06/02/2004
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New Hanover County Health Department
Revenue and Expenditure Summaries for April 2004
Cumulative: 83.33% Month 10 of 12
Revenues
Current Year Prlo,Yea,
Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remalnin Amount Earned Remalnln
Federal & Slale $1,998,125 $,,316,363 $ 681,762 $1,685,731 $1,023,991 $ 661,740 60.74%
AC Fees $ 570,161 $ 552,129 $ 18,032 $ 587,944 $ 444,969 $ 142,975 75.68%
Medicaid $1,044,080 $ 474,246 $ 569,834 $ 707,352 $ 328,034 68.32%
Medicaid Max $ 273,333 $ $
EH Fees $ 300,212 $ 231,742 $ 68,470 $ 239,256 $ 73,644 76.46%
Hea~h Fees $ 113,850 $ 147,558 $ (33,708) $ 134,529 $ (21,679) 119.21%
Expenditures
_ Current Year Prior Year
Type of Budgeted Expended Balance % Budgeted Expended Balance %
Ex endltura Amount Amount Remalnln Amount Amount Remalnln
Salary & Fringe $10,065,456 $7,474,866 $ 2,590,590 9,083,468 $ 7,086,023 $1,997,445 78.01%
Summary
Budgeted Actual %
FY 03~4 FY 03~4
Expenditures:
Salaries & Fringe $10,065,456 $7,474,866
Operating Expenses $ 1,731,192 $1,212,403
Capital Outlay $ 378,622 $ 213,942
Total Expenditures $12,175,270 $ 8,901,211 73.11%
Revenue: $ 6,698,166 $ 4,922,926 73.50%
_ Net County $$ $ 5,477,104 $3,978,285 72.63%
Revenue and Expenditure Snmmary
For the Month of April 2004
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NHCHD BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 03-1l4
::: "'- \
Date (BOH) G,ant '-l. ~... Reauesled Pendlna Received Denied
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Kate B, Reynold~ ~ !II- Transportable
5/512004 Dental Unit Grant":: ~ $375,000 $375,000
Cape Fear Memorial Foundation- Dental Grant $185,000 $185,000
Cape Fear Memorial Foundation- School
4n12004 Health Emergency Dente! Services G,ant $ 15,000 $ 15,000
Safe Kids Coalition- Governo(s Highway Safely
Program- (Coalition Vehicle Request) $ 16,000 $ 16,000
Safe Kids Coalltion- Safe Kids Buckle Up
31312004 Program- Child Safely Seat Grent $3,500 $3,500
2/4/2004 No activity to report for February 2004.
Cape Fear Memorial Foundation- Funds needed to
enhance hearth education In 4 areas other than Diabetes
(an enhancement to Diabetes Today Grant). (LMng
1n 12004 WelQ $20,000 $18,500 $1,500
1213/2003 No activity to report for October 2003.
Cape Fear Memorial Foundatlon- Funds needed to
cover dental services for needy children as Identified by
11/512003 School Health Nurses. $3,000 $3,000
NC Medical Foundation - Through the Good Shephard
Ministries for nursing services to the population
frequenting the shetter. $25,000 $25,000
Duke Unlvel8lty- To provide 10 hours of nursing
e services for TB Outreach. $10,388 $10,700 -$312
NC Tobacco and Control Branch, DHH8-
Continuation of Tobacco Prevention Program. $100,000 $64,093 $35,907
1011/2003 No activity to report for October 2003.
New Hanove, County Safe Schools- Uniting for
Youth "U4Youth"(funding will be received ove, a
91312003 3 year grant period) $49,000 $ 12,702 $36,298
Safe Kids Coalltlon- Fire Prevention (Plea.. note
this grant was pulled- coalition not able to meet deadline
for request) $2,500 $2,500
8/612003 NC DHHS- OPH Preparedness and Response $82,350 $31,950 $50,400
.
Smart Start- Partnership fo, Children (Grant
7/312003 Increase for Part Time Nurse Position) $5,523 $5,523
Cape Fear Memorial Foundation. Diabetes
Today (two-yeer request; $42,740 annually)
(Received $25.00 year 1 and $20,000 yesr 2) $85,460 $45,000 $40,480
Duke University Nicholas School of the
Envlronment-Ge09raphic Information Systems
Grant (Env Health) $10,000 $10,000
Safe Kids Coalitlon- 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
e Smart Start- Partnership fo, Children: Child
5n 12003 Care Nursing Program (Preliminary Approval) $171,977 $172,500
Smart Start- Partnership fo' Child,en: Hea~
Check (Preliminary Approval) $41,035 $41,747
UNC.cH: Child Care Health Consuitent $62,649 $64,495
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As of 5/1912004
. NOTE: Notification received since last report.
NHCHD BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 03-1l4
Date (BOHI Grant Requested PendinG Received Denied
Cape Fear Memorial Foundation (through
Partnership for Children): Navigator ProGram $178,707 $180,000
41312003 No activity to report lor April 2003.
3/512003 No activity to report lor 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
121412002 No activity to report for December 2002.
NC Health andWellness Trust Fund-Teen
Tobacco Use Prevention & Cessation Program
11/612002 ($100.000 per year for 3 years) $100,000 $100,000
Safe Kids Buckle Up Program-North Carolina
101212002 Safe Kida $5,000 $5.000
Developing Geographic Information Systems
(GIS) Capacity In Local Health Department In
Eastern North Carolina-Duke University
Nicholas School 01 the Environment and Earth
Sciences (NSEES) $18,000 $18,000
NO activit)' to report lor :ieptemDer 2UUl.
NO actiVity to report lor AUgUst ;lUU~.
o acttvlty to report .or JulY 2002-
Totals $1,741,259 $591,000 $752,287 $404,545
33,94%
43.20%
2324%
Pending Grants 4 15%
Funded Total Request ,t 42%
Partially Funded 7 27%
Denied Total Request 4 15%
Numbers 01 Grants Applied For 26 100%
As 015/1912004
. NOTE: Nollflcatlon racelved since last report,
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NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda: Consent Meeting Date:
A enda:D
Department: Health Presenter: Cindy Hewett, Business
Mana er
Contact: Cindy Hewett, Business Mana er, ext 6680
Subject: Request for approval to purchase needed supplies for Animal Control Services
S a / Neuter Facili $19,973
Brief Summary: New Hanover County Animal Control Services is requesting approval
to purchase necessary supplies for the Spay/Neuter Facility in the amount of$19,973.
These funds are available in the existin FY04 0 eratin Bud et.
Recommended Motion and Requested Actions: To approve request for purchase of
needed supplies for Spay/ Neuter Facility in the amount of $19,973 and associated budget
amendment.
I Funding Source: County Appropriations
WiIl above action result in:
DNew Position Number ofPosition(s)
Dposition(s) Modification or change
~o Chan e in Position s
Explanation: This transaction does not require approval from the Board of County
Commissioners due to no changes occurring in the total amount of the Animal Control
Services FY04 Budget (no overall increase or decrease will occur in revenue or expenses
as a result of this transaction .
I Attachments: Bid information and quotes from prospective vendors.
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FAX TRANSMISSION
NEW HANOVER COUNTY ANIMAL CONTROL SERVICES
180 Division Drive
WILMINGTON, NC 28401
Telephone: (910) 341-4197
Fax: (910) 341-4349
To:
Merritt Veterinary Supply, Steve Beust
Date: 5/7/04
Pages: 2 (including this cover sheet)
From: Jean McNeil, Animal Control Services Manager
Subject: Invitation to Bid on Supplies for Animal Control Sheher
Attached is a request for pricing for supplies for the Animal Control Facility. This is an informal bid and
there is not a public bid opening. Bids must be received by 12:00 noon Wednesday, May 12, 2004. Any
bids received after the scheduled closing time for the receipt of bids will not be considered. Bids may be
faxed to (910) 341-4349 or delivered to:
New Hanover County Animal Control
Attn: Jean McNeil, Animal Control Services Manager
180 Division Drive
Wilmington, NC 28401
Bids must be on bid proposal form provided with this request. All goods shall be new and in no case will
used, reconditioned or obsolete parts be accepted. The award of this bid will be made to the lowest
responsible bidder, taking into consideration quality, performance and time specified in the proposal for the
performance of the contract. Award for all items will be made as a group to one bidder. New Hanover
County reserves the right to add or delete quantities.
New Hanover County is exempt from and will not pay Federal Excise Taxes or Transportation Taxes. If
bidder is required to charge North Carolina sales tax on bidder's sales, bidder shall not include it as part of
the bid price. County will pay North Carolina sales tax over and above bid prices when invoiced.
Prices quoted for supplies shall include delivery costs. Goods shall be delivered F.O.B. Animal Control,
180 Division Drive, Wilmington, North Carolina and shall be complete and ready for use unless otherwise
specified.
The successful bidder shall be responsible for instructing County personnel in the proper use and
maintenance of the goods.
The County reserves the right to reject any or all bids.
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If you have any questions, please contact me at (910) 341-4197.
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New Hanover County
Animal Control Services
Equipment Older Request
(910) 341-4349 (fax)
(910) 341-4197 Contact: Jean McNeil
Item
Vapor Stick Plus Anesthesia ~ine
T ec III Style Vaporizer
Audio Patient Monitor
Midmark Ultraclave 11 x 18 chamber (M11)
Littmann Cardia. III Stethescope (burg)
SurgeIY Light Single Head. Wall Mounted
Mayo Instrument Stand (chrome)
IV Stand (chrome)
Miltex Canine/Feline Spay Pack - no strg
The V5SI Way Platform Scale
Advantage V-top Hydraulic Surg. Table
Kick Bucket wi Rolling Stand
Tom Cat Posilioner
Shipping & Handling Fees
Grand Total
Quantitv Cost/Unit
2
2
2
1
2
2
2
1
10
1
2
1
2
Total Cost
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2UU2IMAR/20/WED 08:45 AM Webster Vet.Supply
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FAX No.
P.002
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Webster Veterinary Supply, Inc.
86 Leominstlr Road, Sterling, Massachusetl$ 01564 . Phone: (978) 422-S211 . Pax: (978) 422-8959
To: New Hanover County
Anitn.a1 Control Services
Equipment Bid
Contact: Jean McNeil
"Shipping and Handling is an estimated cost.
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2
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1
2
2
2
1
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2
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'Shlpplng
$1 500.00
795.00
$193.00
$3 800.00
$142.00
$670.00
$99.00
$40.00
$408.00
880.00
Sl 900.00
. $115.00 .'
S30.00
& Handling
Grand Total
Total C
$3 000.00
$1 590.00
386.00
$3 800.00
$284.00
$1 340.00
$198.00
$40.00
$4 080.00
$880.00
$3 800.00
$115.00
$60.00
$400.00
$19,973.00
Dlst1lbutfon Centers 111:
Sterlfng, MA. HaIIlsburg, PA. Charlotte, NC · GaInesville, PI.. BIID1lngham, AL. Houston, TX i 3
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MY-01-2004 FRl 03:50 PI! ANlllAl CON1'ROL
New Hanover CoImlr
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~ OtderReqIlll8t
(ItO) 341-4d Cfu)
'ItO) 341~t7 Contact: ......1IcNtliI
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Vapof SIk;k Plus AI_... Ua:hinll
Tee III ~ Vaporizer
Audio P&&ient MonIIcr
Midmark UllnDave 11 x 18 dlan1ber (Ml1)
lltlmann CardIa. III Sbdhe...ope (bIJrg)
SuIgeIy Uglll SlI9I Head. WlIII Maunted
Mavo InslM'Illlnl SliInd (chrOme)
IVSland (cIUom8l
MiIlex CanIneIFdlne Spay Pack - no 5bg
Th8 VSSI Wf/fY Plalfann Sc:aIe
AdIIanl8ge V-blp HydfauI1c SU19. Table
Kick Buc:Mt wi RllllInO Stand
Tam Cat Poeilioner
ShipPng & Handling Fees
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FAX NO. 910 341 4349
P. 02/02
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2 ''i51'> ).<;00
2 ~SO L<(ijD
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MERRITT VRTERINARY SUPPLIJl9
\.800.4??17Z3 EXT. 304
STllVn BRUn'
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1) You will need hose and Quick connect alIachmenlS. I couldn't Include this since the hoses iJRI
different prices depending on the length required.
