HNC 2030 Scorecard: Cumberland 2021-2024

Executive Summary

Vision Statement

The Cumberland County Community Health Needs Assessment (CHNA) is done on a regional schedule in collaboration with Health ENC, the local health department and local hospitals. The process is designed to provide perspective on quality of life, resources and health outcomes of the community.

Its purpose is to identify social determinants of health through surveys, focus groups and secondary data to learn about the community. This assessment is the foundation for selecting health priorities that will be used in the Community Health Improvement Plan (CHIP) and to develop programs and strategies to improve the overall well-being of our citizens.

This data is informed by state and national evidence and summarizes strengths, weaknesses, opportunities and threats. 

Leadership

The collaborative process of the 2021 Cumberland County CHNA involved the Cumberland County Department of Public Health directed by Dr. Jennifer Green, Cape Fear Valley Health System whose Chief Executive Officer is Mr. Mike Nagowski, and Health ENC led by Chairperson Melissa Roupe. This process allowed for multi-county input to review systems of care, availability and access to resources, and shared goals amongst stakeholders to gather input from residents Those responses were considered, along with recent health statistics to make informed decisions in selecting priorities to focus on in the coming years.

Priorities

Health Priorities

After receiving the survey results and finding key themes from focus groups completed in the CHNA process, key stakeholders were organized to identify top priorities. The stakeholders consisted of representatives from human service agencies, Cape Fear Valley Health System, behavioral health professionals, institutes of higher education, emergency management/preparedness groups, Hispanic-serving agencies, faith-based institutions and the public health agency.

Through primary survey data, focus groups and synthesis of secondary data, key stakeholders identified top health priorities for Cumberland County. Stakeholders selected the following health priorities to focus on in the next three years:

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

These priorities align with the Cumberland County Health Department’s current 2021-2022 Strategic Plan and have been identified as significant by the Board of Health moving forward with the 2023-2027 Health Department strategic plan.

Why Is This Important?

Factors like education, employment, income, family and social support, and community safety provide the foundation for health and wellbeing. These social and economic factors strongly determine where we live, the jobs we have, the people we interact with, and our day-to-day experiences. These factors are also highly inter-related. For example, educational attainment drives opportunities for employment, and thus income. Families with lower incomes have a higher likelihood of living in areas with poor quality schools and have fewer resources to send their children to college. People with higher incomes can choose safer communities to live in.

What We Do

The purpose of the Business Loan Program is to provide financing for the start-up or expansion of businesses that will create jobs for low to moderate income citizens in Cumberland County

Who We Serve

Business owners that will create jobs for low to moderate-income Cumberland County residents

Note: Low/moderate income is determined at the time the employee is initially hired – not the salary offered to the resident.

How We Impact

Type of Assistance:

Loan Type: Micro Loans – Businesses with 5 or fewer employees, including the owner
Loan Amount: $500 - $25,000

Loan Type: Economic Development Loans – Businesses with 6 or more employees, including the owner.
Loan Amount: $25,001 and up*

*(based on business debt capacity)

Loan Purpose: Property Acquisition and/or Site Improvements
Interest Rate: 5%
Loan Term: 15 years

Loan Purpose: Machinery & Equipment
Interest Rate: 5%
Loan Term: 10 years

Loan Purpose: Working Capital
Interest Rate: 5%
Loan Term: 5 years

What We Do

 Most of the assistance is material in nature, such as free baby items, food, or clothes. There is also counseling as well as immigration help, Support for the Family including limited financial aid for bills, disaster relief and more.

Who We Serve

Catholic Charities provides support to the low income, immigrants, and poor in Fayetteville and Cumberland County North Carolina area.

How We Impact

• When an emergency arises and or in between paychecks, there is often a struggle to purchase groceries. To help in this capacity, the Free Food Pantry provides approximately 3-5 days of shelf-stable food, fruits, fresh produce, and frozen ground turkey or beef to families in Cumberland County North Carolina who live in the service territory.
• Supplies are given to new moms with infants or babies or expectant mother such as new clothes, diapers, bibs, cribs, car seats, towels and baby blankets. 

Why Is This Important?

