The Cumberland County Health Department is excited to share the Healthy NC 2030 Scorecard for Cumberland County 2021-2024. This Community Health Improvement Plan Scorecard is an easy way to learn about some of the efforts currently underway in Cumberland County to address four health priorities identified in the 2021 Cumberland County Community Health Assessment (CHA): 

• Economy (employment access, affordable housing, food security, low income/poverty)
• Substance Misuse (drugs, alcohol, and opioid misuse)
• Mental Health
• Public Safety (violent crime, including murder and assault)

Economy

Business Loan Program: The Business Loan Program established in 2021 assists in providing financing for start-up or expansion of businesses that will create jobs for low to moderate income citizens in Cumberland County. In 2023, the U.S. Small Business Administration awarded 33 loans totaling 25 million dollars between Cumberland and another county. Cumberland received 29 loans and served 72 small businesses.

Cumberland County & Fayetteville, NC Catholic Charities Assistance Program: Catholic Charities provides support to the low income, immigrants, and poverty-stricken individuals in the Cumberland County area. Support for families include food, children's clothing, infant supplies, diapers, menstrual products, and adult incontinence items, immigration legal services, disaster relief, and additional resources, as needed. Catholic Charities served nearly 4,000 households in the fiscal year 22-23. 

Rental Rehabilitation Program: The Rental Rehabilitation Program is designed to provide financial assistance to investors to repair substandard housing and increase the supply of decent safe affordable housing in Cumberland County. Financial assistance is provided as low interest loans and the amount is determined on an individual basis. In 2021, housing rehabilitation assistance was provided to 10 homeowners and rehabilitation was completed for 32 rental units located at Hillside Manor Apartments which houses a large population of senior citizens. 

Substance Misuse (drugs, alcohol, and opioid misuse)

NC Harm Reduction Coalition: Harm reduction focuses on promoting scientifically proven ways of mitigating health risks associated with drug use and other high-risk behaviors, including condom distribution, access to sterile syringes, and overdose prevention. Cumberland County Department of Public Health was selected and awarded $200,000 to complete specific strategies toward opioid response in Cumberland County. Direct services are provided to people impacted by drug use, incarceration, sex work, overdose, gender, HIV, and hepatitis, as well as first responders.

Narcan Distribution: Funding from the NC Harm Reduction award allowed the agency to establish a Narcan Kit Distribution Program. Over 5,400 naloxone kits distrbuted in the fiscal year 22-23. 

Cumberland-Fayetteville Opioid Response Team (C-FORT): is dedicated to improving the opioid response in our community through a collaborative effort among local government and community stakeholders (32 partnering agencies). The Cumberland-Fayetteville Opioid Response Teams overall goals are to launch a treatment center that revolves around treating community members who have an addiction to opioids, launch a recovery response center and develop a successful committee. C-FORT is committed to identifying strategies that will impact the opioid issue while creating a sustainable community response for years to come.

Carolina Treatment Center of Fayetteville: Carolina Treatment Center of Fayetteville (CTC), also known as Comprehensive Treatment Centers: Opioid Use Disorder Programs, is a for-profit outpatient provider of treatment services to adults with opioid addiction. CTC serves adults aged 18 and older of all genders who are struggling with an addiction to heroin, fentanyl, prescription painkillers, or other opioids.

Myrover-Reese Fellowship Homes, INC.: Myrover-Reese Fellowship Homes thrives to provide a safe and supportive environment for those seeking recovery from alcohol and other drugs, based on a 12 Step Program. In 2023, ten individuals completed the program. Four did not complete the program, but remained sober. 

Family Drug Treatment Court: Cumberland County Department of Public Health was selected and awarded $80,000 to complete work towards opioid response in Cumberland County. These funds will be administered by Cumberland County Justice Services.  As a diversion court, Family Drug Treatment Court, was created to promote the safety and welfare of children and their families and to expedite permanency for children by providing comprehensive case management and treatment services to substances-abusing parents or guardians through a well-designed judicial intervention plan. The program helps parents achieve a fundamental change in lifestyle by providing support and assisting them in recovering from drug and/or alcohol addiction. The program is a 12-to-18-month participant commitment and includes participation in substance abuse treatment (including NA/AA meetings), random drug testing, parenting programs, education and job-related programs, court attendance every other week, immediate court sanctions or reward, and monitoring of treatment of activities by social workers and case management. The participant is expected to be drug free and working toward a plan to become a productive, positive member of the community and hopefully, a fully functioning parent upon graduation from the program. FDTC uses a Care Plan and Best Practice Model as a diversion court and has goals that will reduce recidivism and offer recovery from addiction. 

