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HomeMy WebLinkAboutAgenda - 11-20-2012 - 6a 1 ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: November 20, 2012 Action Agenda Item No. 6-a SUBJECT: Smoke Free Public Places DEPARTMENT: Health PUBLIC HEARING: (Y/N) Yes ATTACHMENT(S): INFORMATION CONTACT: 1) Board of Health Rule — Smoke Free Colleen Bridger, Health Director, 245- Public Places 2400 2) Smoke Free Public Places Frequently Asked Questions (FAQ) 3) Fact Sheet 4) Community Leaders Survey Results 5) Community Survey Results 6) Draft Minutes from the October 24, 2012 Board of Health Public Hearing 7) Excerpt from Draft October 22, 2012 Town of Hillsborough Board of Commissioners Workshop Minutes 8) Ordinance Approving an Orange County Board of Health Rule Prohibiting Smoking in County and Town Buildings, Grounds, Vehicles, and Public Places PURPOSE: To conduct a public hearing to receive comments from the public regarding smoke free public places and to consider approval, by Ordinance, of the Orange County Board of Health's Smoke Free Public Places Rule adopted by the Board of Health on October 24, 2012. BACKGROUND: In 2006, a report issued by the United States Surgeon General stated that the scientific evidence indicates that there is no risk-free level of exposure to secondhand smoke and that secondhand smoke has been proven to cause cancer, heart disease, and asthma attacks in both smokers and nonsmokers. Also, research indicates that, during active smoking, outdoor levels of secondhand smoke may be as high as indoor levels and may pose a health risk for people in close proximity such as those sitting beside someone on a park bench or children accompanying a smoking parent or guardian. Given this and other information regarding the adverse health effects from secondhand smoke, and extensive input from municipal leaders and residents, the Orange County Board of Health voted to adopt a Smoke Free Public Places Rule. The details of this Rule are included in the attachments. Essentially, under this Rule, smoking would be banned: 1) in all indoor areas where the public is invited or allowed (including County and Municipal-owned vehicles) and 2) all County or Municipal-owned, maintained or controlled outdoor areas such as parks, parking 2 lots and sidewalks. There are some state-mandated exceptions such as the University of North Carolina-Chapel Hill campus and tobacco/smoke shops. The Board of Health began consideration of this Rule two years ago when the North Carolina General Assembly approved House Bill 2, a law that banned smoking in restaurants and bars and allowed local Boards of Health, in collaboration with local Boards of County Commissioners, the authority to pass more restrictive rules banning smoking in public places. Consideration of this Rule is in the Board of Health's strategic plan for 2012-2014. The draft Rule was shared with community leaders via email; survey and forum. It was modified based on input and then shared with the general public. The Board of Health received feedback from over 750 residents through: 1) an on-line survey; 2) email/regular mail; 3) a telephone hotline; and 4) a public hearing. General support for Smoke Free Public Places was high among both community leaders and the public. The Rule would go into effect January 1, 2013 for a "soft implementation" period of 6 months during which community education would begin, signage would be erected, and no citations would be issued for violations. Effective July 1, 2013, the Rule would go into full effect and local law enforcement could, if deemed appropriate, issue a $25 citation for failure to comply with the Rule. FINANCIAL IMPACT: The signs to notify the public of this change are the most expensive component. To date the Health Department has received approximately $30,000 from Federal grants to pay for signage and is actively seeking additional funding to help the Municipalities with sign purchases. RECOMMENDATION(S): The Manager recommends that the Board conduct the public hearing, approve by Ordinance the Orange County Board of Health's Smoke Free Public Places Rule, and authorize the Chair to sign the Ordinance. Attachment 1 3 ORANGE COUNTY BOARD OF HEALTH RULE A RULE TO PROHIBIT SMOKING IN COUNTY AND TOWN BUILDINGS, VEHICLES AND GROUNDS AND IN PUBLIC PLACES IN THE COUNTY OF ORANGE, THE TOWNS OF CARRBORO, CHAPEL HILL, HILLSBOROUGH AND THOSE PARTS OF MEBANE IN ORANGE COUNTY WHEREAS, according to the Centers for Disease Control and Prevention (CDC), Tobacco use and secondhand smoke exposure are leading preventable causes of illness and premature death in North Carolina and the nation;I and WHEREAS, in 2006, a report issued by the United States Surgeon General stated that the scientific evidence indicates that there is no risk-free level of exposure to secondhand smoke and that secondhand smoke has been proven to cause cancer, heart disease, and asthma attacks in both smokers and nonsmokers;2 and WHEREAS, the CDC advises that all individuals with coronary heart disease or known risk factors for coronary heart disease should avoid all indoor environments that permit smoking;3 and WHEREAS, research indicates that, during active smoking, outdoor levels of secondhand smoke may be as high as indoor levels and may pose a health risk for people in close proximity (such as those sitting beside someone on a park bench or children accompanying a smoking parent or guardian)4; and WHEREAS, in air quality tests, concentrations of secondhand smoke in vehicles have been found to be far greater than in any other micro-environments tested, including smoke-free homes, smokers' homes, smoke-filled bars, and outdoor air-even with a vehicle's windows open and its fan set on highs;and 1 Centers for Disease Control and Prevention, Smoking and Tobacco Use Fast Facts, http://www.cdc.gov/tobacco/data statistics/fact sheets/fast facts/#toll (last visited Oct. 7,2010). s U.S.DEP'TOFHEALTH& HUMAN SERVS, THE HEALTH CONSEQUENCES OF INVOLUNTARY EXPOSURE TO TOBACCO SMOKE: A REPORT OF THE SURGEON GENERAL 11, 14-16 (2006), 3 http://www.surgeongeneral.gov/library/secondhandsmoke/report/index.html. See id at 15; Centers for Disease Control and Prevention, Smoking and Tobacco Use Health Effects of Secondhand Smoke, http://www.cdo.gov/tobacco/data statistics/fact sheets/secondhand smoke/health effects/index htm (last visited March 25,2011). a Neil E.Klepeis, Wayne R.Ott, and Paul Switzer, Real-time Measurement of Outdoor Tobacco Smoke .Particles, 57 J.AIR&WASTE MGMT.Ass 'N 522, 522(2007); Neil E.Klepeis, Etienne B. Gabel, Wayne R.Ott, and Paul Switzer, Outdoor Ah,Pollution in Close Proximity to a Continuous Point Source, 43 ATMOSPHERICENV'T 3155,3165 (2009). s Wayne Ott,Neil Klepeis&Paul Switzer,Air Change Rates of Motor Vehicles and In-Vehicle Pollutant Concentrations from Secondhand Smoke,18 J.ExP05URE SCI.AND EVNTL.EPIDEMIOLOGY 312,312(2007),available at http://tobaccosmoke.exposurescience.org/pub/reprints/Ott CarStudy.pdf;see also Ontario Medical Ass'n, Backgrounder Tobacco Smoke Concentration in Cars, https://www.oma.org/Resources/Documents/fTobaccosmokeConcentrationsinCars.pdf (last visited March 30, Final ' 1 4 WHEREAS, on January 2, 2010, "An Act To Prohibit Smoking In Certain Public Places And Certain Places Of Employment," Session Law 2009-27, became effective, authorizing local governments to adopt and enforce ordinances "that are more restrictive than State law and that apply in local government buildings, on local government grounds, in local vehicles, or in public places;" and WHEREAS, pursuant to N.C. Gen. Stat. 130A-39(a), local boards of health have the responsibility to protect and promote the public's health and to adopt rules necessary for that purpose; and WHEREAS, the Orange County Board of Health is committed to providing a safe and healthy workplace in all County and Town facilities for County and Town employees and a safe and healthy environment for the visiting public; and I WHEREAS, the Orange County Board of Health finds and declares that, in order to protect the public health and welfare, it is in the best interests of the citizens of Orange County to adopt a Rule prohibiting smoking in County and Town buildings, vehicles and grounds and all public places in Orange County;and WHEREAS, the Orange County of Board of Health provides support to employees and residents who want to quit smoking and also encourages them to talk to their health care provider about quitting, ask about appropriate pharrnacotherapy available through their health insurance plan or employee's insurer, and to use the flee quitting support services of the North Carolina Tobacco Use Quitline at 1-800-QUIT-NOW (1-800-784-8669); and WHEREAS, the Orange County Board of Health wishes to minimize the harmful effects of smoking among Orange County and Town employees and eliminate secondhand smoke exposure for employees and the public in public places and in those buildings, vehicles, and grounds controlled by Orange County and the Towns of Carrboro, Chapel Hill, Hillsborough and those parts of Mebane in Orange County;and WHEREAS, the Orange County Board of Health finds and declares that, in order to protect the public health and welfare, it is in the best interests of the citizens of Orange County to adopt a Rule prohibiting smoking in public places and in County and Town buildings, grounds, and vehicles. NOW, THEREFORE, THE ORANGE COUNTY BOARD OF HEALTH ADOPTS THE FOLLOWING RULES: Section 1. Authority This Rule is enacted pursuant to N.C. Gen. Stat. 130A-498 and 130A-39(a). Section 2. Definitions 2011). Final 2 5 The following definitions are applicable to this Rule. 1) "Town" or "Towns". The Towns of Carrboro, Chapel Hill, Hillsborough and those parts of Mebane that are within Orange County. 2) "Town Building". A building owned, leased as lessor, or the area leased as lessee and occupied by the Towns of Carrboro, Chapel Hill, Hillsborough and those parts of Mebane in Orange County 3) "Town Grounds". An unenclosed area owned, leased or occupied by the Towns of Carrboro, Chapel Hill, Hillsborough and those parts of Mebane in Orange County. 4) "Town Vehicle". A passenger-carrying vehicle owned, leased, or otherwise controlled by the Towns of Carrboro, Chapel Hill, Hillsborough and those parts of Mebane in Orange County and assigned permanently or temporarily to their employees, agencies,institutions, or facilities for official Town business. 