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www.wakegov.com
Wake County Human Services Board October 25, 2012
AGENDA Human Services Center
220 Swinburne St., 2nd Fl., Rm. 2132 Standing Time: 7:30AM – 10:00AM
Dianne Dunning, Chair Pablo Escobar, Vice Chair
Purpose: Advocacy, Policy, Advisory, Accountability
--James A. Smith, III, MD, (Psychiatrist) - Oct. 2, 2012 - Nov. 14, 2015
8:05 am Elections of 2013 Board Officers
8:15 am Public Health Committee: Mr. Benny Ridout, Chair
• Review/Discuss Public Health Quarterly Report (Apr.-Jun 2012) - (#2.4) - Dr. Edith Alfano, Epidemiologist & Ms. Sue Ledford, PH Administrator
8:30 am Board Interviews:
8:30am - John H. Myhre, (Pharmacist) 9:00am - Rosine L. Sanders, (Psychologist)
7:30 am Meeting Called to Order
Invocation
Approval of Minutes: September 27, 2012
Next Board Meeting: November 15, 2012 (**3rd Thursday)
7:35 am Oath of Office - Commissioner James West
7:40 am Recognition of Departed/Departing Board Members: 1. Kent Earnhardt: Feb. 15, 2010 - Aug. 01, 2012
2. Richard G. Greb: Aug. 02, 2004 - Aug. 01, 2012 3. Jeffrey K. Smith: Mar. 21, 2005 - Aug. 01, 2012 4. Burton A. Horwitz: Nov. 15, 2004 - Nov. 14, 2012 5. Benny Ridout: Jun. 24, 2004 - Nov. 14, 2012
7:55 am Recognition of Dr. Peter Morris Dr. Morris has been appointed Executive Director of Urban Ministries effective December 4, 2012. A Human Services Reception will be held November 30
th,
2:30pm – 4:30pm, Rm. 5032
Regular Agenda
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9:25 am Discussion of Candidates/Recommendations
9:40 am Board Operating Procedures:
• Review Example of a Committee Structure. (Collect Feedback from Board and Committees)
Human Services Mission Statement
Wake County Human Services in partnership with the community will anticipate and respond to the public health, behavioral health and the economic and social needs of Wake County residents. We will coordinate and sustain efforts that assure safety, equity, access and well-being for all. - December 2006 _____________________________________________________________________________
Environmental Services Mission Statement
To protect and improve the quality of Wake County’s environmental and ensure a healthy future for its citizens through cooperation, education, management and enforcement. Environmental Services combines:
• water quality
• air quality
• solid waste (recycling, landfills, etc.)
• environmental health and safety (sanitation inspections, pest management, swimming pool regulations, animal control)
________________________________________________________________
FY 2011 Board’s Top Six Priorities:
#1 Prevent Child Abuse and Support Families
#2 Housing for Vulnerable Populations
#3 Obesity Prevention and Nutrition
#4 Access to Mental and Physical Health Services
#5 Protect Wake County’s Water Resources
#6 Human Capital Development (added 10/28/10)
9:55 am Chair's Report
10:00 am Adjournment
Information Items:
--Information Update on Duke Foster Care Study (no action required)
--WCHS Budget Update
--Reminder: WCHS Employee Recognition Event: Nov. 14, 1-4pm, Commons Bldg.
Human Services Board Quarterly Meeting Schedule
Note: HS Board Meeting moves to 3rd Thursday in November and December.
November 2012
SunSunSunSun MondayMondayMondayMonday TuesdayTuesdayTuesdayTuesday WednesdayWednesdayWednesdayWednesday ThursdayThursdayThursdayThursday FridayFridayFridayFriday SatSatSatSat
1 2
9am-10:30am Social Services, Rm. 5032
3
4
5
BOC 2pm----
6 7 8
8am – 10am Bd. Executive
Cmte. Mtg.. Rm. 5032 __________
10am – 11am Regional Networks Cmte., Rm. 5040
9
11:30am – 1:30pm
Environmental Services – Library Admin., 4020 Carya Dr.
10
11
12 (County Holiday) 13 14 15
7:30am – 10am HS Board
Mtg. Rm. 2132 __________
3:30pm – 5:15pm - Housing
Cmte., Rm. 5032
16
Noon – 2pm
Public Health, Rex Women Ctr., Rm. 100B
17
18 19
BOC 2pm----
20
21 22 (County Holiday)
23 (County Holiday) 24
25 26
12:45pm – 2pm HRC – Rm. 5032 (tentative)
27 28 29 30
Note: HS Board Meeting moves to 3rd Thursday in December.
December 2012
SunSunSunSun MondayMondayMondayMonday TuesdayTuesdayTuesdayTuesday WednesdayWednesdayWednesdayWednesday ThursdayThursdayThursdayThursday FridayFridayFridayFriday SatSatSatSat
1
2 3
BOC 2pm----
4 5 6 7
9am-10:30am Social Services, Rm. 5032
8
9
10
11 12 13
8am – 10am Bd. Executive Cmte. Mtg., Rm. 5032
14
11:30am – 1:30pm Environmental Services –
Library Admin., 4020 Carya Dr.
15
16 17
No BOC Mtg.-
18
19 20
7:30am – 10am HS Board
Mtg. Rm. 2132 __________
3:30pm – 5:15pm - Housing &
Cmty. Revitalization, Rm. 5032
21
Noon – 2pm
Public Health, Rex Women Ctr., Rm. 100B
22
23 24 (County Holiday)
12:45pm – 2pm HRC – Rm.
5032 (???)
25 (County
Holiday)
26 (County
Holiday) 27 28 29
30 31
January 2013
SUN MON TUES WED THURS FRI SAT
1 2 3 4 5
(County Holiday) 9am-10:30am Social Services,
Rm. 5032
6 7 8 9 10 11 12
8am – 10am Bd. Executive Cmte. Mtg., Rm. 5032
11:30am – 1:30pm Environmental Services –
Library Admin., 4020 Carya Dr.
13 14 15 16 17 18 19
3:30pm – 5:15pm - Housing & Cmty. Revitalization, Rm.
5032
Noon – 2pm
Public Health, Rex Women Ctr., Rm. 100B
20 21 22 23 24 25 26
(County Holiday) 7:30am – 10am HS Board Mtg. Rm. 2132
27 28 29 30 31
12:45pm – 2pm HRC – Rm.
5032
Assignments to Committees
Executive
Committee 2nd Thursday
8am – 10am
Rm. 5032
Community and
Public Health 3rd Friday, noon
Rex Women Ctr.
