Smile 200 I", "Seal Out 2002", as well as other
various Dental Health Education, Prevention, and Access
To Care Programs, once again demonstrate how the
New Hanover County Dental Program collaborates with
numerous community groups and organizations to assure
optimal oral health for the citizens in our community
Through a joint venture with Cape Fear Community College
(CFCC), EHD staff instructed five sessions (171 students)
of the National Restaurant Association's Serving Safe Food
Certification Course. More than 95%, 162 students, obtained
the certification credential. Plaques were awarded to Cape
Fear Riverboats, Inc. and Holiday Inn Sunspree Resort for
having at least five certified employees in their operations.
Representatives of these establishments were given special
recognition by the Health Director and CFCC Dean of Continuing
Education at New Hanover County Board of Health meetings.
The use of numeric scores to notify the public of an
establishment's level of compliance with food safety standards
began on a trial basis almost five years ago. To evaluate impact
of this project, a final survey of was distributed to the public,
restaurateurs and staff to gain input and measure success. This
data was assessed and utilized to make a recommendation to the
North Carolina Commission For Health Services for possible
changes in the method of displaying levels of compliance with
food safety and sanitation standards. To date, a final decision
on its future has not been reached, however, it is certain that
the overall positive experience reported from New Hanover
County will heavily influence the disposition of this project.
Changes in the North Carolina General Statutes regarding the
exempt status of select categories of food service operations
forced Board Of Health action relative to local standards
governing temporary food facilities. Such operations typically
occur during weekend celebration or entertainment activities
such as fairs, festivals and other similar special events. Often
outdoor food preparation and sales are the primary attraction,
thus offering great potential to affect the public's health.
Changes resulting from both state and local action on this issue
generated a huge demand on our available work force as most
ofthese operations are scheduled outside normal business hours.
Body Art Program
Deciding that body piercing was not a passing fade and posed the
risk of disease transmission to customers as well as practitioners
were two factors that prompted enactment of a local standard
essentially patterned after the National Environmental Health
Association Model Code. Local practitioners by and large support
15 NEW HANOVER COUNTY HEALTH DEPARTMENT
Ithe public health motive to regulate their businesses, often
referencing complications and risks resulting from substandard
IPractice. Noncompliant artists are often reported by their
Is whereupon the Department conducts an investigation
makes a concerted effort to gain compliance on a
c perative basis without enforcement action. With the
Ipre-existing state laws and rules governing tattoo artists in
place, a comprehensive approach is available to manage
Ithe risk of disease transmission in body art businesses.
Public Swimming Pool Program
Like eateries, swimming pools have a strong presence throughout
Ithe county Public swimming pools include virtually every kind
of constructed recreational water facility except those found in
residential backyards. Growth experienced in the program continued
IthiS year and led to a record setting issue of permits and inspections.
So as to meet the same proficiency standard established for pool
I operators, staff complete "Certified Pool Operator" training.
This consists of formal classroom instruction and an acceptable
score on written
Q
lexamination. Staff " i
must also demonstrate Transition to a new
application and permitting procedure
IknOWledge in the field for on-site wastewater
to obtain authorization systems has generated
from the North favorable results.
_Iina Department Initiated by examining
I!I!I'nvironment And the requirements
Natural Resources for developing
Ito enforce state new subdivisions
laws and rules. in New Hanover
i?- "" County, and state
Vector Control standards, the resulting
I Program process is a dramatic
Sentinel chicken change from prior
flocks began to test practice. The fee
Ipositive for Eastern schedule was adjusted
Equine Encephalitis to shift focus from the
virus by mid-July and Improvements Permit
Icontinued into to the Authorization
September 2001. Staff .. ,. to Construct Permit.
generated a strong "t C lOt J G' . '( I d . .. All forms underwent
. ad I"d ffi .ec or ontro pera or oe arcla examines mosqUl 0 aIVae un er a mIcroscope.. .