Syringe Exchange: Syringe exchange programs are one of the most effective public health interventions for decreasing the transmission rates of HIV and other blood-borne diseases such as Hepatitis C, as well as connecting users to treatment and other important needs such as housing or food assistance. North Carolina has legalized syringe exchange programs, therefore, people who use injection drugs turn in their used or “dirty” needles in exchange for unused, clean needles. By expanding access to clean syringes and ensuring a safe way to dispose of bio-hazardous materials, syringe exchange programs create safer environments for the community at large. Syringes dispensed during program year 22-23 was 47,7797 and syringes returned by the program was 47,866. ​​​​​​​

SMART Recovery: a  program serving those with an addictive behavior, including both substance and activity/process addictions. Trained volunteer facilitators lead effective mutual support group discussions on these topics: building and maintaining motivation coping with urges and cravings, managing thoughts, feelings, and behaviors, living a balanced life using related tools consistent with evidence-based motivational and cognitive behavioral theories are also offered and discussed. Cumberland county has *# of trained SMART revocery faciliators.*

Medication Assisted Treatment Program (MAT): the Cumberland County Health Department and the Cumberland County Detention Center are collaborating to begin a Medication Assisted Treatment pilot program. Currently, individuals in recovery and are detained, will be able to continue treatment. The pilot is not initiating services to those self-identified as opioid users, but rather to those who require maintenance. A Licensed Clinical Social Worker and a Peer Support Specialist will work to support individuals while incarcerated and then upon discharge assist them with reentry, resume MAT with their provider, resume any other human service agencies, and connect to the recovery support center and other community partners through NCCARE360 referrals and/or Cumberland-Fayetteville Opioid Response Team (C-FORT). 

​​​​​​​​​​​​​​Substance Misuse (Tobacco-related): 

3 of CATCH MY BREATH educators trained

86 of 100% Tobacco-free schools

0 of Quitline referrals

0 Adoptions of tobacco-free policies

Mental Health

988 Suicide and Crisis Hotline (Media Campaign): the 988 Suicide & Crisis Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, seven days a week, in the United States. They are committed to improving crisis services and suicide prevention by empowering individuals, advancing professional best practices, and building awareness. Even though 988 is a nationwide hotline in Cumberland County, we promote the hotline in the communities by using SAMHSA 988 partner toolkit to promote the new dedicated number and invest in materials that promote the availability of crisis services specific to their jurisdiction. This public campaign can encourage people to seek help when experiencing a crisis and destigmatize mental illness. In 2023, Cumberland County Department of Public Health distributed 1,415 of 988 related materials (i.e. cards, posters, safety plans, etc.)

Mental Health First Aid: Mental Health First Aid (MHFA) is provided to lay a foundation that continuously builds support for individuals battling mental health or substance use disorders.  It removes responders' fear or hesitation during a crisis, so those affected can have a safer, more comfortable environment to get the desired help. The Public Health Educator for the Mental Health Section has been trained in MHFA for adults. Two organizations are offering MHFA within the Cumberland County area.

NCCARE360: NCCARE360 is the first statewide network that unites health care and human services organizations with a shared technology that enables a coordinated, community-oriented, person-centered approach to delivering care in North Carolina. NCCARE360 helps providers electronically connect those with identified needs to community resources and allows for feedback and follow-up. This solution ensures accountability for services delivered, provides a “no wrong door” approach, closes the loop on every referral made, and reports the outcomes of that connection. NCCARE360 is available in all 100 counties across North Carolina. NCCARE360 is free for community-based organizations, social service agencies, local health departments, and other local partners and will be subsidized for major health systems and payors. Here in Cumberland County, we use NCCARE360 in partnering with the Cumberland County Dept. of HHS. We currently have over 100 in-network organizations to partner with when sending referrals for our community members. 

Cumberland HealthNet: CHN is a collaborative network of community organizations whose primary focus is to improve the health outcomes for the uninsured in Cumberland County by linking them with a medical home and other needed health and community services.