Environmental
Services 2nd Fri., 11:30am, Library
Admin. Carya Dr.
Social Services 1st Friday
9am – 10:30am
Rm. 5032
Dianne Dunning
Pablo Escobar
Frank Eagles
Leila Goodwin
Paul Norman
Benny Ridout
Staff:
Regina Petteway
Joe Durham
Ramon Rojano
Joseph Threadcraft
Bob Sorrels
Matt Roylance
Benny Ridout
Burton Horwitz
Sharon Foster
Staff:
Michelle Ricci
Sue Lynn Ledford
Brent Myers, EMS
Peter Morris
Regina Petteway
Andre Pierce
Matt Roylance
Yvonne Torres
Community:
Laura Aiken
Kevin Cain
Barbara A. Hughes
Anne McLaurin
Leena Mehta
Ann Rollins
Heidi Swygard
Penny Washington
Leila Goodwin
Dianne Dunning
Frank Eagles
Benny Ridout
Staff:
Joseph Threadcraft
Sue Lynn Ledford
Deborah Peterson
Andre Pierce
Matt Roylance
Community:
Rodney Dickerson
Les Hall
Glenn Harris
Suzanne Harris
Don Haydon
Bryan Hicks
Lana Hygh
Buck Kennedy
Jacob Reynolds
Bob Rubin
Henk Schuitemaker
Paula Thomas
Liz Turpin
Kenny Waldroup
Julie Wilkins
Phillip White
John Whitson
Paul Norman
Burton Horwitz
Julian Smith
Staff:
Katherine Williams Giang Le
Liz Scott
Natasha Adwaters
Martha Crowley
Vielka Gabriel
Warren Ludwig
Jenny Wheeler
Community:
Lisa Bireline
David Cottengim
Pam Dowdy
Lisa Draper
Dudley Flood
Glenn Harsh
Marjorie Menestres
Rick Miller
John Parker
Bob Robinson
Georgia Steele
Lynn Templeton
Cherie Thierrault
Brandon Trainer
Tracy Turner
Angie Welsh
April Womack
Marc Zarate
Affordable
Housing &
Community
Revitalization 3rd Thursday
3:30pm – 5pm, Rm. 5032
Regional
Networks
Development Qtrly, Rm. 5040
Human Rights/
Consumer Affairs 4th Mon., 12:45-2pm
Rm. 5032
Dianne Dunning
Staff:
Annemarie Maiorano
Bob Sorrels
Community:
Emmett Curl
Steven Hess
Michele Grant
Teresa Piner
José M Serrano
Mark Shelburne
Trace Stone-Dino
Yolanda Winstead
Frank Eagles
Benny Ridout
Staff:
Darryl Blevins
Rosena West
Ross Yeager
Regina Petteway
Staff:
Matt Burton
Sharon Brown
Andre Pierce
Bob Sorrels
Community: Arsenio Carlos, ERC
Rev. Lenwood Long, NRC
Eugenia Pleasant, NRC
Lunette Vaughan, SRC
Pablo Escobar
Osama Said
Staff:
Brian Gunter
Leticia Mendez
Fabiola Sherman
Community:
Laura Goddard
Naima Moussa
Martha Pitts
Olivia Simons
Don Wiseman
Recognition to 2012 Departed/Departing Board Members
1. Kent Earnhardt February 15, 2010 – August 1, 2012 -Consumer & Family Advisory Committee -Human Rights/Consumer Affairs Committee -LME Advisory Committee
2. Richard G. Greb August 2, 2004 – August 1, 2012 -Chair, LME Human Rights Committee -Past Chair, Human Rights/Consumer Affairs Committee
3. Jeffrey K. Smith March 21, 2005 – August 1, 2012 -Consumer & Family Advisory Committee -LME Advisory Committee -Environmental Services Committee
4. Burton A. Horwitz November 15, 2004 – November 14, 2012 -Social Services Committee -Public Health Committee
5. Benny Ridout June 24, 2004 – November 14, 2012 -Chair, Public Health Committee -Regional Networks Committee -Environmental Services Committee -Board Advocacy Workgroup -Board Appeal Hearing Panel
SLATE for
2013 BOARD CHAIR and VICE CHAIR
Wake County Human Services Board (Open Nominations and Vote at the October 25 Board Meeting)
Nominations for Board Chair
Pablo Escobar Mr. Escobar has been nominated for the Office of Board Chair. Mr. Escobar is completing his
second term as Board Vice Chair (2011 and 2012). He is also Chair of the HRC/Consumer
Affairs Committee. He has been a member of the Board since December 2008.
Nominations for Board Vice Chair
Leila Goodwin Ms. Leila Goodwin has been nominated for the office of Board Vice Chair. She has served as
Chair of the Environmental Services Committee since her Board appointment in November
2010.
VOTING PROCESS:
Election of Chair and Vice-Chair will be held at the October 25 Board meeting. After opening
the floor for additional nominations, votes will be taken in open session for each office.
To be elected Chair or Vice-Chair, a candidate must receive a minimum number of votes equal
to a majority of the duly appointed and currently serving members of the Board. If no candidate
for an office receives a majority of the votes, a run-off will then be conducted between the two
candidates receiving the greatest number of votes.
EFFECTIVE DATE:
Terms for Board Officers take effect at the December Board meeting.
HUMAN SERVICES AND ENVIRONMENTAL SERVICES
BOARD AGENDA ITEM
Agenda Date: Executive Committee: October 11, 2012
HS & ES Board: October 25, 2012
Committee/Item: Public Health Committee/Public Health Quarterly Report April –June2012
Specific Action Requested: Receive Public Health Quarterly Report
Item Summary: The Public Health Quarterly Report is published by WCHS Public Health
Division. This report highlights communicable disease data and includes data from the second
quarter of calendar year 2012.
Purpose for Action (Proposed Solutions/Accomplishments):
Public Health Accreditation requires that “The local health department shall analyze and note
reportable events occurring within the community and shall report atypical incidence, if any, to the
Division and the local board of health” (Benchmark 2 Activity 2.4).
Next Steps:
Accept quarterly report and use as needed to inform discussions, decisions and advocacy efforts
related to public health.