5) "Bus Stop". A designated area, whether enclosed or unenclosed, where buses stop for passengers to board or exit a bus. This term shall include areas at bus stops and shelters, beginning at the bus stop sign and extending for a radius of one hundred (100) feet around the bus stop sign. This area expressly excludes any private property that may fall within the one hundred foot radius of the bus stop sign or any area exempt by this Rule. 6) "County Building". A building owned, leased as lessor, or the area leased as lessee and occupied by Orange County. 7) "County Grounds". An unenclosed area owned, leased or occupied by Orange County. 8) "County Vehicle". A passenger-carrying vehicle owned, leased, or otherwise controlled by Orange County and assigned permanently or temporarily to its employees, agencies, institutions, or facilities for official County business. 9) "Employee". A person who is employed by the County of Orange or by the Towns of Carrboro, Chapel Hill, Hillsborough and those parts of Mebane in Orange County; or who contracts with the County or Towns; a third person who performs services for the County or Towns; or who otherwise performs services for the County or Towns with or without compensation. 10) "Local Health Department". The Orange County Health Department, the jurisdiction of which includes Orange County and the Towns of Carrboro, Chapel Hill,Hillsborough and those parts of Mebane in Orange County. Final 3 6 11) "Local health director". Administrative head of the Orange County Health Department appointed pursuant to N.C. Gen. Stat. Chapter 130A. 12)"Sidewalk". Any sidewalk that is owned, leased, or occupied by the County or Towns, including those maintained or controlled by the County and Towns and those that abut the County, Town and public school grounds. 13)"Smoking". The use or possession of a lighted cigarette, lighted cigar, lighted pipe, or any other lighted tobacco product. 13) "International 'No Smoking' symbol". Symbol consisting of a pictorial representation of a burning cigarette enclosed in a red circle with a red bar across it. 14) "Cigar bar". An establishment with a permit to sell alcoholic beverages pursuant to subdivision (1), (3), (5), or (10) of N.C. Gen. Stat. 18B-1001 that satisfies all of the following: a. Generates sixty percent (60%) or more of its quarterly gross revenue from the sale of alcoholic beverages and twenty-five percent (25%) or more of its quarterly gross revenue from the sale of cigars; b. Has a humidor on the premises; and c. Does not allow individuals under the age of 21 to enter the premises. d. Revenue generated from other tobacco sales, including cigarette vending machines, shall not be used to determine whether an establishment satisfies the definition of cigar bar. 15) "Enclosed area". An area with a roof or other overhead covering of any kind and walls or side coverings of any kind, regardless of the presence of openings for ingress and egress, on all sides or on all sides but one. 16) "Lodging establishment". An establishment that provides lodging for pay to the public. 17) "Private club". A country club or an organization that maintains selective members, is operated by the membership, does not provide food or lodging for pay to anyone who is not a member or a member's guest, and is either incorporated as a nonprofit corporation in accordance with Chapter 55A of the General Statutes or is exempt from federal income tax under the Internal Revenue Code as defined in N.C. Gen. Stat. 105-130.2(1). For the purposes of this Rule, private club includes country club. Final 4 7 18) 'Private residence". A private dwelling that is not a child care facility, as defined in N.C. Gen. Stat. 110-86(3), and not a long-term care facility, as defined in N.C. Gen. Stat. 131E-114.3(a)(1). 19) 'Private vehicle". A privately owned vehicle that is not used for commercial or employment purposes. 20) 'Public place". An enclosed area to which the public is invited or in which the public is permitted. 21) "Tobacco shop". A business establishment, the main purpose of which is the sale of tobacco, tobacco products, and accessories for such products, that receives no less than seventy-five percent (75%) of its total annual revenues from the sale of tobacco, tobacco products, and accessories for such products, and does not serve food or alcohol on its premises. Section 3. Areas in Which Smoking is Prohibited 1) Smoking is prohibited in all of the following: a. In any County building and Town building. b. In any County vehicle and Town vehicle. c. On any County grounds and Town grounds. d. All other County and Town property including,but not limited to: is County and Town Parks Systems including playgrounds and athletic fields; ii. County and Town Bus Stops; iii. Sidewalks; iv. Public Transportation; V. County and Town Trails and Parks; and vi. Polling Places 2) Smoking is prohibited in County buildings and Town buildings and grounds being used for private events. 3) Except as provided in Section 4 of this Rule, smoking shall be prohibited in all public places within the County and Towns, including but not limited to: Final 5 8 a. Child Care Facilities; b. Shopping Malls; c. Elevators; d. Polling Places; e. Public Restrooms; f. Restaurants; g. Bars; h. Retail Stores; i. Galleries,Libraries and Museums; j. Entertainment and Sports Arenas; k. Gaming facilities including, but not limited to, Internet Sweepstakes and Video Poker; 1. Lobbies, Hallways and other Common Areas in Apartment Buildings, Condominiums, Retirement Facilities, Nursing Homes and other Multi-Unit Residential Facilities;and m. Office and Other Commercial Establishments Where the Public is invited, or permitted. Section 4. Exceptions: Where Smoking is Not Regulated By This Rule 1) In accordance with N.C. Gen. Stat. 130A-498(bl), smoking is not prohibited by this Rule in the following places: a. A private residence. b. A private vehicle. c. A tobacco shop if smoke from the business does not migrate into an enclosed area where smoking is prohibited pursuant Article 23 of the North Carolina General Statutes. A tobacco shop that begins operation after July 1, 2009, may only allow smoking if it is located in a freestanding structure occupied solely by the tobacco shop and smoke from the shop does not migrate into an enclosed area where smoking is prohibited pursuant to Article 23 of the North Carolina General Statutes. Final 6 9 d. All of the premises, facilities, and vehicles owned, operated, or leased by any tobacco products processor or manufacturer, or any tobacco leaf grower, processor, or dealer. e. A designated smoking guest room in a lodging establishment. No greater than twenty percent (20%) of a lodging establishment's guest rooms may be designated smoking guest rooms. f. A cigar bar if smoke from the cigar bar does not migrate into an enclosed public place where smoking is prohibited pursuant to Article 23 of the North Carolina General Statutes. A cigar bar that begins operation after July 1, 2009, may only allow smoking if it is located in a freestanding structure occupied solely by the cigar bar and smoke from the cigar bar does not migrate into an enclosed area where smoking is prohibited pursuant to Article 23 of the North Carolina General Statutes. g., A private club. h. A motion picture, television, theater, or other live production set. This exemption applies only to the actor or performer portraying the use of tobacco products during the production. (2) This Rule does not apply to any property owned, leased, or maintained by the State of North Carolina. Section 5. Implementation Requirements (1) The Implementation period shall be January 1,2013 to June 30, 2013. (2) During the Implementation period the County and the Towns where smoking is prohibited by the Rule shall: a. Post signs that meet all the requirements in Section 6 of this Rule. b. Remove all indoor ashtrays and other smoking receptacles from the area in which smolcing is prohibited, except for ashtrays and receptacles for sale and not intended for use on the premises. c. Direct a person who is smoking or using a tobacco product in a prohibited area to extinguish the lighted tobacco product and, if the person does not comply, ask the person to leave the premises. d. If a person in violation refuses to leave the premises, contact the Final 7 10 County sheriff department or the police department in the Towns in which the violation occurred. An oral or written notice shall be provided to the person. e. Engage in public education as provided in Section 8 below. (3) During the implementation period a person who manages, operates, or controls a public place in which smoking is prohibited by this Rule shall: a. Post signs that meet all the requirements in Section 6 of this Rule. b. Remove all indoor ashtrays and other smoking receptacles from the area in which smoking is prohibited, except for ashtrays and receptacles for sale and not intended for use on the premises. c. Direct a person who is smoking in a prohibited area to extinguish the lighted tobacco product and, if the person does not comply, ask, the person to leave the premises. d. If a person in violation refuses to leave the premises, contact the County sheriff department or the police department in the Town in which the violation occurred. An oral or written notice shall be provided to the person. Section 6. Signage (1) The County and the Towns where smoking is prohibited by the Rule shall post signs as required by Section 5 that must: a. State in English an d S p a n i s h that smoking is prohibited and include the universal "No Smoking" symbol. b. Be of sufficient size to be clearly legible to a person of normal vision, and be conspicuously posted. c. Be posted at each entrance to a County a n d T o w n building and in other locations within the buildings reasonably calculated to inform employees and the public of the prohibition. d. Be posted on County grounds and Town grounds in locations and at intervals reasonably calculated to inform employees and the public of the prohibition. (2) The County or Towns where smoking is prohibited by the Rule may in Final 8 11 their discretion post a sign that either states "No