CLEVELAND COUNTY MAY 8, 2018 PAGE 1
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1 MAY 8, 2018 PAGE 1 The Cleveland County Board of Health met on Tuesday, May 8, 2018 at 6:00 p.m., at the Cleveland County Public Health Center. Board members present: Katie Borders, Street Hamrick, Randy Sweeting, Ronnie Whetstine, Robert Miller, Dianne Sanders, Tom Spurling and Theresa Taylor. Health Department staff present: Dorothea Wyant, Tracy Barrett, Anne Short, Alisa Leonard, DeShay Oliver, Nathan McNeilly, Jamie Todd, Holly Wall and Brittney Smith and Debbie Dyer. Chuck Wilson, representing the County Attorney was present. CALL TO ORDER/WELCOME: Chair Spurling called the meeting to order and welcomed everyone. Robert Miller provided the invocation and reviewed the agency Mission Statement. CITIZEN RECOGNITION: No citizens requested to appear before the Board. MOTION TO ADOPT THE AGENDA FOR THE MAY 8, 2018 MEETING: Chair Spurling asked for a motion to approve the proposed agenda for the May 8, 2018 Board of Health meeting. Motion: A motion was made by Randy Sweeting, with a second by Katie Borders to adopt the proposed agenda for the May 8, 2018 Board of Health meeting as presented. Motion passed unanimously. APPROVAL OF APRIL 10, 2018 MEETING MINUTES: Chair Spurling presented the April 10, 2018 Board of Health meeting minutes for consideration of approval. Motion: There being no corrections, additions, nor deletions to the minutes of the April 10, 2018 Board of Health meeting minutes, motion was made by Street Hamrick, with a second by Katie Borders that they be approved as written. Motion carried unanimously.
2 MAY 8, 2018 PAGE 2 OPIOID CRISIS UPDATE: DeShay Oliver introduced Jamie Todd as a Health Education Specialist with the Cleveland County Public Health Center serving as the Drug Free Community Grant Coordinator. Ms. Oliver provided information regarding the Opioid Crisis, accompanied by a power point presentation. Opioid abuse is a major problem nationally, statewide and in Cleveland County. Nationally, opioid overdose is now the leading cause of accidental death in the United States and has reduced the life expectancy in the country. In 2015, 33,000 deaths were attributed to opioid overdose, increasing in 2016 to 54,000 which is five times higher than in An estimated 115 Americans die each day due to opioid overdose. On October 26, 2017, President Trump declared that opioid overdose is an epidemic and a public health emergency. Ms. Oliver noted that opioid abuse is not a new problem, with data showing that the problem was identified in 1999 with a rise in prescription opioid overdose deaths. The second wave occurred around 2010 with a rise in Heroin overdose deaths. Around this time, practitioners became more conscious of the addictive nature of opioids and began to limit prescribing them, resulting in an increase in heroin use and subsequent overdoses. Beginning in 2013 to the present, there has been a significant rise in overdose deaths caused by Synthetic Opioids. On a national level, there are more overdose deaths attributed to Synthetic Opioids than heroin or prescription opioids. In 2017, there were 1,371 opioid related deaths in North Carolina, a 14% increase from 2016 with four North Carolina cities ranked among the top 20 nationally for opioid abuse. Wilmington is ranked #1, Hickory is ranked #2, Jacksonville is ranked #12 and Fayetteville is ranked #18. As a State, North Carolina has one of the largest Opioid problems in the United States, and Cleveland County is ranked among the top Counties within the State for opioid related deaths. In North Carolina during 2016, there were 620 overdose deaths from commonly prescribed opioid medications, 579 overdose deaths from other synthetic narcotics, 538 overdose deaths from Heroin and 488 overdose deaths from Cocaine. In Cleveland County in 2016, there were a total of 14 unintentional medication and drug overdose deaths, which was a decrease from 23 in County demographics of unintentional medication and drug overdose deaths by sex, age, race and ethnicity from 2012 to 2016 were identified and discussed. The opioid prescribing rate and the number of opioid pills dispensed in Cleveland County was identified and discussed. Presently, Cleveland County is experiencing more overdose deaths from prescribed opioid medications than synthetics and heroin, but based on national and state statistics, it is anticipated those numbers will increase. The total opioid consumption in the United States was reviewed. The United States has 4.6% of the world s population, and uses 80% of the worlds opioids, while 83% of the world population has no access to any opioids. Opioid misuse facts reveal that 20 to 30 percent of patients prescribed
3 MAY 8, 2018 PAGE 3 opioids for chronic pain misuse them. 8 to 12 percent develop an opioid use disorder. 4 to 6 percent of those who misuse prescription opioids transition to heroin, and approximately 80 percent of people who use Heroin first misused prescription opioids. It takes an average of 3 to 5 days for a person to develop a tolerance to opioid pain medication and an average of 2 to 3 weeks when taking opioid pain medication as prescribed to develop a dependence to opioids. Ms. Oliver noted the importance to emphasize to patients who are prescribed opioid pain medication to use them exactly as prescribed, or take less than prescribed. Synthetic opioids are manmade to produce opiate-like effects, and the most commonly abused forms are Fentanyl and Carfentanil which are legal, prescribed medications. Because synthetic opioids are manmade, they are often made counterfeit in foreign countries and smuggled into the United States. Charlotte has been identified as a large distribution hub for synthetic opioids, which are so potent that often an overdose is not able to be reversed with Naloxone. Synthetic opioids are available for purchase on-line on the dark web, as are