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F <br /> Y Nnsc* <br /> North Carolina Department of Health and Human Services <br /> Division of Public Health <br /> Pat McCrory Aldona Z.Wos,M.D. <br /> Govemor Ambassador(Ret.) <br /> Secretary DHHS <br /> Laura Gerald,M.D.,M.P.H. <br /> State Health Director <br /> TO: Local Health Directors and Nursing Directors <br /> FROM: Joy F. Reed,EdD,RN,FAAN <br /> S�- <br /> Branch Head,Local Technical sistance and Training <br /> Public Health Nursing&Professional Development Unit <br /> DATE: February 15,2013 <br /> SUBJECT: Public Health Nurse Training Funds <br /> The protocol for reimbursement under the Public Health Nurse Training Funds is an integral component in the 2013- <br /> 14 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 /> Please 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 • wwwpubfchealth.nc.gov <br /> Tel 919-707-5000•Fax 919-8704829 <br /> Location: 5605 Six Forks Road•Raleigh,NC 27609 <br /> Mailing Address: 1931 Mail Service Center•Raleigh,NC 27699-1931 jk <br /> i"S An Equal Opportunity/Affirmative Action Employer P°,G 'H;IC <br />