Smoking" or contains the International "No Smoking" symbol in County or Town vehicles in an area visible to passengers, provided that their placement does not interfere with the safe operation of the vehicle. If the vehicle is used for undercover law enforcement operations, a sign is not required to be placed in the vehicle. (3) A person who manages, operates, or controls a public place in which smoking is prohibited by this Rule shall post signs required to be posted in enclosed areas of public places that must: a. Clearly state in English and Spanish that smoking is prohibited and include the International "No Smoking" symbol. b. Be conspicuously posted at each entrance to the p u b l i c p l a c e. c. Be at least 24 square inches in size. d. Be at least 16 point font size. Section 7. Enforcement and Penalties (1) Violations by persons smoking in prohibited areas. Failure to cease s in o k in g in a prohibited area constitutes an infraction punishable by a fine of t w e n t y- f i v e dollars ($25.00). A citation may be issued by a sworn law enforcement officer. Conviction of an infraction under this section has no consequence other than payment of a penalty, and no court costs may be assessed. (2) Sanctions for employees. In addition to any penalty under subsection (1), employees of Orange County and employees of the Towns who violate this Rule shall be subject to disciplinary action consistent with their respective employer's personnel ordinances or policies. (3) Violations by persons who manage, operate, or control a public place. The Orange County health directormay take the following actions and may impose the following administrative penalty on a person who manages, operates, or controls a public place and fails to comply with the provisions of this Rule: a. First violation. Written notice of the person's first violation and notification of action to be taken in the event of subsequent violations. b. Second violation- Written notice of the person's second violation and Final 9 12 notification of administrative penalties to be imposed for subsequent violations. c. Third and subsequent violations-Impose an administrative penalty of not more than two hundred dollars ($200.00). Each day on which a violation of this Rule occurs may be considered a separate and distinct violation. Section 8. Public Education The County and the Towns shall engage in an ongoing program to explain and clarify the purposes and requirements of this Rule to citizens affected by it, and to guide operators and managers in their compliance with it. In doing so, the County and Towns may rely upon materials and information provided by the local health department, The County and Towns shall: (1) Educate the public about the rule and the reasons for the new rule prior to its implementation date through the news media, website and educational media. This education shall include information on resources for quitting smoking or tobacco use including information about the free quitting support services of the North Carolina Tobacco use Quitline 1-800 QUIT NOW(1- 800-784-8569). (2) Educate County and Town employees at covered facilities, about the Rule and how they can assist with compliance with the Rule. (3) Provide County and Town employees with information on cessation of smoking, including information about the flee quitting support services of the North Carolina Tobacco use Quitline 1-800 QUIT NOW (1-800-784- 8659). (4) Post n o t i c e s at each entrance to a County o r T o w n building and in other locations within the buildings reasonably calculated to inform employees and the public of the prohibition. Section 10. Effective Date These Rules become effective January 1, 2013 following adoption by the Orange County Board of Health and approval of these Rules by an Ordinance adopted by the Orange County Board of Commissioners pursuant to N.C. Gen. Siat. 153A-121(a). There shall be an implementation period from January I through June 30, 2013 where enforcement shall be limited to Section 5 of the Rule. On July 1, 2013 and thereafter the Ordinance shall be enforced as provided in Section 7 of this Rule. Final 10 13 Section 11. Abrogation This Rule is not intended to repeal, abrogate or impair any greater restriction imposed by any other state law or local government ordinance. Wherever the provisions of any other law, ordinance, regulation or restriction impose higher standards than are required by the provisions of this Rule, this Rule does not prohibit enforcement of any such law, ordinance, regulation or restriction. Adopted this the a`t day of O c oe ,,£ (- ,201 . Chair Orange County Board of Health ATTEST: �wl 1�1- Secretary to the Orange Coui ty Board of Health Approved as to form: Of*6f Attor ey Final 11 Attachment 2 Orange County Board of Health Smoke-Free Public Places Rule Frequently Asked Questions Q. Why is the Orange County Board of Health(BOH)considering a Smoke-Free Public Places Rule? Health impacts • Everyone has the right to breathe clean air in public places. • According to the Centers for Disease Control and Prevention (CDC),tobacco use and secondhand smoke exposure are leading preventable causes of illness and premature death in North Carolina and the nation. • There are solutions to the health and environmental impacts of smoking. After restaurants and bars became smoke- free in NC,average weekly emergency room visits by people experiencing heart attacks decreased by 21%. Dangers of secondhand smoke • Secondhand smoke contains more than 7,000 chemicals, hundreds of which are toxic(such as formaldehyde, arsenic and lead)and about 70 can cause cancer. • In 2006, a report issued by the United States Surgeon General stated that the scientific evidence indicates that there is no risk-free level of exposure to secondhand smoke and that secondhand smoke has been proven to cause cancer, heart disease, and asthma attacks in both smokers and nonsmokers. • The CDC advises that all individuals with coronary heart disease or known risk factors for coronary heart disease should avoid all indoor environments that permit smoking. Healthy Orange • As the 2nd healthiest county in North Carolina,the Board of Health feels it is in the best interest of our citizens and those who visit Orange County to be provided with a healthy and smoke-free environment. Q. Why is the BOH considering smoke-free outdoor areas? Impact of secondhand smoke outdoors • Research indicates that, during active smoking,outdoor levels of secondhand smoke may be as high as indoor levels and may pose a health risk for people in close proximity (such as those sitting beside someone on a park bench). • The 2006 U.S.Surgeon General's report states that"Breathing even a little secondhand smoke can be harmful." • The Surgeon General has concluded that the only way to fully protect yourself and your loved ones from the dangers of secondhand smoke is through 100%smoke-free environments. Cleaner environment • Cigarette butts are the most commonly littered item in America. • Outdoor smoke-free policies have been shown to decrease litter and therefore, reduce clean-up costs at outdoor areas. It's good for our youth • Creating smoke-free environments reduces opportunities for youth to learn the behavior of smoking. Q. How does the proposed new rule differ from existing laws and ordinances? • The proposed rule would broaden what is currently in effect to include places such as government grounds, parks, recreational facilities and any enclosed facility where the public is invited such as lobbies and other common areas. 15 Q.Why��Ist this onsibility?Isn't smoking a personal choice? spo s Ity to Prot ct prom t r 1c's ,--�Oc s of health have the responsibility to protect and promote the public's health and to adopt rules necessary for that purpose(N.C. Gen.Stat. 130A-39(a)). • The Orange County Board of Health wishes to minimize the harmful effects of smoking and eliminate secondhand smoke exposure for its citizens and the visiting public. • Smoke-free laws help the seven out of every ten smokers who want to quit smoking by providing them with public environments free from any pressure or temptation to smoke. • There is support for people who want to quit smoking.Smokers can talk to their health care provider about quitting and ask about appropriate medications available through their health insurance plan or employee's insurer.They can also use the free quitting support services of QuitlineNC at 1-800-QUIT-NOW(1-800-784-8669)or www.QuitlineNC.com. Q. How will this rule be implemented and enforced? • Starting January 1, 2013, implementation would include six months of public education about the new rule and reasons for it, posting signs and removing ashtrays and smoking receptacles. Fines would go into effect on July 1, 2013. • Most outdoor policies depend upon the cooperation of the public—generally those who frequent the areas.Since most people will refrain from smoking if they know a smoke-free policy is in place,the best way to enhance enforcement is to educate the public and local businesses about the policy early and often in the implementation process. • According to the NC Tobacco Prevention and Control Branch the State is currently receiving only 10 complaints per month about the Smoke-Free Restaurants and Bars Law. High compliance is based on education and clear communication. Q.Where can I find additional information? • Secondhand Smoke Exposure(Source: NC Division of Health and Human Services): www.tobaccopreventionandcontrol.ncdhhs.gov/shs/index.htm • Smoking and Health Effects(Source:Centers for Disease Control and Prevention) http://www.cdc.gov/`­t­obacco/­- data statistics/fact sheets/health effects/effects cig smokinglindex.htm • For help quitting tobacco use,call toll free 1-800-QUIT-NOW or visit www.QuitlineNC.com References: 1. CDC, Smoking and Tobacco Use Fast Facts,http://www.cdc.gov/tobacco/data statistics/fact sheets/fast facts/#toll 2. NC Tobacco Prevention and Control Branch(2011).The North Carolina Smoke Free Restaurants and Bars Law and Emergency Department Admissions for Acute Myocardial Infarction.A Report to the North Carolina State Health Director. 