Attachments: Public Health Quarterly Report April – June 2012
Opportunities for Advocacy, Policy or Advisory: (see next steps)
Connections to Other Committees: Environmental Services
W A K E C O U N T Y
H U M A N S E R V I C E S
P U B L I C H E A L T H
Q U A R T E R L Y R E P O R T
S P E C I A L E D I T I O N :
C O M M U N I C A B L E D I S E A S E S
A P R I L — J U N E 2 0 1 2
Wake County Human Services
Public Health Division
10 Sunnybrook Road
P.O. Box 14049
Raleigh, NC 27620-4049
www.wakegov.com
SEPTEMBER 17, 2012
P u b l i c H e a l t h Prevent · Promote · Protect
Ramon Rojano, Human Services Director
Sue Lynn Ledford, Public Health Division Director
Editor-in chief: Edie Alfano–Sobsey, Public Health Epidemiologist
Editorial Staff: Roxanne Deter, Public Health Nurse and
Carla Piedrahita, Public Health Educator
Design and Layout: Michelle Ricci, Public Health Educator
2 2
Table of Contents
Topic Page
Introduction 3
Wake County Communicable Disease Morbidity 2008-2011 4 & 5
Foodborne Illness 6
Tickborne Illness 6
Tuberculosis 7
Sexually Transmitted Diseases 8 & 9
Field Delivered Therapy 9 & 10
Hepatitis B 11
Acknowledgements 12
3 3
Introduction
Surveillance for Reportable Communicable Diseases in Wake County
Communicable diseases are illnesses caused by infectious agents (bacteria, viruses, parasites, fungi or prions) or their toxins that are transmitted from an infected person, animal, plant or from the environment. Because communicable diseases can have so much impact on populations, they are tracked and information analyzed (called surveillance) so that measures can be put in place for protecting the public's health. Certain communicable diseases are required by law to be reported to local health departments by physicians, school administrators, child care operators, medical facilities and operators of restaurants and other food or drink establishments (G.S. § 130A-135 through 130A-139). There are 71 “reportable” diseases specified in the N.C. Administrative Code rule 10A NCAC 41A .0101 (http://epi.publichealth.nc.gov/cd/index.html). After initial notification about a case or cases of a communicable disease, an investigation begins to collect details such as demographic, clinical, and epidemiological information. After verifying that a reported case meets the reporting requirements in the standardized case definitions, it is reported electronically to the N.C. Division of Public Health via the North Carolina Electronic Disease Surveillance System (NC EDSS) and then to the Centers for Disease Control and Prevention’s (CDC) National Notifiable Diseases Surveillance System. This report focuses on all reportable diseases that have been detected in Wake County during 2011 and information about selected reportable communicable diseases of public health significance for Wake County detected during 2012. Other diseases of public health significance for which reporting is not required except during outbreaks, for example norovirus infection, are not included in this report.
Wake County Human Services (WCHS), an
accredited health department, continues to strive
to perform the three core functions of assessment,
policy development and assurance and the 10
public health essential services (see Figure 1).
This report helps fulfill public health essential
services:
Number 1: Monitor health status to
identify community health problems
and
Number 3: Inform, educate, and
empower people about health issues.
Information is provided on a quarterly basis about
health and safety trends for Wake County
residents, providers, policy makers and
community partners to better inform decision
making. Strategies used by WCHS Public Health
programs and services to improve health
outcomes are also featured in these reports. For
additional information, point of contact
information is provided for each area.
Figure 1
4 4
Wake County Communicable Disease Morbidity 2008—2011
Wake County Communicable Disease Morbidity 2008-2011
Disease (A-I) 2011 2010 2009 2008
Campylobacter infection 49 64 45 50
Chancroid 0 1 0 0
Chlamydia 4962 4529 2891 3412
Creutzfeldt-Jakob Disease 1 1 4 0
Cryptosporidiosis 0 2 5 6
Cyclosporiasis 0 0 1 0
Dengue 2 2 0 1
E. coli-shiga toxin producing 31 11 13 17
Ehrlichiosis (Anaplasmosis, HME, Unspecified) 18 17 3 10
Encephalisits, arboviral, LaCrosse 0 0 2 0
Encephalitis, arboviral, other 0 0 1 0
Encephalitis, arboviral, West Nile Virus 0 0 1 0
Foodborne disease-staphylococcal 2 1 0 0
Foodborne poisoning (fish/mushroom/ciguatera) 0 0 13 0
Gonorrhea 1420 1249 804 1279
Granuloma inguinale 0 0 0 1
Haemophilus influenzae, invasive disease 9 11 12 10
Hemolytic Uremic Syndrome 0 1 2 1
Hepatitis A 2 2 6 15
Hepatitis B-Acute 4 4 7 5
Hepatitis B-Chronic 187 180 104 100
Hepatitis C-Acute 1 1 1 1
HIV** * 172 184 203
Influenza, adult death (18 years of age or more)*** 7 0 4 0
Influenza, NOVEL virus infection 0 0 144 0
Influenza, pediatric death (<18 years of age) 1 0 1 0
The table below shows the number of probable and confirmed disease cases in Wake County by
disease for reported cases 2008-2011. Reportable communicable diseases with NO reported cases in
the period 2008-2011 were not included. Because cases are routinely updated, case numbers may
change (data was extracted February 2012). Case definitions for these diseases are available at
http://epi.publichealth.nc.gov/cd/lhds/manuals/cd/toc.html.
Imported.
* HIV data for 2011 not available at the time of this report.
** HIV Disease includes all newly diagnosed HIV infected individuals by the date of first diagnosis regardless of
status (HIV or AIDS) and does not include cases that were unassigned due to diagnosis at long term care facilities
such as prison.
*** Influenza associated adult deaths became reportable in 2010.
Table 1
5 5
Wake County Communicable Disease Morbidity 2008—2011
Wake County Communicable Disease Morbidity 2008-2011
Disease (J-Z) 2011 2010 2009 2008
Legionellois 8 4 3 3
Leptospirosis 1 0 0 0
Listeriosis 1 1 3 2
Lyme Disease 15 17 5 8
Malaria 9 15 3 3
Meningitis, pneumococcal 4 2 1 1
Meningococcal invasive disease 3 1 0 0
Mumps 0 0 0 1
Non-gonococcal urethritis 514 372 291 351
Pertussis 6 19 10 12
PID 272 192 115 133
Rocky Mountain Spotted Fever 28 26 10 47
Salmonellosis 229 261 221 144
Shigellosis 11 14 10 18
Staph aureus, reduced susceptible to vancomycin (VISA/
VRSA) 0 0 0 2
Streptococcal invasive infection, Group A 27 13 10 8
Syphilis (Primary, Secondary, Early Latent) 76 83 116 45
Toxic Shock Syndrome, streptococcal 2 2 0 1
Tuberculosis 29 37 22 40
Tularemia 0 0 0 1
Typhoid Fever - acute 1 3 2 1
Vibrio infection (other than cholera and vulnificus) 1 1 1 0
Total 7933 7311 5071 5932
Data Source: NC Division of Public Health, Epidemiology Section, Communicable Disease Branch.