ImosqUlto u tlCI ee ort major deSign and
to minimize the risk of human exposure. A $400 million project layout changes. Collaboration with the Inspections and
to deepen the Wilmington Harbor made Eagle Island a control Planning Departments were essential to this endeavor
I focus throughout FYO I -02. Increased water depth including
routine maintenance along the Cape Fear River and Intracoastal From grants received through Duke University and the
Waterway brought many challenges. Navigating the Cape Fear University Of North Carolina School Of Public Health, staff
I River to Snow's Cut and north through the Intracoastal Waterway is building capacity both in equipment and skill to utilize
was a routine necessity for surveillance and application oflarvicide geographic information systems (GIS) as a platform for future
Atall dredge disposal islands located within theses bodies of operational strategies. The greatest value, however, is probably
Wr. Staff vigilantly monitored and treated several hundred acres yet to be realized through enhanced implementation of analytic
10fSPOi! deposition with larvicide product. Succ.ess ~n ~ewatering and graphic functions. A toolbox offering extraordinary
much of the acreage on Eagle Island supported thiS miSSion. Heavy possibilities to environmental and public health professionals,
equipment excavated and maintained perimeter ditches to lesson GIS will be a requisite skill in the not too distant future.
I the impact zone of these potential mosquito-breeding sites.
16 NEW HANOVER COUNTY HEALTH DEPARTMENT
Enhanced collaboration with City Of Wilmington Code
Enforcement officials reduced the number of tire piles
serving as mosquito-breeding habitats. Businesses were
enlisted to implement handling practices that minimize the
potential for collection of stormwater in tires. Transplanting
Gambusia affinis, mosquito-eating fish, to low-lying areas
still proves to be a desirable and effective biological control
method. Newly constructed storm water retention ponds
and changes in the landscape that allow standing water are
annually evaluated to verify the presence of Gambusia.
Wastewater-Water Quality Program
As a hallmark On-Site Wastewater Program in North Carolina, this
section continued the trend-setting pace in FYO I -02. Application
of cutting edge technologies brought resolution to wastewater
treatment issues. Experimental and innovative options address
many of the limitations inherent to coastal geography for properly
functioning septic systems. Components offering pretreatment of
wastewatereffiuent prior to disposing into the soil is given strong
consideration so as to better assure protection of groundwater
resources.
I Laboratory
lie Laboratory provides technical support and testing to
th Department programs and serves as a support service to
I munity health programs and private health care providers.
The Laboratory has established written policies and procedures for
a comprehensive Quality Assurance program designed to monitor
and evaluate the quality of the total testing process. The program
I evaluates the effectiveness of policies and procedures, identifies
and corrects problems, evaluates the accuracy, reliability and
prompt reporting of test results, and assures competency oftesting
I personnel. Proficiency testing, quality assurance programs, testing
quality control and competent personnel enables the Division to
continue to provide the best of services.
I GOAL
I Provide quality assured medical and environmental laboratory
services to public and private health care providers responsible
for the protection of the health of the citizens of New Hanover
I County and surrounding areas.
LICENSING
I The Laboratory is governed by the Federal Clinical Laboratory
Improvement Amendments (CLlA) that places all medical
IlAratories under the control and licensing of the federal
.....ernment. The North Carolina Department of Facility
Services is the inspecting agency for the Health Department
I Laboratory and issues the CLlA Laboratory Certificate of
Compliance allowing the laboratory to perform testing. During
the bi-annual inspection, the Laboratory received a report of no
I deficiencies. The Water Bacteriology Program is licensed by
the North Carolina State Laboratory of Public Health to perform
bacteriological testing of potable water samples and is subject to
I yearly on-site inspections. This year as in the past 27 years, the
Laboratory received no deficiencies on the inspection.
I SERVICES
I
I
STD Program 23.398
Women's Preventive Health 48,508
Women, Infants and Children 35,865
Jail Clinic 1,305
Child Health Programs 4,561
Neurology Clinic 1,352
Tuberculosis (TB) Program 5,537
Water Bacteriology Program 537
profiles; glucose, cholesterol and liver panels in clinical
chemistry; test for the HIV virus, qualitative and quantitative
tests for syphilis; lead testing on children; stool cultures to control
shigella outbreak; and water coliform tests.