Cumberland County does have an issue with homelessness and equitable housing that is being addressed under several plans and organizational efforts. There are Housing Rehab, Rental Rehab, First Time Homebuyers, and Affordable Housing Development programs at the county level. These programs work to provide affordable homes or assistantce for a wide range of residents; from low income families to single parents and event families with homes not on permanent foundation. 

Equitable housing efforts are often overwhelmed including those of affordable housing units and housing authorities. Without available units or because of not qualifying, families and individuals often find themselves unsheltered. 

The issue of homelessness is important and evident by the 2022 Point-In-Time Count (PIT Count).The PIT count is held annually in January and creates a census of the homeless population during a 24-hour period. It is designed to be a snapshot of both the sheltered and unsheltered homeless population in a particular area and should not be considered an exact count of homeless individuals. The 2022 PIT is as follows: 

2022 PIT Count

Unsheltered homeless                        392

Sheltered homeless                              43

Transitional housing                              40

Total                                                    475

Description

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 the county.

What We Do

In 2021, states began administering Emergency Rental Assistance programs with federal funds through the U.S. Department of the Treasury as authorized by the Consolidated Appropriations Act of 2021 (ERA 1: $25 billion) and the American Rescue Plan Act (ERA 2: $21.66 billion). The ERA 1 program concluded on September 30, 2022. ERA 2 runs until September 30, 2025.

Who We Serve

Low-income. Qualifying assistance program participant already (Medicaid, EBT-food stamps, TANF, etc.)

How We Impact

Making referrals to the RAP improves the likelihood that individuals and families will remain housed and avoing eviction. Homelessness is a problem in the Cumberland community which City Council making efforts to address encampments throughout the area. By providing referrals to RAP, assiting with applications for those with literacy issues, and ensuring that referrals made are completed/closed, we are contributing to reducing the instances where citizens are forced to figure out where to live and have shelter. 

Why Is This Important?

The Cumberland County community is one of several communities hit hard by opioid-related injury and death. Data from the Injury & Violence Prevention Branch indicated that in 2020 there were 631 emergency department visits for unintentional opioid poisoning in the county. Unfortunately, 8256 residents were lost to unintentional drug poisonings. In the same year, 142 residents died due to unintentional opioid poisoning.

In 2020, 13.8% of residents received dispensed opioid pills in Cumberland County.

For more local data, visit https://injuryfreenc.ncdhhs.gov/DataSurveillance/Poisoning.htm. To see county level data, scroll to “County Overdose Slide Set”. To see county level emergency room data, scroll to “NC DETECT Opioid Overdose ED Visits Reports”.

Description

A selected entity of the RFP #23-16-PH Opioid Settlements. This agency was selected and awarded $200,000 to complete work toward opioid response in Cumberland. 

Direct Services for people impacted by drug use, incarceration, sex work, overdose, gender, HIV, and hepatitis, as well as first responders.

*talk about --Active Post Overdose Response Teams in the story**

**Referral system plan for first responders**

Description

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. C-FORT is committed to identifying strategies that will impact the opioid issue while creating a sustainable community response for years to come. http://www.co.cumberland.nc.us/departments/public-health-group/public-health/community-services/c-fort-(opioid-response)/about-cfort 

One of the activities funded is the Narcan Kit Distribution Program.

What We Do

The 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. The Cumberland-Fayetteville Opiod Response Teams overall goals are to lauch a treatment center that revolves around treating community members who have an addiction to opiods, 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.

Who We Serve

We currently have over 90 stakeholders participating with C-FORT. We believe everyone can play a critical role in these efforts and hope you will join to impact the lives of Cumberland County residents.

How We Impact

To achieve the collaborative, multi-faceted approach so crucial to tackling the opioid crisis in North Carolina, the UNC School of Government is supporting this collaborative learning model by providing direct support to each of the North Carolina communities. In early 2018, our community was selected as one of 10 sites across the state to receive funding from Blue Cross and Blue Shield of North Carolina to engage in a collective impact initiative to bring stakeholders together to develop localized potential solutions to the opioid crisis. This is a two-year initiative in which team members meet monthly to engage in a series of planning activities to include assessing community resources and gaps, reviewing data surrounding the issue, goal setting, and strategic planning.