8ft.
10ft.
75.00
78.00
85.00
V7159
V7160
V7161
6ft.
2) You will also need a scavenging system. F-Air canisters are the least ~ensive way to go.
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18.75 for a kR that includes a 4ft. hose, basket to hold the canis1er and 3 adaptms.
3) This quote is for the Tech IV Vaporizer. They are on special for half price. The Tech III and Tech
IV are identical except for an added safety feature in the Tech IV. It has built in baffle. This is in
case the machine is tihBd; the anesthesia agent Will not spUl over on to the wick.
4) One a1temative is the Tullenhauer AulDclave 10x18. Their price wlIh automatic door is 3450.
Their freight changes would be higher, $130. Total price difference is MidlT\ll1( 4O49 plus $70
freight for a total of 4119 vs. Tut!enhauer 3451 + 130 freight with a total 3580. Savings would be
$539 if you decide on Tut1enhauer.
5) We win need III know if you1I want 22' 01 27' models.
6) Surgery Light-0ne other option is VSSI which has one for $1622. Their shipping cost is $100.
7) I quoted you on a 4 wheel, two hook chrome IV Stand. They have other options Including 4
wheel- 4 hook, 5 wheel (more stable), 2 hook and the most expensive, 5 wheel 4 hook for $128.
8) This quote is for MII\elt first quality spay packs. Rlcah is an option for you, Their spay packs cost
$289. This Is a very good Gennan line that we have sold quile II lot of. They Cll!Y the same
guarantee as MIIlex. 10 spay packs would cost of $2890. ThIs will save you $2060.
9) Itemized Freigh~: Vaper Stick Plus: 562. VSSI with assls1ed: 5639. VSSI without light
but assisted: $529. Quoted: VSSI without assiS18d and with out surgery lights: 5429. ~:
Mldmat1c 570. ~: Medical IUumtnllllon: $100. Total Freight- $661
Note: AsslS18d means they wDI help you bIIng the Items inside. Otherwise, they unload in your
panang lot and leave.
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NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda:D Consent Meeting Date:
Agenda: D
Department: Health Presenter: Cindy Hewett, Business
,- Manager
Contact: Cindy Hewett, Business Manager, ext 6680
Subject: Budget Amendment in the amount of $11,547 for completing installation of
Buildin Securi S stem for the New Hanover Coun Health De artment.
Brief Summary: The New Hanover County Health Department recently had a security
system installed throughout the facility. This system mirrors the one installed at the
County Administration Building and at Marketplace Mall. We are requesting to remove
eight (8) proximity card readers at all eight (8) out-reader locations and to add six (6)
additional in-readers for ent control onl .
Recommended Motion and Requested Actions: To approve enhancements to existing
securit s stem and associated bud et amendment in the amount of $11 ,547.
Funding Source: The Department of Health and Human Services, Division of Public
Health, E idemiolo Section, Public Health Pre aredness and Res onse Branch.
Will above action result in:
DNew Position Number ofPosition(s)
DPosition(s) Modification or change
IZINo Chan e in Position(s
Explanation: The building security system was installed to serve as a mechanism to
secure our facility and protect our employees and clients from potential threats or acts of
bioterrorism. This is an approved expenditure for use of Bioterrorism funding. This
transaction does not require approval from the Board of County Commissioners due to no
changes occurring in the total amount of the Bioterrorism FY04 Budget (no increase or
decrease will occur in revenue or ex enses as a result of this transaction .
I Attachments: Budget Amendment and quote from Universal Security and Fire, Inc.
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"Making Your World Secure"
2108 Capital Dr. Unit 103
Wilmington, NC 28405
(910) 452-7233
(910) 452-9876 (Fax)
April 12, 2004
Ms. Cindy Hewett, Business Manager
New Hanover County Health Department
2029 South 1 T" Street
Wilmington, N. C. 28401
Dear Ms. Hewett,
This proposal responds to the Health Department request to remove eight (8) proximity card
readers at all eight (8) out-reader doors and to add six (6) additional doors for entry control only
(see attached drawing). 1
Scope of work will include the installation of door strikes, by Elkins Safe and Lock Co, on the
six (6) new doors, installation of request- to-exit motion detectors on new doors plus the eight (8)
doors where proximity readers have been removed. A credit is included that considers the
"trade-out" of two (2) removed and excess proximity readers for two (2) required request-to-exit
motion detectors.
The installation includes equipment and labor'
Installed Price:
Sales TaX
Total
$11,547.00
$ 295.65
$11,842.65
Please call me with any questions or concerns.
Sincerely,
""
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May 20, 2004
To:
From:
Subject:
NEW HANOVER COUNTY
HEALTH DEPARTMENT
2029 SOUTH 17TH STREET
WILMINGTON, NC 28401-4946
TELEPHONE (910) 343-6500 FAX (910) 341-4146
New Hanover County Board of Health
Cynthia W. Hewett, MSIS ~
NHCHD Business Manager
FY05 Recommended Budget
We have received a copy of the FY05 Recommended Budget from the County Manager. Below,
I have identified those items that have changed (either increased or decreased) from the FY05
Requested Budget submitted by the New Hanover County Health Department.
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Please note when our FY05 Requested Budget was prepared it was completed under the directive
given by the County Manager's Office which was to maintain operating expenses at or below the
level of the FY04 Adopted Budget. We were also directed not to ask for new positions.
It is also important to note that our FY05 Requested Budget included estimates on figures for
salary and fringe. These figures are finalized by the County Human Resources Office and
entered in our budget by the County Budget Office. The FY05 Recommended Budget does not
include the five (5) Environmental Health Specialist positions recently approved by the Board of
Health and submitted to the County Commissioners for consideration. The County Manager
pulled this request from the County Commissioners Agenda noting that these positions would be
discussed during FY05 Budget deliberations.
Revenues:
Proaram ReQuested Amount Recommended Amount Difference
Care Coordination 15123\ $1,109,481 $ 1,105,199 ($ 4 282\
WIC 15141\ $ 399 347 $ 448,743 $ 49 396
Partnership for Children (5166\ $ 184,259 $ 172,500 ($11759\
School Health (5169\ $ 1,764,483 $ 1,673,200 ($ 91,2831
Proiect Assist 151811 $ 64,094 $ 64,324 $230
Aaencv Totals $ 6,299,164 $ 6,241,466 1$ 57 698\
Revenue adjustments resulted from either salary and fringe figures being adjusted or changes in levels of
grant funding (as is the case for Partnership for Children- 5166).
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"Healthy People, Healthy Environment, Healthy Community"
Operating and Capital Expenditures: e
Proaram Requested Amount Recommended Amount Difference
Vector Control (5112) (Suildinal $ 86,200 $0 1$ 86,2001
Sioterrorism (5122{al
(Travel and Trainin $ 38,880 $ 59,558 $ 20 678
Women's Preventive Health (5124)
(Contract Services) $ 20,762 $ 47,762 $ 27,000
(Departmental Supplies) $114,103 $ 134,103 $ 20,000
Navigator-Partnership (5134)
(Departmental Suppliesl $ 1,080 $ 6,069 $ 4989
Epidemiology (5151)
(Contracted Services) $ 8,805 $ 17,805 $ 9,000
iDepartmental Suopliesl $ 106771 $ 124,771 $ 18,000
Child Care Health Consultant
(5155)
(Travel and Training) $ 500 $ 3,383 $ 2,883
Health Check (5160)
(Travel and Trainin!il $ 500 $ 2,045 $1,545
Aaencv Totals $ 12,005,349 $ 11,925,959 $ 79,390
Changes in Operating and Capital Expenditures resulted from a variety of events. In Vector
Control, the County Manager is not recommending the purchase of the mow tractor and
peripherals. Additionally, once salary and fringe figures were in place, operating expenses
needed to be adjusted for the following grant funded programs: Bi-terrorism, Navigator
Partnership, Child Care Health Consultant and Health Check so that revenue and expenditure _
would balance for these programs. ..
As noted earlier, when our FYOS Requested Budget was submitted we maintained operating
expenses at the FY04 Adopted Budget level. We did however; submit narrative to the County
identifying needed increases in two of our programs (Women's Preventive Health and
Epidemiology) particularly in the areas of contracted services and departmental supplies. These
increases are needed to cover the increased costs of processing pap-smears, increased interpreter
needs, and increased costs in vaccines, drugs and other laboratory test kits needed to support
these programs. The County has included these requests in the FY05 Recommended Budget.
"Healthy People, Healthy Environment, Healthy Community"
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NEW HANOVER COUNTY
RECOMMENDED BUDGET
FISCAL YEAR 2004-2005
County Commissioners
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Robert G. Greer, Chairman
Julia Boseman, Vice Chairman
William A. Caster
Ted Davis, Jr.
Nancy H. Pritchett
County Manager
Allen O'Neal
Budget Department Staff
Cam Griffin, Budget Director
Norma S. Troutman, Senior Budget Analyst
Donna Seal, Budget Analyst
Karen J. Wagner, Administrative Support Specialist
320 Chestnut Street, Room 506
Wilmington, North Carolina 28401
http://www.nhcgov.com/bgt
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Call (910)341-7170 to provide citizens' input on budget or e-mail ccriffintlilnhcoov.com.
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ALLEN O'NEAL
County Manager
. I,
NEW HANOVER COUNTY
OFFICE OF THE COUNTY MANAGER
320 CHESTNUT STREET, ROOM 502
WilMINGTON, NORTH CAROLINA 28401-4058
TELEPHONE (910) 341-7184
FAX (910) 341-4027
PATRICIA A. MELVIN
Assistant County Manager
DAVID F. WEAVER
Assistant County Manager
230 'Marketplace Drive
Wilmington, NC 28403
Telephone (910) 798-7139
Fax (910) 341-4035
May 13, 2004
To the New Hanover County Board of Commissioners and Citizens:
I present to you the recommended budget for fiscal year 2004-2005. In accordance
with the Commissioners directive to prepare a budget with no tax increase and after
completing a very thorough budget review process, I propose a tax rate of 68 cents that
represents no increase from the tax rate for FY 03-04.
This was a challenging budget to prepare. Budgets continue to be held constant, which
becomes more difficult with each successive year, as the population of the County
increases, County facilities and services expand and inflation increases costs to the
County.
SiQnificant Increases in Anticipated County Expenditures
. The General Fund Transfer to the Schools is recommended to increase $1 million.
. The Sheriff's Office budget is recommended to increase $1.2 million primarily
due to the opening of the new Detention Facility.
. Funds in the amount of $2.1 million are included for salary adjustments for
County employees.
. The Department of Social Services budget increase is estimated to be $.9 million
primarily due to increases in Medicaid.
GENERAL FUND
Public Schools:
A transfer of $68.7 million-from the General.fund is recommended for the Schools. Of
this amount, $5.7 million is funded by the portion of the sales tax designated for the
Schools.