This year the Laboratory provided services to the "Sentinal
Chicken Program" processing the blood samples drawn by the
Vector Control Section, worked with the State HIV /STD Section
to test blood samples drawn at a special Saturday Cure AIDS
clinic for syphilis and processed the samples for HIV testing at
the State Laboratory and is working with the Women's Preventive
Health Clinic to be part ofthe Wise Women Program providing
HDL Cholesterol testing to the BCCCP Program. The Laboratory
also provided laboratory coverage for evening Well Baby Clinics
performing hemoglobin and blood lead testing. The Laboratory
passed all required proficiency testing samples with a grade of
100. In April the Laboratory Staff celebrated the National Medical
Laboratory Week with shirts, pens, magnets, pads, posters and a
bulletin board displaying the theme of "Laboratory Professionals,
Quality Care Through Quality Testing" and participated in the
Annual Employee Appreciation Luncheon to celebrate Public
Health Month. The Laboratory lost its clerical position to staff
reduction by the County requiring the testing staff to cover all
of the clerical functions.
Nutrition
The Nutrition Division Provides a variety of services for the
residents of New Hanover County Two programs within
this division are the Supplemental Nutrition Program for
Women, Infants and Children (WIC) and the General Nutrition
program .
WIC PROGRAM
WIC provides nutrition education and supplemental foods to
prenatal, postpartum, and breastfeeding women; infants and
children up to 5 years of age. These are critical times for growth
and development, when proper nutrition is especially important.
The supplemental foods are high in protein, vitamins, and minerals
(particularly Vitamin C and iron), to prevent anemia, to increase
the birth weigh of infants, and to permit maximum mental and
physical development. WIC foods have been carefully selected
and are individually prescribed to meet each WIC participant's
nutrition needs. During this fiscal year, participants receive
vouchers worth $1.9 million to use at area grocery and drug
stores. WIC nutritionists completed 5,819 WIC certifications
and 3,856 additional nutritional assessments.
I
_ Laboratory performed 121,063 procedures during FY 01-02
I Testing included but was not limited to gonorrhea and wet
smears; urine, throat and gonorrhea cultures; urinalysis and
I microscopic tests on urine; pregnancy tests; hematology
17 NEW HANOVER COUNTY HEALTH DEPARTMENT
I WIC management support staff also provided 1,388 "mini"
nutrition lessons for low risk WIC participants. An average of
I 2,856 people were served each month.
_ WIC program serves as an adjunct to
I health care. WIC staff refer children for
lead testing and immunizations. Identified
WIC clients are referred to other health
I department programs such as Children's
Service Coordination, the Navigator
Program, and Maternity Care Coordination.
I Clients can also be referred for substance
abuse counseling, for Department of Social
Services programs such as Medicaid and
I food stamps, and Health Check/Health
Choice.
I The WIC Program encourages breastfeeding
as the feeding of choice for infants.
I Breastfeeding equipment and supplies are
available for breastfeeding mothers and
their babies. During the past year, 76 mom-
I baby pairs borrowed one of the program's
25 electric breastpumps. Mothers with
infants still in the neonatal intensive unit
.a mothers who want to continue to
"lusively breastfeed their babies after
returning to work or school benefit greatly
I from this service.
I
I
I
I
I
and current nutrition recommendations for a wide variety of
nutritional problems.
!
,
\ ~
\ "
\.
\
\
\
\
\0\
In September 2001 , the WIC Program began
to use MICR (Magnetic Ink Character
Recognition) prints to print food vouchers.
The benefit of the change was improved
program efficiency, increased accuracy in voucher issuance
data, and increased security for voucher issuance. Clients like
the new WIC vouchers since they now look like a bank check,
and they are more comfortable using these at local stores.
GENERAL NUTRITION
The registered dietitian in the General Nutrition Program provides
individual nutrition counseling and presents nutrition programs
to many groups throughout the community. During FYO 1-02,
individual contacts included 133 at Coastal OB/GYN prenatal
clinics, 118 at the NICU follow-up clinic, 38 at community
I well baby clinics, and 191 sessions at the Health Department.
&rrals for individual nutrition counseling come from other
.lth Department programs, area physicians, and self-referrals.
I New Hanover county citizens call and ask questions about many
different nutrition topics. Health department nutritionists must
I stay up- to-date in the latest nutrition research findings
'.
-
"",~~,. 1':..
'1"..', I' \...~.'" .->I.:s.