Everyone is invited to join the work of C-FORT. We currently have over 90 stakeholders participating with C-FORT.

C-FORT Representatives

C-FORT is constantly growing as new stakeholders join the team. Below is a list of agencies with representatives:

Cumberland County Opioid Injury & Death Data

Unfortunately, our community is one of several communities hit hard by opioid-related injury and death. Data from the Injury & Violence Prevention Branch indicates in 2016 Cumberland County lost 56 residents to unintentional drug poisonings. Preliminary data for 2017 indicates this number significantly climbed to 79.  In 2017, there were almost 20 million opioid pills dispensed in Cumberland County. For more local data, visit https://injuryfreenc.ncdhhs.gov/DataSurveillance/Poisoning.htm. To see county-level data, scroll to “County Overdose Slide Set” and to see county-level emergency room data, scroll to “NC DETECT Opioid Overdose ED Visits Reports”

Resource links:

• North Carolina Harm Reduction Coalition
• UNC School of Government Opioid Response Project

Description

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 age 18 and older of all genders who are struggling with an addiction to heroin, fentanyl, prescription painkillers, or other opioids.

Treatment at Fayetteville CTC includes prescription medication and counseling. This approach, which is known as medication-assisted treatment (MAT), is recommended by the National Institutes of Health and other reputable organizations as an effective means of helping people achieve successful long-term recovery from opioid addiction.

When individuals begin treatment at Fayetteville CTC, one of their first experiences will be to complete a thorough assessment. This will help us determine which medication is right for you, and it will also provide your treatment team with insights into the impact opioid addiction has had on your life.

Mission and Vision: Carolina Treatment Center of Fayetteville’s mission is to operate a behavioral
health center where people receive care that enables them to regain hope in a supportive,
caring environment. Our vision, as part of Acadia Healthcare’s CTC Division, is to set the standard
for excellence in addiction treatment.

Description

A selected entity of the RFP #23-16-PH Opioid Settlements. This agency was selected and awarded $200,000 to complete work towards opioid response in Cumberland.

Agency’s Mission and Vision: Mission: To provide a safe and supportive environment for those seeking recovery from alcohol and other drugs, based on a 12 Step Program. Vision: We envision Myrover Reese as a beacon of hope, where those suffering from addiction have the opportunity to be restored and transition into productive members of society.

Name of Project Myrover-Reese Opioid Recovery Housing and Recovery Support Services Project

Programs to support people in treatment and recovery (Option A, Strategies 3 and 4)
• Recovery support services
• Recovery housing
Project Description and Implementation Plan
Myrover-Reese Fellowship Homes, Inc. (MRFH) is a non-profit 501(c)(3) corporation formed in 1961 to provide drug and alcohol treatment services to members of our community. Myrover-Reese provides supervised recovery housing in three licensed 24-hour facilities. The primary goal of these services is the rehabilitation of individuals who have substance use disorder with close to half of all cases being opioid dependency. This is accomplished by providing Recovery Support Services (Strategy 3) and Recovery Housing Support (Strategy 4).
Implementation of Recovery Support Services (Strategy 3) and Recovery Support Housing (Strategy 4):
The three licensed facilities have a total of 38 beds, 10 of which are designated for female residents and the remaining 28 are designated for male residents. The program goal is to provide recovery support and housing to reduce opioid use disorder relapse. This program is provided at no cost to the client and transitions the individual into stable housing and employment while reducing and preventing relapse. The two-year funding request will provide the ability to expand capacity to treat additional clients and improve support services by adding a certified peer support specialist on-site staff.
There is 24-hour staff that supervises the residents. During the day, the staff transports residents to IOP counseling, medical appointments, recovery meetings, as well as distribute medication and other needs. An individual treatment plan is developed for each resident, setting requirements and individual goals to be accomplished prior to successful completion of the program. These requirements and goals have intermediate steps to be completed by a certain timeframe. For example, obtaining employment after 90 days.

