FEBRUARY 13, 2018 PAGE 1

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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, Robert Miller, Kale Meade, Tom Spurling, Dianne Sanders, Stan Pitts, Ronnie Whetstine and Randy Sweeting. Health Department staff present: Dorothea Wyant, Tonya Sigmon, Kim Crane, Nathan McNeilly, Anne Short, Holly Wall, DeShay Oliver, Brittney Smith and Debbie Dyer. Tim Moore, County Attorney was present. Guests present: Laney Avery. CALL TO ORDER/WELCOME: Chair Spurling called the meeting to order and welcomed everyone. Robert Miller provided the invocation. Laney Avery, student intern from the University of North Carolina, Greensboro was introduced and welcomed. CITIZEN RECOGNITION: No citizens requested to appear before the Board. APPROVAL OF AGENDA FOR THE FEBRUARY 13, 2018 MEETING: Chair Spurling presented the proposed agenda for the February 13, 2018 Board of Health meeting for consideration of adoption. Motion: A motion was made by Robert Miller, with a second by Sara Karner to adopt the agenda for the February 13, 2018 Board of Health meeting as presented. APPROVAL OF JANUARY 9, 2018 MEETING MINUTES: Chair Spurling presented the January 9, 2018 Board of Health meeting minutes for consideration of approval. Motion: Katie Borders moved that the minutes of the January 9, 2018 Board of Health meeting be approved as presented. Kale Meade seconded and the motion carried unanimously.

FEBRUARY 13, 2018 PAGE 2 STATE OF THE COUNTY HEALTH REPORT: Anne Short presented the Cleveland County State of the County Health Report (SOTCH) for 2017. This report is compiled annually during the years a full community assessment is not conducted. The report has met all of the standards required by the NC Division of Public Health. A copy of the report was included in the packet of information received by Board of Health members. The 2017 SOTCH reviewed the highlights of the 2017 calendar year. Among the issues discussed in the report are current demographic information about the County (including population statistics, unemployment data, and current poverty levels), and morbidity/mortality data for County residents during 2011-2015 and 2012-2016. Detailed information is included in the report and was reviewed with the Board regarding the progress toward meeting goals established in the Community Health Action Plans for substance abuse, unintended pregnancy and sexually transmitted diseases, and physical activity and nutrition as the three priority health issues affecting the County. Ms. Short highlighted the success of reduction in teen pregnancy rates in Cleveland County over a period of the past nine years, and contributes this reduction to two factors; first, the family planning clinic continues to be proactive in offering long-acting reversible contraceptives (IUDs and implants) to patients requesting them, second, the Nurse Family Partnership program targets high risk, low-income first time mothers and works to support healthy babies, provide education about sexually transmitted diseases and promotes appropriate spacing of pregnancies to reduce repeat pregnancies. In order to address physical activity and nutrition, a new website Live Healthy Cleveland County will launch on April 11, 2018 at an Alliance for Health Partners meeting. This website will be dedicated to directing individuals to places they can be physically active and options for purchasing healthy food throughout Cleveland County. Ms. Short requested consideration of approval for this report from the Board of Health. Upon approval, the report will be sent to the NC Department of Health and Human Services and copies of the report will be distributed to the following entities: Cleveland County Board of Commissioners, Alliance for Health Board of Directors, Department of Social Services Board, Cleveland County Memorial Library, Spangler Library in Lawndale, Mauney Memorial Library in Kings Mountain, Rose Library at Cleveland Community College and the Dover Library at Gardner-Webb University. Additional copies will be provided for members of the legislative delegation serving Cleveland County in the NC General Assembly. A full copy of the report will be posted on the Cleveland County Health Department web site. Additional copies will be provided on request to residents and agencies in the County and may be accessed by contacting Ms. Short. Motion: Robert Miller moved, with a second by Ronnie Whetstine, that the Cleveland County Board of Health approve the State of County Health Report 2017 as presented and

