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05/08/1996 I I I 10') 0.:) Dr. Dennis Jackson, Chairman, called the regular business meeting of the New Hanover County Board of Health (NHCBH) to order at 8:00 a.m. on Wednesday, May 8, 1996, in the Carl Thomas Durham Auditorium, New Hanover County Health Department, Wilmington, North Carolina. Members Present: Dennis L. Jackson, DVM, Chairman W. Keith Elmore, Vice-Chairman Mary Lou Alford, RN Thomas V. Clancy, MD Mary King Dean Michael E. Goins, OD Robert G. Greer Mark A. Veenstra, PE Estelle G. Whitted, RN Members Absent: John M. Coble Spiro J. Macris, DDS Others Present: Robert S. (Bob) Parker, Health Director Frances F. De Vane, Recording Secretary Invocation: Mr. Mark Veenstra gave the invocation. Minutes: Dr. Jackson called for corrections to the minutes of April 10, 1996. Mrs. Dean requested for the April 1 0 minutes to be corrected. The minutes were corrected and approved by the Board of Health. Recognitions: Mr. Parker recognized the following health department employees: New Employees: Susan Brittain, Administrative Assistant, WIC Christina Casazza, Animal Control Officer, Animal Control Robert Keenan, Environmental Health Specialist, Environmental Health .184- Years of Service: Fifteen (15) Years I Susan Harper, Clerical Specialist, Women's Health Care Betty Jo McCorkle, Public Health Nursing Director, Women's Health Care March of Dimes WALKAMERICA 1996 Mr. Parker displayed a plague presented to the health department for participation in the March of Dimes WALKAMERICA held on March 16, 1996. The NHCHD was on the Top 10 List and ranked third in the WALKAMERICA Campaign. Contributions to the March of Dimes were $2,800. Cathy Bundy, Licensed Practical Nurse, and Shelia Jamerson, Medical Laboratory Assistant, Co-Chairpersons, and the March of Dimes Committee were commended and thanked for a successful March of Dimes Campaign. Department Focal: Integrated Pest Manaaement for Urban MosQuitoes Mr. Ken Sholar, Vector Control Manager, introduced Dr. Charles Apperson, Entomology Department, North Carolina State University, who gave the department focal on Integrated Pest Management for Urban Mosquitoes. Asian Tiger (Aedesalbopictus) mosquitoes, the I most significant urban mosquitoes, were discovered in 1985 in New Hanover County and are now widespread in our area. Control measures for the Asian Tiger mosquitoes include surveillance techniques, public education, spraying, and monitoring of breeding sites. Mr. Parker announced that Mosquito Control Program funds were deleted from Governor Hunt's Fiscal Year 1996-97 State Budget. He thanked Dr. Apperson for his support and services to NHCHD Mosquito Control Program. Committee Reports: Budget Committee Mrs. Dean, Chairman, Budget Committee, deferred to Ms. Lynda Smith, Assistant Health Director, to present a health department budget report. Ms. Smith reported that Fiscal Year 1995-96 Revenues from fees and Medicaid have increased over the budgeted amount by $148,700. The funds will decrease the county's portion needed to offset expenditures. For Fiscal Year 1996-97 the Tuberculosis (TB) Program has recently received an additional state grant of $35,000. A Public Health Nurse I position has been requested for I the TB Program. If this position is approved, the request to change a part-time Licensed Practical Nurse" in TB to a full-time position will be withdrawn from the FY97 Budget. I I I 185 Also, an additional $90,000 in Revenue from Medicaid (Title XIX) and from a state grant have been added to the FY97 Budgeted Revenue accounts. Dental and Laboratory Budget Program Reviews will be presented at an announced Board meeting. Mrs. Dean stated the agenda indicated that these program reviews were to be presented at today's meeting. She suggested that the budget reviews be presented in one complete report. It was the consensus of the Board of Health to defer the Health Department Budget Program Reviews. Executive Committee Dr. Jackson, Chairman, Executive Committee, advised the Board that the Executive Committee met at 6:00 P.M. on April 30, 1996. Items discussed are on the Board of Health Agenda under Unfinished Business and New Business. Health Promotions Committee Mrs. Mary Lou Alford, Chairman, Health Promotions Committee, reported that the Health Promotions Committee met at 6:00 p.m. on April 29, 1996. The committee decided not to pursue the Seat Belts on School Buses Project due