Public Safety

Stewards of Children Darkness to Light: Darkness to Light  (D2L) is a non-profit committed to empowering adults to prevent child sexual abuse.  Introduced in 2006, it's the only nationally distributed, evidence-based program proven to increase knowledge, improve attitudes, and change child protective behaviors. As of September 2023, one public health professional within CCDPH is authorized and trained facilitator through the Child Advocacy Center in Fayetteville, NC who can train anyone in Cumberland County for free.  CAC will train facilitators for Stewards of Children.  Other facilitators of Stewards of Children in Cumberland County, NC are available through the CAC and D2L.  https://www.d2l.org/

Triple P-Positive Parenting Program: Triple P is a parenting program, but it doesn’t tell people how to be a parent. It’s more like a toolbox of ideas. The parents choose the strategies they need. They choose the way they want to use them. It’s all about making Triple P work for the parent(s).

Connected Care Program: CCP is a collaborative program between Cumberland County’s Department of Public Health and Department of Social Services. This program aligns with the efforts of the NC Department of Health and Human Services to address the needs of individuals and families by promoting collaboration across Cumberland County Departments. 

Opioids:

In 2023, there were 638 overdose ED visits compared to 688 in 2022, with the highest occurrences among white and black individuals aged 25-44. Cumberland County saw 252 opioid overdose ED visits in 2023, slightly down from 255 in 2022. EMS encountered 285 opioid overdose cases from Jan-Jun 2023, a decrease from 412 in Jan-Jun 2022.

Covid-19:

In June 2023, North Carolina officially lifted the state of emergency for COVID-19. As a result, the COVID-19 clinic ceased its operations and efforts related to managing the effects of COVID-19 shifted towards distributing at-home test kits. Vaccinations remained available to individuals upon their request at the Cumberland County Department of Public Health. From May 2022 to May 2023, we had 28,639 cases, and 5,869 of vaccinations were given out from 2022 to 2023.

Syphilis:

Primary & Secondary Syphilis in Cumberland County:

2022 Cases: 134

Early and Latent Syphilis in Cumberland County:

2022 Cases: 105

Total Cases for 2022= 239

Congenital Syphilis 2022: 43 Cases

Congenital Syphilis 2023:  5 Cases (Stillborn deaths/neonatal deaths) Jan.1, 2023 -Sept. 1,2023. From 2012-2022 there was a 547% increase. 1 case in 2012 to 57 cases in 2022.

Syphilis in AA Males Increased to 1542 cases.

Chlamydia in Cumberland County:

2022 Cases: 3903

Chlamydia STI and EPI Clinic – End of Year Report 2023 CureMD Report (3,535)

As of Dec. 2023, In NC Chlamydia ranks highest among women than men.

Women: 42, 494 cases

Men:       22,515

Gonorrhea:

As of 2023 Gonorrhea rates were higher among males than females.

Males:     14,848 cases

Females: 11,252 cases

Gonorrhea STI and EPI Clinic- End of Year 2023 Report CureMD Report (1,356)

HIV/AIDS: Cumberland County:

2022 Newly Diagnosed HIV Infections: 78

2022 Newly Diagnosed AIDS/ Stage 3:  26

Tuberculosis 2022:

New Cases: 11

Rollover Active Cases from 2022: 4

TB Related Deaths: 2

Total Cases for 2023: 15

Hepatitis B/C:

Hepatitis B: Acute 9

Hepatitis B: Chronic 28

Hepatitis B: Perinatal *0

Hepatitis C- Acute 2

Hepatitis C- Chronic 362

Mpox:

1^ST case was identified on 6/23/2022. Nearly all cases of Mpox in NC have been MSM.

The Health Education Department provided a large number of materials (9,200+) through Community Outreach Events. (Educational Pamphlets, Condoms, Hygiene Kits, Branded Incentives, Prevention/Awareness Brochures. This was due to the increased number of Syphilis/Chlamydia cases in the community, Partnering with Methodist College, Fayetteville State University, CityBlock, and other local agencies.