The program includes Intensive Outpatient (IOP) Group and individual counseling specifically designed by Carolina Outreach to treat addiction disorders. The residents at Myrover-Reese are required to attend intensive outpatient through Carolina Outreach three times a week for the first three months for three hours per day, then two times a week for the next two months and then once a week for the last month of their treatment plan. Carolina Outreach also offers continuity of care to the resident after discharge from Myrover-Reese.
The residents also are treated through individual therapy and psychiatric care through Carolina Outreach as often as needed. Myrover-Reese has an onsite, full-time staffed Certified Substance Abuse Counselor (CSAC) who offers educational interactive groups once a week for the residents to learn about addiction, relapse prevention, and the 12-step recovery process.
Myrover-Reese also offers each resident an individualized treatment plan that is collaboratively put together by the resident and CSAC. The CSAC uses this to help the resident participate in their treatment, make goals, and assist the resident in planning for discharge. The CSAC meets with each resident at minimum monthly, but many times weekly, to monitor progress and assist the residents in creating their discharge plan to include obtaining transitional housing and employment.
The residents are required to obtain a 12-step sponsor within the first 30 days, call their sponsor daily, and complete step work as directed by the sponsor throughout the program period. The residents are also required to attend six 12-step meetings per week. The path to success starts with collaborative planning between the resident and CSAC, IOP through Carolina Outreach, educational interactive groups led by a CSAC, 12-step meetings and step work with a sponsor. A resident's journey in recovery will continue outside of Myrover-Reese after they obtain housing, employment, and a connection to the 12-step community.

Description

A selected entity of the RFP #23-16-PH Opioid Settlements. This agency was selected and awarded $80,000 to complete work towards opioid response in Cumberland. These funds will be administered by Cumberland County Justice Services. Funding continuation is contingent upon terms of MOU met and reporting indicative of appropriate expenditures. Program will then extend to full $200,000. 

Agency Mission and Vision: As a diversion court, Family Drug Treatment Court, hereinafter referred to ("FDTC") 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. 

Name of project: FAMILY DRUG TREATMENT COURT- Cumberland County, NC

Option A Strategy 10: Criminal Justice Diverstion Programs

Project Description: The first FDTC program was started in 2004 under the previous Chief District Court Judge, A. Elizabeth Keever. FDTC is a specialty treatment court for cases involving parents and guardiants who are in danger of losing custody of their children because of substance abuse and child neglect issues. The courts help ensure compliance with the Adoption and Safe Families Act. 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 hoepfully, a fully functioning parent upon graduation from the program. 

Goals of FDTC include: 

• provide parent(s)/guardian(s) with an opportunity to be clean and sober
• provding support to aid them in resisting further criminal activity; and skills that will aid them in leading productive, substance-free and crime-free lives
• helping the parent to become emotionally, financially, and personally self-sufficient
• to increate the personal, familial, and societal accountability of offenders
• helping the parent(s)/guardain(s) develop adequate parenting and "coping" skills to be able to serve as an effective parent on a day-to-day basis and 
• decrease the amount of time needed to determine if reunification is a plausible goal

FDTC is a response to the need for greater accoutnability of parents of absued and/or negleted children and the treatment and justice systems intended to serve them. The program is available to parents who have lost custody of their children or who are in danger of losing custody of their children due to abuse and/or neglect where the courts have jurisdiction over the case and families. Parents must be determined to be addicted or have a high likelihood of addiction to drugs and/or alcohol and they must agree to enter the program. 

FDTC participants are also assessed for domestic violence, trauma and other mental health concerns 

and are referred to treatment. Family Drug Courts follow the same principles as other "problem solving" courts. Participants are provided a court-based case manager who ensures the parents receive treatment and other needed services. Participants must submit to frequent and random urinalysis and/or breathalyzer to determine whether they are becoming and remianing free of drugs and alcohol. They must attend and participate in treatment and are required to compelte other educational programs as prescribed by the court and the Department of Social Services (DSS). FDTC participants are generally required to attend court every two weeks and receive praise and other incentives to maintain their recovery and progress in treatment. although the FDTC cannot promise successful parents that their children will be returned to them, a parent who is successful in the FDTC is much more likely to be determined by DSS and the Abuse, Neglect, and Dependency Court to be fit to have their child(ren) returned. Parents who do not comply with the requirements of the FDTC will be sanctioned by the court and may be ordered to serve jail time. 