Table 1 Continued
Contact: Edie Alfano-Sobsey, Public Heath Division 919-212-9674 [email protected]
Chlamydia and gonorrhea represent the most frequently reported number of cases in Wake County.
6 6
Foodborne Illnesses
From April to June 2012,
salmonellosis (salmonella),
and campylobacter were the
most frequently reported
foodborne illnesses (see
figure 2) and Rocky
Mountain spotted fever and
Lyme disease were the most
frequently reported tickborne
illnesses (see figure 3) in
Wake County. “Reported
Investigations” represents the
diseases that were
investigated and reported in
NCEDSS by the
Communicable Disease
Surveillance Team from April
through June. “Reported
Cases” represent the
investigations that were
confirmed by meeting the
case definition and reported
into NCEDSS.
Tickborne Illnesses
Figure 2
The contrast between
“reported investigations”
and “reported cases” is due
to several variables
including length of time
needed for testing and
diagnosis to confirm
suspect cases and delayed
reporting. This is
particularly true for
tickborne illnesses because
diagnoses and case
confirmation is more
complicated compared to
foodborne illnesses.
Figure 3
Data Source: NC Electronic Disease Surveillance System, 9-11-12.
Data Source: NC Electronic Disease Surveillance System, 9-11-12.
Contact: Edie Alfano-Sobsey, Public Heath Division 919-212-9674 [email protected]
7 7
Tuberculosis (TB)
The body’s immune system is able to stop TB bacteria from multiplying in most people who
become infected with the bacteria. This is called latent TB infection (LTBI). TB bacteria can become
active and cause damage to the lungs and/or other body organs when the immune system is
weakened. This is known as active TB disease.
According to the CDC, people who have both HIV infection and latent tuberculosis infection (LTBI)
are 20 to 30 times as likely to develop active TB disease as compared to those who do not have HIV
infection. Worldwide, TB is the leading cause of death among people with HIV infection. Almost one
in four deaths among people with HIV infection is due to TB.
The CDC recommends that all people newly diagnosed with HIV infection be tested for TB as soon
as possible. Annual TB testing of people with HIV/AIDS should be considered for those with a
substantial risk of exposure to TB. In 2009, the CDC reported, that among persons with TB who had
a documented positive HIV test result, more than 10% (690 of 6,743) were co-infected with HIV.
From July 1, 2011 to June 30, 2012, 400 tests for TB were provided in the HIV clinic for 1013
different patients (WCHS Patient Care Management System annual report).
WCHS also offers TB testing at its non-traditional HIV/STD testing sites (NTS). NTS are
community locations throughout the county where HIV/STD and TB testing services would not
customarily be provided. These tests are provided in locations such as shelters, the Women's Center
and substance abuse centers for detection and early intervention in high risk populations.
Figure 4
Contact: Roxanne Deter, Public Health Division, 919-250-4637 [email protected]
0
20
40
60
80
100
120
Quarter 1 Quarter 2 Quarter 3 Quarter 4
6 6 5 6
2343
8697
0
6
72
FY 2012
Clients with Positive, Negative and Borderline Tuberculosis Screening Results from T-Spot Testing at Non-Traditional Testing
Sites
Wake County Human ServicesN=287
Borderline
Negative
Positive
WCHS Tuberculosis Program FY 2012 Program Data
8 8
Sexually Transmitted Infections (STIs)
To increase detection of and treatment for all STIs in high risk populations, testing services for HIV,
syphilis, chlamydia, gonorrhea, and hepatitis C are integrated by offering them at the same time to
clients at community, as well as clinical, testing sites. Table 2 shows the number of tests performed at
community sites and the positivity test rates for HIV, syphilis, gonorrhea, chlamydia and hepatitis C
by quarter from October, 2011 through June, 2012. Hepatitis C has been detected most frequently for
all quarters at the non-traditional testing sites and the substance abuse centers (Tables 3 and 4).
Chlamydia is frequently detected at all sites (Tables 2, 3 and 4). Enhanced testing is made possible
through the CDC Program Collaboration and Service Integration (PCSI) and other grant funding.
Table 2
Number of Tests and Test Positivity Rate (%) at Non-Traditional Testing Sites in
Wake County by Quarter October, 2011 through June, 2012
Oct—Dec 2011 Jan—Mar 2012 Apr—Jun 2012 Oct 2011—Jun 2012
Test
Number
Tested
%
positive
Number
Tested
%
Positive
Number
Tested
%
Positive
Total
Tested % Positive
HIV 680 0.4 743 0.1 603 0.2 2026 0.05
Syphilis 682 0.1 737 0 603 0 2022 0.05
Gonorrhea 500 1.4 511 1.4 414 1 1425 1.3
Chlamydia 500 9.6 511 9.2 414 8.9 1425 9.3
Hepatitis C 39 12.8 90 13.3 73 8.2 202 11.4
Data Source: Wake County Human Services HIV/STD Community Program
Number of Tests and Test Positivity Rate (%) at Substance Abuse Centers in
Wake County by Quarter from October, 2011 through June, 2012
Oct—Dec 2011 Jan—Mar 2012 Apr—Jun
2012 Oct 2011—Jun 2012
Test Number
Tested
%
Positive
Number
Tested
%
Positive
Number
Tested
%
Positive
Total
Tested % Positive
HIV 90 0 86 0 114 0.9 290 0.3
Syphilis 91 0 86 0 116 0 293 0
Gonorrhea 61 0 63 0 96 1 220 0.4
Chlamydia 61 0 63 1.6 96 7.3 220 3.6
Hepatitis C 76 15.8 48 21 53 13.2 177 16.4
Data Source: Wake County Human Services HIV/STD Community Program
Table 3
9 9
Sexually Transmitted Infections (STIs)
Table 4
Data Source: Wake County Human Services HIV/STD Community Program
Number of Tests and Test Positivity Rate (%) at Jails in Wake County
by Quarter from October, 2011 through June, 2012
Oct—Dec 2011 Jan—Mar 2012 Apr—Jun 2012 Oct 2011—Jun 2012
Test Number
Tested
%
Positive
Number
Tested
%
Positive
Number
Tested
%
Positive
Total
Tested % Positive
HIV 398 0 406 0.2 267 0 1071 0.09
Syphilis 407 2 406 3.2 267 1.9 1080 2.4
Gonorrhea 406 2.5 405 2.7 269 1.5 1080 2.3
Chlamydia 406 6.9 405 7.9 269 7.4 1080 7.4
Hepatitis C Not tested
Field Delivered Therapy (FDT)
Field delivered therapy (FDT) is a strategy to reach patients with positive laboratory results for
gonorrhea and/or chlamydia that are unlikely, unwilling and/or unable to seek treatment. After
researching best practices for alternative methods of treating STIs, FDT was implemented on
November 29, 2011. FDT allows medication to be delivered to the patient outside of the clinic (field)
assuring appropriate treatment.
