Columbus County
Board of Health
Handbook
Revised March, 2011
Revised Jan, 2010
July, 2009
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Columbus
County Board of Health
Handbook
Table of Contents
Columbus County Health Department’s Mission, Vision & Values …………………..…. ……………………3
Public Health Core Functions & 10 Essential PH Services ……………………… ……………………………..6
Columbus County Health Department Services…………………………………………………………..…….11
Powers and Duties of Board of Health (G.S. 130A-39)……………………………………………………….....17
Executive Session Law (G.S. 143-318.11) ……………… …………………………………………….................18
Appeals Procedure (G.S. 130A-24)……………….……………………………………………………..…….…19
Appointment of Local Health Director (G.S. 130A-40)…………………………………..………………….….20
Powers and Duties of Health Director (G.S. 130A-41)………………………………………………………….21
Columbus County Board of Health Operating Procedures ……………………………………………..……..22
Columbus County Board of Health Public Participation Policy……………………………………………….24
Columbus County Health Department Policy Development and Revision Policy…………………………….26
Columbus Count y Health Department Appeals Policy………………………………………………………..29
Columbus County Health Department Reduction in Force Policy……………………………………………34
Columbus County Board of Health Members/Professions/Terms…………………………………………….36
Columbus County Board of Health Meeting Schedule .......……………………………………………………38
Health Director’s Annual Evaluation Form ……………………………………………………………………39
Columbus County Health Department Management Team …………………………………………………..40
Sample County Health Department’s Organizational Chart …………………………………………….…...41
Healthy North Carolina 2020 A Better State of Health………………………………………………………...43
Columbus County Health Department Community Health Assessment …………………………………….. 44
Columbus County Health Department Strategic Plan ……………..………………………………………….45
Columbus County Health Department SOTCH Report ………………………………………………………56
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MISSION STATEMENT
The mission of the Columbus County Health Department is to prevent disease, promote health and protect the
environment for all citizens and to continually assess and respond to the health needs of the community as a whole.
Public health looks not only at the individual but also the family and community. With regard to stewardship of
resources, public health strives for the most good for the greatest number of people.
The Mission is based on the following beliefs:
• Public health is community based
• Prevention and early intervention are essential in maintaining health
• The health of the individual affects the quality of life of the community
• Health education is essential for making choices for healthy living
• Individuals have a responsibility for their own health
• All individuals should have access to basic health care
• A holistic approach promotes optimal health
• Health care providers are valuable resources for the community
• A pollution free environment (clean air, water, soil and food) is essential to optimum
health
• The health needs of a community are dynamic and measurable
• Quality assurance is essential in health care

We PROTECT residents from environmental risks such as exposure to lead, foodborne diseases,
waterborne diseases, and communicable diseases.

We PROMOTE individual, family, and community health behaviors which maintain and/or
increase the span of healthy life.

We ASSURE and/or advocate for access to essential preventive health services for all residents.
Our mission is accomplished through a commitment to quality and customer-centered services.
VISION STATEMENT
Columbus County Health Department will provide confidential, individual, and community interventions
regardless of race, color, creed, martial status national origin, political beliefs, sex, age, or handicap, with
respect and integrity through the efficient and effective management of available resources in accordance with
federal, state and local guidelines.
VALUES
TRUSTWORTHINESS
Definition:
Trustworthy is being honest, fair, dependable, and worthy of
confidence.
Behaviors:
1.
When you are wrong, admit it.
2.
Be where you say you're going to be and do what you say you're going to do.
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3.
Walk the talk; practice what you preach.
4.
Respect privacy of customers and co-workers.
5.
Be truthful, yet compassionate.
6.
Be impartial and fair to customers and each other.
CUSTOMER-CENTERED
Definition:
Behaviors:
We ask our customers what they need and strive to respond to their needs.
1.
Ask customers what they want rather than assuming you know.
2.
Put customers' needs before your needs.
3.
Respect customers' individual choices and lifestyles.
4.
Reduce barriers to service. Provide services for customers when and where needed,
when possible.
5.
Work together as a multi-disciplinary team to serve the customer.
6.
Don't say "no" to customers without offering explanations and/or options.
7.
Continuously ask why you do what you do and be willing to change if needed.
8.
Ask your customers how you are doing with regard to customer service.
TEAMWORK
Definition:
Behaviors:
Working together, everyone achieves more.
1.
Find solutions, not fault.
2.
Don't assume others know what is going on; ask when you don't know.
3.
Include others' input in decision making.
4.
Respect team members' unique roles and work styles.
5.
Share responsibility and workload; don't say "It's not my job".
6.
Do what you agree to do.
7.
Stay with the task until it is done.
8.
Be open to change.
9.
Agree to disagree.
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EFFECTIVE COMMUNICATION
Definition:
Behaviors:
Ability to clearly disseminate and receive information in all interactions in a manner that
treats the customer and co-worker with respect and compassion.
1.
Share thoughts, concerns, and expectations with each other.
2.
Let people finish talking; don't interrupt.
3.
Talk to others the way you'd like to be talked to.
4.
Praise more than you criticize.
5.
Get the facts; don't spread rumors.
6.
Have good eye contact.
7.
Deal with the facts; don't get personal or take it personal.
8.
Share information with those who need to know it.
9.
Ask for opinions and input from others.
PROFESSIONALISM
Definition:
Behaviors:
We serve customers with competence, integrity, and a positive attitude.
1.
Be a self starter; don't wait to be asked.
2.
Be polite.
3.
Be accountable for your behavior.
4.
Don't push your beliefs on others.
5.
Support and promote agency goals and objectives.
6.
Demonstrate knowledge and skills in your area of expertise.
7.
Maintain confidentiality.
8.
Seek opportunities to learn more.
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Public Health Core Functions and
10 Essential Public Health Services
CORE FUNCTIONS:
Assessment, Policy Development, Assurance
ESSENTIAL SERVICES:
1.
Monitor health status to identify and solve community health problems.
2.
Diagnose and investigate health problems and health hazards in the community.
3.
Inform, educate and empower people about health issues.
4.
Mobilize community partnerships and action to identify and solve health problems.
5.
Develop policies and plans that support individual and community health efforts.
6.
Enforce laws and regulations that protect health and ensure safety.
7.
Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
8.
Assure a competent public and personal health care workforce
9.
Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
10. Research for new insights and innovative solutions to health problems
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The core competencies represent a set of skills, knowledge, and attitudes necessary for the broad practice of public
health. They transcend the boundaries of the specific disciplines within public health and help to unify the
profession. Descriptions of programs offered by OCE include competencies addressed from the list below.
I.
EP: Emergency Preparedness
Emergency preparedness has been identified as a critical part of public health practice. The following
competencies outline emergency response activities in public health as established by the Columbia School of
Nursing Center for Health Policy and the CDC.
a. Define situations that require an emergency response
b. Describe the responsibilities of a health department during an emergency situation
c. Describe your health department's emergency response plan
d. Describe the incident command system in your community
e. Carry out your role and responsibilities in an emergency response
f. Use emergency communication equipment
g. Perform your communication role in an emergency (communication within the health department, with the
media, or with the community)
h. Find resources that will help you carry out your responsibilities during an emergency
i. Describe the signs and symptoms of biological agents that may be used in a bio-terrorist attack (i.e. Plague,
Small Pox, Anthrax), and respond appropriately when you suspect someone in your community has been exposed
to one of these agents
j. Describe the signs and symptoms of exposure to chemicals that might be used in a terrorist attack (i.e. Sarin, Ricin), and respond
appropriately when you suspect someone in your community has been exposed to one of these agents
II.
ES: Essential Services in Public Health
Established by the Council on Linkages between Academia and Public Health Practice.
1. Monitor health status to identify community problems
a. Be aware of amount of each important health problem in your community.
b. Use reports from disease surveillance or vital registry systems to identify important health issues in your
community.
c. Determine appropriate uses and limitations or gaps of existing health data for your community
d. Conduct community assessments including identifying needs, assets and priorities.
e. Communicate with other agencies to identify new disease cases in your community.
f. Recognize a disease outbreak in your community or nearby communities.
g. Use statistics to analyze health data and make relevant inferences from the data.
h. Present information or data on health issues to other health professionals or to the general public.
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i. Solicit input from individuals and organizations about important health issues in the community.
j. Use public health software like EPI-INFO.
k. Maintain the security and confidentiality of personal and public health information.
2. Diagnose and investigate health problems and health hazards in the community
a. Design research studies to identify risk factors for a health problem.
b. Read scientific literature to keep up-to-date with knowledge of new diseases and disease risk factors.
c. Understand strengths and weaknesses of published research.
d. Collect biological or environmental samples to better understand a health problem.
e. Perform environmental health risk assessments.
f. Explain your technical/computer needs to the appropriate people.
3. Inform, educate and empower people about health issues
a. Communicate effectively both in writing and speaking.
b. Meet with professionals and community members to gather opinions about how to promote the health of the
population to address a priority health problem.
c. Identify cultural, social, and behavioral factors that affect health problems in your community.
d. Provide health promotion and disease prevention information to groups or individuals.
e. Use the media (newspapers, radio, television) to communicate health information.
f. Use a computer-based catalog like Medline to identify articles or books related to a health topic.
4. Mobilize community partnerships and action to solve health problems
a. Interact effectively with people from diverse cultural, socioeconomic, and educational backgrounds.
b. Help conduct health promotion campaigns and programs.
c. Use health promotion models to design or evaluate a health intervention program.
d. Use the internet to make health information available to the community.
e. Advocate for public health programs and resources.
f. Apply principles of group dynamics to develop effective partnerships.
g. Establish and maintain community partnerships to maximize use of community assets.
5. Develop policies and plans that support individual and community health efforts
a. Collect, summarize, and interpret information relevant to a health issue.
b. Formulate policy options.
c. Understand the feasibility and expected outcome of each policy option.
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d. Use current techniques in decision analysis and health planning.
e. Develop long-range plans for health programs.
f. Plan and implement effective emergency response services.
6. Enforce laws and regulations that protect health and ensure safety
a. Stay informed of public health laws and regulations.
b. Monitor enforcement of public health laws and regulations.
c. Work with law enforcement agencies to enforce regulations that protect health and ensure safety.
d. Use regulations to promote health in your community.
e. Explain public health regulations to community.
7. Link people to needed personal health services and assure the provision of healthcare when otherwise
unavailable
a. Identify healthcare service needs in your community.
b. Work with interpreters to provide public health services to non-English speaking members of the community.
c. Coordinate with other groups and agencies to ensure appropriate health care services are provided to your
community.
d. Refer clients to other agencies where appropriate to receive personal health services.
e. Develop a clinical health or social service plan for clients.
f. Negotiate contracts.
g. Write proposals to obtain funding.
h. Develop a budget.
i. Adapt healthcare service programs to take into account cultural differences in the population.
8. Assure an expert public health workforce
a. Create appropriate staff development and training plans for employees.
b. Recruit and interview applicants for positions in your agency.
c. Use organizational theory to improve professional practice in your agency.
d. Ensure that staff have and maintain appropriate licenses and credentials.
e. Translate state or local policy into organizational structure and programs.
9. Evaluate effectiveness, accessibility, and quality of health services
a. Develop surveys and studies to measure cost effectiveness, accessibility or quality of health care services in
your community.
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b. Understand factors that influence use of health services
c. Follow-up with clients to ensure that they have received health or social services.
d. Evaluate programs to ensure that objectives and performance goals are met.
e. Monitor day-to-day operations of programs that provide health services.
10. Research for new insights and innovative solutions to health problems
a. Conduct research or interventions to develop unique approaches to solving health problems.
b. Educate legislature on new policy options.
c. Create partnerships between public and private organizations to deliver public health services.
Last updated August 25, 2008
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Columbus County Health Department
Services
Infant And Child Health

Well Child Screening: Infants and children are provided screenings, well childcare and child service coordination at the
Health Department by appointment only.