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. 

Description

Description

Description

Description

The Cumberland County Health Department and the Cumberland County Detention Center are collaborating to begin a Medication Assisted Treatment pilot program. Currently, individuals who are currently 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). 

Why Is This Important?

Why Is This Important?

Mental and behavioral health remains a top identified need among Cumberland County residents and community stakeholders. Mental health includes an individual's emotional, psychological, and social well-being. Good mental wellness is vital at every stage of life, but. Still, limited services and providers and the stigma associated with mental illness have left many individuals isolated and alone. The prevalence of substance use disorders is also a concern at the national, state, and local levels. Opioid use disorders have become especially problematic, leading to increased emergency department visits and overdose deaths. Despite effective treatments, people often don’t get the treatment they need. Mental and substance use disorders are also linked to other health concerns. " According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the coexistence of a mental illness and a substance use disorder, known as a co-occurring disorder, is common among people in treatment."  Research from NIMH has also shown that individuals diagnosed with chronic health conditions or diseases like cancer, diabetes, chronic pain, and heart disease are at higher risk of developing a mental illness. "Research suggests that people with depression and another medical illness tend to have more severe symptoms of both illnesses. They may have more difficulty adapting to their medical condition and may have higher medical costs than those who do not have depression or a medical illness. Symptoms of depression may continue even as a person’s physical health improves."

If we are successful in fully achieving this result for Behavioral Health and Opioid Misuse, we envision a Cumberland County where all Cumberland County children, adults, and families: 

• Live free of stigma associated with mental health diagnoses or substance use issues.

• Develop and maintain strong social support.

• Access to high-quality oral health interventions, including integrating mental health care in primary and emergency care.

• Can readily access effective prevention, treatment, and recovery programs for mental health and substance dependence. 

• Conduct education and outreach to combat the stigma associated with mental health and substance use problems emphasizing vulnerable populations such as youth, racial/ethnic minority groups, and others to be identified. 

References:

1. Co-Occurring Disorders and Other Health Conditions | SAMHSA

2. NIMH » Chronic Illness and Mental Health: Recognizing and Treating Depression (nih.gov)

What We Do

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.  

Who We Serve

Anyone in a U.S. state, territory, or tribe who needs suicide or mental health-related crisis support or who has a loved one in crisis can connect with a trained counselor by calling (multiple languages), chatting, or texting (English only) 988 (as long as the caller has telephone, cellular or internet services available to them). 

How We Impact

In 2020, the U.S. had one death by suicide every 11 minutes. Suicide is a leading cause of death for people aged 10-34. 988 Provides 24/7, free and confidential support to people in suicidal crisis or emotional distress works. The Lifeline helps thousands of people overcome problems every day. As of April 2023, there have been 5,178 calls received to the 988 crisis line from the state of North Carolina. However, we cannot see the county the phone calls are coming from. Promoting the 988 materials as much as possible within the communities is still good to help decrease the number of calls received. Staying up to date with all the new promotional materials that have been released is another way we can also impact this matter.  We plan to continue to promote this matter by using major outlets such as the radio, social media platforms ( Facebook and Instagram), and Newspapers. 

We can measure this performance by tracking data through our Health Education Log, which tracks when promotional materials have been given out to the community members, either for an event or personal use. We also advertise the 988 materials on the TV screens in our main lobby for the patients to see while they wait. About five promotional materials appear on the screens every 20 minutes in one cycle of a day by staying consistent with these efforts. We believe our suicide rates for the county can be lowered. 

What We Do

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 effects of the COVID-19 pandemic have placed a strain on community resources, prompting our agency to be equipped to promote mental wellness in the lives of those we serve.

Who We Serve

Mental Health First Aid can be helpful for anyone: Employers, Police Officers, Hospital Staff, First Responders, Teachers, Faith Leaders, Community Members, and Caring Individuals. This training will resource our staff, adolescents, parents, and all those who request assistance to help those battling substance use or mental health disorders overcome a crisis.   Offered through our LME, Eastpointe, we will partner to enroll participants through this 8-hour course.  This offering will be provided quarterly to allow flexibility with enrollment and participation. 