Disease Intervention Specialists (DIS) and/or a DIS nurse routinely follow up diagnoses of gonorrhea
and/or chlamydia reported by physicians to Wake County Human Services (WCHS) Communicable
Disease Program. A DIS contacts the patients to determine if the patient:
• Completed treatment
• Plans to receive treatment or
• Is unlikely, unwilling and/or unable to seek treatment.
For patients unlikely, unwilling and/or unable to seek treatment, FDT is provided. A DIS meets the
client in a place convenient to the patient providing appropriate medication for the treatment of
gonorrhea and/or chlamydia.
Continued on page 9.
Contact: Yvonne Torres, HIV/STD Community Section 919-250-4479 [email protected] or Edie Alfano-Sobsey, Public
Heath Division 919-212-9674 [email protected]
10 10
Field Delivered Therapy (FDT)
Of the 403 contacts made by DIS from November 29, 2011 - August 23, 2012 verification of patients
securing treatment include:
• 105 (26%) treated through FTD,
• 196 (49%) treated at WCHS clinics
• 84 (21%) treated by a non-WCHS physician
• 18 (4%) out of county residents. Out of county residents were contacted and referred to a
medical provider. It is unknown if treatment was completed as follow-up is the responsibility
of the county where the patient resides.
FTD is a strategy increasing early intervention and treatment of reported gonorrhea and/or chlamydia
infections. As a result of this successful strategy, FTD continues to be provided by DIS and in March
2012 HIV/STD counselors began providing FDT as well.
Figure 5
Contact: Ramsay Hoke, Communicable Disease Program, 919-250-4423 [email protected]
11 11
H e p a t i t i s B
Hepatitis B is a serious disease caused by the hepatitis B virus. It can cause chronic (lifelong)
infection, scarring of the liver, liver cancer, liver failure and death. The hepatitis B virus is spread
through infected blood and other body fluids.
Anyone can get hepatitis B. Some people have a higher risk of getting hepatitis B because of their
lifestyle (ex. illegal drug use) or because of the kind of work they do ( ex. health care workers) .
Most adults recover from hepatitis B infection. However, about 10% of those who get hepatitis B
develop chronic infection. The younger someone is when they become infected, the more likely they
are to develop chronic infection. Hepatitis B can be prevented by vaccination.
Babies born to mothers infected with hepatitis B are at greater risk for hepatitis B infection. Wake
County Human Services Communicable Disease Program investigates all cases of infants born to
hepatitis B infected mothers to prevent chronic hepatitis B disease. These infants are immunized
according to Centers for Disease Control and Prevention recommendations (hepatitis B immune
globulin and the first dose of hepatitis vaccine within 12 hours of birth followed by the second and
third doses of vaccine at 1 and 6 months of age, respectively). Post vaccination testing is performed at
12 –15 months as recommended to ensure that these babies are protected against lifelong hepatitis B
infection.
“Reported Investigations” represent the reportable diseases that were investigated by the
Communicable Disease Surveillance Team while “Reported Cases” represent the investigations that
met case definition and were reported into NC EDSS.
Contact: Ruth Lassiter, Communicable Disease Surveillance Section, 919-212-7344 [email protected]
Data Source: NC Electronic Disease Surveillance System, 9-11-12.
Figure 6
12 12
We wish to thank all staff for their daily efforts toward improving the health and safety of the citizens
of Wake County.
Contributors to this Public Health Quarterly Report are:
Edie Alfano-Sobsey
Roxanne Deter
Ramsay Hoke
Jodi Reber
Michelle Ricci
Yvonne Torres
Acknowledgements
Board Applications for Interview
October 25, 2012
Interview Packet:
• Application
• Interview Questions
• Rubric
• Current race/geographic diversity sheets
CATEGORY: Pharmacist
Term: Nov. 15, 2012 – Nov. 14, 2016
Candidate:
8:30am Mr. John H. Myhre, RPh
CATEGORY: Psychologist
Unexpired Term: Current – Nov. 14, 2015
Candidate:
9:00am Dr. Rosine L. Sanders, Ph.D
RATING SHEET - INTERVIEWEES FOR THE HUMAN SERVICES BOARD
Pharmacist Position
John
Myhre
Assessment Criteria/Candidates
Knowledge of and experience with building and
implementing some of the priorities on the current HS
Board agenda
Strong business, financial and/or legal background
Articulated interest, past history of serving, and/or
commitment to serve the WCHS target population
Knowledge and experience in public health related matters
Knowledge and experience in social services related matters
Knowledge and experience in other human services related
matters
Experience in representing diverse communities and/or
working on jobs, committees or boards that address existing
disparities
Capacity to connect, represent and communicate the HS
agenda to the Wake County community
Capacity to connect and influence community, county, or
state leaders
Demonstrated experience of previous effective work on a
board, commission or committee
Total (Rating Scale 1 -10) 0 0 0 0
SCALE
Commitment and time availability for HS Board Activities
� Yes
� No
� Yes
� No
� Yes
� No
� Yes
� No
Absence of a conflict of interest
� Yes
� No
� Yes
� No
� Yes
� No
� Yes
� No
Date:________________________Name of Rater:__________________________
1 2 3 4 5 6 7 8 9 10
Minimum or Acceptable level Excellent level
no evidence of of experience, knowledge, skill of experience, knowledge, skill
experience, knowledge, skill
RATING SHEET - INTERVIEWEES FOR THE HUMAN SERVICES BOARD
Psychologist Position
Rosine
Sanders
Assessment Criteria/Candidates
Knowledge of and experience with building and
implementing some of the priorities on the current HS
Board agenda
Strong business, financial and/or legal background
Articulated interest, past history of serving, and/or
commitment to serve the WCHS target population
Knowledge and experience in public health related matters
Knowledge and experience in social services related matters
Knowledge and experience in other human services related
matters
Experience in representing diverse communities and/or
working on jobs, committees or boards that address existing
disparities
Capacity to connect, represent and communicate the HS
agenda to the Wake County community
Capacity to connect and influence community, county, or
state leaders
Demonstrated experience of previous effective work on a
board, commission or committee
Total (Rating Scale 1 -10) 0 0 0 0
SCALE
Commitment and time availability for HS Board Activities
� Yes
� No
� Yes
� No
� Yes
� No
� Yes
� No
Absence of a conflict of interest
� Yes
� No
� Yes
� No
� Yes
� No
� Yes
� No
Date:________________________Name of Rater:__________________________
1 2 3 4 5 6 7 8 9 10
Minimum or Acceptable level Excellent level
no evidence of of experience, knowledge, skill of experience, knowledge, skill
experience, knowledge, skill
Wake County Human Services Board
Summary of Statutory Information
North Carolina General Statutes § 153 A 77
Functions and Authority of the Wake County Human Services
Board
153A-77: Authority of Board of Commissioners in certain counties over commissions, boards, agencies, etc.over commissions, boards, agencies, etc.