to cost, maintenance, and possible childhood injuries from the belts. Tobacco control initiatives regarding youth access to tobacco products were discussed. Resolution - Stop Tobacco Sales to Minors in North Carolina Mrs. Alford presented to the Board for their consideration two resolutions (Options #1 and #2) on Stop Tobacco Sales to Minors in North Carolina. Mrs. Alford recommended from the Health Promotions Committee for the Board to approve the Resolution - Stop Tobacco Sales to Minors in North Carolina (Option #2). Mr. Parker explained that the two resolutions regarding youth access to tobacco products have similar meanings. The proposed resolution either Option #1 or Option #2 requests for the word "knowingly" to be removed from the present state law regarding the sale of tobacco products to minors, identification checks for teenagers purchasing tobacco products, repeal of state preemption legislation, and the removal of cigarette vending machines accessible to teenagers. The Option #1 resolution is shorter than Option #2. The Board reviewed both options. Dr. Clancy stated he prefers the shorter resolution as nothing was lost in the meaning by deleting the verbiage from Option #2 the longer resolution. Mr. Greer inquired why identification for the purchase of tobacco products is not required by retailers on a purchaser determined to be 30 years of age or older. Mr. Parker explained that this age is used to make retailers check identifications. Dr. Goins lsa expressed his support for removing the word "knowingly" from state legislation regulating the purchase of tobacco products to minors. Mrs. Alford explained that the proposed resolution will be sent to hundreds of local and state organizations for their adoption and then presented to the 1997 North Carolina General Assembly to request a change in the state tobacco control law. I MOTION: Mrs. Alford, Chairman, Health Promotions Committee, moved from the Health Promotions Committee for the Board of Health to approve the Resolution - Stop Tobacco Sales to Minors in North Carolina (Option #2). SUBSTITUTE MOTION: Dr. Clancy moved and Mrs. Dean seconded to substitute and adopt the Resolution - Stop Tobacco Sales to Minors in North Carolina (Option #1). Upon vote, the MOTION CARRIED as follows: (Attachment #1 is incorporated as a part of these minutes.) l Aye --L Nay (Mr. Greer) Youth Access to Tobacco Vending Machines in New Hanover County - A Research Proiect Mrs. Alford recommended from the Health Promotions Committee for the Board of Health I to endorse a study of the accessibility of tobacco products in vending machines to minors in New Hanover County. During this study youth will be assigned to purchase cigarettes from vending machines. The Board will evaluate the results of the proposed research project and the feasibility of the endorsing a regulation like the City of Raleigh Ordinance (Raleigh North Carolina Youth Snuff Out Vending Machines) which prohibits tobacco vending machines in any location accessible to youth. Mrs. Dean expressed that she has difficulty with teenagers participating in these types of studies and accepting the validity of the studies. Mr. Parker stated that high school groups will be solicited to participate in the project with the assistance of law enforcement agencies, school system, and health department personnel. Mr. Greer stated he has a problem with conducting this study, since he doesn't know what good it will do. He concluded he didn't think the Board will stop kids from buying cigarettes just from the removal of cigarette vending machines. Dr. Goins stated he supports the study. It is an attempt to do something positive to prevent youth from smoking. I I I I 18, Dr. Jackson expressed he would like for the Board to know more about how the study is to be conducted before a vote is taken on the issue. He informed the Board that statistics prove that most people start smoking from ages 12-17; and, if the removal of vending machines would help these statistics, he concludes it would be worthwhile. Dr. Clancy stated he would like for the Board to learn more about how the City of Raleigh regulation which prohibits tobacco vending machines in any location accessible to youth. He stated the proposed study could be bypassed. MOTION: Mrs. Alford, Chairman, Health Promotions Committee, moved from the Health Promotions Committee for the Board of Health to approve A Research Project, entitled Youth