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on the WIC. She sat in on two WIC interviews and went with Paula Troutman on a call. She worked
with Linda Hale,who is the Wellness Coordinator. She said the laboratory needs a refrigerator. She
attended staff meetings also.
Chairman Hedrick said he appreciated their coming. There is a feeling that the board is down
on the health department. In the process of going over the budget the board is faced by taxpayers
with the charge of maintaining or reducing taxes, and the board sometimes raises questions and looks
to Mr. Deal for the answers he can supply. Where there are representatives of the county board on
other boards, they usually have a lot of input into that particular budget. It was apparent that
the majority of the questions that were raised last Monday were raised basically by the board's
representative to the health board. Mr.Hedrick asked Mr. Deal to get copies of minutes of the board
of health meetings. There were questions that came up about the health board's actions regarding
certain matters in the budget. The minutes were not complete or the meetings were not complete.
That raised some questions in Chairman Hedrick's mind.
Dr. Nicholson said the process had been going on beforehand.
Commissioner Crosswhite said she was judging from her own time spent with the board on the
budget. She said she was called to the health department on March 19th at 2:00 p.m. and was shown
over the health department and introduced to the staff. That evening the budget was presented to
the health board. She felt that she had not had any input in the budget.
Dr. Nicholson said they did not expect to get everything they asked for. They felt these new
positions were important --the nurses for the public schools. There is one nurse with 16,000 stu-
dents in the county.
Commissioner Murdock said the school health nurse was one of the matters she had concerns
about. She thought that was included in the Basic Education Program. She did not understand if it
was included in that, why do you fund it in the health department?
Dr. Nicholson said the county school people came to them and asked for the health nurses. Mr.
Deal said the health nurses are a part of the Basic School Program.
Mr. Mashburn said regardless of this Basic Education Plan, it is the responsibility of the
public health department to handle communicable diseases and hepatitis programs. They are still
called upon to provide a lot of immunizations. A lot of this is spelled out in the General Statutes
for the health department to do. It is just virtually impossible to cover 33 schools and 16,000
students with a part-time school health nurse, he said. They have some people who work in the
schools, and Mr. Mashburn named some of these. He said there is still a need for a general school
health nurse. He felt the kids were being short-changed. At the same time he said they would work
with the schools to use the money that is coming to them to hire a public health nurse.
Commissioner Murdock spoke about a line item of "Generalized Nursing" at $12,237.
Mr. Mashburn said this was a special state fund to provide services on a formula basis for
special treatment services. Most of it goes to the dentist for children who otherwise don't have
cny way to get the dental work done. Dr. Rogers does some of the work. Some of it is done by Dr.
Hunter.
Dr. Hunter said the amount is inadequate. The funds always run out.
Commissioner Crosswhite inquired about the nurse who is in school working on an advanced
degree. This is why the health department decided last year that since they were paying the tuition
for the advanced degree and the salary that an additional position would not be funded.
Mr. Mashburn said this tuition was partially underwritten by the county and partially under-
written by the State. She received a grant.
Chairman Hedrick said he apologized for causing the health department concerns and that the
questions messed up the health board's weekend.
Commissioner Murdock questioned the generalized nursing. The travel for 1983-84 to 1986-87 was
a big jump. She said she noticed it came down quite a bit in 87-88.
Mr. Mashburn said last year they combined some of the budgets. The reason the travel looks
larger is that it was all in one block. Departments that were combined were Maternal -Child Health,
Family Planning, Dental, and Generalized Nursing.
Commissioner Murdock inquired about Family Planning. There is also Family Planning at the
Social Services Department. Mr. Mashburn said there were counseling and State funds for abortions
in the Social services Department. The Health Department program is for contraceptives, education,
and preventing of unwanted pregnancies.
Commissioner Stewart said when the board is discussing the departmental budgets and come to
areas where the commissioners cannot answer questions and Mr. Deal cannot answer these questions,
the only place the board can go is to the department. In order for the commissioners to make the
best judgments, they have to be able to understand the budget or cannot act on it. She said she
would request mor, than anything else in preparing the budget next year that someone be able to
understand the budget better than they have had the opportunity to understand it in the last two
years. _
Mr. Mashburn said they did not introduce any new programs. ,