This level of funding will provide for $49.3 million in school operating .expenses, $3
million in capital outlay, $.5 million in school pension, and $15.9 million in d.ebt service.
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New Hanover County Board of Commissioners and Citizens
M~y 13, 2004
The Board of Education requested an increase of $2.1 million or 4 percent in operating
expenses and $1.9 million in capital outlay. A tax increase of 3 cents would be
necessary to fund the balance of th~ School's request and debt service.
It is recommended the Board of Education appropriate their fund balance to meet the
additional needs of the-schools.-The,Board-of,E-ducation.fund,.balance is .currently $7.6
million. '
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School systems are not required to maintain a fund balance, therefore appropriation of
their fund balance will not impact the financial credibility of the school system.
Cape Fear Community College (CFCC):
Funding of $4.7 million is recommended for Cape Fear Community College. This is an
increase of $600,000.
Personnel Issues:
There are five new positions recommended for FY 04-05.
. Two additional Grounds Maintenance Workers for Parks, due to the expansion
that has taken place in the number of acres maintained by this department.
. One Landscape Technician position for Airlie Gardens to assist with the e
continued development of the gardens. 1
. One additional Custodian for Property Management to help maintain the
expanded county facilities.
. One Administrative Support Specialist to assist with the efficient operation of the
Emergency Management Department and to meet their expanded scope of work.
Funding is included for a 2 percent market adjustment and 1 percent merit adjustment
for deserving employees, and for a 1 percent contribution to a 401 (k) or 457 plan for
those employees who do not currently receive a state-mandated contribution.
A new classification of Detention Officer, Corporal has been added to the Sheriffs
Office.
Department of Social Services (DSS):
I recommend funding to increase by $.9 million, approximately 5 percent, due to
increases in Medicaid and minor increases in Adoption Assistance and Foster Care
programs.
The County's cost of Medicaid is -projected to increase by $600,000, or 7.8 percent,
from FY 03-04. Expenditure data for the current year shows a decline in Medicaid a
costs, but I am recommending the state estimate for conservative budget purposes..
DSS is still in the early phases of the implementation of the state pilot program called
MRS (Multiple Response System), which causes uncertainty about the financial impact
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New Hanover County Board of Commissioners and Citizens
May 13, 2004
on the FY 04-05 Budget. MRS is a state-mandated approach to Child Welfare Services.
It emphasizes strengthening families and using more community resources.
A $3 million shortfall in state day care funding exists between the current amended
amount and the FY 04-05 preliminary estimate. Due to the limited availability of
childcare subsidy funds, DSS may be looking to identify county and community
resourcesio financially.support childcare -services~n the.future.
Sheriff's Office:
The budget for the Sheriff's Office is based on the expectation that the New Hanover
County Detention Facility will be open for all of FY 04-05.
Emergency Management:
.No funds are recommended for improvement of emergency response communication
for the south em end of the County. The issue is still being reviewed.
Juvenile Day Treatment Center:
County funding for the Juvenile Day Treatment Center for FY 04-05 is $174,000; this
amount is an increase of $114,000 compared to FY 03-04 adopted amount of $60,000
for county funding.
Southeastern Center:
Funding of $1.7 million is recommended for the Southeastem Center for Mental Health,
Developmental Disabilities, and Substance Abuse Services. This amount has been
constant since FY 02-03.
The 2001 session of the General Assembly passed legislation to phase in
implementation of mental health system reform at the state and local level. This act is
designed to restructure the state's mental health system. It expands the role of counties
in choosing how these services will be offered and reduces the number of delivery
areas.
Counties are required to develop business plans describing how administrative
functions will be carried out and services delivered. Statewide, counties are concemed
that the local cost of providing mental health services may increase as the responsibility
for meeting the needs of patients currently served by the state, is shifted to the counties.
Airlle Gardens:
Revenue generated by Airlie that was budgeted in the General Fund in FY 03-04 will be
classified as revenue for the Airlie Gardens Foundation in FY 04-05. This will assist
Airlie in becoming more financially self-supporting.
The revenue amount budgeted in the General Fund for FY 03-04 was $53,500.
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New Hanover County Board of Commissioners and Citizens
May 13,2004
Non-County Agencies: I
Funding at the FY 03-04 adopted amount is included for seven human service non-
County agencies. Funding is included for the New Hanover Soil and Water
Conservation District, and The Wilmington-New Hanover Port, Waterway and Beach
Commission at the FY 03-04 amount.
Funding is also included for four agencies with multi-year contracts that provide
economic and physical development services to the community.
REVENUES
The tax base growth between FY 03-04 and FY 04-05 is expected to be 3 percent. The
ad valorem tax base'is estimated to be $17.9 billion. Based on this estimate, a penny
will be worth $1.8 million.
The 1 cent sales tax revenue is estimated to increase by $1.4 million from the FY 03-04
adopted amount. Revenue for FY 03-04 is estimated to exceed the amount budgeted.
Revenues are estimated to increase by 3.5 percent above the estimated receipts for the
current fiscal year, based on the most recent growth estimates of the North Carolina
Association of County Commissioners and the County's current share of the distribution.
Local sales taxes are distributed by the ad valorem method and are the second largest
revenue source for the County.
I
Approximately $5 million of the undesignated portion of the two existing one-half cent
sales tax is budgeted for General Fund operations. $1.9 million is budgeted as a
transfer to the Water and Sewer District, the same amount that has been transferred
since FY 01-02.
An amount of $7.5 million is budgeted in the General Fund for the new one-half cent
sales tax that became effective July 1, 2003. This estimate is also based on a 3.5
percent increase over the FY 03-04 estimated receipts. All 100 counties in the state
have enacted this sales tax to replace local government reimbursements that were
eliminated by the state in FY 02-03.
Fund Balance:
I am recommending appropriating $3.9 million of the County fund balance. Of this
amount, $1.1 million is due to shifting debt service from FY 03-04 to the FY 04-05
budget (due to restructuring of the debt, which resulted in a savings to the county of
$2.4 million over the next 15 years). The appropriation of fund balance at this level will
not jeopardize the strong financial position of the county. Fund balance grew by $8.3
million between FY 02-03aRd FY 03-04. Very preliminary projections for FY 03-04
indicate a growth of $1 to $2 million.
The unobligated fund balance is $41.5 million, which exceeds the 16.7 percent goal for
fund balance established by the County.
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New Hanover County Board of Commissioners and Citizens
May 13, 2004
e ENVIRONMENTAL MANAGEMENT FUND
I,
The Environmental Management Fund is balanced with a $46 tipping fee. No transfer
from the General Fund is budgeted. Funds are included to ~tart preparation of the next
cell, and a construction and demolition facility.
SPECIAL FIRE-SERVICES DISTRICT-FUND
The tax rate of 6 cents is recommended for the Fire Service District, no increase from
the tax rate for FY 03-04.
Recent improvements in the Fire Service District have increased the .Ievel of service
provided to the citizens and visitors of New Hanover County. Four of the six fire districts
have reduced insurance rates with the North Carolina Department of Insurance,
resulting in lower insurance premiums for homeowners. The Fire Services District
responded to over 5,000 calls during the calendar year ending 2003, which is a sixteen
percent increase from 2002. Growth and demands for service have all divisions of Fire
Services stretching resources. Capital improvements must be addressed.
e
Major considerations for this fiscal year include the replacement of one fire engine,
upgrades to one existing facility where fire apparatus are not adequately stored, and the
request for insurance inspections for the remaining two fire departments that serve the
Fire Service District. New and existing programs will be evaluated and implemented to
improve the quality of service provided.
WATER AND SEWER DISTRICT FUND
The Water and Sewer District currently provides service to approximately 30,000 water
and sewer customers (residential, industrial, and commercial), which is far greater than
many municipalities in North Carolina. The District's current operation and future
expansion is funded by user fees, a $1.9 million transfer funded by sales tax revenue
from the General Fund, and approximately $2 million in Water and Sewer Fund
Balance.
The fund balance will fund the anticipated debt service on the Northside Wastewater
Treatment and Water Treatment Well Field. No ad valorem property taxes are used to
fund the district.
CAPITAL IMPROVEMENT PROGRAM
Capital requests for FY 04-05 were all valuable projects. Due to budgetary constraints,
no funding will be recommended.
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New Hanover County Board of Commissioners and Citizens
May 13, 2004
ACCOMPLISHMENTS
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Summarized below are a few of the many items that the County and its staff have
accomplished during the current fiscal year.
. Two projects from New Hanover County won the annual Ralph W. Ketner
Productivity Award. -The 'projects-were: a computer-automated .dialing system to
remind patrons of overdue library books, and a bar-coding system to manage Health
Department records.
. Security was improved at the Department of Social Services building to address
safety concerns of both citizens and employees.
. Staff was hired to fill several high level County positions due to retirements:
Information Technology Director, Clerk to the Board of County Commissioners and
County Engineer.
. The North Carolina Department of Health and Human Services selected New
Hanover to be one of two counties to participate in an initiative designed to
strengthen local services to meet the long term care needs of older and dis~bled
adults and their families.
o A savings to the County of $2.4 million over the next 15 years was accomplished by e
restructuring debt through bond refinancing.
. The University of North Carolina at Wilmington's Master of Public Administration
program and the Cape Fear Chapter of the American Society for Public
Administration named two County staff members Public SeNants afthe Year.
. The civil, records and front desk sections of the Sheriffs Office relocated to the new
Judicial Building. Several County departments moved to the Marketplace Annex
providing service to citizens at a more central location. Veterans Services and
Human Relations moved to larger offices at 801 Princess Street.
. The Finance Department was awarded the Certificate for Excellence in Financial
Reporting from the Government Finance Officers Association (GFOA) for the twenty-
third consecutive year.
. The Budget Department was awarded the Distinguished Budget Presentation Award
from the Government Finance Officers Association (GFOA) for the thirteenth
consecutive year.
. A restructuring of the County Manager's office was completed after the retirement of
the Deputy County Manager. The Deputy County Manager position was eliminated ...
and the responsibilities were divided between the County Manager, the two .
Assistant County Managers, and the upgraded Executive Assistant position.
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New Hanover County Board of Commissioners and Citizens
May 13, 2004
"
e . Economic Development - The County collaborated with Wilmington Industrial
Development, Inc., and other local leaders to bring several new businesses to the
County including Verizon and the television series .One Tree Hill".
. After the Inter-local Agreement was approved by the City Council and the Board of
County Commissioners, County and City staff worked with the WAVE Board of
Director'S to develop s'plan;'and implement policies and procedures to create a new
Transportation Authority with increased services and routes.
I am personally and professionally grateful to the employees of New Hanover County.
As the County faces many challenges, I know the citizens can continue to rely upon
high employee dedication.
The staff and I look forward to working with you as the FY 04-05 budget process is
completed.
QAtt--L
All n O'Neal
e County Manager
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PROGRAMMATIC GOALS
As recommended by the Govemment Finance Officers Association (GFOA), and the
National Advisory Council on State and Local Budgeting, the following programmatic
goals have been designed to guide the development of the 2004-2005 budget. These
goals have been developed to provide direction for County departments in their
allocation of resources to areas the County Commissioners deem to be most important.
All deoartments have been instructed that at all times. but esoecially. durina the current
economic condition~ that theseaoals are deoendent on available financial and staffina
resources, These oals are in no wav a statement that the end will be achieved in a
soecific time oeriod.
I. Provide a Safe Community for All New Hanover County Citizens
1. Support the Juvenile Day Treatment Center in its continuing effort to address the
needs of youth who have entered the juvenile justice system,
2, Review and implement new security procedures in addressing the safety needs
of staff and the public using County facilities.