Opioid Settlement Funds

The Cumberland County Department of Public Health has taken the lead in creating initiatives, developing programs, and implementing services utilizing the Opioid Settlement Funds. These strategies include:

• Early intervention
• Evidence-based addiction treatment for the uninsured and underinsured
• Programs to support people in treatment and recovery
  • Recovery support services
  • Recovery housing
  • Employment related services
• Re-entry services
• Criminal justice diversion programs

In August 2022, the Cumberland County Board of Commissioners approved the utilization of $800,000 to fund multi-year pilot projects that align with evidence-based, high impact strategies defined in the MOA. After a competitive selection process, agencies Carolina Treatment Center ($200,000), North Carolina Harm Reduction Coalition ($199,990), Family Drug Treatment Court ($200,000), and Myrover-Reese Fellowship Homes, Inc. ($200,000) were selected to receive two years of funding. Since the initiation of these initiatives in Fall 2023, an increase in resources have become available in the community to bolster the recovery process. Among these resources are temporary housing, assistance with vehicle repairs, provision of bus passes and cell phones, aid with dental and medical expenses, as well as peer-to-peer support. Opioid Settlement funds is also supporting the purchase of Narcan ($35,000), syringe service programs ($35,000), and a Medicated Assisted Treatment (MAT) program at Cumberland County Detention Center. Since the dissemination of Narcan, there has been a surge in peer-to-peer overdose reversals within the community.

In January 2023, the Cumberland County Board of Commissioners approved the use of up to $500,000 to fund pilot projects, lasting two years, that provide early intervention initiatives. As of February 2023, The County initiated a formal request for proposals to solicit funding request. Monthly updates about local use of the opioid settlement funds are provided during the Cumberland Fayetteville Opioid Response Team (C-FORT) Meetings.

Advancing Equity

As of May 2023, following the conclusion of the “Advancing Equity” funding agreement service period, the Cumberland County Department of Public Health continues to make strides towards improving health equity within the department. These endeavors involve evaluating workplace equity, implementing digital solution boxes, conducting new employee and annual staff equity trainings, revising company policies, and administering customer service surveys for clients. The agency has also sustained its Equity Advisory Council compromised of representatives from agencies that serve veterans (HMP). This group has continued to provide resource sharing, education, and outreach for veterans that are unsheltered, in need of mental health supports, or other social determinants of health.

Food Insecurity (Ongoing)

The Cumberland County Health Department continues to partner in the Ft. Liberty-Cumberland County Food Policy Council. The efforts of the council and the Ft. Liberty partnership have worked to expand WIC services by establishing a WIC site on the installation to bring food and nutritional services to service members and their families. Their vision is to advance health equity and quality of life by creating a healthy food environment where all members of the Fort Liberty and Cumberland County communities can thrive.  The mission is to provide a forum for representatives involved in all aspects of the local food system to foster effective policies, programs, and community collaboration that decrease food insecurity and increase access to healthy foods within Fort Liberty and Cumberland County. Currently, the council has not made any policy recommendations, however, the council is working toward this goal considering transportation and WIC/EBT recommendations. The Cumberland County WIC office on Fort Liberty hosted one food drop event in November 2023 with support from the Sandhills AGInnovation Center in Ellerbe, NC. In 2024, WIC plans are to host approximately 8 more food drops this year in collaboration with the Second Harvest Food Bank in Fayetteville NC. According to Feeding America, in 2020 food insecurity rate in Cumberland County NC was approximately 16.2%. In 2023, the food insecurity rate in Cumberland County, NC was 16%. The county is under the North Carolina percentage at 12%. The food policy council actively seeks to recruit new members for the council. There are two seats that are held by farmers with the county. They are vested in ensuring that decisions are made considering farmers, challenges, and their efforts to reduce food insecurity. The policy council is looking to work closely with the Murchison Rd Project to address food insecurity and work with the Cumberland County Commissioners to make recommendations and pursue an international famers market in Cumberland County, NC. In May 2023, the Community Food Strategies wrote a letter of support for the council in applying for a 204k grant through Food Research Action Center (FRAC), which focused on WIC, community innovations and opportunities to address food insecurity in Cumberland County and formulate a partnership between WIC and the food policy council. It is the goal of the food policy council to work with farmers of the council to provide insight on soil, water, air quality and farming as it related to food insecurity.

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Healthy Conversations

Healthy Conversations is piloted program in partnership with Cumberland County Commissioners, The Department of Public Health, and local barbers to engage community members on the importance of knowing their health status and advocating for healthier lifestyles on topics such as heart health, prostate cancer, and colorectal cancer. Each barbershop functions as a health hub for their community where the community members can access free blood pressure readings, resources to healthcare, and engaging conversations towards better health. In January and February 2024, ten partnering barbershops throughout the city of Fayetteville attended two trainings facilitated by a Public Health Educator.