" ;"";'''r.
""!.,'. "'"?'-:;~t:!.!;{..~;:t.J.
____~...... '~;e.;.J....~..., I
The Women, Infants and Children (WI C) Program
provides quality service to this mother and child.
Thirty three nutrition programs were presented to a wide variety
of community groups including retirement and senior centers,
school classes ranging in age from Pre K through community
college, child care facilities, parenting groups, school nurses, and
social service agencies.
The general nutrition program is partnering with a NHCHD
health educator and NC Cooperative Extension Service to train
day care workers in the "Color Me Healthy" curriculum for 3
and 4 year olds. The focus is on good nutrition and increased
physical activity.
The Nutrition Division is committed to serving the citizens of
New Hanover County by promoting good nutrition throughout
the life cycle. Good nutrition is the foundation for good health
and a healthy community.
18 NEW HANOVER COUNTY HEALTH DEPARTMENT
. Women's Health Care / Health
. Promotion
_ Women's Health Care (WHC)/Health Promotion Division
. is comprised of Women's Preventive Health, Maternal Health
and Health Promotion.
. GOALS
.
.
Prevent unwanted pregnancies
Improve pregnancy outcomes
Reduce infant mortality
Improve the health status of disadvantaged women
and women of diverse cultures
.
.
. WOMEN'S PREVENTIVE HEALTH
Provide health education for women in the community
Provide breast and cervical cancer screening and
referrals
IIA" Hanover County Health Department (NHCHD) provides
~en's preventive hea~th (WP~) services which include health
screenings, comprehensive phYSicals, Pap smears, breast exams,
mammograms, and health education. WPH services are the only
. source of preventive care for many women, and help prevent
unwanted pregnancies, prevent the spread of sexually transmitted
. diseases, provide valuable prevention education, reduce health
care costs and save lives. For every $1 spent on WPH services,
an average of $4.40 is saved in health, welfare and nutritional
. expenditures. WPH provided 4,091 clinic services to women
during FY 01/02.
.
.
.
The WHC Division supports a nurse out-posted to the NHC
Department of Social Services (DSS) to reach young women
seeking public assistance. The goal is to explain and offer
contraceptive services and reduce the number of out-of-wedlock
births in the county This position provided 118 referrals for
WPH services as a direct result of contacts made at DSS.
Additionally, 612 Work First recipients received direct WPH
education, including contraception information and an invitation
to participate in health department services. Outreach efforts have
also brought in donations of incentive items to encourage women
to keep their appointments and follow-up with instructions.
Since 1960, breast cancer has claimed more American lives than
World War II, Vietnam, and the Gulf Wars combined, and is the
second leading cause of cancer deaths among women in North
Carolina. Nationwide North Carolina ranks ninth for cervical
deaths, fourth highest for African American women, and twelfth
for white women. These cancers are preventable and curable.
Routine breast exams and Pap smears lead to early diagnosis
and treatment. Every woman is at risk, but some women are
less likely to obtain screening services. NHCHD provides
breast and cervical cancer screening free of charge to qualified
women through the Breast and Cervical Cancer Control Program
(BCCCP). WPH conducted 127 mammogram screenings (17
abnormals) and 95 Pap smears (3 abnormals). The Division
also emphasizes outreach to Latino women in New Hanover
County.
Male sterilization is the birth control method of choice for some
couples. The Health Department provides education, counseling,
and scheduling for vasectomies through arrangements with a
local urological group and the Regional Vasectomy Program in
Greensboro, NC. This service is provided free or at a reduced
rate based on income. Services were provided to 14 men during
FY 01/02.
MATERNAL HEALTH
WHC Division goals are improved birth outcomes through early
identification of pregnancy with timely referrals for prenatal
care. Among the teen population in New Hanover County
in 200 I, there were 265 pregnancies in the 10-19 age range.
Teenage mothers are more likely to bear subsequent children
more rapidly and to have more unwanted and out-of-wedlock
births. Unplanned children are at greater risk for abuse and
neglect, which increases with family size. Women who have
unintended pregnancies are more likely to live in poverty
Teenagers are more likely to deliver low birth weight infants
. due to poor nutrition and inadequate prenatal care. Low birth
Aght infants are at greater risk for physical and de~elopmental
_bilities throughout childhood. The cost for thIS long-term
I care is insurmountable and is often funded by taxpayers. The
Division provided 142 pregnancy tests among the teen population
during the year and provided counseling and referrals for 171
. positive pregnancy tests among teens and adults.