Access to Tobacco Vending Machines, to study the accessibility of cigarettes to youth under age 18 through cigarette vending machines in New Hanover County. Upon vote, the MOTION CARRIED as follows: -º- Aye ~ Nay (Mr. Greer and Mrs. Dean) Request to United States Senators and ReDresentatives - "A Commitment to Our Children" Mrs. Alford presented a recommendation from the Health Promotions Committee for the Board to approve a written request entitled '~ Commitment to Our Children". This is a request is to be sent to our United States Senators and Representatives for their endorsement and signatures. Mrs. Dean inquired about the source and validity of the document. Mr. Parker reported that the statistical data in the document is from the Surgeon General's Report. Mr. Greer requested an explanation regarding the meaning of the document. Mr. Parker explained that "A Commitment To Our Children" is a written commitment to support the common- sense goal of decreasing tobacco use by children by reducing the access and appeal of tobacco products to children and to oppose efforts to enact legislation that would weaken or delay President Clinton's proposal to decrease tobacco use by children. It is a national attempt to take action to stop the sale of tobacco products to minors. Other Congressmen and Congresswomen representing other states have signed this commitment. Mr. Parker referred the Board to copies of the FDA Proposed Rule on Tobacco Regulation and President Clinton's Plan. MOTION: Mrs. Alford, Chairman, Health Promotions Committee, moved from the Health Promotions Committee for the Board of Health to approve a document entitled '~ Commitment to Our Children" to be sent to our four United States congressional representatives for their support and signatures. Upon vote, the MOTION CARRIED UNANIMOUSLY. (Attachment #2 is incorporated as a part of these minutes.) .1.88 Unfinished Business: New Hanover County Smoking Control Regulation As It Aoolies to Commercial Realtors Dr. Jackson presented his revised letter addressed to New Hanover County Commercial Realtors regarding the requirements of the New Hanover County Smoking Control Regulation (SCR). The intent of the letter is for the Board of Health to inform all renters and future renters that compliance with the SCR is mandatory and to prevent problems with renters after rental space is occupied. After discussion, Dr. Jackson, Chairman, Executive Committee, recommended from the Executive Committee for the Board to approve the distribution of the letter to commercial realtors in New Hanover County. MOTION: Dr. Jackson, Chairman, Executive Committee, moved from Executive Committee for the Board to approve the revised letter to New Hanover County Commercial Realtors regarding the New Hanover County Smoking Control Regulation as it applies to Commercial Realtors. Upon vote, the MOTION CARRIED UNANIMOUSLY. New Business: HIVe SEXUALLY TRANSMITTED DISEASE (STD) PREVENTION PROJECT Dr. Jackson presented a recommendation to the Board from the Executive Committee to approve an application and funding for the proposed HIV/Sexually Transmitted Disease (STD) Prevention Project. The proposal includes $50,000 state funding for Salary and Fringe for a Health Educator to coordinate HIV Prevention Programs in New Hanover County, Contracted Services, and Operating Expenses. Mrs. Dean explained that the Executive Committee inserted the words "until married" after the word "abstinence" in the proposal. MOTION: Dr. Jackson, Chairman, Executive Committee, moved from the Executive Committee for the Board to approve the HIV/Sexually Transmitted Disease Prevention Project to be funded by a $50,000 state grant. Upon vote, the MOTION CARRIED UNANIMOUSLY. I I I I I I 18~ New Hanover Adolescent Health Center Dr. Jackson reported that the Executive Committee referred to the full Board of Health the issue of health department participation in the New Hanover Adolescent Health Center (NHAHC). Dr. Clancy expressed his endorsement of the NHAHC. He stated the center will target the adolescent population and is a Public Health issue which should be supported by the Public Health Department. Mrs. Dean had questions regarding abortion referrals. Dr. Clancy stated this was not the most important aspect of NHAHC. Mrs. Dean inquired why the Board has been asked to endorse participating in NHAHC when Mr. Parker is currently on the Board and other health department staff are