3. U.S.Department of Health and Human Services.A Report of the Surgeon General:How Tobacco Smoke Causes Disease:What It Means to You.Atlanta: U.S. Department of Health and Human Services,Centers for Disease Control and Prevention,National Center for Chronic Disease Prevention and Health Promotion,Office on Smoking and Health,2010,http://Www.cdc.gov/tobacco/­data statistics/sgr/2010/consumer booklet/index.htm 4. U.S.DEP'TOFHEALTH&HUMAN SERVS.,THE HEALTH CONSEQUENCESOF INVOLUNTARY EXPOSURE TO TOBACCO SMOKE: A REPORT OFTHE SURGEON GENERAL 11, 14 -16(2006),http://www.surgeon general.gov/library/secondhandsmoke/report/`­­index.htmi. 5. CDC, Smoking and Tobacco Use Health Effects of Secondhand Smoke,fittp://www.cdc.gov/tobacco/data statistics/fact sheets/secondhand smoke/ health effects/index.htm. 6. County Health Rankings and Roadmaps:A Healthier Nation County by County.http://,A w.countvhealthrankings.org/#app/north-carolina/2012/rankings) outcomes/overall 7. Neil E.Klepeis,Wayne R.Ott,and Paul Switzer, Real-time Measurement of Outdoor Tobacco Smoke Particles, 57 J.AIR&WASTE MGMT.Ass'N 522, 522(2007); Neil E.Klepeis, Etienne B. Gabel,Wayne R.Ott,and Paul Switzer, Outdoor Air Pollution in Close Proximity to a Continuous Point Source, 43 ATMOSPHERICENV'T 3155,3165 (2009). 8. International Coastal Cleanup-2007 Reports,www.oceanconservancy.org 9. Klein,E.G.,Forster,J.L.,McFadden,B.&OutleyC.W.(2007).Minnesota tobacco-free park policies:Attitudes of the general public and park officials.Nico- tine& Tobacco Research.9(1),49-55. 10. Tobacco Control Legal Consortium,There is No Constitutional Right to Smoke,Samantha K.Graff(2005),http://www.r)ublichealthlawcenter.org/sites/ defaull/bles/­`resources/"­t­cic-syn-constitution-2005.odf 11. Campaign for Tobacco-free Kids,Smoke-free laws do not harm business at restaurants and bars,2011. 11 Tobacco Control Legal Consortium,Regulating Smoking Outdoors:Tips and Tools,http://www.publichealthlawcenter.org/sites/`def3ult/­flies/­`­resoureesl tcic-guide-smokingouldoors-2010.i3df. Attachment 3 MA�Vv Overview Where would smoking be prohibited by this rule? • County and Town buildings and grounds • County and Town vehicles • County and Town Parks Systems including playgrounds,trails, and athletic fields • Bus Stops • Sidewalks that are maintained by the County or Town including those connected to a public school • Public Transportation • • Polling Places • Child Care Facilities • Shopping Malls • Elevators _ • Public Restrooms • Retail Stores • • Galleries, Libraries and Museums • Entertainment and Sports Arenas • Gaming facilities including Internet Sweepstakes and Video Poker • Lobbies, Hallways and other Common Areas in Apartment Buildings, • Condominiums, Retirement Facilities, Nursing Homes and other Multi-Unit Residential Facilities • Office and Other Commercial Establishments where the public is invited,or permitted Where would smoking not be regulated by this rule? • Private residences • Private vehicles • Tobacco shops • Tobacco manufacturers, growers, processors • Designated smoking guest rooms in lodging establishments. No greater than twenty percent (20%) of a lodging establishment's guest rooms may be designated smoking guest rooms • Cigar bars • Private clubs • Motion picture, television,theater, or other live production sets. This exemption applies only to the actor or performer portraying the use of tobacco products during the production • UNC Chapel Hill (Existing University policy will remain in effect) a Implementation Requirements - r- Education and preparation period would begin on January 1,2013 and include: • Educating the public about the rule and the reasons for the new rule • Educating County and Town employees of facilities covered under this rule • Posting signs that meet all local sign requirements • Removing all ashtrays and smoking receptacles • Directing smokers to cease using products in prohibited areas • Contacting law enforcement in cases of non-compliance to issue warnings 17 Smoke-Free Public Places Rule - Continued Enforcement and Penalties - Effective date of July 1, 2013 Citizens - Failure to cease smoking in a prohibited area following warning constitutes an infraction punishable by a fine of$25 issued by law enforcement. Conviction of an infraction under this section has no consequence other than payment of a penalty, and no court costs may be assessed. Employees - In addition to any penalty above, employees of Orange County and employees of the Towns who violate this Rule shall be subject to disciplinary action consistent with their respective employer's personnel ordinances or policies. Persons who manage or operate a public place-The Orange County Health Director may take the following actions and may impose the following administrative penalty on a person who manages, operates, or controls a public place and fails to comply with the provisions of this Rule: • First violation. Written notice of the person's first violation and notification of action to be taken in the event of subsequent violations. • Second violation. Written notice of the person's second violation and notification of administrative penalties to be imposed for subsequent violations. • Third and subsequent violations. Health Director may impose an administrative penalty of not more than$200. Signage Requirements • State in English and Spanish that smoking is prohibited and includes the universal"No Smoking" symbol. • Be of sufficient size to be clearly legible to a person of normal vision. • Post at each entrance to a County or Town and in other locations within the buildings reasonably calculated to inform employees and the public of the prohibition. • Post on County grounds and Town grounds including the Parks System in locations and at intervals reasonably calculated to inform the employees and the public of the prohibition. • Post in each County vehicle and each Town vehicle in areas visible to passengers. If the vehicle is used for undercover law enforcement operations, a sign is not required to be placed in the vehicle. • Post on County and Town sidewalks at intervals so as to reasonably inform the public of the prohibition. • Post at bus stops in areas visible to the public. • A person who manages, operates, or controls a public place in which smoking is prohibited by this Rule shall post signs required to be posted in enclosed areas. Public Education The County and the Towns will engage in ongoing public education to explain and clarify the purposes and requirements of this Rule to citizens, and to guide e operators and managers in their compliance.The Health Department will pro- s vide information and technical assistance for this purpose to: • Educate the public on the new rule and reasons for it through news media, websites and educational materials. • Promote resources for quitting tobacco-QuitlineNC, toll-free 1-800-QUIT- NOW,www.QuitlineNC.com. • Work with County and Town human resource staff to educate employees about the Rule and how they can assist with compliance. • Provide tobacco cessation information to employees. Attachment 4 18 Orange County's Proposed Smoke-Free Public Places Survey Responses On Tuesday,September 18,2012 a survey was sent out to 57 elected officials and key stakeholders across Orange County.The survey closed at 2:00 p.m.on Tuesday,September 25,2012 with a total of 88 responses. Based on the professional titles reported, it appears that the survey was shared outside the original intended audience. Respondents: • 4 reported being current smokers, 10 former smokers and 72 non-smokers • 50 live and/or work in Hillsborough • 26 live and/or work in Chapel Hill • 9 live and/or work in Carrboro • 1 lives and/or works in Mebane • 1 lives and/or works in Bingham • 1 lives and/or works in Efland Professional Titles of Respondents: Project Coordinator; Alderman; VP; Director, Lobbying Compliance Division; Student; Graduate Student; Director of Non-Profit Program; MSW Student; Human Resources Director; Economic Development Director; Retired/Volunteer; Mediator; MSW; Retired; Director of Hospital Police; Environmental Engineer; Retired Director; Guardian ad Litem; Tobacco Treatment Specialist; Teacher; Research Assistant; Tobacco Treatment Specialist; Social Research Associate; Public Health Survey Researcher; CPA,Chapel Hill-Carrboro City Schools Health Coordinator; Police Officer; Landscape Ecologist; Farmer; Admin; Associate Director; Town Employee; Director; Commissioner; Town Council Member-Chapel Hill; Pharmacist;Coordinator; Research Health Analyst; Chef; Town Commissioner; Commissioner; Farmer; Independent Clinical Research Consultant; Home Owner; Writer; Scientist; Preschool Teacher; R.N.; R.N.; HR Manager;Administrative Specialist; VP, Enterprise Sourcing Governance; SAHM; Teacher Assistant; Homemaker/Homeschool Teacher; Stay at Home Mom; Director, Discovery Biology; Pharmacist; Project Manager; Director; Store Manager; Executive Assistant; Pharmacist; Retired Educator; Clinical Applications Coordinator; Software Engineer; Retired Public Safety Director/Chief of Police; Home School Mom; R.N.;Software Engineer; Self- Employed Contract Writer/Personal Property Appraiser; Mom and Piano Teacher; GIS Coordinator; Project Manager; Land Conservation Manager; Environmental Health and Safety Director;Planning Director; Pharmacist; Town Manager; Human Resources Director; Senior Financial Analyst; Mayor;Town Clerk 19 Results Q. Would you support the following places being smoke-free? (Smoke-free includes prohibiting the use of lighted cigarettes, lighted cigars, lighted pipes,or any other lighted tobacco products.) Government vehicles Elevators Galleries,libraries&museums Child care facilities Public restrooms Polling places Entertainment&sports arenas Lobbies,hallways&common areas Bus stops Parks,rec facilities,traits&playgrounds Retail stores,shopping malls,convenience stores Office&commercial space Government grounds Sidewalks Gaming facilities MEMO 0% 20% 40% 60% 80% 100% ■Yes ■No m No opinion Yes No No opinion Gaming facilities 75.3% 8.21 16.5% , Sidewalks 75.9% 21.8% 2.3% Government grounds 81.8% 15.9% 2.3% Office&commercial space 87.2% 12.8% 0% Retail stores,shopping malls,convenience stores 89.5% 10.5% 0% Parks, rec facilities,trails&playgrounds 90.8% 6.9% 2.3% Bus stops 92% 5.7% 2.3% Lobbies, hallways&common areas 92% 5.7% 2.3% Entertainment&sports arenas 94.3% 5.7% 0% Polling places 95.2% 4.8% 0% Public restrooms 96.6% 2.3% 1.1% Child care facilities 97.7% 2.3% 0% Galleries,libraries&museums 97.7% 2.3% 0% Elevators 98.8% 1.2% 0% Government vehicles 100% 0% 0% 20 Q.What do you believe are the most significant benefits of a smoke-free public places rule? Economic Benefits of MF2' EnC0UraFg,,es .