3, Work toward reducing the crime level and improving community security.
4. Promote a responsive Public Safety Communications Center whose employees
are highly skilled in responding to the emergency needs of citizens and the
community at large.
5, Foster a team concept with the public safety agencies served by the Public
Communications Center, and enhance services provided to the public.
6, Provide safe water to the public by maintaining well and tower sites in
accordance with State and Federal regulations and laws.
7. Work with the North Carolina Department of Transportation and the City of
Wilmington to provide alternative forms of transportation including transit. bicycle,
and pedestrian facilities.
8. Provide safe public educational facilities for the children of New Hanover County
by maintaining the established partnership with the schools and its officials in the
deployment of school resource deputies.
9. Ensure the County's ability to effectively handle bio-terrorism, hazardous
materials threats, and natural disasters.
10. Provide a superior level of fire protection through acceptance of public
educational grants, improved community fire protection rating, and development
of a Fire Investigation Task Force focusing on arson related fires.
11. Promote programs such as electronic monitoring for pretrial inmates that provide
for the needs of the County while reducing cost of services,
12. Continue to review issues and seek solutions with radio communication reception
problems in the extreme southem and northem ends of the County.
II. Continue Investing in Electronic Technology (Internet and Intranet) for the
Efficient Facilitation of County Business
1. Enhance the County's technology resources to provide greater public access,
efficient internal operations, and improved electronic communication and
payment system.
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PROGRAMMATIC GOALS CONTINUED
2. Continue expanding the use of the Intemet and Geographic Information System _
(GIS) by migrating the Cadastrai mapping application and data into Geodt;ltabase ,.,
models to support E911, Planning, Land Records, Inspection, and data exchange
services. in addition, provide disaster planning/ response, health service
programs, and improved public data.
3. Expand and enhance departmental Web sites and New Hanover County
Television (NHC-lV) to ensure the public's awareness of all services provided by
County departments, as well as, keeping the public informed of decisions and/or
policies made by County officials.
4. Initiate the use of video conferencing for first court appearances, install a new tax
system, and install a new Financial and Human Resources system.
5. Implement network software for the remote control of our desktop computers.
6. Enhance the security surrounding the entire computing environment for the
County by rejecting all hacking attempts, repulsing all virus attacks, and limiting
the amount of unwanted e-mail.
III. Protect the Environment and the Quality of Life Enjoyed by New Hanover
County Citizens
1. Effectively plan for the orderly growth and development of the County by
providing and reviewing annuai updates on the implementation of the
Wilmington-New Hanover County Coastal Management (CAMA) Land Use Plan.
2. Concentrate on the infrastructure and operational requirements of the Enterprise _
Funds. (The Water and Sewer and Environmental Management operations ,.,
should meet the growth needs of the County.) i
3. Provide for the protection of ground water and air quality by operating the landfill
and WASTEC in accordance with maximum achievable control technology and
best management practices.
4. Address important environmental issues while encouraging citizen input and
involvement in issues such as: storm water management, drainage, waste
disposal, and water and sewer.
5. Continue exploring opportunities and/or options in efficiently and effectively
reducing waste disposal costs.
6. Reduce litter and illegal trash dumping in the County through aggressive
enforcement of anti-litter laws.
IV. Ensure the Health and Welfare of all New Hanover County Citizens
1. Reduce the number of substandard housing units through rehabilitation programs
and housing grants.
2. Support the Community Transportation Program in its efforts to provide low cost
transportation services to and from medical appointments, congregate meals,
employment, education, and social recreational sites.
3. Support the Health'Department in their efforts bimprove access to healthcare,
increase preventive services, reduce lifestyle related risks, and reduce outbreaks ..
of. infectious disease and other public health threats. .,
4. Provide social economic programs to assist citizens with basic subsistence
needs.
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V.
1.
2.
3.
e 4.
5.
6.
7.
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5. Provide protective services to citizens of all ages with physical, social, and
emotional problems.
6. Support the home-delivered and congregate meals programs in an effort to serve
noon meals to the elderly and frail population of the County.
7. Enhance welfare reform by continuing to move clients toward self-sufficiency.
8. Support Department of Social Services' Multiple Response System, a family
centered pro,gram designed to ensure safe, nurturing and permanent families for
children.
9. Maintain and e'Xpend health care coverage to eligible residents of the County in
accordance with federal and state laws, and program regulations.
10. To be proactive in the County's efforts to control the West Nile Virus as well as,
other vector-borne illnesses.
Ensure Equality For All New Hanover County Citizens
Ensure accessibility to the County's many facilities by ensuring County facilities
adhere to the American Disabilities Act (ADA).
Prohibit discrimination in employment and housing by supporting the County's
Fair Employment and Housing ordinances.
Advocate and encourage cultural and ethnic diversity by working with community
development organizations, business, government and educational institutions,
which promote and support diversity.
Encourage broad public participation in government decision making, ensure
public notification of significant changes, solicit responsible public input, and
ensure government is inclusive of all racial and cultural groups.
Provide outreach library services to homebound individuals unable to use library
facilities.
Create and support events, activities, and County services that encourage the
interaction of all cultures and ethnic groups.
Support'the efforts of minorities and women in participating in all aspects of the
County's construction and procurement programs.
VI. Ensure and Encourage Prompt, Courteous, and Professional Services from
All County Employees
1. Conduct an annual salary and benefit's review that will ensure market
competitiveness in recruitment and retention of qualified employees.
2. Ensure satisfaction with County services by encouraging employees to respond
to services and/or inquiries requested by the public, or by other County
departments, in a prompt, courteous, and professional manner.
3. Maximize productivity and improve efficiency by providing appropriate training to
employees.
4. Promote safety by providing routine maintenance and safety inspections of
County facilities and equipment, as well as, 'Offering safety training to all
employees.
5. Ensure qualified and skilled personnel are recruited and hired for all job
vacancies.
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PROGRAMMATIC GOALS CONTINUED
6. Encourage Department of Social Services in their "Leading by Results. initiative _
program designed to measure the organization's effectiveness in providing .,
services to families.
VII. Provide for the Recreational, Educational, and Cultural Needs of the
Community
1. Improve communication and planning efforts with the Board of Education
conceming school funding.
2. Support the library needs of New Hanover County citizens through the Main
Library and its branches.
3. Support the Cape Fear Museum in its effort to teach residents and visitors the
history and science of the Cape Fear region.
4. Efficiently operate the numerous County parks and recreational facilities while
providing safe, clean, hazard-free parks, trails and open space areas.
5. Continue to add new park facilities, and improvements to existing parks, as
funding becomes available.
6. Establish a FaciJitiesReview Group to review requests for new land acquisitions
and capital facilities proposed by various agencies, Boards, and departments of
New Hanover County in order to assist the County Commissioners in
implementing an efficient and effective capital planning process.
7. Incorporate the multi-year Capital Improvement Program as an integral part of
the annual budget process. _
8. Provide a variety of children and youth programs encouraging their imagination .,
and intellectual growth, appreciation of arts and history, uhderstanding of natural
science, and development of healthy lifestyle issues.
9. Provide a comprehensive recreational, educational, volunteer, and health
promotion program for senior adults.
10. Continue development of Airlie Gardens as a premier, world-class garden facility
and environmental quality educational program.
11. Encourage participation and express appreciation to the many volunteers
dedicated to helping their fellow citizens in the giving of their time and talents to
various County programs.
VIII. Ensure the Financial Stability and Legal Protection of the County
1. Support a strongundesignated, unreserved fund balance of at least 16.7 percent
of the total General Fund budget in an effort to maintain adequate reserves and
the highest possible bond rating.
2. Maintain and improve the current bond rating with Moody's and Standard and
Poor's.
3. Encourage all departments to closely monitor expenditures, aggressively collect
revenue when due, seek alternate forms of revenue whenever possible, and
periodically review operational and administrative costs.
4. Continue taking a proactive role in lobbying state officials in protecting local ...
revenues, endorsing alternative revenue sources, and eliminating non-funded ..
mandated programs.
5. Achieve a 98 percent collection rate of ad valorem taxes.
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PROGRAMMATIC GOALS CONTINUED
6. Minimize litigation against the County and maximize legal documents that ensure
the County's protection and le.gal well-being.
7. Enforce State and County code provisions and encourage uniformity and
predictability in all permitting and regulatory policies and procedures.
8. Keep the tax rate as low as possible while providing essential services to citizens
of New Hanover County.
9. Continue risk management to reduce uncertainties regarding potential losses to
assets, maintain continuity of services to the public, and support the integrity of
the budget.
10. Promote excellence in financial and budgetary reporting through continued
qualification for the Certificate of Achievement for Excellence in Financial
Reporting and the Government Finance Officers Association Distinguished
Budget Preparation Award.
11. Provide accurate, efficient and complete tax information in locating, listing, and
valuing of all personal and business property in the County.
_ J
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New Hanover County - SNS-Point of
Distribution Plan
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New Hanovoer County
Strategic National Stoekpile
(SNS)
Program
Dispensing Site Operations Plan
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cf;-,:-c~
1'be mDIJiob oftbe SNS Program is to
_........__of
~medkal::iomaDCl
otbsr medical suwba to .
national emerpnc:J 1IIte.
The PI'DJI'lUD wat d.ipedfor
imp.....~wbIID our
~iDftlIPODlI8toa_
__tr lneldent lIlIIDMdedour
100000capllllUltJ.
Bloterrorlsm: "The
deliberate use of
microorganisms or toxins
derived from living
organisms to Induce death
or disease In humans,
animals or plants- 11" .
(United States .
Department of Justice)
1\..../
'.- "!'~_.. I
A Johnson, Health Planner
April 2004
, .....~l~":"'.....
... . ~,-
~.f,
<-_"'\'-.c,
1
New Hanover County - SNS-Point of
Distribution Plan
Decision to Use SNS
~'~"\\~"'
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, '. :;,pi.'.,"..... <i.-/' J "'-.
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-
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A Johnson, Health Planner
The decision III deploy SNS _ may be
based on evidence showing the overt release of
an agent that might adversely affect public
health. ~ is more likely, however, that subtle
indicators, such as unusual morbidity and/or
mortality identified through lha nation's disease
outbreak surveillance end epidemiology network,
will alert health officials IIllha possibility (and
confirmation) of a biological or chemical incident
..--- ~
c__,._ .
-\..1
CategOl)' A List Agents
The u.s. public healtll system and po1mary
healthcare providers must be prepared to address
various biological agents, Indudlng path_ns that
are rarely seen In the United States. Hlgh-prlortty
agents Indude organisms that pose a risk to
nallonal security because they
ocan be easily disseminated or transmMed from
person to person;
.resultln high mortality rates and have the
potential for major public health Impact;
emlght cause public panic and sodal disruption;
and
'requlre spedal action for public healtll
preparedness.
~'- ..~
~.~, ,~-~,
April 2004
..
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2
.
New Hanover County - SNS-Point of
Distribution Plan
.
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CategOl)' A List Agents
~lriologioal_ag""havinsthe_...po1cnIiaI
for advenc public bea1th impact with map casualties.
VarioIa~-Smallpox .. . '"
&ciIIuo AoIIuacis - _ ' ,
y cninis Pestis - Plague
Cklotridium -... (botulinum toxins) --
Fraocisclla Tu1arcusi8 - TuIamnia
FiJoWuoos and _(EboU, Lasoa) - viral ~
,F7
-.
~(8R.ceII..-)
~lontDXIn(#a:.srrttIum~
Food ~ th..-b (..., SHnondr species., &che~ r>>II 01S7:H1, Sh....)