Except as otherwise provided, the consolidated human services board
shall have the powers and duties conferred by law upon a board of
health and a social services board….
Summary of Statutory Information
Public Health:
Health authorities tend to rule making; oversight, administration and enforcement;
and direct service provision and coordination with other agencies.
Board functions can be organized to address the ten essential public health
services, mandated services, and “typical” services. Or, they can be considered
public health or environmental health.
Wake County Human Services Board
North Carolina General Statutes § 130A-34 Provision of local public health
services
A county shall provide public health services.
A county shall operate a county health department, establish a consolidated
human services agency pursuant to G.S. 153A-77, participate in a district health
department, or contract with the State for the provision of public health services.
North Carolina General Statutes § 130A-1.1
Public Health Mission and essential services
(a) The General Assembly recognizes that unified purpose and direction of the public
health system is necessary to ensure that all citizens in the State have equal
access to essential public health services. The General Assembly declares that
the mission of the public health system is to promote and contribute to the
highest level of health possible for the people of North Carolina by:
(1) Preventing health risks and disease;
(2) Identifying and reducing health risks in the community;
(3) Detecting, investigating, and preventing the spread of disease;
(4) Promoting healthy lifestyles;
(5) Promoting a safe and healthful environment;
(6) Promoting the availability and accessibility of quality health care services through
the private sector; and
(7) Providing health care services when not otherwise available.
North Carolina General Statutes
FUNCTIONS OF A LOCAL HEALTH DEPARTMENT
SECTION 4. G.S. 130A-1.1(b) reads as rewritten: "(b) A local health department shall ensure that the following 10 essential public health services are available and accessible to the population in each county served by the local health department:
(1) Monitoring health status to identify community health problems.
(2) Diagnosing and investigating health hazards in the community.
(3) Informing, educating, and empowering people about health issues.
(4) Mobilizing community partnerships to identify and solve health problems.(4) Mobilizing community partnerships to identify and solve health problems.
(5) Developing policies and plans that support individual and community health efforts.
(6) Enforcing laws and regulations that protect health and ensure safety.
(7) Linking people to needed personal health care services and assuring the provision of health care when otherwise unavailable.
(8) Assuring a competent public health workforce and personal health care workforce.
(9) Evaluating effectiveness, accessibility, and quality of personal and population-based health services.
(10) Conducting research.
North Carolina General Statutes
Chapter 108A. Social Services. Article 1. County Administration.
Part 1. County Boards of Social Services.
§ 108A-1. Creation.
Every county shall have a board of social services or a consolidated
Wake County Human Services Board
Every county shall have a board of social services or a consolidated
human services board created pursuant to G.S. 153A-77(b) which shall
establish county policies for the programs established by this Chapter in
conformity with the rules and regulations of the Social Services
Commission and under the supervision of the Department of Health and
Human Services
Summary of Statutory Information
Social Services:
Board functions can be organized to address public assistance programs
and service programs. They can be considered economic services and
child/adult welfare services.
Statutory Functions
Wake County Human Services Board
Statutory Functions
To advise county and municipal authorities in developing policies and
plans to improve the social conditions of the community;
To consult with the director of social services about problems relating to
his office;
Such other duties and responsibilities as the general assembly, state
Department of Health and Human Services, the Social Services
Commission, or the County Commissioners may assign
North Carolina General Statutes
§ 108A-14.
Responsibilities of a Social Services Department
• To administer the programs of public assistance and social services
• To administer funds provided by the board of commissioners for the care of indigent persons
• To act as agent of the Social Services Commission and Department of Health and Human Services
• To investigate cases for adoption and to supervise adoptive placements;
• To issue employment certificates to children under the regulations of the State Department of Labor;
• To supervise adult care homes under the rules and regulations of the Medical Care Commission;
• To assess reports of child abuse and neglect and to take appropriate action to protect such children pursuant to the Child Abuse Reporting Law;
• To accept children for placement in foster homes and to supervise placements for so long as such children require foster home care;
• To respond by investigation to notification of a proposed adoptive placement , and
• To receive and evaluate reports of abuse, neglect, or exploitation of disabled adults and to take appropriate action as required by the Protection of the Abused, Neglected, or Exploited Disabled Adults
Responsibilities of the Human Services Board Members
BASIC FUNCTIONS:
Function effectively within the context of a Consolidated Human Services
Agency, serving simultaneously as a Public Health and Social Services board
member.
Play an active role in helping to meet the Public Health and Social Services Play an active role in helping to meet the Public Health and Social Services
statutory functions.
Perform necessary reviews of documents and other important materials to be
well prepared to provide sound advice and decision-making.
Attend at least 75% of scheduled meetings
Responsibilities of the Human Services Board
OVERSIGHT
• Monitor compliance will all mandates.
• Ensure that a high quality administrative structure is in place.
• Ensure that consumers are served with appropriate quantity and quality of
services.
• Ensure that a strong financial management system is in place.
• Ensure that consumers are treated with dignity, that customer services are
of high quality and that Human Rights are always honored.
•
REGULATORY
Perform statutory regulatory functions of the Board of Health and the Social
Services Board.
