05/08/1996
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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
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Years of Service:
Fifteen (15) Years
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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.
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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
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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.
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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.
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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.)
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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.
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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.
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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.
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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
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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:
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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
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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
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Signed:
De nis L. Jackson, DV , Chairman
New Hanover County' Board of Health
Date: April 10. 1996
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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.
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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)