GlIrldeni(~mdaIJ
MeIoldosIs(~~
~(~mydiI~
Q..&m (Cox'" jumetI)
8lmJDlD him RJcku ctN1IIIRHW (c:HtDr beans)
SIlIphylococl:llllllllllRltadnB
T,phul:ffter(~~
--
WiltletArety duuts (..g., V.l/ri)~.~pamI1fI)
,.,
;...~' .,'--~,
. .. -
~-,~"
- \ '
-~ ~ \; --
. """':'7-\
"~ ",,"
;',1:
,-'-~I"'-.'-'
A Johnson, Health Planner
April 2004
Category B Diseases/Agents
Second highest priority agents Indude those
that
.are moderately easy to disseminate;
_result In moderate morbidity rates and
low mortality rates; and
_require spedfic enhancements of CDCs
diagnostic capadty and enhanced disease
surveillance.
~>.:'
Category C Diseases/Agents
Third highest priority agents Indude emerging
pathogens that could be engineered for mass
dissemination In the future because of
_availability;
.ease of production and dissemination; and
.potentlal for high morbidity and mortality
rates and major health Impact
-Emerging Infectious diseases such as Nlpsh
virus and hantavlrus
0-1:
c-;_., ."
Pharmaceuticals
. Antibiotics
- dproftoxatin
-doxycyt:IIne
- genlaIIIIcin
- eryIhromydn
"'-../'
0;;;: /j-...----'y>
. Chemical agent antidotes
- atropine
- pnllidoldme (2PAM)
- diazepam
3
New Hanover County - SNS-Point of
Distribution Plan
Pharmaceuticals
o Other Medications
-dopamine
. epinephrine
. methylprednisolone
. albuteroI inhaler
. IIlOI'phine
. Iorazepom
\''-
Medic:al/Surgic:al Supplies
. Airway Management Supplies
. ET tubesl styletlBs
o NG tubes
o Oropharyngeal airways
o Laryngoscopes
o Oxygan masksl tubing
. Manual rasuscitators (bag-valve-mask)
. Ventilators and suction units
o Pediatric and adun sizas wIlera applicable
;~~ :<1.
Note:
VacdDes tor anthrn: _d smallpoK,
__ _dn..... onthru
byperimmune plasma are DOt 10 the
...... -.....
These iUms are IIdpped sep..-ately as
req.~
~-,.-./'
,;...-.,.... ,
A Johnson, Health Planner
April 2004
Medic:al / Surgic:al Supplies
. IV Administration Supplies
o Sterile _ For Injection
o HaCI flush
o Syringes/needleslca_
. Y site administration sebI
. IV solutions
. GIovea
o TapeI dressingo/ gauzel
toumiquelll
. Alc0hoI pads, beladine
swabs. antibiotic ointment
Medic:al/Surgic:al Supplies
. other
. Tablet counting machines
. Power slrips
. Extension cords
. Duct tape
. Zip lock boggles
'_1_",-
pnwIderlnfonn_ "'-
dBbJ__
;,,, /"
'-;-~J .,~-y
How is the SNS Packaged?
".fi
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4
. New Hanover County - SNS-Point of
Distribution Plan
,
.
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SNS Components
.J:
A Two- T/enJd Response
. 12-HourPushP.... :
_ ReadyIor~tD"*"design8IecI.irlielcl>Mthl112
hocnc:lF<<lelalactNation
_ Pnl r .oI1i....- in erMronrnettaDy controlled and secured
faciI...
_ Pfe.conI'9IredfDfl8pldldt..,lifL.A....ndeaeofdistrilution
. Vendor Manaaed IIM!nlDrv IVMI\ p-o._:
_ Will be shipped 10 aniwt watin 24 end 3fJ..hour periods
_ Areaxnprisedofpha... ~andsupplieSthat8RI
delivered fn:m one or monl WI ~
_ "'ailotecr'tDprDlridespec:iflcmatl!lrieldependngupon
~ or oonftlmedaoent
~.~..-(..,
Capacity for Treatment:
-................-
. One 12ol1our Push PllCl<age con pr_:
Prophylalda lpreventiw _ Of asymplamatic
penIOl18)lor.
357,000_X7 days.
T_ treatment Isymplom8t~ penIOl18)1or:
6,000 _. X 7 days
. The Push Package Is deelgned to be 101_ by
VMI
. Number 01 days 01 medication Is oc:enarlo driven
~a
What wiD a 12-bour Push l'acluI8e look
De whenit's delherecl?
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~ ..- \. " ,
- ..
Eac:II SNS 12-11our Push
~
. ~124cwgo~
. Welgha94,42~ ~
. Measun!lS 1D.329Clmicfeel
. R~ 5,000...... fMl:
.-.......-
\'-..-" ....".....,,-,~,_.
v....., ~'--v
A Johnson, Health Planner
April 2004
How Many People Can a
12-hour Push Package
Care for?
"'\. /-
- . -..;.~
What Does
a 12-hour
Push
Package
Look Like?
~a
How Do We Get the SNS?
j~,,\-~-,
v"',, '"
5
New Hanover County - SNS-Point of
Distribution Plan
Readiness/Response
How SNS Assets are Deployed
..
stralOglc
-
slDclqJlle (SNS)
StatefLocal Issue:
Treatment Protocols
. Standenl OporeIIng Procedures (SOP) lor.
_entOfedults.child"",.im~
end gerIaIrIc popWdions
. Petienl ~on SheetlCere 1__
. Trensfor Of oym~ pe\lenb from tr_
slt8 to definitive care sII8
. Mass prophyiaxis end/or immunization of at-risk
05)"",,",'- populetlon8
. Petienl trecldng/loliow-up
;",/7
....-'/ ~""-y
Points of
Dispensing (PoD)
Steps
.Exposure Triage
.symptomatic Triage
.Medlcal Screening
.Dlspenslng and
Abbreviated Counseling
", .,/i .observation and ExIt
v,....;\......;:"
A Johnson, Health Planner
.
April 2004
.
e
Typical Request Process
-Dlspenelng
oIdontify POOlI
-set""" POOlI
o$taftlng
-Equipment
oSec:uri1y
."l;i. "
-' ;>
I OelIvofjto ~
Role of the Dispensing Site
. Provide medication to 8 threatened community
.Tre8l:the~wer
. Mitigate an attd
. Process a "heathy" poplA8llon
eldelCl'ynewlllnnl
.~u:pntmeclclllhlltoty,mecllcetlontntary.nd
. Provide besIc Information 10 the_
community
. Direct esymplllmelic vi<:1Ims """y from the
hospitals
e
. '";,~
I
Exposure Triage
. Purpose
- Situational briefing
- Separation of potentially exposed w.
worried-weIJ
. Description
-Identification of high-riak groups
-I~ation "'!larding exposura, clinical
~ns and symptoms, 1herapeutic _an,
Importanca of compIisnca and mental
health .
, f):~::,
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.
New Hanover County - SNS-Point of
Distribution Plan
.
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Symptomatic Triage
. Purpose
- Separation of symptomatic versus
asymptomatic
. Description
- People are triaged and n symptomatic
directed to medical care staff or facility
Dispensing and Abbreviated
Counseling
. Purpose
- Drug selection based upon protocol and
patient counseling on appropriate
medication use
. Description
- Utilization of dispensing protocols
authorized by the Senior Medical Officer
- Streamlined counseling In doomsday
scenario
7.: .J.
Receiving Site
. North Carolina Ports Authority (primary)
. Alternate site under negotiation
. All SNS Materiel will be delivered to
Raleigh, Greensboro or Charlotte and
then routed to New Hanover County
~';::-:!-.~,
A Johnson, Health Planner
April 2004
Medical Screening
. Purpose
- Assistance and completion of medical
forms
-Identify those people with special needs
o Hearing Impaired, physically handicapped,
foreign language, visuaRy impaired. etc.
. Description
- When forms are complete, people should
be referred to the dispensing area
Observation and Exit
. Purpose
- Observe adverse events and exit
. Description
- it is common practice with ths first
administration of a vaccine or medication
to observe the patient for any adverse
reactions. Following observation patients
should be instnJcted to exit ths faCIlity to
avoid congestion to the flow process.
.'\.c'
New Hanover County
Dispensing Sites
. Ashley High School
. CFCC - Schwartz Center
. Hoggard High School
. Laney High School
. UNCW- Trask Coliseum
,-,./;
,......;-.
7
New Hanover County - SNS-Point of
Distribution Plan
" "
A Johnson, Health Planner
Staffing Needs a 24 Line Dispensing Site
. ~,..~.-
.
April 2004
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partnership
For Children
V; &:,1; ;z::,;; .
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- -
___NEW HANOVERCOUNTY,-,
~
April 26, 2004
Mr. David Rice
Health Director
New Hanover County Health Department
2029 S. 17th Street
Wilmington, NC 28401
RE: Health Check Coordination
Contract # 3-34-3-03-0202
Dear Mr. Rice:
e
Enclosed please find an executed original of Amendment n to the contract between the
Partnership and the New Hanover County Health Department for Health Check Coordination.
The amendment is effective March 31. Thank you for your continued dedication to the children
and families of New Hanover County and your support of Smart Start.
e1y,
'rrt.t((Jh.~
e
omCE 3001-B WrightsviBe Avenue, Wilmington, NC 28403 PHONE 910-815-3731 FAX 910-815-3733 EMAIL nhcpfc@newhanoverklds.org
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New Hanover County a:>ntract II04-0066A
~
AMENDMENT II
CONTRACT # 3-34-3-03-0202
This agreement amends the contract between the New Hanover County Partnership for
Children, hereinafter referred to as the "Local Partnership," and New Hanover County Health
Department, hereinafter referred to as the "Direct Services Provider." This Amendment is
hereby effective on March 31, 2004.
As provided for under the terms of this contract, the Local Partnership and the Direct Services
Provider agree to amend the following provisions:
1. Reference Part 18. "Payment for Services": The not to exceed amount is being
decreased by $6,000.00 from $41,747.00to $35,747.00.
All other terms and conditions as set forth in the original contract document shall remain in
effect for the duration of this agreement.
IN WITNESS WHEREOF, the Local Partnership and the Direct Services Provider have executed
this amendment in duplicate originals, one to be retained by the Local Partnership and one by the
Direct Services Provider.
rship for Children
;;,jI;t,e ~y
Date
BY:
David Rice, Health Director
New Hanover County Partnership for Children
BY: 2J'~~
Janet N son, Executive Director
~I z.-zftJf
Date
~
Approved as to form/County Altomey
~~
THIS IN HAS BE
IN THE ',lAN - miRED
GOVERNME AND FISCAL CONTR
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NEW HANOVER COUNTY
BOARD OF HEALTH
2029 SOUTH 17TH STREET
WILMINGTON, NC 28401-4946
TELEPHONE (910) 343-6500 FAX (910) 341-4146
Melody C. Speck, DVM, Chairman
Donald P. Blake, Vice Chairman
Marvin E. Freeman, Sr.
Commissioner Roher' G. Greer
.James R. Hickmon
Cheryl Lofgren. RN
Sandra L. Miles, DDS
Philip P Smith Sr., MD
.Iohn S. Tunstall, PE
Stanley G. Wardrip, Jr
Edward Weaver, Jr., OD
David E. Rice, MPH, MA
Health Director
May 10, 2004
10,
j 'BIi'-U(vJV)~
"'-'
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~ W.A.~J
tZ/ 'i?>,-~"",
Representative/Senator
Raleigh, NC
Dear Representative/Senator
e
The New Hanover County Board of Health at their May 5, 2004 meeting approved a
request for five (5) additional Environmental Health Specialist positions ($244,900) to
staff the New Hanover County Health Department (NHCHD). This request has been
forwarded for consideration by the New Hanover County Commissioners at their May
17,2004 meeting.