FEBRUARY 13, 2018 PAGE 3 copies be sent to the Cleveland County Board of Commissioners, Cleveland County Legislative Delegation, Cleveland County Alliance for Health Board of Directors, Department of Social Services Board, Cleveland County Memorial Library, Spangler Library, Mauney Memorial Library, Rose Library and Dover Library. Motion passed unanimously. APPROVAL OF UNITED WAY FUNDING FOR CODAP Anne Short presented a request to apply for up to $20,000 in funding from United Way of Cleveland County to support one full time position in CODAP Services in the Health Education Unit of the Health Department. This position provides classroom instruction for all eighth grade students in Cleveland County Schools and coordinates with other health educators the SOBIR (Student Options Begin with Intervention and Recovery) Program for students who violate substance abuse policies. Funding from United Way supports staff time allocated to the classroom education program. Too Good for Drugs is an evidence-based program on the approved list for substance abuse prevention education established by the Substance Abuse and Mental Health Services Administration of the US Department of Health and Human Services. Too Good for Drugs consists of ten fifty minute classroom sessions educating students about tobacco (including electronic delivery devices), alcohol, marijuana, prescription medications, illicit drugs and consequences of substance abuse (physical, mental and legal consequences). Students have the opportunity to participate in activities such as wearing alcohol goggles to simulate various levels of inebriation, receive the most current information about alcohol, tobacco and other drugs and establish refusal skills and goals for a drug free lifestyle. The program is delivered to eighth grade students to prepare them with strong refusal skills prior to entering high school. During the current year, both pre and post testing has been included in all classes to determine if student knowledge about substance abuse has increased and if refusal skills have been strengthened. To date, the results have been extremely favorable and the data is available for review in the health education offices. The PRIDE Student Drug Use Survey data indicates the ninth grade year shows an increase in both annual use and use within the past thirty days for tobacco, alcohol, marijuana and prescription drugs. Over the past years, the Health Department has used the Northland Powerlines curriculum as well as Health Smart for Alcohol, Tobacco and Other Drugs. It is believed that Too Good for Drugs is a more comprehensive curriculum and is better suited to the needs of students in Cleveland County. In fiscal year 2013-2014, 712 eighth grade students participated in the classes. In fiscal year 2014-2015, the program provided classes to 1,068 eighth grade students. 931 eighth grade students were served in 2015-2016 and 1,161 in 2017. It is anticipated that during the current academic year at Crest Middle, Shelby Middle and Kings Mountain Middle Schools, 1,024 eighth grade students

FEBRUARY 13, 2018 PAGE 4 will be served. The curriculum is also provided to students at Turning Point Academy and Cleveland Early College High School upon request. Motion: Katie Borders made a motion for the Cleveland County Board of Health to approve the application for funding request to be presented to the Cleveland County United Way. Robert Miller seconded and the motion carried unanimously. INFLUENZA INFORMATION/REPORT: Communicable Disease Nursing Supervisor Kim Crane reported that it has been a very challenging flu season with stories regarding the flu surfacing in the news almost daily. One reason for the high flu activity is related to the types of strains circulating. The most prevalent strain this year has been the A strain, H3N2. Historically, during seasons where this is the dominant strain, there are higher numbers of flu related hospitalizations and deaths, along with more severe symptoms. Typically, flu season begins during the months of January and February, however, this year confirmed cases were documented as early as December. The flu virus continues to mutate from year to year and over time becomes less well matched to the strains so the antibody response from the vaccine is less effective. Mounting evidence indicates that this years vaccine may be less effective than normal, particularly against the H3N2 strain. There is current research to develop a Universal flu vaccine that would cover all strains, even as they mutate, as opposed to the current method where strains are cherry picked on a prediction of what strains will circulate during the next year. It is anticipated this vaccine may be available within the next 5 to 10 years. There have been numerous flu related deaths this year reported across the country, and a total of 140 lab confirmed influenza associated deaths in North Carolina between the dates of 10/2/2017 to 2/3/2018, but no deaths have been reported in Cleveland County. Ms. Crane noted that it is not too late to get a flu vaccine if you have not received one. The Health Department has administered around 1300 vaccines since September 15, 2017. Although the vaccine this year may not be as effective against a certain strain, it may prevent flu from other strains and decrease the severity of illness. A copy of the Influenza Surveillance, NC 2015-2018 report was provided in the information packet received by the board. BUDGET AMENDMENTS Tonya Sigmon presented the following budget amendment included in the Board of Health packet for consideration of adoption by the Board of Health: Item Number One: The Cleveland County Public Health Center has received a donation of $150.00 to be used to support the Adolescent Pregnancy Prevention (APP) Program. This program offers educational programs to educate adolescents on pregnancy prevention. A request was made to budget these amounts into the Adolescent Pregnancy Prevention Department (536) to be used to purchase incentives for participating students.

FEBRUARY 13, 2018 PAGE 5 Motion: A motion was made by Stan Pitts with a second from Katie Borders to accept the budget amendment as presented. The motion carried unanimously. MISCELLANEOUS BUSINESS: No miscellaneous business was brought before the board ADJOURN There being no further business, Chair Spurling called for a motion to adjourn. Motion: Stan Pitts moved, with a second by Sara Karner that the Cleveland County Board of Health meeting be adjourned. The motion carried unanimously. RESPECTFULLY SUBMITTED, Dorothea Wyant, Secretary