The Cumberland County Department of Public Health is following five bills introduced in the N.C. House of Representatives.
If passed, the bills would make a range of changes, from raising the age of legal tobacco sales to broadening student vaccine exemptions.
HB197: County funding for communicable diseases
HB197, filed in February, would provide $25 million in recurring funds to county health departments to help address communicable diseases.
The funds would be appropriated through fiscal years 2025 and 2026 from the general fund of the North Carolina Department of Health and Human Services.
Communicable diseases addressed by county health departments range from Covid-19 to sexually transmitted diseases. They also address measles, an infection with a growing number of cases across the country. The bill would evenly distribute $12.5 million to all 100 county health departments. A given county’s share of the remaining $12.5 million appropriated in the bill would be determined by population size.
The Cumberland County Board of Health is drafting a letter of support for the bill, to be signed by board chair Dr. Kingsley Momodu.
“These are really important dollars because we typically get very limited funding for communicable diseases,” Green said. “We report on 80 different communicable diseases that are reportable and we have limited staff capacity. This funding also helps to support some testing, outreach, events and response to any communicable disease.”
The bill doesn’t specify a funding formula, so the board doesn’t know how much Cumberland County would receive. At the Board of Health meeting last week, Candice York, public health department business officer, said the county got $742,000 through similar communicable disease funding in 2022. The funding was one-time and spanned about an 18-month period. While Green acknowledged it was a small amount, she said the dollars were crucial to increasing the department’s Covid-19 rapid testing capacity.
HB89 and HB380: Vaccine exemptions
The board is monitoring the progress of HB89 and HB380, which would expand vaccine exemptions for students, to see whether they get heard in the House Committee on Health.
HB89 would repeal the immunization requirements for North Carolina college students in state statute. If passed, students would no longer need to show proof of vaccination against diphtheria, tetanus, whooping cough, poliomyelitis, hepatitis B, measles, mumps, rubella and other viruses to attend any of the state’s public or private universities and colleges. Students already aren’t required to have a Covid-19 vaccine at state-funded institutions unless required by a specific program.
“The House Bill 89 essentially just strikes the language about colleges and universities so that those students would not be required to get some basic immunizations,” Green said. “That’s concerning to us because, if there’s an outbreak on a college campus, they often live in congregate living and that makes it very challenging for us [to address the outbreak].”
The NC Association of Local Health Directors is also following the bill’s progress.
The state already has several exemptions for K-12 and university student vaccine requirements. The medical exemption lets students skip a vaccine if a medical physician licensed in North Carolina determines it is or could be detrimental to their health. This often means the person is severely allergic to the vaccine or its components, is severely immunocompromised or has a family history of immunodeficiency.
The religious exemption requires the parent or guardian to provide “a written statement of the bona fide religious beliefs and opposition to the immunization requirements” to the child care center, school or institution their child is to attend in place of an immunization record, according to state statute. That statement doesn’t need to be notarized, signed by a religious leader, or prepared by an attorney. It also doesn’t need to be reviewed by the state.
HB380, filed on March 12, would expand the religious exemption to be a “religious or conscientious objection.” Under the proposed legislation, parents or guardians could also write a statement describing their bona fide “reasons of conscience and opposition to the immunization requirements” for their child to attend a child care center, school or institution without an immunization record.
Green said the North Carolina Department of Health and Human Services is also monitoring HB380 for its possible ramifications on child vaccination rates. Between the 2020-2021 and the 2023-2024 school years, the percentage of North Carolina’s kindergartners with any type of vaccine exemptions doubled, from 1.5% to almost 3%, according to the Centers for Disease Control and Prevention.
The bill also comes as a measles outbreak that started in Texas has spread to 17 other states, infecting more than 370 people and killing two, including an unvaccinated child.
“It’s more challenging for us if there’s an outbreak of any kind that makes our communities more vulnerable,” Green said. “So we’re monitoring those two bills very closely.”
HB430: Tobacco 21
HB430 and its partner bill in the state Senate SB318 would make it a Class 2 misdemeanor to sell any product containing tobacco or nicotine to someone under 21. People under 21 caught attempting to purchase the products could be hit with an infraction and could be required by the court to complete a tobacco education program. Those trying to use a fake ID could receive a Class 2 misdemeanor.
It would also require retailers of tobacco and nicotine products to get a permit from the North Carolina Alcoholic Beverage Control Commission and renew it annually. Each permit would cost $400. The funds would go into the state’s general fund and be used to enforce the law, according to NC Health News.
The bills would bring North Carolina in line with federal law, which in 2019 banned sales of tobacco products to those under 21. According to NC Health News, almost 22% of randomly sampled tobacco retailers sold to people under 21 in fiscal year 2023.
They would also address the youth vaping epidemic, which Cumberland County Schools is already trying to tackle through a vaping prevention program in its middle and high schools. Over 21% of North Carolina high schoolers who responded to the 2023 Youth Risk Behavior Survey said they currently vaped. The survey also found that nearly 10% of the state’s middle schoolers vaped.
Cumberland County also banned vaping on county property last fall.
HB376: Regulating wastewater
HB376 describes changes to wastewater permitting and regulation processes. The county board is concerned about the latter.
The bill would prevent local boards of health from creating more stringent regulations on wastewater disposal and treatment than the state unless approved by NCDHHS. Part of the state’s approval process would include public hearings hosted by NCDHHS.
NCDHHS would also review any of the approved local rules every four years and rescind any it “finds is unnecessary to protect the public health,” according to the proposed bill.
Green said she and other public health department staff are uncertain why HB376 was introduced. However, they are monitoring the bill’s progress with concern regarding its changes to board powers.
“It undermines your authority because you’re making a local rule for a reason because a state rule doesn’t exist,” Green said to the board.
CityView Reporter Morgan Casey is a corps member with Report for America, a national service program that places journalists into local newsrooms. Morgan’s reporting focuses on health care issues in and around Cumberland County and can be supported through the CityView News Fund.