Kindergarten, Head Start, Daycare and Sports physicals are offered by appointment

Dental Varnishing: Is offered to all children ages three and under when the first
tooth erupts and can be repeated every 6 months. This procedure is available
Monday through Thursday, 8:30am until 4:00pm by appointment and with each
well child check up. This procedure may be reimbursed by Medicaid and Health
Choice. Private pay is accepted.

Sickle Cell Counseling is offered every fourth Wednesday of each month from 9:00 am-11:30 am by appointment only.

Primary care nurse practitioner available for primary care.

Lead screenings are offered to children 12 months-72 months of age.
Bilingual Health Check/Health Choice 0- 5 yrs of age:
State mandated Health Insurance Program to capture children ages 0 through 19 years old
that are either underinsured or not eligible for Medicaid. Health Check Coordinator is
available to help answer questions and assist with application.
Neonatal Clinic
Neonatal Intensive Care Unit (NICU) is offered the first Friday of every odd month. This
clinic is staffed by the New Hanover Regional Medical Center. Columbus County
newborn patients of the NICU Clinic are seen as a follow-up visit at the Columbus
County Health Department.
Immunizations
Daily immunization clinics are held and basic required state supplied immunizations are
administered by public health nurses. Other immunizations are administered at a
minimal cost. Travel immunizations are offered in Adult Health for those traveling
outside the United States. This is to provide necessary immunizations, dietary and disease
information and precautions. Travel immunizations are by appointment only.
Immunizations hours for all other immunizations are Monday - Friday 8:30am-4:00pm.
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Pregnancy Care Manager(PCM)
The Pregnancy Care Manager Program (PCM) is staffed by nurses and social
workers who help pregnant women and new mothers to address concerns that may affect
the outcome of a woman’s pregnancy or parenting success. Through Baby Love
Program, Pregnancy Care Manager can help by providing:

Maternity Care Coordination

Counseling and Emotional Support

Pregnancy and Parenting Education

Childbirth Education Classes

Family Planning

Assistance with Tobacco and Substance use
Referrals are made to the following programs: WIC, Dental, Medical, Nutrition Program,
housing assistance, Medicaid, transportation assistance, day cares, mental health
counseling, paternity testing and assistance with domestic violence issues.
No matter where you receive prenatal care, you can sign up for this program. Just call
(910-640-6615 and ask for a Baby Love worker.
Care Coordination for Children
CC4C focuses on coordination of services and resources to respond to children with
special needs and their families.
Developmental Evaluation
Weekly developmental evaluation clinics are held at the Health Department and staffed
by the Wilmington Children’s Developmental Services Agency (CDSA). Seen by
appointment only with the CDSA (910) 251-5817.
Women, Infant and Children (WIC)
WIC is a supplemental program for pregnant and postpartum women, infants, and
children up to 5 years of age. Nutrition education and counseling are a part of the
program and are provided by qualified nutritionists. WIC appointment times are:
Monday through Thursday: 8:30 AM to 4:30 PM; Friday: 8:30 to 11:30 A.M.
In addition, WIC hold clinics in Bolton on Tuesday from 1:00 – 5:00 PM, in Tabor City on
Wednesday from 9:00 AM to 1:00 PM, and in Chadbourn on Thursday from 1:00 to 5:00 PM
Maternal Health
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Maternity clinics are held weekly. Prenatal patients are seen by appointment and must
meet eligibility requirements. New prenatals are seen on Mondays with follow-up
clinical visits on Wednesdays.
Family Planning
Family planning clinics are held every Tuesday and Thursday from 8:30am until 4:00pm.
Teen clinics are held the first and third Mondays, from 3:00pm until 5:00pm. All family
planning patients are seen by appointment only.
Colposcopy Clinic

Women are referred if they have had an abnormal pap smear.

Procedure for biopsy and treatment of abnormal cells of the cervix.

Colposcopy is important because it can detect cancer of the cervix at an early stage.
Adult Health/Health Promotions

Female physicals which include breast exam, mammogram referral (if needed),
pelvic exam and Pap smear screening are done Monday and Tuesdays 8:30 – 11:00
am by appointments only. Emphasis is placed on self-care, and supplementing and
enhancing treatment provided by patient’s physician.

Breast and cervical cancer control (BCCCP) program: Provides early screening

and follow-up for breast and cervical cancer by appointments. This program is

offered for women from ages 40 to 64 that are not eligible for Medicaid or

Medicare.

Wisewoman program: This program is in conjunction with BCCCP to teach and

promote all aspects of a healthy eating lifestyle

Male screening physicals are performed with testicular and prostate cancer

screening by appointments.

Cholesterol and Glucose screenings are done Thursdays 8:30 – 11:00 free of
charge (only one free test per calendar year).

Immunizations provided daily including travel immunizations, Monday – Friday 8:30 – 4:00 pm.
Tuberculosis
A respiratory chest clinic treatment and follow-up of tuberculosis. Skin-testing and/or Xray are provided for screening, diagnosis and referral, as indicated.
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Sexually Transmitted Diseases
The Health Department provides STD/HIV screening, interviewing, treatment, follow-up
and education. STD/HIV Clinics are held Monday, Tuesday and Thursday from 1:00
pm-3:00 pm, Wednesday and Friday from 8:30 am-11:00 am or by appointment.
Confidential AIDS testing and counseling is available Monday through Friday.
Infectious Disease Clinic is the third Friday of each month.
Communicable Disease Control

Promptly investigate disease outbreaks and implement control measures to
minimize further transmission of disease.

Monitor disease reporting by physicians, clinics and hospitals to detect trends and
to assess the public health impact of diseases.

Provide communication between private physicians, hospitals and occupational
infection control personnel as an essential part of disease control efforts.

Implement public health interventions and disseminate health education messages
to the community and media in order to enhance disease control efforts.
Preparedness
The goal of this program is to plan and promote readiness, response, and to improve
management of a public health threat. A threat that may result from an act of terrorism
using nuclear, biological, chemical agents, or weapons of mass destruction, or explosive
devices resulting in mass trauma or harm to the health of our community.
Health Education
Provide OSHA in-services
Instructor for CPR classes for Health Department staff and other County Agencies as
requested.

Community Outreach in-services as requested

Coordinate Health Department county events

Develops the Health Promotion Action Plan

Compile statistical data for the annual State of The County Report
Miscellaneous
Hearing and vision screenings available Monday from 2:00pm-5:00pm
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Birth and Death Registration
All County births and deaths are registered with Columbus County Health Department.
After processing, these records are recorded in state and local offices.
Counseling Service
Counseling service is available during all clinics held at the Health Department.
Home Visits
Home visits are made as mandated by specific programs and/or as needed.
Laboratory Service
Examples of but not limited to with physician’s orders:
Pregnancy Testing
Hemoglobin A1C
Urinalysis
Hemoglobin/Hematocrit
Pap test
Sputum examinations
Throat Cultures
Blood Typing
Antibody Screening
Hepatitis B Immunity
Herpes/Chlamydia/AIDS testing
Stool for Paracytology
Lead levels
Blood sugars
Chemistry Panels
Gonorrhea cultures
Sickle Cell
Rubella titer (screening)
Cholesterol
Varicella titer
Dental Clinic
The Dental Clinic serves children through the age of 18. The In-house dental clinic is
open Monday-Friday 8:30am-5:00pm scheduled by appointments and emergencies as
time permits. The Toothmobile is a dental clinic on wheels. It parks at Columbus
County Schools and stays 6-8 weeks until most treatment is complete. Children that
attend the host schools are seen during school hours, and seen by appointments after
school hours. Hours for the Toothmobile are Monday-Thursday 8:30am-4:00pm., Friday
8:30 – 2:00pm.
A public health dental hygienist from the NC Department of Environmental Health and
Natural Resources serves as Dental Health Educator in conjunction with Health
Department Staff.
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Home Health
Nursing, aide, physical therapy, speech therapy and occupational therapy are available.
Specific criteria must be met for home health services. Services available 24 hours a day
7 days a week. Telemedicine (HomMed Monitors) is available to patients that meet the
criteria. Durable medical equipment and IV therapy is available for those needing the
services.
Environmental Health Services
The Environmental Health section is responsible for ensuring the following programs
comply with regulations established by the North Carolina Department of Environment,
Health and Natural Resources:
A. Food Lodging and Institutions
Sanitary inspections and plan reviews of restaurants, lodging establishments, food
and drink stands, meat markets, institutions, schools and school cafeterias, local
confinement facilities, child day care facilities and residential care facilities.
B. Water Supplies

Inspection of newly constructed private water supplies. Provides

recommendations to meet North Carolina Division of Health Services construction
codes.

Collection of water sample from private water supplies for bacteriological chemical analysis.
C. Sewage Disposal

Inspection of all newly installed subsurface sewage disposal systems.

Supervisor of maintenance and repairs to existing systems.