Significant and ongoing growth in the local food service, hospitality and tourist industries
requires additional environmental health staff to assure food safety and protection of the
public's health. The North Carolina Department of Environment and Natural Resources,
Regional Environmental Health Specialist conducted an evaluation of staffing in the
Environmental Health Services Division, and determined it would require 5.28 additional
Environmental Health Specialist to adequately provide essential services, and protect
the public's health.
-
The purpose of this letter is to request amendment to Chapter 130A-39 (g) granting
local boards of health the authority to establish additional fees for services. Exceptions
to Section (g) have already been legislated for services specific to: wastewater
systems, public swimming pools, and tattoo operations. The current budget for NHCHD
Environmental Health Services Division is $934,783. Of this amount, only $16,473 is
contributed by the state of North Carolina. More than $300,200 is collected locally as
fees for services; however, the New Hanover County Commissioners must contribute
the balance of this cost. Chapter 130A-39 (g) prohibits the charging of fees for services
specific to food, and lodging establishments, child care facilities and institutions
because NHCHD Environmental Health Services staff is acting and/or performing duties
as agents of the State in these venues.
"Healthy People, Healthy Environment, Healthy Community"
e
e
e
May 10, 2004
Page 2
Section (g) states: "A local board of health may impose a fee for services to be
rendered by a local health department, except where the imposition of a fee is
prohibited by statute or where an employee of the local health department is performing
the services as an agent of the State. Notwithstanding any other provisions of law, a
local board of health may impose cost-related fees for services performed pursuant to
Article 11 of this Chapter, "Wastewater Systems," for services performed pursuant to
Part 10, Article 8 of this Chapter, "Public Swimming Pools", and for services performed
pursuant to Part 11, Article 8 of this Chapter, "Tattooing" Fees shall be based upon a
plan recommended by the local health director and approved by the local board of
health and the appropriate county board or boards of commissioners. The fees collected
under the authority of this subsection are to be deposited to the account of the local
health department so that they may be expended for public health purposes in
accordance with the provisions of the Local Government Budget and Fiscal Control
Act."
The paradox of an improving economy with strong business growth and increasing
numbers of establishments/facilities is an acute shortfall of staff to provide the essential
and supplementary environmental/public health services. Successful businesses
(restaurants, delis, markets, hotels, child care providers, etc.), too., require ongoing
evaluation/inspection to assure food safety and conformance with hygienic standards,
i.e. they remain a portion of the overwhelming workload year to year. Excluding
temporary food service establishments, New Hanover County's number of operating
establishments/facilities requiring periodic inspections in 1990 was 632. On July 1,
2003, this number had increased to 1468 or 133%. It is our experience that the vast
majority of food service, hospitality and tourist businesses value a strong working
relationship with local health departments, and that this relationship requires a serious
commitment of staff time to educate and seek voluntary compliance with regulatory
standards.
Prohibiting the collection of user fees from the food service, hospitality and tourist
industries by local government to use for the management and provision of necessary
services are no longer tolerable. This bridle of local health departments poses imminent
threat to the health of residents and visitors alike throughout this great State. We
appeal to you and your colleagues for quick action to remedy and amend Chapter
130A-39 (g).
Respectfully,
j)vc ;#f~1rG~
p~
Melody C Speck, DVM, Chairman
New Hanover County Board Of Heath
David E. Rice, MPH, MA
Health Director
"Healthy People, Healthy Environment, Healthy Community"
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Star-News
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Kenneth A. Svanum Publisher
Allen Parsons Editor/Associate Publisher
nm Griggs Managing Editor
Charles W. Rlesz.'Jr. Editorial P1ige Editor
ESTAIlI.ISIH.D 1867
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The New\brtTUDes
ComJllll!)'
[ EDITORIALS ]
OUR VIEWS
"
Sanitation
Grade D
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If you get food poisol)ing the next time you go ou, Ho
eat, blame New Hanover County. It hasn't hired
enough health inspectors to protect us.
New Hanover needs at least five more inspectors to
keep up with the explosive growth of eateries, motels,
nursing homes, child-care centers and the like. Their
numbers have more than doubled since 1990, but the
county has the same number of inspectors today- six -
as it did 11 years ago.
That's gross understaffing. And "gross" is the right
word.
State law requires restaurants to be inspected four
times a year. New Hanover County is lucky to inspect
them three.
With inspections reasonably rare, employees can for-
get details or cut corners, and turnover can shrink the
proportion of experienced workers. "
Yet if you berate the County Commissioners aftei you
stagger out of the bathroom all woozy, save some indig-
nation for your state legislators. TheytelI the counties
to inspect restaurants, but give them a pittance to pay
for it.
Worse, legislators forbid the counties from charging
inspection fees to these places. Local ta)cpayers bear
that burden. Local taxpayers, after all, don't hire lobby-
ists to take legislators to boozy dinners and offer them
"campaign contributions."
Citing an "imminent threat to the health of residents
and visitors alike," the New Hanover County Boani of
Health is asking the commissioner.. to hire five more in-
spectors. In addition, it's asking local legislators to help
repeal the prohibition on local inspection fees. ,
The Honorables' task, assuming they accept it, will
take awhile. The restaurant lobby won't late it one bit.
The commissioners' task is to hire five inspectors.
They could agree to it Monday.
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nHY-Il-~UUq TUt: 1U:;j1 An NtlliU nHNHlit:lf;;; Uttllit:
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tKh NU, ~lUjqlqUqc
NEW HANOVER COUNTY
OFFICE OF THE COUNTY MANAGER
320 Chesmut Street, Suite 502
WilmingtoD, NC 28401
www./Ihcgov.c:om
New Hanover county
NORTH+CAROL1NA
r. UI
/01171:
I~~~
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Fax Memo
I
DATE:
May 11, 2004
Dave Rice, Health Director /'Ii)
Allen O'Neal. County Manager 1'--
TO:
FROM:
SUBJECT: Request for Environmental Health Specialist Positions
Thank you for sending the request for five Environmental Health Specialist
positions. I have chosen not to include this on the Board of Commissioners May
17. 2004 agenda. I will, however, present this item as a matter for their
consideration during budget deliberations.
If you have questions or comments, please feel free to call.
c: Board of Commissioners
Dr. Melody C. Speck, Chainnan, New Hanover County Board of Health
Pat MelviD
Cam Griffin
Andre' Mallette
Cindy Hewett
AIleD O'Neal
County MaDager
910.34l-7184
FIX: 910.341-402'7
I'IHI-ll-cUUq IUI: lU:jc tlfl I'Il1 \iV I'IHI'lH\.r!:1\ ::> urn,,!:
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NEW HANOVER COUNTY BOARD OF COMMISSIONERS
REQUEST FOR BOARD ACTION
Item #: Estimated Time: Page Number:
Department: Health Preeenter: Dianne Harvell, Environmental Health Services Manager
Conted: Cindy Hewett, Business Manager
SUBJECT:
Request for (6) Additional Environmental Health Specialist Positions
BRIEF SUMMARY:
Significant and OIlgoing growth In the local food service, hospitality and tDurlst Industries requires
additional environmentaVpublic: health staff In assure food safety and prolllctlon of the public's health. The
(NC DENR) Regional Environmental Health Specialist c:onduc:tad an evaluation of staffing in the
Environmental Health Services Division and determined it would require 5.28 additional Environmental
Health Specialists In adequately provide essential services and protect the public:'s health. Approved by
Board of Hea~h on May 5, 2004,
RECOMMENDED MOTION AND REQUESTED ACTIONS:
FUNDING SOURCE:
e
Will above action result In: New Posltlon(s) Number of Positions: Ii
FY 04-05 c:ost of 5 positions would be $262,700. No funds are Included in recommended budget for these
positions. The additional positions should be considered as part of the FY 04-05 budget proce&6 wI1h
other requests for funding.
Explenetlon: NC Genel'lll Statute 130A-39 (g) prohibits the c:harging of fees for these specific 881\1iC88 lIS
New Hanover County Health Department Environmental Health Services staff are performing these
services as agents of the State. Ne DENR funds only a fraction of the costII for proViding these services,
and does so on a performance basis, I.e. If the required number of InspecllOns of restaurants and other
establishments is not achieved, then NC DENR funding Is proportionately dec:reased. Counties are,
therefore, reliant almost exc:lusively upon other local sources of revenue tD cover costs.
ATTACHMENTS:
Staffing Evaluation Report
REVIEWED BY:
LEGAL: NlA FINANCE: N1A BUDGET' NIA HUMAN RESOURCES: N1A
COUNTY MANAGER'S COMMENTS AND RECOMMENDATIONS:
COMMISSIONERS' ACTIONS/COMMENTS:
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The Public Health Response to
Bioterrorism & Disaster
David E. Rice, MPA, MPH
Health Director
New Hanover County Health Department
Wilmington, NC
27 May 2004
l1li
"..............co...._'"'
We're here to help?
The NHC SNS Committee
. A multi-agency committee or county-based agencies
met to delineate roles in securing and distributing
the SNS contenL AssIstance rrom NC Special
Operations Response Team
. Partners iDelude:
- Health Department I PIIIlST
- Emergency ~
- Hospital I SERAC
- State Ports Authority
- US Coast Guard
- Law Enloreement
- Olben
Objectives
<. Discuss New Hanover County's response plan using the
Strategic National Stockpile (SNS)
<- Describe the health department's mass vaccination and
drug dispensation clinics plan
(. Describe the local health department response to SARS
.:. Describe the Public Health Regional Surveillance Team
(PURST) and their roles in the Health Department's
response & planning activities
.:. Describe what North Carolina bas done with Public
Health Preparedness to help upgrade the County's
capacity to respond to intentional disaster.
.,. Discuss West Nile Virus.
The Strategic National Stockpile
}> The SNS Push Pack consists of medical
equipment, supplies and pharmaceuticals to
augment the state and the counties' ability to
respond to mass casualty events
}> The CDC maintain~ 11 depots, and is sent to Ihe
requesting State at the discretion oflhe CDC's
Director.
}> The State Health Department receives Ihe
shipment from the CDC and distributes to Ihe
Counties. The County Health Department takes
ownership of the contents sent to them.
SNS - 50 tons from the CDC to NC
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SNS - ? tons from NC to Event
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~ _'" _', ~ "'--:"---T:.J;.--- ---- i '
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The Mass Intervention Clinics
. A response plan to protect the Public Health
using prophylaxis by means of vaccination or
drug dispensation.
. The key ohjective is to prophylax as many
county residents within a proscribed number
of days.
. The County HD must determine clinic sites
and the organization & staffing for each.