involved. Dr. Clancy reiterated that the Adolescent Health Center is a Public Health issue. Mr. Parker informed the Board that the issue is before the Board of Health today for their endorsement of his and the health department's participation in the functions of the NHAHC. MOTION: Dr. Goins moved and Mrs. Whitted seconded for the Board of Health to support the New Hanover Adolescent Health Center in their current and future endeavors. Mrs. Dean expressed concern that pregnant teenagers will be referred to the North Carolina Children's Home Society which does abortion referrals. Dr. Jackson stated he could not find a problem with the center's concept but he cannot support the concept of care without parental or guardian consent except in emergency situations. Dr. Goins and Mr. Greer expressed their support of the concept of the NHAHC. SUBSTITUTE MOTION: Mr. Greer moved and Mr. Elmore seconded to endorse the concept of the New Hanover Adolescent Health Center with health department participation as it is now and any other support such as personnel will need Board of Health approval. Upon vote, the MOTION CARRIED as follows: l Aye --L Nay (Mrs. Dean) Comments: Board of Health Members Mrs. Dean referred the Board of Health to an article, Author Disputes Cause of AIDS, for their review. Mrs. Whitted thanked the Board of Health for their expressions of kindness during the illness of her husband, Reverend Whitted. J 90 Health Director: Board of Health Sponsored Luncheon for Staff On behalf of the health department staff, Mr. Parker expressed his appreciation to the Board members for the Staff Luncheon sponsored by the Board of Health from 12 Noon - 1 :00 p.m. on Tuesday, April 16, 1996, at the health department. Notes of appreciation were presented to the Board. Dr. Macris is collecting for incurred staff luncheon expenses. Blood Drive - 6-13-96 - Health Department The New Hanover County Blood Drive is to be held on June 13, 1996, in the Carl Thomas Durham Auditorium, NHCHD. Board members were requested to donate blood on June 13, or one month prior, or one month after the date of the Blood Drive. Board of Health Sunshine Fund - $10.00 Mr. Parker announced that the Board established a voluntary Sunshine Fund to purchase greeting cards, flowers, etc. for remembering those who are sick or bereaved. A $10.00 contribution is being collected from each Board member. Memo from Robert G. Greer Dated 2-27-96 Mr. Parker referred the Board to a memo addressed to Chairpersons of Boards, Committees, Commissions and Authorities appointed by the New Hanover County Board of Commissioners regarding Committee Appointments and an Application Form for these appointments. Ketner Award Aoolications Mr. Parker announced that health department staff is submitting the following Applications for 1995-96 Ralph W Ketner Employee Productivity Awards: Correctional Labor Mosquito Ditching - Kenneth R. Sholar, Vector Control Manager Sharing the Load - Inmate Co-Payment Program - Betty B. Creech, Community Health, Jail Medical Program The monetary award for these awards is $1,000. I I I 19J I Animal Control Services Mr. Parker presented the Animal Control Services Officer Work Schedule. Weekend coverage begins effective Saturday, May 11, 1996. He reported that the Pet Adoptathon held at Animal Control Services was successful. There were 42 pet adoptions. Information on Rabies was distributed to the Board indicating three cases of Rabies identified in New Hanover County. Final Report: Governor's Commission on Reduction of Infant Mortality Mr. Parker asked the Board to review the Governor's Commission on Reduction of Infant Mortality Final Report. Other Business: fiscal Year 96-97 - Public Health Nurse I Position I Ms. Lynda F. Smith, Assistant Health Director, requested that the Board of Health vote on the recommendation from the Executive Committee to establish a Public Health Nurse I position in the Tuberculous Program in FY 96-97 Budget. MOTION: Dr. Jackson, Chairman, Executive Committee, moved from the Executive Committee for the Board to approve the the addition of a Public Health Nurse I position in the Tuberculous Program in FY 96-97 Budget to be funded by a state grant. Upon vote, the MOTION CARRIED UNANIMOUSLY. Adjournment: There being no further business, the regular meeting of the Board of Health was adjourned at 9:30a.m. 9~/ ~ Dennis L. Jackson, :ê New Hanover County Board of Health ~W~ Robert S. (Bob) Parker, Health