Each lot evaluated for on-site sewage disposal prior to issuance of improvement permit.
D. Complaint Investigations
E. Solid Waste Storage, Transportation and Disposal
F. Insect and Rodent Control
G. Swimming Pool Inspection
H. Childhood Lead Exposure and Abatement Program
I. Inspect and approve tattoo artist/parlors
J. Make sure responsible party of Methamphetamine Labs
provide a decontamination plan approved by Environmental
Health and that they do in fact follow through with the plan
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Columbus County Board of Health
G.S. 130A-39. Powers and Duties of a Local Board of Health
130A-39. Powers and duties of a local board of health.
(a)
A local board of health shall have the responsibility to protect and promote the public health. The
board shall have the authority to adopt rules necessary for that purpose.
(b)
A local board of health may adopt a more stringent rule in an area regulated by the Commission for
Health Services or the Environmental Management Commission where, in the opinion of the local board of
health, a more stringent rule is required to protect the public health; otherwise, the rules of the Commission for
Health Services or the rules of the Environmental Management Commission shall prevail over local board of
health rules. However, a local board of health may not adopt a rule concerning the grading, operating, and
permitting of food and lodging facilities as listed in Part 6 of Article 8 of this Chapter and as defined in G.S.
130A-247(1), and a local board of health may adopt rules concerning wastewater collection, treatment and
disposal systems which are not designed to discharge effluent to the land surface or surface waters only in
accordance with G.S. 130A-335(c).
(c)
The rules of a local board of health shall apply to all municipalities within the local board's
jurisdiction.
(d)
Not less than 10 days before the adoption, amendment or repeal of any local board of health rule, the
proposed rule shall be made available at the office of each county clerk within the board's jurisdiction, and a
notice shall be published in a newspaper having general circulation within the area of the board's jurisdiction.
The notice shall contain a statement of the substance of the proposed rule or a description of the subjects and
issues involved, the proposed effective date of the rule and a statement that copies of the proposed rule are
available at the local health department. A local board of health rule shall become effective upon adoption
unless a later effective date is specified in the rule.
(e)
Copies of all rules shall be filed with the secretary of the local board of health.
(f)
A local board of health may, in its rules, adopt by reference any code, standard, rule or regulation
which has been adopted by any agency of this State, another state, any agency of the United States or by a
generally recognized association. Copies of any material adopted by reference shall be filed with the rules.
(g)
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. (1901, c. 245, s. 3; Rev., s.
4444; 1911, c. 62, s. 9; C.S., s. 7065; 1957, c. 1357, s. 1; 1959, c. 1024, s. 1; 1963, c. 1087; 1973, c. 476, s. 128; c. 508; 1977, c. 857, s. 2; 1981, c. 130, s. 2; c. 281; c.
949, s. 4; 1983, c. 891, s. 2; 1985, c. 175, s. 1; 1989, c. 577, s. 2; 1991 (Reg. Sess., 1992), c. 944, s. 10; 1993 (Reg. Sess., 1994), c. 670, s. 2; 1995, c. 507, s. 26.8(c).)
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Columbus County Board of Health
G.S. 143-318.11
EXECUTIVE SESSION LAW
The board shall comply with the N.C. open meetings law.
Closed (executive) sessions are permitted only if a majority of members’ present vote to go into a closed
session and if the matter to be considered is eligible according to the then current open meetings Statute.
GS 143-318.11. In general, subjects eligible for closed sessions are:
(a) The acquisition, lease, or alienation of property;
(b) To consider the qualifications, competence, performance, character, fitness, conditions of
appointment, or conditions of initial employment of an individual public officer or employee; or to
hear or investigate a complaint, charge, or grievance by or against an individual public officer or
employee;
(c) Matters dealing with patients, employees, or members of the medical staff (including but not limited
to all aspects of treatment, all medical records, and summaries, and all charges, accounts, and credit
information pertaining to any patient; all negotiations, contracts, conditions, assignments, regulations
and disciplines relating to employees);
(d) Any matters coming within the physician/patient/lawyer/client, or other privileged relationship;
(e) Conferences with legal counsel and other deliberations concerning the prosecution, defense,
settlement, or litigation of any judicial action or proceeding in which the local board of health is a
party or by which it is directly affected.
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Columbus County Board of Health
G.S. 130A-24. Appeals Procedure
130A-24. Appeals procedure.
(a)
Appeals concerning the enforcement of rules adopted by the Commission, concerning the
suspension and revocation of permits and program participation by the Secretary and concerning the
imposition of administrative penalties by the Secretary shall be governed by Chapter 150B of the
General Statutes, the Administrative Procedure Act.
(a1) Any person appealing an action taken by the Department pursuant to this Chapter or rules of
the Commission shall file a petition for a contested case with the Office of Administrative Hearings as
provided in G.S. 150B-23(a). The petition shall be filed not later than 30 days after notice of the action
which confers the right of appeal unless a federal statute or regulation provides for a different time
limitation. The time limitation imposed under this subsection shall commence when notice of the
agency decision is given to all persons aggrieved. Such notice shall be provided to all persons known to
the agency by personal delivery or by the placing of notice in an official depository of the United States
Postal Service addressed to the person at the latest address provided to the agency by the person.
(b)
Appeals concerning the enforcement of rules adopted by the local board of health and
concerning the imposition of administrative penalties by a local health director shall be conducted in
accordance with this subsection and subsections (c) and (d) of this section. The aggrieved person shall
give written notice of appeal to the local health director within 30 days of the challenged action. The
notice shall contain the name and address of the aggrieved person, a description of the challenged
action and a statement of the reasons why the challenged action is incorrect. Upon filing of the notice,
the local health director shall, within five working days, transmit to the local board of health the notice
of appeal and the papers and materials upon which the challenged action was taken.
(c)
The local board of health shall hold a hearing within 15 days of the receipt of the notice of
appeal. The board shall give the person not less than 10 days' notice of the date, time and place of the
hearing. On appeal, the board shall have authority to affirm, modify or reverse the challenged action.
The local board of health shall issue a written decision based on the evidence presented at the hearing.
The decision shall contain a concise statement of the reasons for the decision.
(d)
A person who wishes to contest a decision of the local board of health under subsection (b)
of this section shall have a right of appeal to the district court having jurisdiction within 30 days after
the date of the decision by the board. The scope of review in district court shall be the same as in G.S.
150B-51.
(e)
The appeals procedures enumerated in this section shall apply to appeals concerning the
enforcement of rules, the imposition of administrative penalties, or any other action taken by the
Department of Environment and Natural Resources pursuant to Articles 8, 9, 10, 11, and 12 of this
Chapter. (1983, c. 891, s. 2; 1987, c. 482; c. 827, s. 248; 1993, c. 211, s. 1; 1997-443, s. 11A.66;
1998-217, s. 33.)
19
Columbus County Board of Health
G.S. 130A-40. Appointment of Local Health Director
130A-40. Appointment of local health director.
(a)
A local board of health, after consulting with the appropriate county board or boards of
commissioners, shall appoint a local health director. All persons who are appointed to the position of local
health director on or after January 1, 1992, must possess minimum education and experience requirements for
that position, as follows:
(1)
A medical doctorate; or
(2)
A masters degree in Public Health Administration, and at least one year of employment
experience in health programs or health services; or
(3)
A masters degree in a public health discipline other than public health administration, and at
least three years of employment experience in health programs or health services; or
(4)
A masters degree in public administration, and at least two years of experience in health
programs or health services; or
(5)
A masters degree in a field related to public health, and at least three years of experience in
health programs or health services; or
(6)
A bachelors degree in public health administration or public administration and at least three
years of experience in health programs or health services.
(b)
Before appointing a person to the position of local health director under subsection (a)(5) of this
section, the local board of health shall forward the application and other pertinent materials of such candidate to
the State Health Director. If the State Health Director determines that the candidate's masters degree is in a
field not related to public health, the State Health Director shall so notify the local board of health in writing
within 15 days of the State Health Director's receipt of the application and materials, and such candidate shall
be deemed not to meet the education requirements of subsection (a)(5) of this section. If the State Health
Director fails to act upon the application within 15 days of receipt of the application and materials from the
local board of health, the application shall be deemed approved with respect to the education requirements of
subsection (a)(5) of this section, and the local board of health may proceed with appointment process.
(c)
The State Health Director shall review requests of educational institutions to determine whether a
particular masters degree offered by the requesting institution is related to public health for the purposes of
subsection (a)(5) of this section. The State Health Director shall act upon such requests within 90 days of
receipt of the request and pertinent materials from the institution, and shall notify the institution of its
determination in writing within the 90-day review period. If the State Health Director determines that an
institution's particular masters degree is not related to public health, the State Health Director shall include the
reasons therefor in his written determination to the institution.
(d)
When a local board of health fails to appoint a local health director within 60 days of the creation of a
vacancy, the State Health Director may appoint a local health director to serve until the local board of health
appoints a local health director in accordance with this section. (1957, c. 1357, s. 1; 1973, c. 152; c. 476, s. 128;
1983, c. 891, s. 2; 1983 (Reg. Sess., 1984), c. 1034, s. 75; 1991, c. 612.)
20
Columbus County Board of Health
G.S. 130A-41. Powers and Duties of Local Health Director
130A-41. Powers and duties of local health director.
(a)
A local health director shall be the administrative head of the local health department, shall
perform public health duties prescribed by and under the supervision of the local board of health and
the Department and shall be employed full time in the field of public health.
(b)
A local health director shall have the following powers and duties:
(1)
To administer programs as directed by the local board of health;
(2)
To enforce the rules of the local board of health;
(3)
To investigate the causes of infectious, communicable and other diseases;
(4)
To exercise quarantine authority and isolation authority pursuant to G.S. 130A-145;
(5)
To disseminate public health information and to promote the benefits of good health;
(6)
To advise local officials concerning public health matters;
(7)
To enforce the immunization requirements of Part 2 of Article 6 of this Chapter;
(8)
To examine and investigate cases of venereal disease pursuant to Parts 3 and 4 of
Article 6 of this Chapter;
(9)
To examine and investigate cases of tuberculosis pursuant to Part 5 of Article 6 of
this Chapter;
(10) To examine, investigate and control rabies pursuant to Part 6 of Article 6 of this
Chapter;
(11) To abate public health nuisances and imminent hazards pursuant to G.S. 130A-19 and
G.S. 130A-20;
(12) To employ and dismiss employees of the local health department in accordance with
Chapter 126 of the General Statutes;
(13) To enter contracts, in accordance with The Local Government Finance Act, G.S.
Chapter 159, on behalf of the local health department. Nothing in this paragraph shall
be construed to abrogate the authority of the board of county commissioners.
(c)
Authority conferred upon a local health director may be exercised only within the county or
counties comprising the local health department. (1957, c. 1357, s. 1; 1973, c. 476, s. 128; 1983, c. 891,
s. 2; 1985, c. 175, s. 2; 1999-110, s. 1.)
21
Operating Procedures
Columbus County Board of Health
1.
Name and Office.
The name of this organization is the Columbus County Board of Health (hereinafter “Board”). The principal office of the Board is
located at 304 Jefferson Street, Whiteville, North Carolina, 28472.
2.
Officers and Committees.
a. Chair and Vice-Chair
The Board members shall elect a Chair and Vice-Chair by majority vote each year at the February meeting.
b.
Secretary
The local health director shall serve as Secretary to the Board, but the director is not a member of the Board. The local health director
may delegate the duties of the Secretary that are set forth in these operating procedures to an appropriate local health department
employee.
c.
Temporary committees
The Board may establish and appoint members for temporary committees as needed to carry out the Board’s work. All temporary
committees are subject to the North Carolina open meeting laws and shall comply with the provisions of those laws.
3.
Meetings.
a.
Regular Meetings.
The Board shall hold a regular meeting on the last Wednesday of the month; bimonthly (August, October, December, February, April,
June) except that if a regular meeting day is a legal holiday, the meeting shall be held on the next business day. The meeting shall be
held at the upstairs conference room (RM # 81), 304 Jefferson Street, Whiteville, North Carolina, 28472 and shall begin at 7:00pm.
b.
Agenda.
The Secretary to the Board shall prepare an agenda for each meeting. Any board member who wishes to place an item of business on
the agenda shall submit a request to the Secretary at least seven (7) working days before the meeting. For regular meetings, the Board
may add items to the agenda or subtract items from the agenda by a majority vote. The agenda for a special or emergency meeting
may be altered only if permitted by and in accordance with the North Carolina open meetings laws.
Any person may request that an item be placed on the Board’s agenda by submitting a written request to the Secretary at least ten (10)
working days before the meeting.
c.
Presiding Officer.
The Chair of the Board shall preside at Board meetings if he or she is present. If the Chair is absent, the Vice-Chair shall preside. If
the Chair and Vice-Chair are both absent, another member designated by a majority vote of members present at the meeting shall
preside.
d.
Quorum.
A majority of the actual membership of the Board, excluding vacant seats, shall constitute a quorum. A member who has withdrawn
from a meeting without being excused by a majority vote of the remaining members shall be counted as present for purposes of
determining whether or not a quorum is present.
e.
Voting.
22
Each Board member shall be permitted to abstain from voting, by so indicating when the vote is taken. A member must abstain from
voting in cases involving conflicts of interest as defined by North Carolina law. If a member has withdrawn from a meeting without
being excused by a majority vote of the remaining members, the member’s vote shall be recorded as an abstention.
f.
Minutes.
The Secretary shall prepare minutes of each Board meeting. Copies of the minutes shall be made available to each Board member
before the next regular Board meeting. At each regular meeting, the Board shall review the minutes of the previous regular meeting as
well as any special or emergency meetings that have occurred since the previous regular meeting, make any necessary revisions, and
approve the minutes as originally drafted or as revised. The public may obtain copies of Board meeting minutes from the Health
Director at 304 Jefferson Street, Whiteville, North Carolina, 28472.
g.
Policy Review
All policies related to Billing, Board of Health, Fees, or Personnel will be reviewed and approved by the Board of Health. Any policy
related to fees will also be presented to the Board of County Commissioners. A list of all of the new and revised policies will be
available at each Board of Health meeting and are subject to review upon request. If they so choose there will be a copy of each of
these polices available for review by the board members. The Board will defer to the discretion of the Health Director for policies
requiring immediate action and/or called meetings for the full Board of Health
h.
Authority to Adopt Rules
The Board of Health will adhere to General Statute 130A-39 when adopting rules to protect and promote the public’s health.
i.
Public Appeals
The Board of Health will adhere to General Statute 130A-24 when an aggrieved citizen appeals a decision to the Board of Health.
4.
Amendments to Operating Procedures.
These operating procedures may be amended at any regular meeting or at any properly called special meeting that includes
amendment of the operating procedures as one of the stated purposes of the meeting. A quorum must be present at the meeting at
which amendments are discussed and approved, and any amendments must be approved by a majority of the members present at the
meeting.
5.
Other Procedural Matters.
The Board shall refer to the current edition of Robert’s Rules of Order Newly Revised (RONR) to answer procedural questions not
addressed in this document, so long as the procedures prescribed in RONR do not conflict with North Carolina law.
6.
Compliance with North Carolina Law.
In conducting its business, the Board shall comply with all applicable North Carolina laws, including but not limited to open meetings
laws, public records laws, and the laws setting forth the powers and duties of local boards of health. To assist the Board in compliance,
the local health director shall maintain a current copy of relevant North Carolina General Statutes and make them available to Board
members on request.
Approved and adopted by the Columbus County Board of Health on the 23rd of February, 2011.
___________________________________
Chair, Columbus County Board of Health
___________________________________
Secretary, Columbus County Board of Health
23
Policy Title:
Columbus County Board of Health Public Participation
Program Area:
Administration
Policy Identifier:
(optional)
Administrative Section I
24.0-24.1
Approval Date:
Approved by:
4/29/09
Effective Date:
4/29/09
April 29, 2009
Revision Date(s):
Columbus County Board of Health
Approved by:
Purpose:
Definitions:
Responsibilities:
Columbus County Health Director and the Columbus County Board of Health.
24
Procedures:
If the Board of Health will be discussing a health issue that is currently being
addressed by, or is of concern for, another community agency, the Health Director
shall contact that agency prior to the Board of Health meeting to invite them to
attend. The Board Chairman shall recognize their attendance and invite them to
address the board if they so choose.
If the Board of Health is considering establishing a program to address a public
health concern, the Health Director shall invite key community stakeholders to a
Board of Health meeting for them to present their thoughts and opinions on what
needs exist relative to said program.
Laws and Rules:
Reference(s):
25
Policy Title:
Columbus County Health Department Policy Development and Revision
(Policy on Policies)
Program Area:
All Health Department Areas
Administration:
Policy Identifier:
(optional)
Administrative section- Pages
18.0-18
Revision 5/1/09, 3/4/2010
Approval Date:
Effective Date:
January 2000
Revision Date:
11/2001, 03/14/07, 2/13/09,
5/1/09, 3/18/2010
May 1st 2009
Approved by:
Kim Smith RN, BSN, MSHCA, Health Director
Approved by:
Hilda Memory RN, BS, MSHA, Director of Nursing
Purpose:
To provide guidance and direction for development of policies and procedures governing the
operations of the Columbus County Health Department.
 To translate the mission into practical terms.
 To provide a standard of practice with legal protection.
 To establish staff expectations of self and others.
 To provide a framework for consistency in methods of practice, personnel, fiscal operations,
management and public health programs.
 To establish guidelines in accordance with state statutes and applicable rules and regulations.
Definitions:
It is the policy of Columbus County Health Department that policies be developed to
address personnel, management, fiscal operations and public health programs and
procedures provided by the agency. Policies/procedures will be developed prior to
beginning new programs or operations, when changes occur, and/or when required by law
or legislation.
Responsibilities:
Procedures:
1. Policies will be developed for the Columbus County Health Department in response to
ongoing evaluation of day to day operations of the Health Department. The need for policy
development may be identified by:



Staff who identify a need to provide or revise a specific service and substantiate it
through literature review and data analysis.
Physicians or referral sources that request the Health Department provide or modify
a service.
The results of internal quality improvement findings which identify areas that
show a need for revision, or a new policy and procedure.
26


Recommendations made by North Carolina Department of Health and Human
Services.
Recommendations made by state consultants.
2. The supervisory personnel in each clinic will perform the initial regulatory review and
ongoing mandatory programmatic requirements and changes needed.
3. The Policies and procedures will be written and/or revised in draft format with detailed
sequential actions by program/clinic supervisors to ensure the policy is implemented
accurately. This is to include the “How”, “Who’, “What”, “When”, Where”.
4. The policy and/or procedure will then be formatted by the Quality Improvement
Coordinator and submitted to the Health Director for review. (See Attached)
5. The Health Director and/or Director of Nursing will review new policies or revisions and
approve the clinical policies. All policies related to Billing, Board of Health, Fees, or
Personnel will be reviewed and approved by the Board of Health, and any policy related to
fees will be presented to the Board of County Commissioners.
6. A list of all of the new and revised policies will be available at each Board of Health
meeting and are subject to review upon requested. If they so choose there will be a copy of
each of these polices available for review. The minutes from the Board of Health Meeting
will include the entire list of all new/revised polices, and identify those policies that require
additional revisions as deemed necessary by the Board of Health.
7. The policies that require revision(s) will be returned to the Quality Improvement
Coordinator. After the revision(s) are completed the policy or polices will be reviewed
by the Health Director.
8. If the revisions are approved, the policies will be filed in the appropriate file folder in
the on line shared files. All policies will be available to each staff member and may be
viewed at anytime on their computer.
9. The staff that will be affected by the new or changed policy will be notified
immediately after the approval of the policy by the Health Director, Director of
Nursing and or the Columbus County Board of Health. The Quality Improvement
Coordinator will email the new or revised policy to the appropriate staff.
10. The staff will be required to review all new and revised polices that affect their clinical
area, staff requirements, patient care responsibilities, and personnel matters.
11. After reviewing the policy each staff member will be required to sign and date the
specified Policy Review Sheet effective 3/25/2010 which will be located in a Policy
Review Manual located in the Library. If the staff has any questions they are to
address this with their immediate supervisor, and if any changes are needed the
supervisor will then forward the information to the QI Coordinator for policy revision.
12. There will be listing of all approved new and revised policies available at each of the
monthly staff meeting to ensure staff awareness.
13. Effective March 8th, 2010 a copy of the old or revised policy will be sent the ‘Old File
Folder” on the “U” drive. The file identifier shall include DTOF (date to old files) with
the date identified.
14. Health Department policies and procedures are reviewed on an ongoing basis, but at least
annually by the Health Director, Director of Nursing, Medical Director and Board of Health
Chair Person.
15. Annual reviews and approvals are evident by official signatures and dates noted on the
cover page of each departmental and administrative policy book.
16. Employee Signature Sheets for review of new or revised policies will be kept in the Library.
27
Levels of Authority for Approval of Policies/Procedures:
Columbus County Board of Commissioners
Fees and fee schedules
Columbus County Board of Health
Personnel and fiscal policies/procedures,
Local Rules, BOH policies, Fees and fee
schedules
Local Health Director
Management and department-wide policies
Director of Nursing
Clinical policies/procedures all programs
Medical Director
Standing orders and clinical medical policies
Environmental Health Supervisor
EH specific policies/procedures
Program Coordinator/Specialist/Supervisor
Program specific policies/procedures
Laws and Rules:
Reference(s):
28
Policy Title:
Appeals Policy
Program Area:
All Areas
Policy Identifier:
(optional)
Approval Date:
Administrative
Section II – Personnel
Pages 7.0-7.4
2/24/2010 BOH
Effective Date:
Revision Date(s):
Approved by:
Kim Smith RN, BSN, MSHCA, Health Director
Approved by:
Columbus County Board of Health
June 2008
September 15th 2009
Purpose:
This policy provides appeal procedures for career-status employees of the Columbus County Health
Department who have been separated due to a reduction-in-force, demoted, suspended, dismissed
or received a reduction in pay for disciplinary reasons. This policy also applies to employees who
believe they have been discriminated against because of age, sex, race, color, national origin,
religion, creed, political affiliation or disability; and for employees who believe they have been
denied protection or coverage of one or more of the federal employment laws including the
Americans with Disabilities Act, Family Medical Leave Act, Fair Labor Standards Act or the Age
Discrimination Employment Act.
Definitions:
No action involving demotion, suspension, or dismissal is to be taken against any employee for
disciplinary reasons until such action has been recommended to and approved by the Department
Director or his/her designee, except when, in the judgment of the supervisor, immediate suspension
is necessary. In no case will an employee be dismissed without approval of the Health Director and
without the furnishing of a statement, in writing, setting forth in numerical order the specific acts or
omissions that are the reasons for the disciplinary action, and a statement of the employee’s appeal
rights.
Responsibilities:
Health Director, Director of Nursing, Columbus County Board of Health
29
Procedures: List the detailed and sequential actions that must be executed to ensure that the policy is implemented.
Describe the “how, who when or where” through which the policy will be carried out.
The procedure will consist of the following steps:
STEP 1 – APPEAL TO DIRECTOR
In cases of involuntary separation due to a reduction-in-force, demotion, suspension, dismissal or
discrimination, or any alleged action as described in PURPOSE above, a career status employee has
the right to appeal to the Columbus County Health Department Director. The appeal must be made
in the form of a written request and must be received by the Director within 15 calendar days after
the alleged demotion, suspension, dismissal, alleged discrimination, alleged unlawful harassment
or denial of federal laws as described above occurred. The request must include the action(s)
being appealed, reasons the action(s) are perceived to be wrong, unfair, or offensive and a proposed
resolution or remedy. Upon receipt of the appeal, the Director will make arrangements for the
employee to present his/her case, if the employee so desires. The Director will issue a decision
within five working days and a written copy of this decision will be furnished immediately to all
parties concerned.
STEP 2 – APPEAL TO COLUMBUS COUNTY BOARD OF HEALTH
If the decision reached by the Director is not acceptable to the employee, he/she may request that
his/her case be presented to the Columbus County Board of Health for its consideration. This
request should be made in writing and submitted through the Director not later than 15 days after
receipt of the Director’s decision. The case will then be placed on the Board’s agenda at its next
regularly scheduled meeting. Facts surrounding the case will be presented to the Board and the
employee may speak to them if he/she so desires. After reviewing the case, the Board will consult
with whatever other sources it deems appropriate and render a recommendation to the Director
within five working days after having heard the appeal. The Director will issue a final agency
decision to the employee within ten (10) working days of receipt of the Board’s recommendation.
STEP 3 – APPEAL TO THE STATE PERSONNEL COMMISSION
If the employee is not satisfied with a final agency decision or is unable to obtain a final agency
decision within a reasonable length of time, he/she may file a written appeal to the State Personnel
Commission not later than thirty days after receipt of the final agency decision. The grievant shall
be informed in writing that an appeal to the State Personnel Commission may be made by filing
such a request with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC
27699-6714.
30
Section 1
(a) Appeals involving a disciplinary action, alleged discrimination, and any other contested
case arising under this Chapter shall be conducted in the Office of Administrative Hearings
as provided in Article 3 of Chapter 150B; provided that no grievance may be appealed
unless the employee has complied with GS 126-34. The State Personnel Commission shall
make a final decision in these cases as provided in GS 150B-36, except as provided in
subsection GS 126-37(b1) of this section. The State Personnel Commission is hereby
authorized to reinstate any employee to the position from which he/she has been removed,
to order the employment, promotion, transfer, or salary adjustment of any individual to
whom it has been wrongfully denied or to direct other suitable action to correct the abuse
which may include the requirement of payment for any loss of salary which has resulted
from the improperly discriminatory action of the appointing authority.
(b1) In
appeals involving local government employees subject to this Chapter pursuant to GS
126-5(a) (2), except in appeals in which discrimination prohibited by Article 6 of this
Chapter is found or in any case where a binding decision is required by applicable federal
standards, the decision of the State Personnel Commission shall be advisory to the local
appointing authority. The State Personnel Commission shall comply with all requirements
of GS 150B-44 in making an advisory decision. The local appointing authority shall, within
90 days of receipt of the advisory decision of the State Personnel Commission, issue a
written, final decision either accepting, rejecting, or modifying the decision of the State
Personnel Commission. If the local appointing authority rejects or modifies the advisory
decision, the local appointing authority must state the specific reasons why it did not adopt
the advisory decision. A copy of final decision shall be served on each party personally or
by certified mail, and on each party’s attorney of record.
(b2) The final
decision is subject to judicial review pursuant to Article 4 of Chapter 150B of the
General Statutes. Appeals in which it is found that discrimination prohibited by Article 6 of
this Chapter has occurred or in any case where a binding decision is required by applicable
federal standards shall be heard as all other appeals, except that the decision of the State
Personnel Commission shall be final.
If the local appointing authority is other than a board of county commissioners, local appointing
authority must give the county notice of the appeal taken pursuant to subsection (a) of this section.
Notice must be given to the County Manager or the Chairperson of the Board of County
Commissioners by certified mail within 15 days of the receipt of the notice of appeal. The county
may intervene in the appeal within 30 days of receipt of the notice. If the action is appealed to
superior court, the county may intervene in the superior court proceeding even if it has not
intervened in the administrative proceeding. The decision of the superior court shall be binding on
the county even if the county does not intervene.
31
Section 2
A contested case shall be commenced by filing a petition with the Office of Administrative
Hearings and, except as provided in Article 3A of Chapter 150B, shall be conducted by that office.
The party who files the petition shall serve a copy of the petition on all other parties and, if the
dispute concerns a license, the person who holds the license. A party who files a petition shall file