19 NEW HANOVER COUNTY HEALTH DEPARTMENT
Early and consistent use of prenatal care provides early iden-
tification of high-risk concerns, improves birth outcomes
and decreases low-weight births and infant mortality. North
Carolina's infant mortality rate continues to be among the top
lOin the nation. Prevention of one high-risk pregnancy can
save over $250,000. Adolescents and unmarried women have a
greater likelihood of poor birth outcomes. The Maternity Care
Coordination program assists potentially eligible clients in ap-
plying for Medicaid, develops a strong referral network, and
increases community awareness of expanded Medicaid cover-
age and benefits for pregnant women. The program determines
clients' strengths and needs including psychosocial, nutritional,
medical, educational, and financial factors. The goals are aimed
at reducing infant mortality and improving the health status of
women and their newborns. The Maternal Outreach Worker
program provides intensive home visiting for pregnant women
. who are at risk for poor pregnancy outcomes. Recruitment of
at-risk women through extensive community networking ensures
. early and continuous prenatal care. Reinforcement through health
4Eation assists participants in adopting healthful behaviors and
les. The Maternal Health Team generated 6,484 contacts
. ~ provided counseling and referrals for 747 new prenatal pa-
tients.
. A new project for the Maternal Health Team during FY 0 1/02 was
the "Baby Bucks" program. Staff wanted to develop an incentive
program to provide rewards for their clients who are compliant
.
I
.'
.
,r II.
" ""
I~~-
.~.. .
.. -,
~-_.
current or previous pregnancy, and emotional stress associated
with HIV / AIDS diagnosis during pregnancy A licensed clinical
social worker addresses these issues among this population and
provides intensive counseling and referrals.
Mothers who deliver newborns in hospitals today receive little
recuperation time or instruction prior to discharge. Issues such
as breast-feeding and newborn care often need reinforcement to
prevent problems. Postpartum home visiting provides in-home
physical assessments, education and referrals for mother/infant
pairs within 72 hours following discharge from the hospital,
an opportune time for early problem identification and
intervention. Last year Maternal Health provided nursing
visits to 308 mother/infant pairs.
Women's Health Care provides quality options for women
seeking contraceptive care, routine women's health care
services, prenatal care and cancer screening. Services are
provided free of charge or on a sliding fee scale based on
income. Medicaid and private insurance are accepted.
Protection of confidentiality is a priority. The Division has
the opportunity and responsibility to provide factual, accurate
and current information on topics such as sexuality, birth
control, abstinence, sexually transmitted diseases and parental
involvement, which are crucial to the health and maturity of
young women and could save lives. Preventive education is
provided on osteoporosis, folic acid's role in the prevention
of neural tube defects in newborns. pre-conceptional health
education, breast and cervical cancer screening and prevention,
childhood obesity and depression. Staff invites opportunities
to share information about services with parents, civic groups,
churches, and other interested organizations.
HEALTH PROMOTION
Health Promotion strives to improve the community's health
by providing educational programs to prevent disease and
injury and to enhance the community's ability to solve health
problems through informed decision making. The section
provides programming in the areas of injury prevention
and tobacco prevention and control, and promotes state
initiatives to reduce chronic disease. Health Promotion
provides health education consultation to all divisions of
NHCHD and coordinates events such as public awareness
campaigns, outreach activities, community health assessments,
and corresponding media coverage.
Jennifer Abney with WEer TV 6 was the Honorary
SpOkeswoman for the "Baby Bucks" Baby Shower.
with appointments and individual goal setting. Maternal Health
. clients can earn the "bucks" throughout their pregnany, and
redeem them for high quality, useful products for mother and
baby Staff held a "baby shower" to promote the program and The Project ASSIST Tobacco Prevention Coalition works
. to gather donations, and the program was highlighted on a local to reduce death and disability related to tobacco use. Local
8s channel to garner additional recognition and support. coalition initiatives focus on youth prevention, youth and adult
,., cessation, and clean indoor air. A successful coalition endeavor
. Psychosocial assessment, clinical observation and counseling was the fourth annual TobaccoAwareness Week, which included
for at-risk pregnant women is essential in cases of domestic presentations to approximately 1,500 students and the signing
violence, emotional crisis, family dysfunction, impending of tobacco-free pledges by over 2,000 middle and high school
. incarceration, substance use/abuse, negative feelings about a students.