-I a I Peo le improved Aviding People to Seoond Improved Chronic Coming General Hand Air Quality Disease& • Because Health Smoke for Everyone we are Expenses Smoke- Free 28 14 13 3 2 Q. What do you believe are the biggest drawbacks of a smoke-free public places rule? Personal No _ Freedoms/ _ Humiliation/Oppression of Drawbacks Overreach of of Smokers Owners Government 25 14 8 Q. What would make you more supportive of a smoke-free public places rule in Orange County and its Towns? I am already Businesses Having Should have Additional Not Being so Effective I am Not • supportive Enforcement Smoking Supportive the Right to Help Areas Decide for �� Themselves 27 8 5 4 Q.Are there any additional comments you would like to share? I personally appreciate this issue being looked into. Thank you. Reasonable regulations in specific areas are fine.What is being considered is over reaching.The county should not be making town law. I'm an evangelical ex-smoker who realizes the health benefits of a smoke-free environment. I also think it will help others quit smoking if the spaces where they can smoke are highly restricted. I hope this is successful. This is a step in changing the culture and I support it. Thanks for working on thisH Thanks for your work in proposing this legislation. 21 Cont'd...Q.Are there any additional comments you would like to share? Banning smoking at bus stops and sidewalks is too restrictive and will have unforeseen consequences such as causing those smokers to smoke in their cars with children present. If all workplaces,park and ride lots,public parking, etc. ban smoking,smokers will have to smoke somewhere and that might negatively affect the children of these smokers.They need to be helped because they are part of the "public"in public health, not looked down upon or ostracized.Smoking is very addictive and most stop smoking aids are not that effective. CHCCS already have tough no-smoking policy that works. Thank you. All public facilities and vehicles that are government owned should absolutely be smoke free. Places like sidewalks (not in front of businesses)would be overkill,though,in my opinion. Prior to living in Orange County,my family and I lived on the west coast for over 10 years where restaurants became smoke-free,then public places, and finally beaches. We love Orange County,however we miss having a totally smoke-free environment.Tobacco smoke is a carcinogen and we should not have to breathe it in when we are out at the park or walking down the sidewalk. I think that it's great Orange County is considering this! Balanced approach is the key with logical reasoning. Please include smokers in the conversation,not just rabid anti-smokers. I don't like smoking and I choose not to, but if done considerately, I believe it should be allowed. I'm just grateful that this is being considered. Careful, careful,careful.....let's not allow governmental intrusion into our lives when not necessary,but at the whim of some individuals. Better for the health of the community Thank you for considering this issue Thank you for taking the time to conduct this survey. This is a great effort that I am happy to support. I consider this expansion of non-smoking areas to be paramount to public health and safety. Non-smoking in child care facilities is a no brainer. The children have no means of avoiding it, even if they wanted to. An incremental approach might be best. Start with all indoor work areas with ten or more employees, bus stops, arenas, parks. Progress to other areas as acceptance grows. Still need to ensure that there are outside public places that people can smoke, but which will not unduly impact non-smokers. Thanks for the survey! Thanks for asking.............. 22 Cont'd...Q.Are there any additional comments you would like to share? There is no evidence that I know of that smokers in open-air public places endanger the health of others. If we are going to disallow all bad habits in public places there are number that are higher on my list. How about prohibiting rap music on beaches and in malls? Or piercings? And,especially,wearing your pants around your knees so your underwear shoes. These are a lot more annoying than smoking. If it isn't making me inhale their second-hand smoke,let people smoke,if they want to,for God's sake! Citizens have the right to smoke if they so choose;however, habits that have a negative effect upon other should be publicly banned. The Town of Hillsborough already has a no smoking- smoke-free policy in place. My family has been in tobacco farming for 300 years,and I grew up in that environment. I am not a smoker, but I believe smokers have a right to smoke in certain locations-outside,and in their private residence. Study history....did we not learn anything from Prohibition? I personally do not like smoking and would prefer more areas to be smoke free.That being said, I feel it's a mistake,an intrusion of government,and counterproductive to overly restrict smoking.The proposed rules go too far. Keep up the great work! Attachment 5 23 Orange County: Smoke-Free Public Places Public Survey Response Summary As part of the Board of Health process of consideration of the Smoke-Free Public Places Rule,public input was sought during the time period beginning on September 27, 2012 and concluding on October 24,2012 with a public hearing. Community members were given five (5)ways to provide input on the proposed rule,all with English and Spanish options:online survey, e-mail,voicemail, US mail,and public hearing. Response prior to the October 24, 2012 public hearing included:735 completed online surveys, 11 e-mail responses,five voicemail messages, and one letter via US mail.Survey responses were largely supportive. When combining responses of Yes and No Opinion, all but Government Grounds(79.1%)and Sidewalks (71.2%) received 80%support or greater.Comments received by email,voicemail, US mail also showed more support than opposition to the proposed ban. Survey respondents'demographics were comparable to the County over all,with two notable exceptions: The survey over-sampled to include more high school student opinions and opinions of citizens with less education than County averages. The race breakdown is roughly comparable to County census data. Income data was difficult to compare given the question format and with a substantial number leaving that question blank This report is an overview of the public input we received. 24 Survey Demographics Location Education Race Prefer not to Less than high Other answer school m 3% 10% High school Eltland 4%4% diploma or GED African encan 2 0 1 9% Hispanic/ Mebane—' Latino 3% 6% [an/Pacific Carrboro Islander 5% 7% '----other Native 4g; American/ ._........^ ....._-.....----.__......_.., ,...,� _ - American -- Indian 1% Income Age 35.0% 70.0% 30.0% -- 60.0% .......-....._._--------__..... 25.0% - 50.0% ..................._................................._............._....__ ..................._-.................................... ...__......-._ 20.0% -- — - 40.0% 15.0% - 30.0% 10.0% --_-- — - 20.0% 5.0% -- — — - 10.0% T 1.5% <$20k $20k-40k $40-60k $60-80k $80k+ Prefer not to Under 18 18-25 2655 56 and Over Prefer not to answer answer Prefer not to Smoker,57,8% answer,11, 2% Former smoker /tobacco user, Smoking Habits 106,14% • Non-smokers supported 87.8%of the 15 locations listed. • Former smokers supported 79.0%of the locations listed. • Smokers& "Prefer not to answer'supported 54.3%and 53.3%of the listed locations respectively. 25 Public Support By Smoking Location Overall,all locations received clear support significantly beyond a majority. All but government grounds and sidewalks received 80106 support or greater, with many receiving 90961 support. Elevators Public Restrooms Child care facilities Government Vehicles Galleries,libraries,and museums Polling places Lobbies,hallways and common areas I Office&commercial space Retail stores,shopping malls and convenience Entertainment and sports arenas Parks,rec facilities,trailers&playgrounds Bus stops I Government grounds Gaming facilities(ex. Internet sweepstakes,...00* Sidewalks 0% 20% UP% 60% 80% 100% USupport No opinion ■Oppose No Yes No opinion Elevators 94.7% 4.7% 0.7% Public Restrooms 93.6% 5.5% 1.0% Child care facilities 93.2% 5.6% 1.2% Government Vehicles 92.9% 5.5% 1.6% Galleries, libraries,and museums 90.6% 7.4% 1.9% Polling places 87.8% 8.7% 3.4% Lobbies,hallways and common areas 87.4% 9.9% 2.6% Office&commercial space 85.3% 10.5% 4.3% Retail stores,shopping malls and convenience stores 84.9% 11.8% 3.3% Entertainment and sports arenas 82.1% 13.6% 4.3% Bus stops 79.0% 16.8% 4.3% Parks,rec facilities,trailers&playgrounds 78.9% 19.2% 1.9% Government grounds 76.9% 20.9% 2.2% Gaming facilities(ex. Internet sweepstakes,video poker) 67.9% 14.2% 17.9% Sidewalks 64.4% 28.8% 6.8% 26 Open Ended Summary Question Analysis Q•What do you believe are the most significant benefits of a smoke-free public places rule? 350 300 250 200 150 100 50 0 146 -_ Avoiding Second Improved Improved Air Less Litter Reduction in Healthy Encourages Other Hand Smoke General Health Quality Chronic Disease Environment for People to Quit &Medical Everyone and/or Not Start Expenses Q•What do you believe are the biggest drawbacks of a smoke-free public places rule? 200 150 100 50 4 0 - M . No Drawbacks Personal Enforcement Humiliation/ Other Angry People Rights of Business Freedoms/ Oppression of Owners Overreach of Smokers Government Large Other Write-in:w Almost half of other represented concerns with the economic impact on businesses with fewer visitors to these places and smokers feeling less welcome. Q•What would make you more supportive of a smoke-free public places rule in Orange County and its towns? 250 200 150 100 50 9 8 14 0 - I I W am already Not being so Effective Having I am not Businesses Additional Other supportive extensive Enforcement Designated supportive should have resoruces to Smoking Areas the right to help people decide for quit themselves Large Other Write-in:_The bulk of the"other"category included requesting adequate advertisements and signage of new regulations and increased information/education on the risks of 2 nd hand smoke and studies of the ban's Impact. 