MHFA is currently being offered to Cumberland County residents by the following organizations:

• Alliance Health
• Veterans Services of the Carolinas
• Steven Cohen at Centerstone

As of July 1, 2023,  we hope to expand the support through the Cumberland County Health Department by getting one of our public health educators trained to teach the Mental Health Frist Aid curriculum. We anticipate funding from our workforce development department housed here in the Health Department. With this funding, we can train our staff on the importance of Mental Health Frist Aid, either in the adult or youth component.  

How We Impact

This evidence-based program will show its impact on fully trained MHFA students and participation in each course.  The effect will also be measured by the number of organizations that continually request training for their staff.  The support through the expansion within the health department will allow more accessible courses to be taught to the community faster. 

We plan to show the impact throughout the years by tracking data on how much time is spent training to get the licensure and the cost. From there, we plan on creating surveys for the participants to complete after each session. That way, we will have quantitative and qualitative data to pull more.  Getting a story from someone on how they like the training and how they would use the movement will give us a better understanding of why the person took the course and how we can use that information to assit the community's needs best. 

What We Do

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 NCCare 360 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. 

Who We Serve

Many North Carolinians struggle daily with food insecurity, housing instability, lack of transportation access, or other needs. NCCARE360 solves a fragmented health and human services system by connecting providers across sectors. NCCARE360 supports individuals in communities, giving them more opportunities to lead healthy and happy lives. NCCARE360 results from a robust public-private partnership between the NC Department of Health and Human Services and the Foundation for Health Leadership & Innovation. The NCCARE360 implementation team includes United Way of NC/2-1-1, Expound Decision Systems, and Unite Us.

We also can't forget about our military community, so it's great to hear that NCServes joins forces with NCCARE360 to bring coordinated care and resources to the North Carolina and to the Cumberland County military communities. 

How We Impact

NCCARE360 has a community engagement team powered by Unite Us working with community-based organizations, health plans, health systems, and government agencies to create a statewide coordinated network. The team directly supports the community through every step of joining the network to ensure that each partner is supported. As new regions launch, the team remains engaged in the community, working with partners to regularly review data and network performance, solicit feedback and input on processes, and provide ongoing technical assistance.

What We Do

In April 2009, a group of community stakeholders met to address the needs of the uninsured residents of Cumberland County. Their commitment to our needs led them to form what is now Cumberland HealthNET (CHN). 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.

Through its collaboration with seventeen other county and community organizations, Cumberland HealthNET seeks to improve access to care for the uninsured, improve coordination of services, provide needs assessments, identify overlaps and gaps in the services provided, provide community education and resources, advocate for behalf of the uninsured, and leverage and develop outside financial resources to support the work in Cumberland County through the following programs: Health Information, Well-Being Information, Housing & Homelessness Services, Insurance Information including qualification information, ACA Insurance, and CHN Insurance, COVID-19 Vaccination Program, Our Health Clinic, help with finding a medical professional, case management, prescription assistance, mental health assistance, and nutrition information.

OUR MISSION
The mission of Cumberland HealthNET is to create a coordinated system of care for the uninsured residents of Cumberland and surrounding counties, resulting in healthier residents with a better quality of life.

Who We Serve

Cumberland HealthNET is dedicated to assisting people in Cumberland, Hoke, Robeson, and Harnett Counties in finding a medical home, resulting in a better quality of life. 

How We Impact

This program provides improved access to care for the uninsured, improves the coordination of services, provides needs assessments, identity overlaps and gaps in the services provided, provides community education and resources, advocates on behalf of the uninsured, and leverages and develops outside financial resources to support our work in Cumberland County.

This program will also serve the Day Center. The City of Fayetteville is also creating a homeless day resource center to support and centralize resources for citizens experiencing homelessness. The day center will be located at 128 South King Street, Fayetteville, NC. The day resource center will also be utilized for emergency shelter purposes as needed. Behavioral health services will also be available in the center. 

Why Is This Important?