20 NEW HANOVER COUNTV HEALTH DEPARTMENT
. The Injury Prevention program focuses on major risks for
injury and coordinates the local Safe Communities/SAFE
. KIDS Coalition, partnering with local and state agencies, law
.rcement and schools to encourage safe environments and
vior change. A primary focus was the Child Passenger
. ety Program, which provided opportunities to increase and
improve the use of child safety seats. Through the Governor's
Highway Safety Program (GHSP), approximately 170 seats
I were distributed to low-income families and to agencies that
serve them. Three Child Passenger Safety Training classes were
offered, resulting in the certification of 30 people by the NC
Department ofInsurance. Ten child safety seat checks were held,
I with approximately 200 seats examined for proper installation,
positioning and recall status, revealing that (locally) 90% of seats
examined were incorrectly used.
I
The Health Promotion Team continues to provide prevention
education on a wide variety of topics in the community. Seasonal
I information on sun safety and heat safety continue to be popular
requests for area summer camps and outdoor businesses. The
Team also assisted in facilitated the "Color Me Healthy" early
. child nutrition and physical activity program, and other initiatives
promoted through state health promotion offices.
.
.nancial Management
The New Hanover County Health Department Amended Budget
I (Adopted Budget plus any amendments during the fiscal year)
for FY 2001-2002 was $11 ,303,703 Actual expenditures for FY
2001-2002 was $10,599,283 The Health Department's budget
I is composed of 36 individual programs. Division Directors
submit a line item budget for each program within the division.
. Budget requests are reviewed by the Health Director, Assistant
Health Director and the Business Officer. Budget hearings are
conducted and a Budget Workbook including all programs with
line item narrative justifications is prepared and submitted to the
. Board of Health for approval.
.
I
I
I
I
Total Actual E xperxlitlresfor FY 2001-2002
Operating
1,722 ,429
16"
C3pil3l Ouday: t
155.534
1"
$
~;-~
~'---------.-~----
Salaries &
FMnges
$8.721,320
S3'i
I
L
I
~. - ---
".L~ ~j ."(;. tl ;:l'7l~
'ga
.:.:~
..
Peer Educators are a valuable resource during this Tobacco
Awareness Month presentation at Bradley Creek Elementary School.
The Health Department's Business Officer if responsible for
preparing expenditure reports to ensure billing and receipt of
the Health Department's state grant funds. The Health Deparment
complies with New Hanover County Financial Policies and
Procedures that includes an annual audit.
Figure 1: illustrates how the Actual
Expenditure Budget is divided
among Salaries/Fringes, Operating and
Capital Outlay items.
21 NEW HANOVER COUNTY HEALTH DEPARTMENT
I
Tola I Rnenue Ell med f"( 200 1.,2 002
Uedt::al:l:
$1,2616 .67
1~
Olle r:$1,~61,~1C
U~
Healll feu'
$169,2 ~7
2~
(Note: Of the $1,266,670 Medicaid
Revenue, $208,176 is Medicaid Cost
Settlement Funds,)
I
I
I
ElulDlmu1a1
Heatl feu'
$:Dl,211
~
Co II 1f
Jlppocr r131bw
$I5,JJl ,77 S
~~
I Figure 2: Illustrates the breakdown of the Health Department's
total earned revenue ($5,261,508) through Health Fees, Medicaid,
Environmental Health Fees, Animal Control Fees, and Other
I (including miscellaneous grants and school contributions). It
also shows Federal and State Grants through the North Carolina
Department of Health and Human Services ($1,468,536 which
I is included in the above total revenue figure) and County
Appropriations ($5,337,775).
I
--
I
I
I
I
I
I
I"
I
I
22 NEW HANOVER COUNTY HEALTH DEPARTMENT