a certificate of service together with the petition. A petition shall be signed by a party or a
representative of the party and, if filed by a party other than an agency, shall state facts tending to
establish that the agency named as the respondent has deprived the petitioner of property, has
ordered the petitioner to pay a fine or civil penalty, or has otherwise substantially prejudiced the
petitioner’s rights and that the agency:
Exceeded its authority or jurisdiction;
Acted erroneously;
Failed to use proper procedure;
Acted arbitrarily or capriciously; or
Failed to act as required by law or rule.
The parties in a contested case shall be given an opportunity for a hearing without undue delay.
Any person aggrieved may commence a contested case hereunder.
A local government employee, applicant for employment, or former employee to whom Chapter
126 of the General Statutes applies may commence a contested case under this Article in the same
manner as any other petitioner. The case shall be conducted in the same
manner as other contested cases under this Article, except that the State Personnel
Commission shall enter final decisions only in cases in which it is found that the employee,
applicant, or former employee has been subjected to discrimination prohibited by Article 6 of
Chapter 126 of the General Statutes or in any case where a binding decision is required by
applicable federal standards. In these cases, the State Personnel Commission’s decision shall be
binding on the local appointing authority. In all other cases, the applicable appointing authority
shall make the final decision.
Policy adopted by
_________________________, Columbus County Health Director
_________________________, Chairperson, Columbus County Board of Health
, Date __________________
32
Laws and Rules:
NC General Statutes- Article 3 chapter 150B, 126-34. 15-B-36. 126-37(1b), 126-5 (a) (2), 150B-44,
Reference(s):
33
Policy Title:
Reduction in Force Policy
Program Area:
All areas
Policy Identifier:
(optional)
Approval Date:
Administration:
Page 34.0-34.3
9/15/09
2/24/2010
Effective Date:
Revision Date(s):
Approved by:
Kim Smith RN, BSN, MSHCA, Health Director
Approved by:
Columbus County Board of Health
11/2001
12/2006, 9/15/2009
Purpose:
Introduction
This policy establishes guidelines for the administration of a reduction-in-force in which employees
are separated due to curtailment of work, lack of funds, reorganization or other significant changes
in duties or organization.
Authority
The rules of the State Personnel Commission authorize the implementation of this policy and state
the essential elements required of Columbus County Health Department in planning and executing
a reduction-in-force. The rule is copied below. It is followed by agency policy for implementation.
The rule states the following:
REDUCTION-IN-FORCE
“For reasons of curtailment of work, reorganization, or lack of funds, the appointing authority may
separate employees. Retention of employees in classes affected shall be based on systematic
consideration of type of appointment, length of service and relative efficiency. No career status
employee shall be separated while there are emergency, intermittent, temporary, probationary,
permanent or trainee employees in their first six months of the trainee progression serving in the
same or related class, unless the career status employee is not willing to transfer to the position held
by the non-career status employee, or the career status employee does not have the knowledge and
skills required to perform the work of the alternate position within a reasonable period of
orientation and training given any new employee. A career status employee who was separated by
reduction-in-force may be reinstated at any time in the future that suitable employment becomes
available. The employer may choose to offer employment with a probationary appointment and
experience standard for the class to which he is being appointed.”
34
Definitions:
Policy
A career status employee of the Columbus County Health Department who is terminated in
accordance with the provisions of this policy and who has a satisfactory employment record will be
considered for any vacant positions for which he/she meets job specific qualifications as stated in
the job announcement. Copies of such job announcements will be forwarded to qualified
individuals in the address provided by the individual for a period of 12 months after the effective
date of termination. A career status employee who is separated due to reduction-in-force shall have
the right to appeal that action.
Responsibilities:
Health Director, Director of Nursing, Board of Health
Procedures:
35
COLUMBUS COUNTY BOARD OF HEALTH
NAME
EXPIRES
_________ TEL/EMAIL
Peggy Blackmon, R.N.
103 North Madison Street
Whiteville, NC 28472
Registered Nurse/Member
12/31/11
Franklin Boone
P. O. Box 261
Cerro Gordo, NC 28431
Educator/Public Member
12/31/13
910-654-3011(H)
Nicole Martin D.V.M.
606 Washington Street
Whiteville, NC 28472
Veterinarian/Member
12/31/12
910-642-3776 (W)
910-642-6152(H) C- 840-0739
910-642-7141 Ext 240 (B)
pblackmon@sccnc.edu
pblackmon@weblnk.net
Giles E. Byrd
Length of Term
1941 Giles Byrd Rd
Hallsboro, NC 28442
Commissioner Appointment
910-646-3365 (W)
910-840-6693
buddybyrd@gmail.com
Dr. Darryl J. Diefes
904 Spivey Road
Whiteville, NC 28472
Dentist/Member (Chairman)
12/31/11
910-640-2292(H) C- 207-1946
910-642-6500(B)
910-646-6305 (Lake)
910-642-7581(Fax)
ddiefes@ec.rr.com
Dr. George Floyd
1308 Canal Cove Road
Lake Waccamaw, NC 28450
Pharmacist/Member
12/31/12
910-646-6380(H)
910-642-1739(B)
gfloyd@crhealthcare.org
Patty Hobbs
867 Pocosin Road
Lake Waccamaw, NC 28450
Registered Nurse
12/31/13
910-840-0405 (C)
910-642-1798 (W)
pattyh52@yahoo.com
36
NAME
EXPIRES
TEL/Cell/ EMAIL
Dr. John Hodgson
PO Box 775
Whiteville, NC 28472
MD/Member
12/31/12
910-642-331(W)
Thomas R. Kirby, OD
34A McNeill Plaza
Whiteville, NC 28472
OD/Member
(call Sarah at office)
12//31/13
910-640-3286 (H)
910-641-0011 (W)
910-840-3160 (C)
oledock@aol.com
C. L. Tate, Jr.
12/31/11
P. O. Box 249
Lake Waccamaw, NC 28450
Forester/Real Estate/Public Member V-Chair
910-646-3068(H)
910-646-3764(B)
910-646-4429 (FAX)
640-7446 (CELL)
640-8106 C
clt@tateforestry.com
Kenneth Waddell
515 East 1st Street
Chadbourn, NC 28431
Educator/Public Member
12/31/13
910-654-3734(H)
kwaddell53@yahoo.com
37
Columbus County Board of Health
Regular Meeting
Schedule for 2011
February 23, 2011 6:00 P.M.
April 27, 2011 7:00 P.M.
June 29, 2011 7:00 P.M.
August 31, 2011 7:00 P.M.
October 26, 2011 7:00 P.M.
December 2011 TBA
38
Columbus County Health Department
Director Performance Review
Please provide your rating of the Director's performance over the last year, Excellent, Good,
Needs Improvement or No Opinion
Rating
1. Leadership in the Department
2. Leadership in the Community
3. Sensitive to diverse needs of the community
4. Motivation and enthusiasm
5. Strong advocate for Public Health
6. Delegates responsibility and authority, seeking staff input on
critical decisions
7. Keeps staff informed on key issues
8. Promotes an environment in which employees are recognized and
rewarded for achievement
9. Is willing to address difficult issues and, if necessary, make unpopular
decisions
10. Keeps Board of Health informed about all issues and conducts well
organized meetings
11. Establishes a realistic budget and manages it
effectively
12. Is effective in obtaining money from grant proposals as well as seeking
grant opportunities
Date: ____________________ Signature (optional):______________________
39
Columbus County Health Department
Management Team
Bonnie Burge
Charlene Bush
Martha Faulk
Sarah Gray
Bill Horne
Becky McDowell
Lorraine Matthews
Hilda Memory
Dwayne Sholar
Kim Smith
Theresa Smith
Management Team meets monthly on the 3rd Tuesday of each month
in the Downstairs Conference Room of the Health Department at
9:00am.
40
Kimberly Smith
Health Director
435-16-301
Hilda Memory
PHN Director I
435-50-401
Theresa Smith
PHN Director I
435-50-351
Patti Strickland
Physician Extender I
435-48-004
Mary Cherry
Physician Extender I
435-48-003
Vacant
Comm Hlth Asst
435-53-460
Lisa Cartrette
PHN III
435-50-130
Amy Smith
PHNI /MCC
435-50-124
Grant – no funds
PA IV
435-04-311
Sarah Gray
Hlth Edu
435-50-165
Tammie Robinson
SW II
435-40-054
Shirley Logan
PHN III
435-50-209
Tammy Lovett
PHN III
435-50-213
Carolyn Strickland
PHN I
435-50-116
Elizabeth Kinlaw
PHN III
435-50-212
Paul Long
PHN III 435-50-211
Vacant
PN II
435-50-136
Anneke Johnson
SW II
435-40-057
Claire Love P-time
PN II
435-50-107
Bonnie Burge
Admin Asst II
435-16-052
Charlene Bush
Acct Tech IV
435-01-301
Vacant
Grade 57
Dwayne Scholar
Medical Lab Technologist II
435-46-211
Sandra Harrelson
Acct Tech II
435-01-100
Vacant
Medical Office Asst
435-53-752
Randy Williams
Medical Lab Tech II
435-46-102
Sylvia Whitehead
PA IV
435-04-316
Becky Cline
Medial Office Asst
435-53-751
Sharon Bishop
Medical Lab Tech II
435-46-101
Office Work Unit Supv V
Vacant
435-04-402
Dominique Hammond
PA III
435-04-202
Brandy Burge
Public Info Asst IV
04-315
435-
Nutrition Program Director
Lorraine Matthews
435-52-501
Medical Office Asst
WIC Lab
435-53-753
Vicky Spivey
Office Asst IV
435-04-307
Janice Ford
PA III
435-04-218
Robert Strickland
Enviro Hlth Specialist
435-56-601
Stephanie Cartrette
Dental Asst
435-48-203
Joel Perez
Foreign Lang Interpreter
435-53-461
Crystal Monroe
PA III WIC
435-04-222
Neil Floyd
Enviro Hlth Prog Specialist
435-56-651
Jennifer McPherson
Dental Asst
435-48-201
Dale Croom
Prenatal
PA III
435-04-221
Sandy Cothern
Nutr II
435-52-303
Brandon Grigsby
Enviro Hlth Specialist
435-56-603
Tiffany Britt
Dental
Asst
Lynn
Jernigan
435-48-202
Becky McDowell
Patient Relation Rep IV
435-04-313
Adrian Williamson
PA III
435-04-223
David Bivens
Enviro Hlth Specialist
435-56-604
Dental Asst
Kim Solomon
435-48-204
Dana Bright
Patient Relation Rep IV
435-04-314
Sarah Potts
Nutr II
435-52-304
Kristie Priest
Enviro Hlth Specialist
435-56-605
Denise Nance
PA III
435-04-238
Donna Lesane
Nutr II 435-52-302
5-48-204
41
Kim Smith
Health Director
435-16-301
William Horne
Enviro Hlth Supv I
435-56-701
Martha Faulk
42
Healthy North Carolina 2020:
A BETTER STATE OF HEALTH
Click on link below
http://publichealth.nc.gov/hnc2020/docs/HNC-2020-FinalLowres.pdf
43
Columbus County Health Department
Community Health Assessment
December 2008
The Community Health Assessment is completed every four years. It is
complied by the Health Department and its community partners. Due to the
size of this document please see the completed assessment on the following
website:
www.columbus.org
On the left of the page click on “County Departments” (this is a dropdown list)
click on “Health Department”. Click on “Community Health Assessment for
Columbus County” in the middle of the page.
44
Columbus County Health Department Strategic Plan 2009 – 2013
Columbus County Health Department Strategic Planning Team used information from the 2008
Community Health Assessment and developed a four year Strategic Plan.
Mission Statement: To prevent disease, promote health and protect the environment for all citizens
and to continually assess and respond to the health needs of the community as a whole. Public
health looks not only at the individual but also the family and community. With regard to stewardship
of resources, public health strives for the most good for the greatest number of people.
Our Planning Team envisions an agency that strives to meet the following for the benefit of the health of Columbus
County:
Will become accredited and maintain accreditation standards
Will provide services driven by community need
Will develop and maintain a well trained staff
Will have a positive image in community
Will help improve health outcomes and quality of life
Will provide health information and health promotion
Will be fiscally responsible
Will improve communication and collaboration in the community
Will utilize best public health practices
Will support new technologies for efficiency & effectiveness
Will provide comprehensive emergency Public Health response
Will pursue funding to support and improve our services
Will be team oriented
The Team determined after review and analysis of factors that the following are:
Strengths
 Computer technology
 Educational and continuing education is promoted
 Innovative ideas are used and encouraged
 Team activities are promoted
 Access to bilingual staff
 Good relationship with contracted medical consultants