27 Summary of"Why No Support?" Open Ended Comments by Location Sorted by lowest%of approval. NOTE:This section is a summary of the oppositional minority,not the average response. Average response was positive even for locations with the"least"amount of support. Sidewalks(64.4%Support,28.8%Against,6.8%No opinion):The majority of responses against banning smoking on sidewalks made references to the fact that sidewalks are outside,in open air and not in enclosed spaces,and transient spaces—people are usually passing by and not exposed to smoke for long.Sidewalks are described as too broad of an area and therefore difficult to enforce.Other big concerns are 1)general government intrusion on personal liberties/rights/freedoms and 2)smokers not having anywhere else to go if smoking is banned on sidewalks.To a smaller degree,the potential effect on businesses with outdoor dining spaces was mentioned as well. Gaming Facilities(67.9%Support, 14.2%Against,17.9%No opinion):The vast majority of responses against banning smoking at gaming facilities said that the decision to allow smoking should be left up to the private business owner.Others said there should be a designated area for smoking within the facility.Some said that smoking was part of the atmosphere.Some comments reinforced the idea of government intrusion and infringement of personal liberties.A number of comments were dismissive of the health of gamblers and therefore also the smokers that frequent this type of establishment. Government Grounds(76.9%Support,20.9%Against): Most respondents spoke to open air/space not being a problem for smoke that would'dissipate'. As in the other questions,government intrusion,civil rights,freedom of choice,personal rights and rights of tax payers to engage in a legal activity was discussed. Many respondents stated parking lots and designated smoking areas away from building entrances should allow for smoking by employees as well as residents using county/municipal building/facilities. Without designated areas employees and clients would be forced to walk away from their service sites or smoke in visible areas (street out front).A few comments addressed the complexity of smoking behavior-addiction,stress relief,and the ability to quit. One mentioned the"Tyranny of the majority"suggesting it was easy for non-smokers to move away from smokers. Parks,rec facilities,trailers&playgrounds(78.9%Support, 19.2%Against): Most respondents agreed no smoking around children,playgrounds,shelters,and indoor rec facilities made sense. Banning smoking in outdoor/open air areas like trails and more open spaces did not. Comments about open air/outdoor spaces were similar to other questions. Government intrusion,civil rights, personal choice and freedom,taxpayer rights and over-regulation were stated as reasons not to ban smoking in Parks,rec facilities, trails and play grounds. Many respondents felt designated areas away from children and gathering places(shelters,playground, etc.)should be provided to allow for smoking. Smokers reminded surveyors that"they paid taxes too." Several comments mentioned litter and enforcing those regulations as a way to address smoking. Bus Stops(79.0%Support, 16.8%Against):A majority of respondents stated that people should be allowed to smoke outdoors, second hand smoke was only deemed problematic if the bus stops were enclosed/shelter or there was not adequate distance or space between smokers or non-smokers.Several respondents spoke to the need of designated areas for smoking and demonstrating common sense and courtesy to those that do and do not smoke—do not smoke if it bothers others,move away from smokers if you are bothered. Generally,second hand smoke in an outdoor environment was not considered a problem under any circumstances for those against the ban. As reflected elsewhere,respondents spoke to government intrusion,civil rights,public taxpayer places,and the freedom of choice. Entertainment&Sports Arenas (82.1%Support,13.6%Against): Of those opposed to regulating a Smoke-Free Public Places Rule in Entertainment and Sports Arenas,the majority state that if the venue is an outdoor facility,it shouldn't be regulated.The general theme seems to reflect the belief that smoking outdoors is not dangerous to those around.However,there was also significant support to provide designated smoking areas that are outside and removed from nonsmoking patrons.The other overarching theme was that business owners should be able to dictate whether or not their facility allows smoking. 28 Attachment 6 MINUTES ORANGE COUNTY BOARD OF HEALTH October 24,2012 ORANGE COUNTY HEALTH DEPARTMENT MISSION STATEMENT: To enhance the quality of life, promote the health, and preserve the environment for all people in the Orange County community. THE ORANGE COUNTY BOARD OF HEALTH MET ON October 24, 2012, at the Orange County Library, 131 West Margaret Lane, Hillsborough, NC. BOARD OF HEALTH MEMBERS PRESENT: Tony Whitaker, Chair; Matthew Kelm, Vice Chair; Commissioner Steve Yuhasz; Corey Davis; Paul Chelminski; Susan Elmore; Carol Haggerty; Michael Wood; Liska Lackey; Mike Carstens; Alexander White BOARD OF HEALTH MEMBERS ABSENT: STAFF PRESENT: Colleen Bridger, Health Director; Pam McCall, Nursing Director; Christy Bradsher, Finance and Administrative Services Director; Donna King, Health Promotions and Education Director; Kathleen Goodhand, Home Visiting Services Supervisor; Carla Julian, Dental Clinic Manager; Lisa Smith, Administrative Assistant; Sue Young, Nursing Supervisor; Stacy Shelp, Communications Manager; Nidhi Sachdeva, Senior Public Health Educator; Pam Diggs, Senior Public Health Educator GUESTS PRESENT: Annette Moore, County Attorney; Carla Banks, Orange County Public Relations Director loft" nnl i� q ,k *11111111tift aft,In a e � kt , �:' f ill I'm 0o 101&1 fe Aft"11**1 061111111"k- AM Board of Health Minutes Transcription completed by Lisa Smith October 24,2012 Page 1 29 Attachment 6 MINUTES ORANGE COUNTY BOARD OF HEALTH October 24,2012 of?th was st aii rtg 'and'`is d it ll 1 "leji i . { ns- s Mad*AW, 1 '4 Meat' "caw II. Approval of October 24, 2012 Agenda Motion to approve the Agenda of October 24, 2012 was made by Matthew Kelm, seconded by Susan Elmore, and carried without dissent. III. Public Comment for Items NOT on Printed Agenda: none IV. Action Items (Consent) A. Minutes approval of September 26. 2012 meeting B. Operating Procedures Annual Policy Susan Elmore requested the minutes of the September 26, 2012 meeting be removed from the consent agenda for corrections. Motion to remove Item A. Meeting Minutes from the Consent Action Items and approve Action Item B. Operating Procedures Annual Policy was made by Steve Yuhasz, seconded by Matthew Kelm, and carried without dissent Susan Elmore requested an addition to the minutes on the CD Report discussion to address why the number of rabies exposures was up since 2004. Motion to approve the Consent Action Item A. Meeting Minutes with the addition to the minutes as requested by Susan Elmore was made by Susan Elmore, seconded by Liska Lackey, and carried without dissent. V.: A. Smoke Frets P c ft e. Resuks of� .., lo e mawt b. Review of Comm ul Lo Forum ilyd M*m1W1 r NW**d ems,dWXmod dew gem `.ate:VAft,W4K4 period 00 Board mernber Mitael Wood opposed,the Ram,eftina cent Ow pad4oti of 00°WAS OW bed iemoW*t . Board of Health Minutes Transcription completed by Lisa Smith October 24,2012 Page 2 30 Attachment 6 MINUTES ORANGE COUNTY BOARD OF HEALTH October 24,2012 If r WI VI. Reports and Discussion with Possible Action A. Health Director Annual Review The Health Director's Annual Review is due to the County by November 30. The proposal from the Chair is to complete a 360 degree feedback-style evaluation. This will include soliciting feedback from: 1)All Direct Reports(Tom Konsler, Pam McCall, Carla Julian, Michael Day, Donna King, Stacy Shelp and Christy Bradsher); 2) 10 randomly selected Health Department Employees(-10%); 3) County Management(County Manager, Assistant County Manager); 4) Board of Health members and 5) Co-Workers(HR Director, DSS Director, Finance Director, Emergency Management Director, Dale Pratt-Wilson - Executive Director of Chapel Hill/Carrboro Drug and Alcohol Free Partnership, and Brian Toomey— CEO Piedmont Health Services.) A feedback tool will be developed and emailed to the list above. County Management will also be given the opportunity to discuss thoughts/concerns in person. The Chair will review the results with the full Board during the November Board of Health meeting in a closed session. The Board will then vote on the rating for the Health Director (needs improvement, proficient, exceptional). The Chair will share the results with the Health Director after the meeting. The minutes will reflect the rating and the completed forms will be sent to HR no later than 11-30-12. B. Informational Items a. Health Director's Report See attached Health Director's Report VII. Board Comments Board of Health Minutes Transcription completed by Lisa Smith October 24,2012 Page 3 31 Attachment 6 MINUTES ORANGE COUNTY BOARD OF HEALTH October 24,2012 VIII. Adjournment Motion to adjourn,the meeting at 8:30 p.m. was made by Alex White, seconded by Steve Yuhasz, and carried without dissent. The next Board of Health Meeting will be held November 28, 2012 at the Orange County Health Department, 300 West Tryon Street, Hillsborough, NC at 7:00 p.m. Respectfully submitted, Colleen Bridger, MPH, PhD. Health Director Secretary to the Board Board of Health Minutes Transcription completed by Lisa Smith October 24,2012 Page 4 32 ATTACHMENT 7 EXCERPT from Draft October 22,2012 October 22, 2012 Hillsborough Board of _Board Monthly Workshop Commissioners Workshop Minutes Approved: Page 1 of21 MINUTES Board of Commissioners Month?7_ hop Monday, October 22, 2012 — Town Barn Al PRESENT: Mayor Tom Stevens,Mike Gering, L.Eri allman, Brian Lowen, a elyn Lloyd n,r EXCUSED ABSENCE: Commissioner Frances Danc STAFF PRESENT: Town Manager Eric Peterson, To rk/Director of Administration and Human Resources Donna Armbrister, Pla Director Marga uth, Public Works Director Ken Hines, Finance Director Greg Siler, and To ey Bob Horni 1. Open the Workshop 7:01:43 PM Mayor Tom lled the Wor to order. stated they would be having a Public Hearing and asked each p n w t to speak sign up. added that they did not have the public charge tonight but he k that an e speaking be ief, to the point, and respectful. Decisions are not usually made at these ee o it's e of a time to lis 2. Agenda Cha e &Agen o 7:02:51 Town Eric son added a Resolution to appoint two volunteers to the Orange Count an Relations sion a 1A. Commissioner Mike Gering moved to approve the adding oft f* 1 ommissioner B owen s ded. Upon a unanimous vote of 4-0,the motion was carried. �r 3. Commit dates and R is 7:03:34 PM The re non 4. Public Hearing on t roposed canoe/kayak or non-motorized boat launch in Kings Highway Park as part of the Lake n Johnston dredging project. 