“The disparities we often see in health outcomes for people of color are rooted in the historical and continued structural racism found in our society that has resulted in inequitable opportunities for healthy lives”(North Carolina Institute of Medicine 2020). A person’s health can be affected by access to financial and community resources, educational system, safety, and “interpersonal relationships” (U.S. Department of Health and Human Services 2020). The impacts of structural racism are numerous, including unemployment, fewer educational resources, harsher punishments in schools and the judicial system, intergenerational poverty, and the accumulated stress of discrimination regardless of socioeconomic status (i.e., “weathering”).18 These issues encompass many of the upstream causes of the poor health outcomes that are seen for people of color.

Child maltreatment is defined as the abuse and neglect of a child younger than age 18 by a parent, guardian, or caregiver (North Carolina Division of Public Health 2019). Factors that can contribute to child maltreatment include the presence of adults facing substance use disorders, mental illness (notably maternal depression), and intimate partner violence (U.S. Department of Health and Human Services 2020). Young children are especially vulnerable to adverse childhood experiences (North Carolina Division of Public Health 2019).

Geronimus AT, Hicken M, Keene D, Bound J. “Weathering” and Age Patterns of Allostatic Load Scores Among Blacks and Whites in the United States. American Journal of Public Health. 2006;96(5):826-833. doi:10.2105/AJPH.2004.060749.

North Carolina Institute of Medicine. (2020). Healthy North Carolina 2030: A Path Toward Health. Morrisville, NC: North Carolina Institute of Medicine; 2020. Retrieved from: https://www.healthenc.org/nc-social-determinants-map/

U.S. Department of Health and Human Services. (2020) Strategic Goal 2: Protect the Health of Americans Where They Live, Learn, Work, and Play. Retrieved from: https://www.hhs.gov/about/strategic-plan/strategic-goal-2/index.html.

North Carolina Division of Public Health. (2019). Early Childhood Action Plan Cumberland County. Retrieved from: https://files.nc.gov/ncdhhs/Cumberland_County.pdf

What We Do

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.

There are two professionals within CC DPH who are authorized and trained facilitators 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/

Who We Serve

This program is available to any adults within Cumberland County that are interested in preventing child sexual abuse, including but not limited to children within the foster care system.

How We Impact

Darkness to Light uses qualitative and quantitative methods to inform our program design, and then we monitor and evaluate change. We use results to iterate and improve programming and to ensure that we are creating meaningful and sustainable change. Child sexual abuse research is critical to effectively protect children.  According to D2L research, for every adult who receives a certificate of completion of the Steward of Children prgram, 12 child are protected from sexual abuse.

https://www.d2l.org/our-work/child-sexual-abuse-research/

What We Do

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).

Who We Serve

Triple P is often a required court order for parents involved with family court; however, any parent or parents can take this training for their own benefit and the benifit of thier children.

How We Impact

It is a method to help parents rethink parenting skills and apply more effective methods. 

From the Triple P website:

DOES IT WORK?

If you’re going to invest your time doing a parenting program, you want to be confident that you will get results. The Triple P – Positive Parenting Program has more evidence to back it up and show it works than any other parenting program in the world. 

Triple P has been tested with thousands of families over more than four decades and been shown to help families in many different situations and cultures. In fact, Triple P’s evidence base now includes:

• More than 650 international trials, studies and published papers, including 
• More than 340 evaluation studies, which also includes
• More than 170 randomized controlled trials

Triple P has been shown to help reduce kids’ and teens’ problem behavior and also reduce children’s emotional problems. The evidence also shows it helps parents feel more confident, less stressed, less angry and less depressed. And that’s positive!

https://www.triplep.net/glo-en/the-triple-p-system-at-work/evidence-based/what-the-experts-say/read-what-experts-say/

What We Do

Who We Serve

How We Impact

Progress on CHIPs

The Cumberland County State of the County Health Report (SOTCH) identifies the work being done on the health priorities identified from the 2021 Community Health Assessment (CHA). The actions and programs being taken collectively identify progress towards goals of the Community Health Improvement Plan (CHIP). 

**Add priority updates**

Morbidity and Mortality Changes Since Last CHA

Opioids
From January to May of 2022, there were 332 Overdose ED visits for Med/Drugs with dependency potential in Cumberland County. There were 104 ED visits for opioid overdose compared to 786 across the state. There were 997 EMS suspected opioid overdose encounters. 