Responsibilities of the Human Services Board
PUBLIC RELATIONS AND ADVOCACY:
• Develop an on-going relationship with County Manager office and Board
of County Commissioners keeping them informed and abreast of Human
Services related matters and contributing to the development of mandates
for all important HS programs and projects.
• Work with legislators promoting and/or supporting state laws beneficial to
Wake County residents.Wake County residents.
• Educate the Wake County community about the needs and the
importance of Human Services.
• Represent and advocate for the department at various venues as needed.
• Identify and advocate for resources needed to carry out the department’s
mission.
• Attend events and represent the HS Board at various venues as
requested
North Carolina General Statutes
Article 5. Administration.
Part 1. Organization and Reorganization of County Government.
§ 153A-76. Board of commissioners to organize county government.The board of commissioners may create, change, abolish, and consolidate offices, positions, departments, boards, commissions, and agencies of the county government, may impose ex officio the duties of more than one office on a single officer, may change the composition and manner of selection of boards, commissions, and agencies, and may generally organize and reorganize the county government in order to promote orderly and efficient administration of county affairs, subject to the following limitations:
(1) The board may not abolish an office, position, department, board, commission, or (1) The board may not abolish an office, position, department, board, commission, or agency established or required by law.
(2) The board may not combine offices or confer certain duties on the same officer when this action is specifically forbidden by law.
(3) The board may not discontinue or assign elsewhere a function or duty assigned by law to a particular office, position, department, board, commission, or agency.
(4) The board may not change the composition or manner of selection of a local board of education, the board of health, the board of social services, the board of elections, or the board of alcoholic beverage control. (1973, c. 822, s. 1.)
North Carolina General Statutes § 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 Public Health 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;
(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.
(e) Copies of all rules shall be filed with the secretary of the local board of health.(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.
(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.
……..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
Example of a Structure of the New Human Services Board - Fall 2013
HS Board Goals:
• Comply With the Law and Perform Statutory Social Services and Public Health Functions
• Incorporate Feedback from Board Members
• Maintain/Enhance Community Participation
• Strengthen Relationships with BOC and Management• Strengthen Relationships with BOC and Management
• Align Board Work with WCHS Strategic Plan
• Provide Board Members Opportunities to Work on Areas of Their Choice
• Provide Venues to Carry Necessary Activities
• Manage Time Effectively and Prevent Burnout
Board Structure Example
Wake County Human Services Board
Statutory Committees Advisory Groups Ad-Hoc & Work Groups
Social
ServicesPublic
Health
• Child & Family Matters
Consumer Rights
Housing
Board Operations
Functions: To plan and organize Board ActivitiesReplaces Executive Committee. Includes Chair and Co-Chair & Director and Board Staff – Other Board
• Child & Family Matters
• Youth Development
• Aging Services
• Adult Protection
• Safety Net
• Crisis Assistance
• Self-Sufficiency
• Child Protection
• Foster Care
• Adoption
• Child Support
• Employment
• Transportation
• Human Capital Dev.
• 10 PH Essential Services
• Communicable Diseases
• Immunization
• Health Care Access
• Epidemiology
• Environmental Health
• PH Preparedness
• HIV-AIDS
• Maternal & Child Health
• Pre-Natal Care
• Women’s Health
• Nutrition
• Health SafetyAdvisory Groups Functions:
Provide Advise to Administration
Quarterly Reports Presented to the
HS Board
Include 1-2 Board Members and
Community members
Housing
Regional Networks
Environmental
Services
Advocacy Group
Issue-Specific
Workgroups
Functions: Assist the Board in the Performance of its statutory
Social Services & Public Health Functions. Review critical issues
and bring recommendations to the full board. Meets Monthly
Include at least 6 Board Members who are Voting Members
Can include non-voting community members as needed
Workgroups Functions: Linked to strategic plan. Staff responsible to work on specific indicators. E.g. Obesity- Child Abuse
Includes staff and PartnersOptional 1-2 Board MembersBi-Annual reports presented to the Board
Director and Board Staff – Other Board members optional. Meets Monthly
Functions: To plan advocacy activitiesIncludes 2-3 Board membersMeets as needed. Presents reports to the full Board
WCHS Board –Example of Structure with Potential Assignments
HS
Board
Statutory
Committees
Advisory to Administration Ad-Hoc Groups Work
Groups
Others
Meeting- HS Board
Meeting
Social
Services
Public
Health
Environme
ntal Health
Housing Consumer
Rights
Board
Planning
Advocacy Issue
Specific
Meeting
Manager
BOC NCGA,
Others
Total
Date 1 x month Varies Varies 1 x month Varies
Duration
1 Member 1 x x x x x 5
2 Member 2 x x x 3
3 Member 3 x x 2
4 Member 4 x x 2
5 Member 5 x x 2
6 Member 6 x x 2
7 Member 7 x x 2
8 Member 8 x x 2
9 Member 9 x x 2
10 Member 10 x x 2
11 Member 11 x x 2
12 Member 12 x x 2
13 Member 13 x x 2
14 Member 14 x x 2
15 Member 15 x x 2
16 Member 16 x x 2
17 Member 17 x x 2
18 Member 18 x x 2
19 Member 19 x x 2
Total 19 6 6 2 2 2 1 2 4
1 Ramon Rojano x x x x x
2 Jonica Hinton x x
3 Regina Petteway x x
4 Jos. Threadcraft x x Description
Regular
Meeting
Statutory
Group
Statutory
Group
2 Board
members-
&Volunteers
2 Board
members- &
Volunteers
2 Board
members- &
Volunteers
Replaces
Executive
Committee
To Advocate
for HS
Optional
Upon
interest-
Chair & Vice-
Chair
Chair, Vice-
Chair & Lead
Advocate
WCHS Board Existing Structure and Assignments- September 2012 – MONTHLY RESPONSIBILITIES