Director New Hanover County Health Department I Approved: I I I 193 Attachment #1 RESOLUTION STOP TOBACCO SALES TO MINORS IN NORTH CAROLINA WHEREAS, Tobacco use is the number one preventable cause of premature death and disease;! and WHEREAS, approximately 25,000 teenagers in North Carolina start smoking each year;2 and WHEREAS, most smokers start at the ages of 13 and 14, and 90% start smoking before the age of 20.3 and , WHEREAS, the earlier a young person starts to use tobacco, the less likely it is that he/she will be able to quit later;4 and WHEREAS, in locations where tobacco sales to underage persons have been curtailed, the prevalence of smoking by teenagers has decreased, particularly among the youngest age groups;5 THEREFORE, BE IT RESOLVED, that the New Hanover County Board of Health requests the North Carolina General Assembly to change North Carolina Law to effectively prohibit the sale of tobacco products to persons under 18. BE IT FURTHER RESOLVED, that the word "knowingly" be removed from the present state law concerning selling cigarettes to minors. BE IT FURTHER RESOLVED, that the law should read that no person shall sell or distribute tobacco products to any individual who does not produce proper identification that the individual is at least 18 years of age. Such identification is not required for an individual who the retailer has reason to believe is 30 years of age or older. BE IT FURTHER RESOLVED, that the North Carolina General Assembly requires that cigarette vending machines only be permitted in locations to which minors are not allowed. BE IT FURTHER RESOLVED, that state legislation which preempts local ordinances be repealed; thus setting "floor" or minimum requirements, while allowing the continued adoption and implementation of local regulations and ordinances that create a higher level of public health protection. Adopted this 10th day April , 19 ~. ,~ Signed: De nis L. Jackson, DV , Chairman New Hanover County' Board of Health Date: April 10. 1996 194 I RESOLUTION References: 1) Centers for Disease Control and Prevention. "Preventing Tobacco Use Among Young People. A Report of the Surgeon General". Washington DC: US Department of Health and Human Services, (1994). 2) Institute of Medicine, "Growing Up Tobacco Free": Preventing Nicotine Addiction in Children and Youths, (1994) (Estimate from National Data). 3) Centers for Disease Control and Prevention. "Preventing Tobacco Use Among Young People. A Report of the Surgeon General". Washington DC: US Department of Health and Human I Services, (1994). 4) Kozlowski, L, A. Wilkinson et. al. "Comparing Tobacco Cigarette Dependence with Other Drug Dependencies: Greater or Equal Difficulty Quitting and Urges to Use, but Less Pleasure from Cigarettes." Journal of American Medical Association. 261:6 (1989): 896-901. 5) Jason, L. et. al. "Active Enforcement of Cigarette Control Laws in the Prevention of Cigarette Sales to Minors." Journal of the American Medical Association. 266.22 (11 Dec. 1991): 3159- 3161. I I I I 195 Attachment #2 A COMMITMENT TO OUR CHILDREN WHEREAS, more children alive today will die from tobacco use than from any other single cause - including AIDS, alcohol, car accidents, murders, suicides, illegal drugs and fires combined; WHEREAS, child smoking rates are rising, with the number of eighth-graders who smoke increasing 30% between 1991 and 1994; WHEREAS, every day, another 3,000 American children start to smoke, nearly 1,000 of whom will die from lung cancer and other diseases caused by smoking; WHEREAS, the tobacco industry spends over $6 billion a year on advertisements and promotions that, whether intentional or not, have the effect of encouraging children to use tobacco products; WHEREAS, over 85% of the children who smoke use one of the three most heavily advertised cigarette brands (Marlboro, Camel, or Newport); WHEREAS, state and local laws restricting tobacco sales to mmors have been largely ineffective; THEREFORE, I commit: 1. To support the common-sense goal of decreasing tobacco use by children by reducing the access and appeal oftobacco products to children; and 2. To oppose efforts to enact legislation that would weaken or delay the President's proposal to decrease tobacco use by children. Signed: Member of Congress State Date: Return to: Bryan Williams in Representative Hensen's Office (2466 Rayburn) or to Elizabeth Drye in Representative Waxman's Office (2408 Rayburn)