Public Health & SARS
. Worldwide Outbreak (11/02 -7/03):
- 8096 cases, 774 deaths; USA = no ratalities
. NC: 8 suspected, I confirmed case
. 4/03: SARS included as Quarantine disease
. Since 7/03: 4 cases in China, 3 lab exposures
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NHC SNS Plan
. Receiving Site
- NC State Pon
. Dispensing Sites
- Ashley High School
- CFCC - Schwartz Center
- Hoggard High School
- Laney High School
- UNCW- Trask Coliseum
NHC Mass Vaccination
Exercise
(. In planning stage - expeeted date: October 2004
.:. Deliverable in
Aid-to-County
BT grant
.> Flu vaccine
may be used as
incentive
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North Carolina
SARS Response Plan
}> Put together by the NC DPH, Jan 2004
}> Available on the web:
http://www.dhhs.state.nc.usldphlsarsl
state sars plan.htm
~ The Plan is applicable to Avian Influenza
(human cases were limited to Viet Nam,
Thailand) or any contagious disease
}> Appendices in Quarantine & Isolation orders
--
2
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Quarantine & Isolation Authority
NC General Statute 130A - 145
. The State Health Director and the local
health director are empowered to exercise
quarantine and isolation authority
Quarantine and Isolation authority shall be
exercised only when and so long as the
public health is endangered, all other
reasonable means for correcting the
problem have been exhausted, and no less
restrictive alternative exists.
PHRST Roles
(. Partnership development
.:. SurveUlance
.:. Education and training
(. Consultation
<. Preparedness
.:. Response
NC Public Health Infrastructure:
Where does PHRSTfit in?
-
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Public Health Regional
Surveillance Teams - 7 in NC
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Risky Sites in Region 2
~ I Int'l airport (lLM)
~ 2 State Port locations
~ I nudear plant (Snutbport)
~ 2 military installati?ns
~ 3 USCG stations
)- Numerous bridges
)0 Ferry services
)0 Industrial complexes
). Numerous Farms
PHRST . 2
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~ Developed as a response to .
bioterrorism
~ 7 teams consisting of:
o MD - epidemiologist
o RN - epidemiologist
o Industrial Hygienist
o Admin Assistant
o DVM liaison
~ Funded by tbe CDC via
tbe NC Division of
Public Healtb
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Other Preparedness Initiatives
West Nile VIrus In the Unltld States, 111WOO1
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A Pub6c Health System Is Complex
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Rip current
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A break in the incoming wave pattern is one sign of a rip current.
Facts about rip currents
. Rip current speeds vary Average
speeds are 1-2 feet per second, but
they have been measured as fast
as 8 feet per second-faster than
an Olympic swimmer!
. Rip currents can be very narrow
or more than 50 yards wide.
. Sometimes rip currents end just
beyond the line of breaking waves;
however, they may continue to pull
hundreds of yards offshore.
. Rip currents do not pull people under
the water-they pull people away
from shore.
. Rip currents are not "undertow" or
"riptides." These improper terms
should not be used to describe them.
~
Safety tips.
. Know how to swim.
. Never swim alone.
. For maximum safety, swim
near a lifeguard.
. Obey all instructions and orders
from lifeguards.
. Be cautious at all times.
. If in doubt, don't go out!
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United States Lifesaving
Association statistics indicate
that the chance of death by
drowning at a beach protected
by lifeguards is 1 in 18 million.
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Where can I get more information
about rip currents?
. Before you leave for the beach, check
the latest National Weather Service
l.5i:;ecast for local beach conditions.
~ny offices issue a Surf Zone Forecast.
. When you arrive at the beach, ask on-
duty lifeguards about rip currents and
any other hazards that may be present,
. More information about rip currents
can be found at the following web sites:
www.ripcurrents.noaa.gov
www.usla.org
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NOAA's National Weather
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College Program, and the
United States Lifesaving
Association are working to
educate the public on the
dangers of rip currents.
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I MAKING A DIFFERENCE IN DIABETES WITH TIMELY INFORMATION FOR THE CITIZENS OF NEW HANOVER COUNTY I
L___~_"___,.____~__________ __~ .________ ___~ ____~"_____.________ _____ __ ___ _ ________ ________ ____~_______._J
Scale Weight Goes Down
and Self-Esteem Goes Up
Muscles tighten and flab disappears. Stamina, strength and endurance improve along with
outlook, and there is an overall feeling of good health and high energy. Those who exercise
regularly know this - and so do our Fight the Fat participan!s.
The New Hanover Diabetes Today Coalition sponsored Fight the Fat - a ten week weight
loss program for people with diabetes and at risk for diabetes.
"It brought my attention to what I eat," said~
Roger Ryan. "I've changed what I eat and how much. I've
lost 14 pounds in 7 weeks and spend a whole lot of time
reading the nutrition information on packages. I've learned
my lesson - and I'm happy."
6 of every 10 People
in North Carolina are
Overweight or Obese
Among those with diabetes, 8 of every 10 fit
into this category. The correlation between
diabetes and obesity is so high that the
term "diabesity" has been coined to
describe both.
Since 1990, obesity has increased
86% and diabetes has increased
82% in the adult population
according to NC Diabetes and
Prevention Program. The
good news is that recent studies
have shown that modest weight
loss of 5-7% of starting weight
and regular physical' activity can
reduce the incidence or even
prevent the diagnosis of diabetes.
"I've probably drunk more water in the
last five weeks than I have in the last 5 years," says
Alice Tobey. "And I'm walking - a lot more than I
ever did before. The pedometer has given me the
incentive to get moving. What's more, I've signed up
to go to the Diabetes Self-Management class to learn
how to better take care of my diabetes."
r
Belk, Dillard's,
Je Penney and Sears
Support Fight the Fat
The department stores at Westfield
Shoppingtown Independence donated
$250 gift cards. Fight the Fat participants
who met their weight loss goals were
entered into a drawing at the final
luncheon.
Four lucky people won gift cards to
shop for new wardrobes for their slim-
mer selves.
~ ~
Can you
Fight the Fat?
A summer Fight the Fat program is beginning.
You will: /
. Set a personal weight loss goal of 1 to.2 pounds
per week.
. Attend Fight the Fat nutrition and fitness classes
three hours per week.
. Commit to 30 minutes or more of physical
activity 6 times per week.
Fight the Fat includes weekly nutrition sessions and
twice weekly classes with a personal trainer. The
$20.00 fee includes the use of a pedometer for 10
weeks, a log book and all classes and materials. The
fee is refunded to those who meet their weight loss
goal. Classes will be held at the Senior Center, 2222
South College Road on Mondays from 8.30 -9:30
a.m. and on Wednesdays from 8:30 - 10:30 a.m.
Registration and weigh-in is set for Monday,June 14
from 8.30 - 10:00 a.m. in the multi-purpose room at
the Senior Center.
For more information, call 343-6758.
UPCOMING
"'
June 14
Fight the Fat Summer Signups at
Senior Center 8:30 to 10:00 AM.
June 12 and 19
Diabetes Self-Management Class at
New Hanover Community Health
Center, 925 North Fourth Street.
10 AM -12 noon.
Call Nella at 343-0270
July 17
Diabetes Day Camp in Pender County
FOR MORE INFORMATION
CALL 343-6758
Diabetes Today is a special publication of the New Hanover County Diabetes Today Coalition which provides the editorial content. The Diabetes Today Coalition was formed in 1999 to advocate
for
diabetes care and prevention in New Hanover County. The Coalition is supported by a grant from Cape Fear Memorial Foundation. Editor: Trish Snyder
~
:iabetes To~r.'>1ay 2004
8
J
Page2
.
"
Summer is the Time
for Family Reunions
you have family members with diabetes, use
hese tips to help them stay in control at family
atherings:
Offer a variety of low-fat, high fiber foods.
Transform traditionally high-fat and high-
calorie foods into low-fat, healthier versions.
Incorporate exercise into your family
gathering.
Support your family members with diabetes
by encouraging them, not chastising them.
you have diabetes, use these tiPs to stay in control
t family gatherings:
Have a plan for what, when and how much
you will eat.
Eat a low calorie snack before you leave
home, so you don't arrive hungry.
Bring your favorite healthy dish so you are
guaranteed to have at least one thing you'll
enjoy.
Eat slowly to reduce your chances of
overeating. ,
, Drink water-the healthy, no calorie
beverage.
Discuss your diabetes control plan with your
family so they can help you.
~Courtesy of the National Diabetes Education
Program, call 1-80fF.5383, or log on to http://
7Jtlep.nih.gov
llJ1
ington Health 'Associates
'W Center Drive wilmington, NC 28401
. Bryson Ley, M.D., FACP, FACE-----
Kimberly Pugh, M.D. I
Deborah Duchesneau, NP , Jean Denne, CNS
,
mrn......! "", helping y~u care
ftlt tile /111 S you love.'
3tt 375 !
."'...> I
Be Prepared for a Hurricane
Make sure you have enough .
medical supplies for 2 weeks /'f::::::"
in your hurricane kit. These,~ :i,.'
supplies should be checked ~
every 2 to 3 months. Watch for
expiration dates and replace as needed.
During a disaster, it may be difficult for you to
get food supplies. Keep the following in a dry,
handy place.
I large box saltines
I jar peanut butter
I small box powdered milk
I gallon of water per day per person for at
least one week
2 packages cheese and crackers or I jar
soft cheese
I package dry, unsweetened cereal
6 pack of canned fruit juice or sports
drink
6 cans of fruit packed in water or its own
juice
I spoon, fork and knife per person
Disposable cups
Small, hard candies for low blood sugar
Cans of tuna, chicken, salmon, nuts
Manual can opener
FOOD SUPPliES SHOULD BE CHECKED
AND REPLACED YEARLY
News from the Trianglel Eastern
NC Chapter of the Juvenile
Diabetes Research Foundation...
With the help of the Triangle Chapter of
the Juvenile Diabetes Research Foundation
ODRF) in Raleigh and a very dedicated
group of parents, the Wilmington affiliate of
JDRF was established for all of eastern North
Carolina. The support group meets monthly
and often features speakers with specialized
diabetes knowledge. These meetings are open
to people with Type 1 diabetes, their family aiJ.d
friends. The support group also holds various
events during the year, including a summer
pool party, a Christmas ornament party, and
participation in the annual Wilmington Walk
to Cure Diabetes. Meeting dates vaiy but
are always advertised on television and in the
newspapers.
The JDRF and several parents in the support
group have put together a notebook designed
to reach out to newly diagnosed families to
let parents know they are not alone and to
help them feel more comfortable. Members of
the local support group range in age from 18
months to 65 years.
Meeting Schedule
May 27 6-7pm Magnolia Greens Owners'
Grill Shelter. "Flower of Hope" Bring a pot to
plant in.
June 9 Ham Beach Party at Wrightsville
Beach Park at Crystal Pier. Bring picnic lunch
and beach gear.
July 18 1-5pm Family teams kickoff - potluck
cookout. Get information about family teams
for the annual walk. Bring a dish to share.
August 8 1-5pm Swim party - Magnolia
Greens Owners Clubhouse. Bring a snaCk to
share, drinks for your family and towels. For
more information, contact Lorraine Beadore at
910-383-3810 orJean Denne at 910-341-3331.
Come to a Diabetes Day Camp
For adults and children (aged 6 to 13) with diabetes
- who live in Pender County.
This FREE ONE-DAY CAMP will (.Over
blood glucose control, managing your diabetes,
medications, dental care, nutrition, foot care,
eye care, and physical activity. There will be
hands on learning for the children.
Place: Camp Kirkwood, Watha, NC
Date: Saturday,July 17,2004
TIme: 9am - 3pm
Lunch and snack provided
Pre-registration required. Call Jean Rawls,NC
Cooperative Extension Service, at 259-1235 or
Alane Savod, Healthy Carolinians of Pender at
259-5451 extension 205.
. HANOVER MEDICAL SPECIALISTS. 'A
. H and the ( Division of Endocrinology) .
1515 Doctor's Circle,
Wilmington, NC 28401
Your Certified Diabetes Shoe Fitter
Mandy W""tm Cf1fII/1kId
tubianad training on woU1U/ <<J1e
& conservative management of
diahetes. fA her expertise put you
in the right slwe!