Note: the 4 ORANGE shaded members are schedule to leave November-December 2012
Meeting- HS Board
Meeting
Executive
Committee
Social
Services
Public
Health
Environm-
ental Health
Housing Consumer
Rights
Regional
Networks
Advo-
cacy
Meeting
Director
Meeting
Manager
Other
Functions
Total
Date 1 x
month
1 x month Varies
Duration 2.5 hr 2 2 2 2 2 2 1.5 1 1 1
1 Dianne Dunning X X X X X XX 6
2 Pablo Escobar X X X X X XX 7
3 Leila Goodwin X X X 3
4 Frank Eagles X X X X 4
5 Sharon Foster X X X X 4
6 Julian Smith X X X 3
7 Osama Said X X 2
8 Paul Norman X X X 3
9 Burton Horwitz X X X 3
10 Benny Ridout X X X X X X 5
11 James West X 1
12 Marg Raynor X NEW
13 Tomeeko Piggee x NEW Soc Worker
14 James Smith x NEW Psychiatry
15 McKinl Wooten x NEW Consumer
16 Psychologist To be Recruited
17 General Public To be Recruited
18 Consumer To be Recruited
19 Consumer To be Recruited
Total 19 7 3 3 5 2 2 2 2 2
WCHS Board Previous Structure and Assignments- June 2011 – MONTHLY RESPONSIBILITIES
Meeting- HS Board
Meeting
Executive
Committee
Social
Services
Public
Health
Environm-
ental Health
LME
Committee
Housing Consumer
Rights
Regional
Networks
Advo-
cacy
Meeting
Director
Meeting
Manager
Others Total
Date 1 1 Varies
Duration 2.5 hr 2 2 2 2 2 2 1.5 1 1 1
1 Dianne Dunning X X X X X XX 6
2 Pablo Escobar X X X X X X XX 7
3 Leila Goodwin X X X 3
4 Frank Eagles X X X X 4
5 Sharon Foster X X X X 4
6 Julian Smith X X X 3
7 Osama Said X X 2
8 Paul Norman X X X 3
9 Burton Horwitz X X X 3
10 Benny Ridout X X X X X X 5
11 Melissa Jemison X X X X X 5
12 Steph Treadway X X X 3
13 Rich Greb X X 2
14 Jeff Smith X X 2
15 Jim Edgerton X X X X X 5
16 George Corvin X X X 3
17 Dave Filpowski X X 2
18 Jim Mebane X X X X 4
19 Bill Stanford X X X X 4
20 Kent Earnhardt, X X X 2
21 Alexand Herring X X 2
22 C. James West X 1
23 Lena Mehta X X 2
24 Vacant
25 Vacant
Total 22 10 3 5 5 8 2 5 3 4 2 2
WCHS Board Previous Structure and Assignments- May 2007 – MONTHLY RESPONSIBILITIES
Meeting- HS Board
Meeting
Executive
Committee
Success-
ful HS
Children
Comm-
Public
Health
Environment
Services
Watershed
Continuum
of Care
Afforda-
ble
Housing
Human
Rights
Regional
Networks
CFAC Meeting
Director
Meeting
Manager
Others Total
Date 1 1 Varies
Duration 2.5 hr 2 2 2 2 2 2 2 1.5 1 1 1
1 Dave Filipowski X X X X X - 5
2 Jim Mebane X X X X - 4
3 Bill Stanford X X X X X 5
4 Dianne Dunning X X X X 4
5 Sharon Foster X X 2
6 Ann Ackland X X X X 3
7 Lou Mitchell X X X 3
8 Benny Ridout X X X X 4
9 Paul Norman X X 2
10 Burton Horwitz X X X 3
11 Seth Tabb X X X 3
12 Buck Kennedy X X X 3
13 Rich Greb X X X 3
14 Jeff Smith X X 2
15 Kent Goddard X X 2
16 John Key X X X X 4
17 Charles King X X 2
18 Octavia Rainey X X 2
19 Leena Mehta X X 2
20 Susan O’Dell X X 2
21 Vacant X
22 Vacant X
23 Vacant
24 Vacant
25 Vacant
Total 22 9 3 6 4 5 2 4 4 n/a
Staff
Meeting- HS Board
Meeting
Executive
Committee
Social
Services
Public
Health
Environmen-
tal Health
Housing Consumer
Rights
Regional
Networks
Meeting
Director
Meeting
Manager
Other
Functions
Total
Date 1 x month 1 x month Varies
Duration
1 Ramon Rojano
2 Jonica Hinton
3 Regina Petteway
4 Sue Ledford
5 Michelle Ricci
6 Katherine Williams
7 Annemarie Maio-
Jos. Threadcraft
Joe Durham
David Cooke
Historic Information – June 2011 September 2012 Executive Committee: 10 Members 7 Members LME Committee : 8 Members N/A Environmental Committee: 5 Members 5 Members Public Health: 5 Members 3 Members Consumer Rights: 5 Members 2 Members Advocacy: 4 Members 2 Members Social Services: 4 Members 3 Members Regional Networks: 3 Members 2 Members Housing: 2 Members ? Members
WAKE COUNTY HUMAN SERVICES BOARD
INFORMATION ITEM
Agenda Date: October 25, 2012
Committee/Item: Human Rights-Consumer Affairs/Research Proposal
Specific Action Requested: Information Item Only. The Committee is reporting the
participation of the WCHS Foster Care services in a multi-site study that focuses on the
relationships between agency staff and foster parents. Participation did not require HS Board
approval, but is being reported as an information item for the benefit of the Board.
Item Summary: Foster Care services will be participating in a Duke Endowment funded effort
known as Together Facing the Challenge (TFC). The project seeks to maximize the support to
foster parents, and to identify key systemic factors that lead to enhanced support.
Purpose for Action: Information Item Only
Attachments: Summary of the proposal
Opportunities for Advocacy, Policy or Advisory: None at this time.
Connections to Other Committees: Social Services
Information Item
Human Research Proposal in Foster Care
This project is funded by the Duke Endowment and carried out by Duke
University. The project seeks to evaluate effectiveness of different approaches to
providing foster care. For most of a decade this project has worked to develop,
test (random trial published in 2010), and apply a hybrid approach to working
with foster care families and agency staff called Together Facing the Challenge
(TFC) at 14 sites across NC.
This study concentrates on how supervisors work with the treatment parents. The
TFC approach provides tools for supervisors that help them support and guide
foster parents. The approach is to focus on training and consultation with
supervisors, focus on systematic evaluation and monitoring of progress, and to
use group supervision with foster parents to increase connectedness and
professionalism of TFC practitioners.
No foster children are interviewed or directly observed at any time in any way.
Supervisors and foster parents complete questionnaires and are observed
working together. Confidentiality is protected through the use of unique numeric
identifiers secured by the chief researcher. Parents or legal guardians must give
consent, though, since the child will be discussed in the interviews.
The sole risk associated with the proposal is loss of confidentiality, and the study
procedures call for use of unique numeric identifiers maintained by the principal
investigator to guard against that risk. No additional institutional review is
mandated, therefore the planned participation of WCHS foster care is being
reported as an information item only.
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