7:03:39 PM Mayor Stevens opened the Public Hearing. Ms.Hauth said Kings Highway Park is on the banks of the Eno where it is called Lake Ben Johnston. As the damn located there across the river and the town's water intake is just above that, the utilities department has a dredging utilities project in place to clear out the sediment behind the damn to improve the quality of the water going into the water treatment plant. As they own the land that surrounds it, the intent is to take out that sediment and deposit it in a depressed area within Kings Highway Park. Part of the environmental permitting for that process involves stabilizing a portion of the bank 33 October 22,2012 Town Board Monthly Workshop Approved: Page 6 of21 gets recorded in the Register of Deeds the logic of their thought process. That might be unnecessary but she could still provide other documentation for them that can get read into the record when they're making the decision. 7:33:11 PM Commissioner Hallman moved to close the Public Hearing. Commissioner Lloyd seconded. Upon a unanimous vote of 4-0,the Public Hearing was closed. 7:34:15 PM Tony Whitaker, Chair of the Orange County Health ent, came forward. Colleen Bridger,Orange County Health Director,came forward as well. 7:34:38 PM Commissioner Gering said they probably neede,fd�l- c "ss the j11ri n these guests would have for Hillsborough. He said Mr. Hornik's analysis rais ome serious question t whether County policies can apply without the Board's approval. Mr. Hor referred NCGS 130A-4 ch the statute under which they're operating. At the lack of case law tatute, t " uestion remains whether the County or the County Board of Health can adopt this particul lati 11 make it effec i -in Hillsborough and on Hillsborough Town property or for Town vehicles withou n Board saying okay. Mr. Hornik said this whole section of the la adopted in 2007 a ve different and special authority to local governments, including Town Boards, to lations bannin it* g smoking in public places. The way the statute is written, it's not clear to unty Board th or the County could make prohibition effective in the Town without the Bo adop lution s ng they're okay with it. That is NCGS 153A-122. This is referred to in the secti and county employees are operating. It generally says that in order for ordinance to I I cti e wit e jurisdictional limits of the town,the Town has to adopt a resolu Ire okay wi it. He does t know whether the Board is okay or not okay with all or part of at is bei oposed but h ng looked at it, there's a question he has and there doesn't seem to be a c, tive an r. 7:37:12 PM Ms. Bridger a re a county ordinance it could not apply to the municipalitie ealth uthority ales that encompass the entire area of the county where they serve r. Ho I how here are special statutory authorities on smoking prohibitions which I t. s. Bridger o e are di M sc ar worlds they're dealing with. Commissioners can't; Board of Heal There was a hyb le of la at was created when House Bill 2 passed and Boards of Health were given c the authority to ct sma ng prohibitions but only with the agreement of the County Board of Commissione r. Hornik sal e statute specifically refers to the County Board of Commissioners adoption of the ordinance " ving the rue Ms. Bridger replied Hillsborough would be the second county to be doing this as Durham ha ady pa d a rule that was "adopted by ordinance" which was what the School of Government recomme er for the rule to apply to the entire county. The guidance they've been given by the School of Gove is if a Board of Health rule is "adopted by ordinance" and it's not a separate ordinance adopted by th oard of Commissioners, then it does indeed apply to the entire county and all the municipalities. That is what they applied in the Durham County example. She told Mr. Hornik Jill Moore would be the contact person at the School of Government. 7:39:23 PM Ms. Bridger added they've discussed this with the School of Government to make sure they do it correctly. At the legal conference in April, there was an entire session about this, and very clearly, the guidance was if the Commissioners "adopt by ordinance,"then it is a Board of Health rule which does apply to the entire county. ' 34 _ October 22,2012 Town Board Monthly Workshop Approved: 7:39:58 PM Commissioner Gering asked if state rights ofway were considered under this. Ma. Bridger said no. Nothing owned by the state is covered hythis. Commissioner Gering asked then ifthe establishments along Cbudou Street downtown that allow smoking outdoors at the restaurants would not he covered. Ms. £;ddger replied that io the dofiuftiuuof the rule,they specifically talk about sidewalks and the dofioitiuoo[n sidewalk im ifdim owned,maintained,or controlled hy the county orumunicipality. Iu her mind,the question is,if there's u problem with that area in front of the storefronts on Cbm1mu,who pays to repair it. Commissioner Gering said that would be a question for Staff to provide guidance on. Mr. Peterson added historically ai that have been necessary on Churton,for example,the Town has paid for.The s of thousands of dollars th on maintenance costs in the last couple of years but that doesn't mean s , ,ect. 7:41:16 PM Commissioner Gering asked Mr. Hornik if he a d t - ' uld be covered by that qualification. Mr. Hornik replied that he's not sure. They in int in 'as far a irs but he doesn't know whether that's by arrangement or just by them deciding it e est inter the town to do so. Commissioner Gering said he brings this up because it see ike an equity issue o to consider what businesses in Hillsborough would be affected or if it would plied evenly to everyone 0 o e. 7:42:15 PM Mr. Whitaker stated the situation alo Fr et 4pel Hill was th me as Churton Street. The state DOT right of way essentially goes 0 the s r the entire sidewalk along the frontage of Churton and Franklin, while in the DOT right ay, is ally controlled sidewalk for practical Mr. Whitaker added by way of clarification wi e equity issu ny dining area or area that's outdoors on private property, or private dining pati, ha is e public ewalk,would not be covered by this rule. If they're enclosed,however,it's covered the 7:43:48 PM Commissi id it just see counterpr uctive to walk down the street through town and smoke. He as fthey w 1 ot subject to p *ce enforcement since they are on town property. He asked if he would be re the la he stood in th ' t of way that is fifteen feet from his house and smoked a cigarette. 7:44:37 P said t alogy t ey o use there is the open container law. If he's standing in the front of his is ac, owned by the town and he's drinking a beer, he is technically in violati the open contal w. H one is going to come enforce that. The same analogy applies Ms. Bridger ey are pullin gether the Chiefs of local law enforcement and the Sheriff to talk about consistency in e ent of thi le if it does pass. Like a lot of other laws,the police have discretion in how they enforce it and . *mple r inder from someone that an area is smoke-free is sufficient,that person can move away, and the o e who doesn't want to breathe the smoke is good. There's no need to involve law enforcement. She be it will be a rare situation. Ms. Bridger stated the example they have is with the implementation of House Bill 2. There was a lot of concern about enforcement of this with the smoke-free restaurants and bars. In that law, the local Health Director enforces violation of that law. She's been the local Health Director since before it was implemented and never once has had to go to restaurant or a bar and enforce it. It was enough for there to be that law for the owner to say there is no smoking. They've heard the enforcement concerns and that is why they are bringing the local law enforcement leaders together to make sure they're consistent across the county. They have other 35 October 22,2012 Town Board Monthly Workshop Approved: Page 8 of 21 precedents they can look to, however, to say it's probably not going to be as much of an enforcement issue as it is going to be an educational issue. 7:46:58 PM Mr. Whitaker clarified within the rights. of way, it is only on the sidewalk or at bus stops that this rule could apply within a state right of way. Otherwise, there's no applicability in the right of way. Many places don't have a sidewalk in the right of way so there will be no area there that this would even cover. 7:47:30 PM Commissioner Hallman said he's very much in favor of the eff With regard to the open container law, any night of the week, someone could be cited for that if you wn Churton Street. They see that all the time. He personally hates cigarette smoke, especially w he's eating, but people are all concerned about that one stretch of downtown Churton where people see ect each other. As it gets later in the evening, however, more smokers do come out. He added that t ave ted the smoke-free parks so they have it pretty much everywhere else in town but they're all foc se I n what s on the sidewalk. 