Enthusiastic, professional, positive staff
 Supportive Board of Health
 WIC & WiseWoman serve over 100% of assigned caseloads
 Staff is being cross trained
 Building strategic alliances with numerous agencies and organizations
 Successfully implemented state data bases(NCIR, NCEDSS, HIS)
 Evolving QA review process
 County immunization rates higher than state rates, lead rates lower than state rates
 Using alliances to address the county health rankings
Weaknesses
 Political issues often give negative tone to efforts of Public Health
 Grant Funding is low because of lack of matching funds
 Small staff must each wear many hats, leaves little time for special projects
 Lack of consistency and coordination of emergency planning because of turn over and absence of
County Emergency Manager(County EM Director now in place)
45




Columbus County is a rural county with very little industry, therefore few job opportunities with health
insurance
Lack of formal process for ordering of medical and other supplies(now in place, July 2010)
Lack of marketing of services in area newspapers and on the county website
Staff not using computer technology to their fullest potential
In the Community Health Assessment 2008 process, the Columbus County Human Services Coalition reviewed
survey results and data and determined the top ten health issues for the County. Then the Strategic Planning
Team from Columbus County Health Department chose four main priorities to address. They are:
1.
2.
3.
4.
Affordable Health Care
Cancer Reduction
Heart Disease Reduction
Reduce Obesity
Based on the priority choices, our Strategic Planning Team determined nine Goals for our new four-year Strategic Plan,
and then developed objectives for the activities in our action plan. The list follows:
Goals and Objectives
1. Reduce Cancer Rates in our County
a. Increase educational opportunities in the community about the dangers and risks associated with all
forms of tobacco and exposure to second hand smoke.
b. Provide information to community and staff on smoking cessation and tobacco use.
c. Provide information on various carcinomas as requested
2. Reduce Heart Disease
a. Promote/increase the number of walking trails available in community
b. Educate the general population on heart healthy eating and physical activity
c. Annually the health department will coordinate community outreach for Heart Health Month.
3. Develop qualified Public Health Workforce
a. Conduct yearly HIPAA training for all employees
b. Conduct yearly Cultural Competency/Title VI training for all employees
c. Promote training opportunities for all staff
d. Train employees on Customer Service
e. Educate New staff to Public Health and the 10 Essential Services
4. Increase Revenue Collections for Services
a. Promote credit/debit services
b. Continue payment agreements and set up specific timeline for monthly review
c. Get credentialed for ability to file other insurances
d. Annual training for coding/use of encounter forms
e. Continue presumptive eligibility
f. Continue to send delinquent accounts to debt set-off that have been reviewed in specific scheduled
timeline
5. Increase Public Health Awareness of Environmental Health Issues
a. Reduce exposure to unsafe food supplies & unsanitary environments in food, lodging, public
schools and child cares
b. Reduce exposures to disease from contaminated water supplies & malfunctioning septic systems
c. Reduce exposure to possible vector borne disease via mosquito control
d. Implement new Environmental Health software via use of laptops in the field
6. Prevent/Reduce Teen Pregnancy
a. Evaluate/increase family planning services for teens. Offer services at times convenient for teens
46
b. Provide community education events to assist/encourage teens in making wise contraceptive
choices including abstinence
7. Continue to Develop All Hazard Public Health Plan in collaboration with other agencies
a. Educate the community on what should be in emergency Preparedness Kits
b. Staff to remain current on ICS
c. Work regionally towards preparedness objectives
d. Review Crisis Communication Plan so that we will assure effective and timely dissemination of
information in time of crisis
e. Advocate regular meetings of LEPC – Local Emergency Planning Committee and actively
participate
f. Conduct/participate in a minimum of 2 Emergency Preparedness Exercises annually
8. Increase communicable disease reporting & understanding of reportable disease prevention and
control of these
a. Health Department will keep local providers updated as to most current CD laws using various
modes of communication
b. Health Department will educate on HIV especially with minorities to help reduce incidence of
HIV/AIDS
9. Promote services of the Health Department, health data, health issues to inform and help the public
a. Monthly informational columns in the newspaper educating/advertising services available
b. Advertise on community cable channel
c. Help community members by placing links to providers within their reach
d. Use Public Health week/month to educate/make public aware of preventive health and public health
services and impact
47
Goal 1: Reduce cancer rates in Columbus County
Objectives
Tasks/Action Plan
A. Increase educational
opportunities in the community
about the dangers and risks
associated with all forms of tobacco
and exposure to second hand
smoke
B. Provide information to the
community on smoking cessation
and tobacco prevention
C. Provide information on various
carcinomas as requested
CHA Priority: Cancer rates #2 leading cause of death
Responsible
Timeframe/ Completion
Persons
Date
Annually present written information
Health Educator,
Ongoing
on Red Dress Day to women in the
PHN, MCC, local
county regarding smoking hazards in
media
a least 2 new settings
Provide specific information on
different techniques used to promote
smoking cessation and tobacco
reduction annually by 2013
-As requested provide/promote
cancer awareness and prevention
annually through media, health fairs
and at child care centers/preschools
Health Educator,
MCC, PHN
Ongoing
Health Educator,
Ongoing
media, medical
providers, Healthy
Carolinians, school
nurses
Colposcopy Clinic patients increased, BCCCP patient screenings increased, county wide smoke-free buildings and
vehicles, decreased report time for PAP test
Goal 2: Reduce heart disease
death
Objectives
CHA Priority: Heart Disease leading cause of
Tasks/Action Plan
Responsible
Persons
Timeframe/
Completion
Date
A. Promote/increase the number of
walking trails available in the
community
- Identify existing trails and establish at
least 5 new trails in the community by
2013
Healthy
Carolinians,
Health
Department,
community groups
By year 2013
Add walking trail
info to website
-Develop physical activity and nutrition
brochure highlighting walking trails
B. Educate the general population on
heart healthy eating and physical
activity
- Produce and distribute 2 newsletters
with articles, recipes, etc. on nutrition
and physical activity
C. Annually coordinate community
outreach efforts for Heart Health Month
-Annually submit one article and
updates on CCHD’s website
-Distribute educational materials to all
Columbus County employees at their
staff meetings or via department heads
-Distribute educational materials to at
least one industry/agency in the
community annually; have them answer
heart health questions after receiving
information/education
48
Health Educator,
Healthy
Carolinians
Health Educator,
WIC, Hospital
Nutritionist, HD
staff
By year 2013
By year 2013
Ongoing
Ongoing
By year 2013
Goal 3: Develop qualified public health workforce
N/A
Objectives
Tasks/Action Plan
CHA Priority:
Responsible
Persons
-HIPAA privacy
coordinator and
security officer,
supervisors
Timeframe/
Completion Date
Annually (August –
September) Ongoing
A. Conduct HIPAA training annually
for all CCHD
Employees
-Ensure all employees complete HIPAA
training annually. Document completion on
employee’s record of continuing education
and development log
B. Conduct yearly Cultural
Competency/Title VI training for all
employees
-Ensure that all new hires complete Title IV
training; All employees to complete cultural
diversity training. Document completion on
“Employees Record of Continuing
Education and Professional Development”
log
Supervisor, Heath
Educator
Southeastern
Community
College staff
Begin January 2010
Completed March
2010 And Ongoing
C. Promote training opportunities to
all staff
-Identify and document training needs of all
staff during annual job assessment. Post
available trainings
Supervisor,
Employee
Ongoing
Supervisors,
Health Director
Ongoing
Supervisors,
Health Educator
Begin September
2009 and ongoing
Supervisor, Health
Educator
Begin September
2009 and ongoing
-Discuss available trainings and encourage
employees to take advantage of continuing
education relevant to their jobs
D. Train employees on customer
service
-Ensure that all new hires complete
“customer service training” offered within
one year of hire date; document on new
hire checklist
-Additional trainings as needed for staff;
document completion on employee’s record
of continuing education and development
log
E. Educate new staff to public
health and the 10 essential services
-Ensure that all new hires complete
orientation within one month of hire date;
document on new hire orientation checklist
49
Goal 4: Increase revenue collection for services
Objective
Tasks/Action Plan
A. Promote credit/debit services
B. Continue payment agreements
and set up specific timeline for
monthly review
CHA Priority: Affordable health care
Responsible
Timeframe/
Persons
Completion Date
-Educate patients on the many payment
Patient Relation
Daily and ongoing
options at CCHD
Rep IV
-Continue current practice of establishing
Patient Relation
Daily and ongoing
payment agreements when balance is not
Rep IV
paid in full
Ongoing
-Debt setoff will be explained to all clients
Debt set-off language
when establishing payment agreement;
added to payment
continue process of notifying clients
agreement form 2010
through monthly statements/billing of debt
setoff plan
Monthly and
-Establish system for payment agreements
ongoing
to be reviewed on a monthly basis for
compliance
-HIS implementation will allow accounts
receivable reports to be monitored on a
monthly basis; HIS will allow usage of one
accounts receivable system
Begin as soon as
HIS is rolled out
Began May 2010
C. Get credentialed for ability to file
other insurances
-Monitor insurance claims and re-file denied
claims with in a specific time period of
eligibility for reimbursement
D. Annual training for coding/use of
encounter forms
-Ensure new hires are trained on coding as
part of orientation. Attend additional training
annually if available
Patient Relation
Rep IV, Health
Director, PA IV,
communication
with DSS staff
Nursing
Supervisor, PA,
IV, PHN
Monthly and ongoing
(Medicare pending,
need Tricare and
others as changes
occur)
Ongoing
-Continue to review coding methods with
nurse consultant
Ongoing
E. Continue presumptive eligibility
-Continue to identify clients for presumptive
eligibility and complete submit completed
forms to DSS next day
F. Continue to send delinquent
-Accounts reviewed on a quarterly basis
accounts to debt set off that have
assuming the debt meets all requirements.
been reviewed in scheduled
Payment agreements will also be reviewed
timeline
for compliance.
Debt set-off being billed on an annual basis 2009
Goal 5: Increase awareness of public health environmental issues