pill presses used to produce counterfeit pills that contain Fentanyl and/or Carfentanil. Many times, consumers believe they are purchasing natural opioids but the drugs are laced with Fentanyl or Carfentanil, resulting in significant increases in the numbers of overdoses. In May, 2017, a drug bust in Iredell County resulted in the confiscation of 5,000 pills containing Fentanyl disguised as OxyContin, and in Davidson County the Sheriff s Office seized approximately 800 counterfeit Fentanyl and MDMA pills made to resemble Xanax, Oxycodone and Adderall. To illustrate the potency of Fentanyl and Carfentanil, Ms. Oliver stated that Heroin is 50 times stronger than Morphine, Fentanyl is 100 times stronger than Morphine and Carfentanil is 1000 times stronger than Morphine. Naloxone is a drug that reverses the effects of opioids by blocking the receptors that receive the Opioids. In 2016, EMS in Cleveland County administered Naloxone 146 times, 151 times in 2017 and as of April 22, 2018, 40 times. Ms. Oliver noted that all of the doses administered are not necessarily effective. Availability and approximate costs of Naloxone in Cleveland County was reviewed and discussed. New overdose prevention Initiatives/Partnerships include: Cleveland County Sheriff s deputies, Shelby police officers and Kings Mountain police patrol officers are carrying Naloxone; plans are developing to make Naloxone available to School Resource officers and Detention Center officers; and a partnership with EMS/first responders and Ollie Harris Behavioral Health to establish a Naloxone distribution voucher program. The Naloxone kits are being housed at the Ollie Harris Behavioral Health Center to allow those seeking Naloxone the opportunity to establish a relationship with the mental health facility and to connect with other needed resources. Plans are in development to establish a Law Enforcement Assisted Diversion (LEAD) Program. This program would allow those charged with misdemeanor drug possession to divert prior to arrest and booking to the LEAD Program where they would connect with a case worker and a peer
4 support specialist to provide them with an individualized treatment plan and constant check-ins and support. If during this time they are non-compliant with the program, the charges would be MAY 8, 2018 PAGE 4 re-established. POLICY REVISION: Board of Health members received copies of the following Cleveland County Board of Health policy in their Board packets for review of revisions and consideration of approval: Board of Health Staff Training and Continuing Education review and revision DeShay Oliver identified and reviewed revisions to the Cleveland County Board of Health Staff Training and Continuing Education Policy. The Board of Health discussed changes to the policy. Chair Spurling opened the floor for questions and/or further discussion regarding the presented policy. None were voiced, and Chair Spurling called for a motion. Motion: Robert Miller moved that the Cleveland County Board of Health Staff Training and Continuing Education Policy be approved as presented. Dianne Sanders seconded the motion and the policy was approved as presented unanimously. Chair Spurling directed Board of Health members to contact Ms. Wyant with any questions regarding agency policies. COMMUNITY SATISFACTION SURVEY RESULTS: As a requirement of the contract with the State, the Cleveland County Public Health Center conducts a general community survey annually. Anne Short presented results of the Community Satisfaction Survey conducted during the month of April, A copy of the 2018 Community Satisfaction Survey results is included in the information packet received by Board members. The ten question survey was posted on the Cleveland County Public Health Center website using a Survey Monkey format, and copies were sent to selected distribution lists in order to obtain a variety of answers. Notices about the availability of the survey were posted on the Cleveland County Public Health Communicator electronic sign, the Cleveland County Public Health Center web page and the Cleveland County Public Health Center Face Book page. There were 340 participants, with ninety-eight percent of those participating stating they would refer their family
5 and friends to the Public Health Center for services. Overall ratings were very positive. Further information received from the survey was identified and discussed. Ms. Short stated the results of this survey will be reviewed with the Management Team and used as a tool to improve overall customer satisfaction. The Customer Satisfaction Survey will be conducted during the month of MAY 8, 2018 PAGE 5 September and findings will be presented to the Board of Health in October. MISCELLANEOUS BUSINESS: Health Director Annual Job Performance Evaluation/Job Description Review: Chair Spurling stated that he conducted the Health Directors annual job performance evaluation and reviewed the job description with Dorothea Wyant on May 8, Board of Health members were encouraged to provide input to Chair Spurling prior to the review. Chair Spurling stated that Ms. Wyant received an excellent performance evaluation, and thanked Ms. Wyant for her positive leadership skills. Chair Spurling thanked the Board of Health for the input they provided for Ms. Wyants evaluation. ADJOURN There being no further business, Chair Spurling called for a motion to adjourn. Motion: Robert Miller moved, with a second by Randy Sweeting, that the Cleveland County Board of Health meeting be adjourned. Motion carried unanimously. RESPECTFULLY SUBMITTED, Dorothea Wyant, Secretary Cleveland County Board of Health
FEBRUARY 13, 2018 PAGE 1
FEBRUARY 13, 2018 PAGE 1 The Cleveland County Board of Health met on Tuesday, February 13, 2018 at 6:00 p.m., at the Cleveland County Public Health Center. Board members present: Katie Borders, Sara Karner,
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