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. <br />North Carolina Department of Health and Human Services <br />Division of Public Health <br />Pat McCrory <br />Governor <br />TO: Local Health Directors and Nursing Directors <br />FROM: Joy F. Reed, EdD, RN, FAAN <br />Branch Head, Local Technical Astaace and T <br />rauung <br />Public Health Nursing & Professional Development Unit <br />DATE: February 15, 2014 <br />SUBJECT: Public Health Nurse 'Draining Ponds <br />Aldona Z. Wos, M.D. <br />Ambassador (Rat.) <br />Secretary DHHS <br />Daniel Staley <br />Acting Division Director <br />The protocol for reimbursement under the Public Health Nurse Training Funds is an integral component in the 2014 <br />15 Consolidated Agreement with each local health department (see B -12 Funding Stipulations in the Consolidated <br />Agreement). In order to be reimbursed from the training funds, the attached form (DHHS 3300) will need to be <br />completed for individuals for whom the agency is requesting reimbursement. <br />1. County name <br />2. Name(s) of Participant(s) <br />3. Title of Course attended <br />4. Dates of attendance (month and year) <br />5. Amount requested <br />6. Health Director's signature and date <br />7. Name and telephone number of person preparing the form DHHS 3300 <br />You may request reimbursement upon notification of successful completion of the Introduction to Principles and <br />Practices of Public Health and Public Health Nursing course (reimbursement is $400), or the Management and <br />Supervision for Public Health Managers and Supervisors course (reimbursement is $600), but reimbursement must <br />be requested within one year of successful completion of either course. <br />All reimbursements are based on availability of funds. <br />PIease submit the completed form directly to Public Health Nursing and Professional Development Unit, 1916 Mail <br />Service Center, Raleigh, NC 27699 -1916. <br />Attachment: Form DHHS 3300 <br />www.ncdhhs.gov • www.pubhehealth.no.gov <br />Tel 919 - 707 -5130 • Fax 919- 870 -4833 <br />Location: 5605 Six Forks Road • Raleigh, NC 27609 <br />Mailing Address: 1916 Mail Service Center • Raleigh, NC 27699 -1916 <br />An Equal Opportunity / Affirmative Action Employer <br />In-, <br />