Objectives
Tasks/Action Plan
50
Nursing
Supervisor,
Admin, Assistant
1, RNs, clerical
staff
Interpreter, Patient
Relation Rep IV,
PA III
Communication w/
DSS staff
Patient Relation
Rep IV, Health
Director
CHA Priority: N/A
Responsible
Persons
Daily and ongoing
Completed annually
be December 15th
Timeframe/
Completion Date
A. Reduce exposure to unsafe food
supplies and unsanitary environments
in food, lodging, public schools and
child care centers
-Inspect 100 % of all food service, lodging,
and child care centers as required using
risked based methodology and make
revisits to establishments with recurring
critical violations to ensure compliance;
document corrective educational
information for each
Food and
Lodging Staff
-Assist in offering 2 food safety training
courses annually for all food service
workers
- Upon request from individual day care
centers, Southeast Resource &Referral or
Smart Start, presentations will be offered
on specific topics
- Post monthly scores of facilities in the
paper and on website
Daily and ongoing
100% inspected 2009,
2010
Classes completed
annually by
November 15th
Food and
Lodging
Staff/Cooperativ
e Ext.
Food and
Lodging Staff
Ongoing
To MIS staff by 5th of
each month; C. Bush
& V. Hufton to
create spread
sheet for website
EH Supervisor
County MIS
staff, Admin
Asst II
B. Reduce exposures to disease from
contaminated water supplies and
malfunctioning septic systems
-Maintain state well program
OSWW Staff,
NCDERNR
Ongoing
-Within 5 days increase response times to
wastewater complaints
OSWW Staff
Ongoing
-Increase surveillance for failing systems
by visual inspections of subdivisions,
website information/newspaper ads asking
citizens to report any failures, as well as
follow up compliance visits and legal
action as necessary
-Promote Health Department website for
access to sanitation information to public
via signage and discussions with
customers; placing EH website address on
business cards, applications, letterhead
OSWW
Program
Specialist
EH Supervisor,
OSWW staff,
EH Supervisor,
IT
All EH staff
51
Waiting/Prepared for
county regulations to
pass on MH,
subdivisions
-ongoing,
passed began 2010
January 2010
ongoing
C. Reduce exposure to possible
vector borne disease via mosquito
control
-Continue to reduce potential mosquito
illness with Integrated Pest Management
practices by maintaining 1 sentinel flock
and monitoring areas of the county that
have documented prevalent mosquito
population; recommend/implement
methods to reduce breeding areas
Mosquito
Control
Staff/Health
Educator
-Increase public awareness through
education materials to grade school
children annually. Also provide at least 2
news articles and presentations to at least
2 civic groups annually
Mosquito
Control
Staff/Health
Educator
-Will participate in community health fairs
D. Implement new Environmental
Health software via use of laptops in
the field
Purchase new software, implement
software. Purchase new laptops
Mosquito
Control
Staff/Health
Educator
All
Environmental
Health Staff
Ongoing
Beginning April 2010
Newspaper articles
completed 2010
Ongoing
Begin September 2009,
2 laptops per year
begin 2010 until 6
have been purchased
Refurbished 2 laptops
from Home Health
July 2010 now only
1 working
January 2011
Mosquito Control funding cut totally out by state 2009/2010 and for 2010/2011
Goal 6: Prevent/Reduce teen pregnancy
Objectives
Tasks/Action Plan
A. Evaluate increase family planning
services for teens. Offer services at
times convenient to teens
B. Provide community education
events to assist/encourage teens in
making wise contraceptive decisions
including abstinence
CHA Priority: Affordable health care
Responsible
Timeframe/
Persons
Completion Date
-Develop and implement special teen
Health
Beginning October
brochure to give at appointments and give Educator, FP
2010
to 100% of teen clients
staff, School
Ongoing
Nurses, SCC
Officials,
-Provide at least 2 educational sessions to
churches within the community annually
-Develop and provide educational
materials specific to teen family planning
services and distribute materials to at least
2 community events annually
Health
Educator, FP
staff, Faith
Based
Community
Beginning January
2010
FP staff, Health
Educator,
Columbus
County Schools,
Whiteville City
Schools, Private
Schools
3 year Teen Pregnancy grant received in partnership with Columbus County Schools
52
Beginning January
2010
Hope to use “social media” to educate Teens
Goal 7: Continue to develop all hazards in public health plan in collaboration with other agencies CHA Priority: N/A
Objectives
Tasks/Action Plan
Responsible
Timeframe/
Persons
Completion Date
A. Educate the community on what
-Offer family emergency preparedness
Preparedness
Ongoing
should be in Emergency
presentations/information
Coordinator,
Preparedness kits
Emergency
Management,
PHRST Team,
Red Cross
B. Staff remains current on ICS
-Develop and institute a training plan for
Preparedness
Updated every 3
any additional/newly required ICS
Coordinator,
Years (next update
trainings for staff
Health Director
due in 2011)
-Incorporate ICS structure into exercise or
events(ex. mass vaccination clinics,
communicable disease outbreaks) to
apply knowledge and reinforce learning
Preparedness
Coordinator,
Health Director
-Ensure all staff has completed minimum
level of ICS training within 6 months by
maintaining a database, copies of
certificates of completion
B1. Ensure all new employees
complete ICS training per the level
determined by the Health Director
-Take IS-120A HSEEP- Homeland
Security Exercise and Evaluation Program
online
-Implement 120A HSEEP skills by
developing exercises and AAR’s (After
Action Reports) and CAP(Corrective
Action Plans)
B2. Learn IS-120A HSEEPHomeland Security Exercise and
Evaluation Program, 5
modules(introduction, online)
C. Work regionally towards
preparedness objectives
-Continue partnership with PHRST 2
Preparedness Coordinators on updating
SNS to reflect latest TAR(Technical
Assistance Review) from CDC; assist to
develop increased regional approach plan
Used during every
“flu” clinic annually
Ongoing
Preparedness
Coordinator,
Supervisors,
Health Director
Preparedness
Coordinator,
DON, Health
Director, Home
Health Super
Ongoing
Completed 2010
Preparedness
Coordinator,
DON, Health
Director
Preparedness
Coordinator
Ongoing
Preparedness
Coordinator,
Health Director
Preparedness
Coordinator,
Health Director,
Epi team
Preparedness
Coordinator,
Health Director,
Ongoing
Ongoing
-Attend quarterly regional advisor
committee meetings
D. Review crisis communication plan
to ensure effective and timely
dissemination of information in crisis
E. Advocate for, attend, and actively
participate in LEPC(Local
Emergency Planning Committee)
-Review the crisis communication plan
utilizing available guidance; add to the
communication media policy and review
annually
-Work with county emergency manager to
maintain a viable LEPC
53
Annually and ongoing
Plan updated 2010
Quarterly and ongoing
F. Conduct/participate in a minimum
of 2 Emergency Preparedness
exercise annually
-Annually exercise part of/whole SNS plan
and use data from corrective action plan to
make revisions necessary
-Participate in regional preparedness
exercises, when available
-Annually exercise part of/whole Pan Flu
Plan, use data from corrective action plan
to make revisions
Emergency
Management
Preparedness
Coordinator,
Health Director,
Emergency
Management,
Schools,
PHRST team,
Pharmacist,
Hospitals,
medical
providers,
CCHD BOH,
law
enforcement,
etc.
Ongoing
Completed 2009, 2010
Ongoing
Completed 2009, 2010
Ongoing
Completed 2009, 2010
Goal 8: Increase communicable disease reporting, understanding of prevention and control CHA Priority: Affordable
health care
Objectives
Tasks/Action Plan
Responsible
Timeframe/
Persons
Completion Date
A. Health Department will keep local
-Provide a link on CCHD website to the
Communicable
October 2009
providers updated on current CD
NC General Communicable Disease
Disease PHN,
laws using various modes of
Branch Epidemiology website
Health
communication
Educator, MIS
-Provide via email links to NC General
staff
Communicable Disease Branch
Epidemiology website and CDC website
Beginning October
for quick access to diseases
2009
Communicable
All computers
-Attend and distribute CD information at
Disease PHN,
Updated 2009
CRHS’s Medical Staff meeting annually
MIS Staff
-Maintain list of current fax numbers of
those responsible for reporting CDs at
each providers office
B. Health Department will provide
HIV education to minorities to
decrease HIV/AIDS incidence
-CCHD will increase HIV/AIDS educational
and outreach activities to the minority
-Place HIV Counter on webpage
54
January 2010
Communicable
Disease PHN,
Health
Educator,
Director of
Nursing, Health
Director
Communicable
Disease PHN,
Preparedness
Coordinator
Health
Educator, PH
Disease
Intervention
Specialist, CD
PHN
Community
Ongoing
Beginning December
2009 and ongoing
January 2012
Partners
Health Educator
Updated medical information x2 sent to medical providers in county via blast fax 2010
Goal 9: Promote CCHD services/data/issues
care
Objectives
Tasks/Action Plan
A. Submit monthly informational
columns in the paper educating/
advertising services
CHA Priority: Affordable health
-Management team will identify topics for
two articles per month highlighting CCHD
services
-Have a “hot topic” advertisement
spotlighting particular service per month
and promote DHHS advertisements on
county website
- Review CCHD brochure highlighting
services
Responsible
Persons
CCHD
Management
Team
Timeframe/
Completion Date
Beginning July 2009
Beginning January
2010
CCHD
Management
Team, Health
Educator, MIS
Staff,
Health
Educator,
Health Director,
Media Review
Committee
B. Advertise on community cable
channel
-Schedule 1 appearance on “SCC
Presents” highlighting CCHD services and
announce “hot topic” concept
C. Help community members by
placing links to providers within their
reach
-Add new web page to CCHD website and
list resources obtained in CHA
D. Use public health week/month to
increase public awareness of
preventive and public health services
- Educate the community about public
health week and services that impact
community via programs, website, have
annual exhibit in CCHD lobby highlighting
public health week topic
“52 Weeks of Wellness” (full page
newspaper health articles)
Hope to use “social media” to
promote public health services
Approved August, 2009
Updated January, 2011
55
Health
Educator, SCC
Presents Staff,
PHN Staff, HH
Staff
Environmental
Health Staff
Health
Educator, MIS
staff, PHNS
Beginning April 2010
Completed 2010
Health
Education,
CCHD
Management, all
staff
Beginning April 2010
and ongoing
Ongoing
Columbus County
State of the County Report 2010
"A Snapshot of Our Health"
Presented By:
Columbus County Health Department
304
304Jefferson
JeffersonStreet
Street
Whiteville,
Whiteville,NC
NC28472
28472
910-640-6615
Phone
910-640-6615 Phone
Columbus County NC Quick Facts
from http://quickfacts.census.gov
What is the State of the County Health SOTCH) Report?
(
High school graduates 68.6%
The SOTCH report is a supplemental report to the Columbus County
Community Health Assessment. The health assessment is conducted
every four years(2008 was the last one) and the SOTCH report is
distributed every year in between to report on any current updates
or information that pertain to our county's priority areas
(identified in the community health assessment). Our county's
priority areas are as follows:

Dr ug s/ S ub sta n ce A b u s e

Access to Care

Heart Disease
Median household income $33,329


Persons below poverty 21.9%


Population
Population Facts
White
African American
American Indian
Hispanic
54, 212
65%
30.4%
3.3%
3.5%
Unemployment Rate for Columbus
County (as of September 2010) 11%
Leading Causes of Death in Columbus
County(2008, NC State Center Health
Statistics)
1. Heart Disease
2. C anc er
3. S t r o k e
4 . Chronic Lower Respiratory
Diseases
5 . M o t o r V e h ic l e I n j u r i es
6. All other unintentional Injuries
7, Diabetes
8. Alzheimer's Disease
9. S e p t i c e m i a
10. Nephritis, Nephrotic Syndrome,
Physical Activity/Nutrition
Infectious Diseases
U ni nte nt io na l Mot or V ehi c le In j ur ies
Diabetes
The full 2008 health assessment report and the latest SOTCH
reports can be viewed at :www.columbusco.orq/dotnetnuke 2/health
Did you know?
 Minorities in Columbus County die from heart disease, cancer,
stroke, diabetes, at significant higher rates than whites
 Only 41% of residents report being physically active*
 Tuberculosis rates have increased in Columbus County in the past
four years


67.3% of Columbus County children are on free or reduced lunch
36 % of residents are overweight*

1381 of our county's youth ages 0-17 are estimated to have
severe emotional disturbances
Information provided by North Carolina State Center for Health Statistics
*Regional Data, North Carolina State Center for Health Statistics
Got Questions?
56 Call 910-640-6615 ext.362
North Carolina
Public Health ____
Updates on Healthy Carolinians Priority Areas
 Drugs and Substance Abuse remains a "hot topic" among residents. Our Healthy Ca rolinians Partnership
continues to work with Southeastern Regional Mental Health to address ways to better serve our residents.
Southeastern Regional Mental Health has recently began exploring the possibility of offering Columbus
Regional Healthcare System's Emergency Department patients access to psychiatric and
addiction/treatment specialists. In addition, Allied Home Health has secured funding to provide non insured
residents with access to drug and substance abuse counselors at little or no cost. The Co lumbus County
Community Health Center and the Columbus County Dream Center also provides referrals to patients who
need drug and substance abuse counseling and they provide education about the dangers of substance abuse
to residents.

Access to Care- The Columbus County Community Health Center is currently undergoing renovations to
expand and it offers health programs to migrant farm workers. The Columbus County Health Department's
Mobile Dental Unit continues to provide school children with dental screening s. Columbus County Healthy
Carolinians have distributed discount prescription cards, provided blood sugar, cholesterol, and blood
pressure screenings, and free dental check-ups and vanishings. These services have been coordinated with
the Mobile Medical and Dental Care Van, Incorporated at various community events.
Recently, the N.C. Department of Health and Human Services announced that it will be collaborating with
Community Care of North Carolina Inc., Blue Cross Blue Shield of North Carolina, and the St ate Health Plan
for Teachers and State Employees in a three -year multi-payer Advanced Primary Care Practice
Demonstration. The funding for the partnership comes from the federal Center for Medicare and Medicaid
Services. Columbus County will be one of the grant project sites, thus improving health access and care for
our rural county.
 Heart Disease- The Columbus County Board of Commissioners passed a smoking policy that prohibits
smoking in county buildings and cars.
 Physical Activity/Nutrition- The Columbus County Health Department was awarded an ACHIEVE grant to
work with faith organizations to promote physical activity and/or nutrition policies and will hold a faith and
health summit on January 29, 2011 in which Robeson and Bladen County churches will als o be invited to
attend. As part of the ACHIEVE grant process, our ACHIEVE gra nt team has collected data for the
Centers of Disease Control and Prevention's CHANGE tool to determine and identify the number of existing
policies and environments that are in p lace in our county that address physical activity, nutrition, and
tobacco. The Columbus County Health Department also adopted an exercise policy for employees to increase
physical activity by allowing them 15 extra minutes, 3 days a week. Signage to promot e physical activity
awareness has been distributed to all Columbus County Departments to post. Exercise classes are currently
being offered to county employees and to one county faith based organization. In addition, 3 faith
organizations and one child care center have marked and posted walking trail signage. There have also been 4
other additional community use walking paths established in the county, provided by Columbus County
Healthy Carolinians Partnership. A community Physical Activity and Nutrition C oalition has been formed
which is a part of the Columbus County Farmer's Market.
A worksite health survey was distributed to county employers to determine interest in adopting policies and
environmental changes to improve their employee's health. Currently , the Columbus County Health
Department is working to provide follow -up and technical assistance to those worksites that expressed
interest.
Whiteville City Schools has a USDA health and nutrition grant to increase fruit and vegetable consumption
among students.
57
Whiteville City Parks and Recreation is conducting a community assessment to determine resident
interest in current and/or potential new programs and will also be offering residents the
opportunity to walk indoors at their recreation facility duri ng the winter months and cold weather.
The Columbus County Farmer's Market is a 21st century Farmer's Market SNAP EBT( accepts Visa,
MasterCard, EBT cards, etc) participant - it is one of seven in the state that is a part of this
program.

Infectious Diseases- The Columbus County Community Health Center has provided approximately
700 outreach and prevention educational opportunities to address Tuberculosis, HIV and
Sexually Transmitted Infections. The Columbus County Dream Center also offers HIV testing
and counseling to Columbus residents. The Columbus County Health Department offers an
Infectious Disease Clinic.

Unintentional Motor Vehicle Injuries-Strategic Prevention Framework - The Columbus County
Dream Center has a State Incentive Grant (SPF-SIG) grant to work on reducing the number of
motor vehicle injuries in Columbus County. They are currently working and providing DUI/DWI
checkpoints with Columbus County law enforcement and are providing education and outreach. The
News Reporter (county paper) supported and publicized the "Drive Alive" Campaign in May 2010 in
conjunction with the Columbus County Healthy Carolinians Partnership, North Carolina Highway
Patrol and local police departments to provide seat belt check points.
Four persons from the county have been trained to be Certified Child Safety Passenger Technicians
and have provided 3 child seat check point clinics at community events.

Diabetes- Columbus Regional Healthcare System is offering Diabetes Support groups to
residents. A Diabetes foot care clinic took place in November 2010. Once a year, residents can

visit Columbus County Health Department to receive a free blood sugar and cholesterol
screening and referrals will be made to the individual's heath care provider. In addition, the
Columbus County Healthy Carolinians Partnership is exploring additional funding opportunities to
increase our diabetes education efforts.
Cancer- Columbus Regional Healthcare System offers a breast cancer support group. The Wise
Woman and Breast and Cervical Prevention Program are continually offered at the Columbus
County Health Department.
Emerging Issues
This year has presented itself with many challenges for Columbus County. Our county was
ranked last in the state for health outcomes and we continue to face budget cutbacks to many of
our public health programs. Despite this, our county has created a new subcommittee under our
Healthy Carolinians group and is aptly named "Healthier Columbus." This group has hosted multiple
symposiums and meetings to share information with Columbus residents about what they can do to
make our county healthier. We have recently collected data asking county agencies to share what
they are currently doing to improve the county's health and this information is posted on the
Columbus County Health Department's website. We also hosted a Healthier Columbus Summit where
over 75 agency representatives attended, and a large majority of the attendees signed pledges of
what they would commit to in order to improve the health of their agency or orga nization. The
Healthier Columbus group is providing follow up and technical assistance to these individuals.
Regular updates are provided to the Healthy Carolinians Partnership from this group.
58
Another initiative to improve the health of our county includ es six representatives chosen to
participate in the 12th cohort of the University of North Carolina at Chapel Hill's Management
Academy for Public Health. This group's proposed five year plan is to secure and build a
community wellness center that will serve all Columbus residents. We have approached the North
Carolina Blue Cross Blue Shield Foundation to assist us in strengthening our plan and to bring
community leaders together to make our dream a reality.
Information and Updates on Columbus County Healthy Carolinians
The Columbus County Healthy Carolinians Partnership has been in existence for over 15 years with a
mission to "coordinate and facilitate the "process" of ''connecting" county -wide health initiatives in an effort
to "build the capacity" by pooling resources, eliminating duplication and ultimately creating an environment
that supports "total health".
The Columbus County Healthier Carolinians Partnership is also currently working with the North Carolina
Department of Health and Human Services in a coalition building assessment and planning project. We are
surveying partnership members to determine partnership areas that need to be addresses so that the
Columbus County Healthy Carolinians Partnership continues to grow and prosper. For more informat ion,
please contact Beth Brown, at 910-641-3673 or at bbrownecrhealthcare.
Did you Know?

All seven Columbus County Council on Aging sites are offered health education and information on a
monthly basis, provided by the Columbus County Healthy Carolinians P artnership's Director.

West Columbus High School is participating in a teen pregnancy prevention grant. The grant is a
collaborative effort between Columbus County Schools and the Columbus County Health Department.
The News Reporter is running "52 Weeks of Wellness" articles in its Monday editions. Be sure to check it
out to get health information and health tips.






Organizations, residents, and agencies can request speakers or health information at any time by calling
the Columbus County Health Department at 910-640-6615 or by calling the Columbus County Healthy
Carolinians Partnership at 910-641-3673.
The Columbus County Farmer's Market provides a wide array of fresh fruits and vegetables and
even has provided schools with access to the farmer's market for e ducational presentations.
A master list of Columbus County agencies and organizations current offerings and programs to
promote healthier lifestyles is available at http://www.columbusco.org/DotNetNuke_2 and see
"Columbus County Health Rankings Report."
Chadbourn Elementary and Middle Schools are currently involved in a Safe Routes to School grant.
Visit www.dropaton.org or www.takethelake.org for useful health information and information about the
annual Take the Lake events.
This report was compiled by: Sarah Gray, Columbus County Health Department 910-640-6615 ext.362/5arah.gray@columbusco.org
Columbus County
HEALTHY
CAROLINIANS
BUILDING
SUCESSFUL
PRATNERSHIPS
N or th Ca rolin a
Public Health