Medical Center
~i{
....-
Home Care
908 S, 16th St
762-7007
Hours:
M-F 8-5:30
OFFICE HOURS
BY APPOINTMENT
TELEPHONE
(910) 763-6332
www.medicalcenterhomecare.com
- '"
'. ~..'J';' >>."
""J
Paul C. Michael S.
WhItesides,Jr, M.D. McGarrity, M.D.
Amy G. Gaweda, FNP-C
John C.
Parker, M.D.
(
Diabetes Todjly; May 2004 Page3
--.-------'-'-.----------'-. - --,-.------------- --- --'---------,
HEWS_YOU_CAN_U~SEII_IIJ1IF~Y.QU-HAVE--QIAB~1:ES-- I
I've Never Heard of an A1C Test. Know the Difference I Have Been Diagnosed
What Can It Do For Me? Between High Blood Sugar with Diabetes....and Don't
and Low Blood Sugar Know Where to Start.
HIGH BLOOD SUGAR
Symptoms are noticed within hours or several days
and include increased thirst and urination, large
amounts of sugar in the blood, ketones in urine,
weakness, pains in stomach, aching, heavy, labored
breathing, loss of appetite, nausea, vomiting.
What You Should Do. Call your doctor immediately,
take fluids without sugar if able to swallow, test blood
sugar frequently, test urine for ketones.
Caused by not enough insulin, too much food,
tnfection, illness or fever, emotional stress.
WW BLOOD SUGAR
Symptoms are noticed within minutes or hours and
include cold sweats, dizziness, faintness. headache,
pounding heart, nervousness, trembling, blurred
vision, hunger, inability to awaken, grouchiness,
personality change.
What You Should Do. Take liquids or food containing
sugar such as orange juice, regular soda.
Check blood sugar level, do not give insulin, do not
give anything by mouth if unconscious. Call doctor.
Caused by too much insulin, not enough food,
delayed meal, unusual amount of exercise.
r
,
r-.--~....-,.---...-...w-....-..-,.- -:
I It can help you
I find out how
I you h.ave been
! managing your
I diabetes every' I
! 3.4J;n.onths.; i
!______ _'.,~_____.,__~.J
Your blood sugar levels
go up and down minute
to minute. How high is it
now? Or at 4 a.m.? You
can't test your blood
sugar levels constantly,
so how can you know if
you are in good overall
control?
The AIC test is like a
batting average - it lets you know how you have
done at controlling your diabetes during the past
few months. The greater the amount of blood
sugar in your blood, the higher your Al C results
will be. High blood sugars over a long period of
time may cause damage to large and small blood
vessels. This may increase your risk of diabetes
complications.
Reducing your blood sugar levels to near normal
can help reduce your risk of eye problems by up
to 76%; nerve damage 60%; and severe kidney
problems 56%.
An AIC test <:an lead to better care, helping you
reduce your risk of diabetes complications.
You should have this test when you are first
diagnosed. From then on, take this test three to
four times a year. Talk to your doctor if this test
isn't being done.
~
I
'-
:J
Consider signing up for a
diabetes self-management
class to help you learn to
control and understand
your diabetes. The New
Hanover County Diabetes
Today Coalition sponsors
free Saturday classes at the
New Hanover Community
Health Center. Taught by
certified diabetes educators, Pam DiBiase and
Nancy Manock, this four hour class covers testing,
medications, monitoring, nutrition, avoiding
complications and more. Call Marinella Smith at
343-0270 to sign up.
Learn more about diabetes.
The National Diabetes Education Program can be
reached at 1-800-438-5383 or visit their website at_-
_r
http://ndep.nih.gov
The American Diabetes Association can be
reached at 1-800-DIABETES or visit their website
at www.diabetes .org
In New Hanover County, call the Consumer
Health Library at 798-6307.
What To Do When All The Squash is Ripe at The Same Time
Diana D'Abruzzo has been successfully losing weight for over a year. We asked her to share a few recipes.
Get Real! Y oil 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 Hwnan Services
Division of Public Health. Diabetes Prevention and Control Branch
~www,n~Cdiabetes_o,~~,
. , .
"".~:u~
---
Here are two recipes that are great for summertin:te.
One's a refreshing dessert; the other a nice side dish.
Squash Casserole (Serves 6)
4 large yellow squaSh
1 small onion, chopped
1/2 cup water
1 garlic clove, crushed
1/4 cup nonfat cream cheese at room
temperature
1/2 cup shredded sharp cheddar cheese
1 large egg, lightly beaten
1/4 teaspoon salt and pepper, to taste
6 unsalted soda crackers
~ffi\([
North carolina Dlabetn AcMaory Council
~ Boyan Georgiev. M.D.
. INTERNAL.. MEDICINE
. ~;;'" Tammy Melger, PA'C
' . , . "'ACCEPTING NEW PATIENTS'
Boord Certified in Internal Medicine.
Special interests in cardiology, diabetes
and cholesterol disorders.
342-9969
CAROliNA PRIME
1908 Meeting Court (off Hospital Plaza Drtvel
Preheat oven to 350 degrees. Spray a shallow I-quart
dish. Combine squash, onion, water and garlic. Bring
to a boil. Reduce heat and simmer for 12 minutes or
until tender. Drain well. Mash with potato masher.
Stir in cream cheese and 6 tablespoons of cheddar
cheese, egg, salt and pepper. Pour into a baking dish.
Crush crackers and mix with remaining cheddar
cheese and sprinkle on top of casserole. Bake 30
minutes or until bubbly. Let stand for 10 minutes
before serving.
Fluft'
1 cup crushed pineapple (with juice)
1 cup mandarin oranges (with juice)
1 (8-ounce) fat-free vanilla yogurt
1 (8-ounce) fat-free Cool Whip
1 box instant fat-free sugar-free white chocolate
OR vanilla pudding
Dump all of it in a bowl. Mix. Refrigerate. A serving
size is I cup. (A big disclaimer. Make sure you portion out the
dish into little one-cup containers. You don't want to
sit down with a big bowl of fluff and fmd the whole
thing gone by the first commercial break.)
Thank you, Diana!!!
';.-~
SUMMIT
PODIATRY
Glaser Foot &
Ankle Clinic
1717 Shipyard Blvd.
791-1300
If you're diabetic,
your feet need special a"entlon,
. INFECTION. FOOT ULCERS' NEUROPATHY
. VASCULAR DISEASE. BONE PROBLEMS
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Weight Loss T-Ips
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i By Mindy Saenz, RD, LDN, CDE
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When it comes to weight loss, there are a lot of' ideas on what is best. To really
nd out what works, researchers at the University of Colorado started the National
veight Control Registry. This registry is made up of surveys given to people who
ad lost at least 30 pounds and kept it off for at least one year. The surveys asked
eople what they had done to lose weight and how they were keeping it of. There
re currently 3000 people in the registry who have lost an average of 60 pounds and
.ave kept it off for an average of 5 years. Most of them said they were overweight
s children and have family members who are also-obese or overweight.
So how did all these people manage to lose weight and keep it off? We know that
",be successful you need to change your lifestyle NOT just go on a diet. About half the people
Jst the weight on their own. The other half had help from some kind of program. But they all
lad similar habits that helped them.
The successful weight losers reported eating a low-fat, high carbohydrate diet that was about
400 calories a day ,
They ate breakfast everyday. Eating breakfast helps your body bl!ffi fat more easily (it increases
rour metabolism).
They kept journals and wrote down what they ate each day and how much they weighed every-
lay. Keeping a journal helps you see the progress you are inaking.
Physical activity is another important thing that all the successful weight losers had in common.
four goal should be to exercise for 30-60 minutes most days of the week. You can split your
lC.tivity up and do it in several shorter bursts throughout the day. One simple thing that can help
ldd movement is to get up and walk around during the commercials of your favorite TV show
instead of just changing channels until your show comes back on.
Pay close attention to serving sizes. Even low fat, healthy foods can make you gain weight if you
are eating too much of them. It is a good idea, especially when you are first getting started with
these lifestyle changes, to use measuring cups and spoons so you can really see what a serving
size looks like. You should also go back and check your serving sizes every so often. Over time,
1/2 cup will start to grow if you aren't paying attention.
Keep a positive attitude. You don't gain weight overnight and you won't lose it overnight either.
It's healthier to have a slow, gradual weight loss. The recommendation is to lose 112 - 2 pounds
a week. It only takes losing 5- 10 % of your starting weight before you start to see improvements
in your blood pressure, diabetes and cholesterol levels.
_, ~emember - to lose weight and keep it off means changing your lifestyle not just dieting. Diets
may work for a while but usually when you stop the met, you gain the weight back and some-
! times even gain more than you lost. Pick one or two changes at a time and work on them until
they are habits, then pick one or two more. Start today.
from People Who
Have Lost Weight
and Kept It Off
Breakfast Lunch SUDDer
2 servings of grains, 2 servings of grains, 2 servings of grains,
beans, or starchy vegetables beans, or starchy vegetables beans, or starchy vegetables
1 serving of fruit 1 serving of fruit 1 serving of fruit
1 serving of milk 1 serving of milk 2-3 servings of vegetables
1 servina of fat 1-2 servinas of veaetables 2 ounces of meat
2 ounces of meat 2 servina of fat
-'- 1 serving of fat
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To get 1400 calories a day y
plan bottom left_
A serving in the grains, be
group is I slice of bread, 'h
noodles, com, peas or beans
1/3 cup of rice, or 'h of a b
hamburger or hot dog bun.
A serving in the fruit group .
fruit, 'h cup of canned or
dried fruit
A serving in the vegetable
vegebles or '12 cup of cooke
Two ounces of meat is the s
leg or a piece that is a little
of cards,
A serving in the fat group is
margarine, mayonnaise or s
choose low fat items, you c
and if you choose fat free, y
spoons,
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,-Dr :]effreyB~-PuPPi; DpM~T'J.'
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Dr. Kevin G. Bachm'antpP1j1:
.Boar~"Certified'ln Foot And'Ankl~~SurgerY';:--' .
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WQUND CARE
Type 2 Diabetes
GMng Medication a Try
Living with diabetes is not easy. Sometimes the
proper diet and the right exercise are not enough.
Local physicians are participating in a research study
with an investigational medication to see if it safely
and effectively helps control blood sugar levels.
To be considered, you must be tryinQ to manage
your diabetes through diet and exercise alone, and
not currently on an oral antidiabetic medication.
If you qualify, you will receive all study-related care
and study medication. Financial compensation is
also provided.
New Hanover Medical Research
799-5500
Volunteer for your future.
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;'7'f' UI ~u;;u
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DiabetIc;~: .
Retinopathy
Board Certified In Ophthalmology
Igor Westra, ~D . Erik van Rena, MD
1801 New Hanover Med,cal Park Or. . Wilmington. NC
1703 COUntry Ctutl Rd. Suite 104 . Jacksonville, NC
4eOO HIghway fE. Suite 240 . little RIver. NC
www.r-etl.fcoastalcarolina.com
CENYER
l77tl WELLINGTON AVENUE' WIlMINGtON
910.815.0005
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FooT & ANKLE SURGERY' DIABETIC FoOT CARE
SPRAINS & FRAGURES . AMBULAlORY SuRGERY
INGROWN NAILS . ENDOSCO~C SURGERY
SECOND O~NION CONSULTATIONS. X-RAY FAOUTIES
COASTAl CAROLINA FOOT CENTER
1602 Doctor'S Cirde' Wilmington 343-8889
WALLACE FOOT CENTER
114 N, Norwood Sl . Wallace 285-3362
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