7:49:05 PM Mayor Stevens said his biggest concern is t e- 'dewal as well and th y robably an area of discussion where they could really have a debate becau f this. I-Le's thinking abo n t ey are just walking down the sidewalk and seeing it and he doesn't her. 7:50:04 PM Commissioner Gering said this is an example w I jurisdiction should have more control and not be covered under a single umbrella f r the whole county. inks they should tell people they can smoke on the sidewalk because he does not b despite what the on General says about second hand smoke, that the public will not be affected by s alking down th t sing by smoking. He has a problem with that. Also, the County has a histo o .ng by the T ordinances and it annoys him that the County seems to want to apply this stand , this to the wn when there's still a question about whether they have the authority to do so. He oul e old that better and thinks it would be bad for Hillsborough to acced sdiction to the withou cussing whether the County is going to abide by the Town's ordin or r the Town li by theirs. Commissioner Gering a Iso rea e requirement I ing signage and asked who would pay for that and decide where it would g s. B LLeplied they' dentified $30,000 to pay for the signage but they can't implement it ithout the ss,they've been softly planning a meeting with some of the Plannit d Par ec Direc talk about how they can equitably distribute the signs they have ney to p Plac Hillsborough Park, which is already smoke-free, don't need signs. Their is to do a thor sessm eas where signage needs to be placed, figure out where that sign e' y exists or whe re are a' y plans for that signage, and then come up with a needs list and using that 0, divide up th ns an ctively seek additional funding. Ms. Bridger said she was also in a meeting this nd heard aba Bother $48,000 that they may be eligible to receive which they could use towards the pur of signs. I their intention to work with the County and the municipalities to provide those signs as muc ssible. ommissioner Gering said it is then not Hillsborough's expense. Ms. Bridger replied not necessaril .` e they would work with everyone affected and divide up that money as much as they can. Commissioner Gering asked Ms. Bridger if her department decided there needed to be a sign on Churton Street and they didn't have the money to pay for it, if the Town would be obligated to buy one. Ms. Bridger said technically yes. Again, they're going to work with the Town and do this in a friendly way. Commissioner Gering said he just wants to understand where the boundaries are and he's not implying they won't. He wants to understand who is responsible for implementing everything. 36 ^ October 22,2012 Town Board Monthly Workshop Approved: Page 9 of 21 7:53:55 PM Mc Whitaker said bo is in the habit of respecting jurisdictional boundaries. He makes those distinctions daily muit's easy for him to make a mistake ufequating that to the Board ufHealth. From the Board of Health's jurisdictional perspective and strategic and objective approach to public health, Hillsborough is as much u part of Orange County am Cedar Grove or White Cross. There ia not distinction'uriodictional}ybetween public health issues covered by Board of Health matters. 7:54:45 PM Commissioner Gering said bc agreed with that but the only difference iaiu this case,the County mind,Commissioners would have to adopt by ordinance so in his u6 Commissioners when they adopt that ordinance. That's why he questions the jurisdictional iss kW without their approval, this couldn't be done. 7:55:21 PM Mr. Hornik said the power they're trying to exercis g t not the same power they usually have. This is not the power they have under NCGS 138A- 9. his is s statutory power that is conveyed to all of governance. The Town of Hillsborougb ' o t under 138-498 so this is a different kind of power with different rules that are not cl He dded that it's in the Durham example, Jill Moore said it should be a certain way but s not on tbe Supreme Cou s_j�,a different animal. This animal has certain rules that the legislat in 200 d 2009 and one: se is that in order for this to be effective, the County Commissioners h pr In the same s ion of the law, there's a provision that says in order for an ordinance adopted unty ommissioners to be effective in the Town, the Town has to adopt a resolution agreeing to it. He' tire with respect to this particular rule how those all work together. They have the model-but that i cessarily what the law is. It's what the parties in Durham agreed to. 7:57:22 PM Commissioner Gering commente ey co up in c with the County. Ms. Bridger said she hoped they would contact Jill Moore and her I .t. The Institute of Govertiment has said this is how they interpret this is not th ty attorn ing how she interprets the law. 7:57:47 PM Mr. Ho aid there courts which ve disagreed with the Institute of Government. Ms. Bridger said there are ot t have agreed with ot rts. That's what lawyers do. She didn't want them to think this was just ba th of the Con 7:5 8:04 P er Lo id he'd e urham mentioned a couple of times and feels like this is unique. urham, th the ci I e county, and no other entity. If the two of them agree, it's a done deal. e County has Hill, illsborough, and the County. As a town,they do a good job vehicles or on town property. He doesn't see them having a problem ri that this addi I e ement would be an issue. 7:59:30 PM issioner G g asked if smokeless tobacco products were covered. Ms.Bridger said no. 7:59:42 PM Comm 'loyd said she didn't think any of the Board smokes but they're not arguing for 8:00:12 PM Mr.Whitaker said he identified two issues, one being the jurisdictional issue, and the second is a more intense concern about sidewalks. If the jurisdictional question didn't exist,there would still be a concern about sidewalks. 8:01:00 PM Mayor Stevens said he thinks it's pushing the regulation and he worries about it becoming counterproductive. If the sidewalk were removed from this, it's close to what they already have. The sidewalk issue seems like it's a bit too much. 37 October 22,2012 Town Board Monthly Workshop Approved: Page 10 of 21 8:01:56 PM Ms. Bridger replied they've been trying to get public input as well as community leader input. She hoped the Board had seen the results of the survey from the community leaders but they're also about to send out the results of the residents survey. They had close to 750 responses to that survey through email and hotline and so forth and there's overwhelming support in the community for smoke-free public places. The lowest support is on the sidewalk issue but 65% of people still support it. She believes there was another 4% who didn't have an opinion. That's pushing 70% of residents who responded to the survey who are supportive of regulating smoking on the sidewalks. She doesn't know if that makes them feel etter or not. 8:03:18 PM Commissioner Gering asked if those were all Hillsborou sidents. Ms. Bridger said it is county wide, Commissioner Gering replied that didn't mean much to Bridger told him she could break it out by Hillsborough. Commissioner Gering said there may w e a ence between the responses from Chapel Hill and Carrboro versus Hillsborough. Ms. Bridger t Id she w o that and send it to him. Commissioner Gering said they would like to see that informatic, 8:03:44 PM Commissioner Lowen agreed. He said to in mind Vy've had this di venal times and Hillsborough goes as far out as St. Mary's Road. to — L,,,something to the stituents, it's much smaller. Ms.Bridger said she lives off Walker Road in oro she hopes they',, not referring to the fact she's not a legitimate resident. Commissioner Lowen r she's not a Hillsborough tax payer as she doesn't live within the city limits. She couldn't vote for anyon he Board and they couldn't write their smoking law that would affect her on Walker When they loo e decisions they have to make, they have to consider first the residents they affect. er said she can't it t by those numbers. 8:04:43 PM Mayor Stevens said he understan here . to the d and they have to live with that. Ms. Bridger replied she does feel good about the s ey. , e many surveys they've sent out and gotten that big of a response t Is people wer interests esponding to the survey. 8:05:05 PM Mr. Pet said the rveys have ra ed within 23% and 31% return which anything over 20%is good 8:05:37 PM issioner n thing might be for them to offer the County Commissio optio unicipa 1 Ms.Bridger said she did not think they were allowed to do that. or ik sta ould t. 6.A. D ITEM: iderati of a Resolution asking the Board of Orange County Commissio ,to appoint Mr rald P nder and Dr. Li-Chen Chin as Hillsborough's Representatives on the Orang » my Human ations Commission 8:07:14 PM Co K,a oner4ven moved to make this appointment. Commissioner Lloyd seconded the motion. Upon a unam of 4-0,the appointment was approved. 7. Consider request frp Stratford Development to adopt a resolution to authorize (a) proceeding with the Waterstone Special Assessment District, (b)application to the Local Government Commission for approval, and (c) subsequent sale of up to approximately $5.0 million in bonds to pay for Phase 3 infrastructure (primarily Cates Creek Drive extension to Old NC 86), reimburse the developer for existing Waterstone infrastructure, and pay down part of Stratford's loan obligation to Bank of America 38 ORD-2012-054 Attachment 8 AN ORDINANCE APPROVING AN ORANGE COUNTY BOARD OF HEALTH RULE PROHIBITING SMOKING IN COUNTY AND TOWN BUILDINGS, GROUNDS,VEHICLES,AND PUBLIC PLACES I WHEREAS, in 2009 the North Carolina General Assembly enacted Session Law 2009-27, which authorized local governments and local boards of health to prohibit smoking in certain areas; and WHEREAS,rules adopted by local boards of health are generally applicable throughout the county of adoption including within town jurisdictions;and WHEREAS, on October 24, 2012 the Orange County Board of Health adopted a rule (Attached hereto as Exhibit 1) prohibiting smoking in County and Town buildings, grounds,vehicles,and public places;and WHEREAS,the Commissioners of Orange County,believing it to be in the best interest of the citizens and residents of Orange County,have determined that the rule by the Orange County Board of Health prohibiting smoking throughout Orange County is approved. NOW THEREFORE BE IT ORDAINED, by the Orange County Board of Commissioners that the Orange County Board of Health Rule prohibiting smoking in county and town buildings,grounds,vehicles,and public places is approved. Adopted by the Orange County Board of Commissioners this day of 2012. By: Attest Bernadette Pelissier,Chair Donna Baker,Clerk to the Board Orange County Board of Commissioners [SEAL]