COVID-19
Throughout 2022, the Cumberland County Health Department conducted multiple outreach clinics to combat the surge of COVID-19 cases. Testing and vaccination were provided in outreach and onsite daily and at-home test kits were made readily available to community members.

**Add case count and vaccinations for 2022**

Emerging Issues Since Last CHA

Tuberculosis:

• (8) cases in 2022 (25% increase from 2021; 6 cases in 2021)

• (1) case of ocular TB (First for Cumberland County)

Hepatitis B/C:

• (11) cases of acute Hep B in 2022 (45% increase from 2021: 6 cases in 2021)

• (2) cases of acute Hep C in 2022 (no change from 2021)

• (32) new cases of Chronic Hep B

• (330) new cases of Chronic Hep C

Mpox:

• (22) confirmed cases mostly among African American MSM population

• High rate of comorbidity to include HIV and Syphilis

• Low rates of mpox vaccination amongst target population

Syphilis:

• (238) cases of syphilis is 2022 (38% increase from 2021; 172 cases in 2021)

• High increase in women ages 14-44, African American males, and MSM population

• Cumberland County 4^th in the state for syphilis (behind Mecklenburg, Wake, Guildford counties)

• (4) cases of congenital syphilis in 2022 (100% increase from 2021; there were no cases in 2021)

HIV/AIDS:

• (76) new cases of HIV and (26) new cases of stage 3 AIDS in 2022 (82 for HIV and 46 for AIDS in 2021; 7% decrease for HIV and 43% decrease for AIDS in 2021)

• 4^th in the state for HIV and 6^th for AIDS

• 69% of newly diagnosed cases amongst MSM population

Chlamydia/Gonorrhea:

• Cumberland County makes up 6% of all chlamydia and gonorrhea cases in 2022

• 4^th in the state for chlamydia and gonorrhea in 2022

• Chlamydia rates highest among women and gonorrhea highest among males

New/Paused/Discontinued Initiatives Since Last CHA

Opioid Settlement Funds (New)
The Cumberland County Health Department has led the charge in developing programs and services utilizing the Opioid Settlement Funds. In August 2022, the Cumberland County Board of Commissioners approved the utilization of $800,000 to fund multi-year (two-years) pilot projects that align with evidence-based, high-impact strategies defined in the MOA. 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

The Health Department hosted Community meetings to discuss the strategies and solicit input on the recommendations being given to County Commissioners on the programs to be offered under the county solicited funding requests for funding through a formal competitive Request for Proposal process. Awardees are slated to begin work on programs and strategies in July 2023. 

Advancing Equity (New)
Cumberland County Health Department received funding from the North Carolina Department of Health and Human Services titled titled "Advancing Equity." This funding initiative aimed at reducing COVID-19 related health disparities and advancing health equity by expanding health department capacity and services to prevent and control COVID-19 infection or transmission among historically marginalized populations, or other priority populations. The agreement service period is from September 2021- May 2023. The Health Department identified it's HMP in unsheltered veterans and worked to establish an Equity Advisory Council, a collaborative of veteran serving individuals & agencies to assist them with reducing health dispatiries related to smoking and offering cessation services, offering testing and vaccination for COVID-19, and assiting with social supports through referrals via NCCare360 platform. 

Food Security(Ongoing)
The Cumberland County Health Department continues to partner in the Ft. Liberty-Cumberland County Food Policy Council. The efforts of the concil 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 membes 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.The Council is working on the following initiatives: 

1. Increase access to healthy, nutritious, and culturally inclusive foods in both Fort Bragg and Cumberland County by identifying and recommending policy changes to Fort Bragg and Cumberland County leadership
2. Incorporate health, equity, and sustainability considerations in policies, processes, and decisions as it relates to food insecurity
3. Decrease the current number of adults and children facing food insecurity in the Cumberland County
4. Communicate with various food system stakeholders for their expertise and build a better sense of cohesion amongst food system workers
5. Collaborate with Community Food Strategies to network with other existing Food Policy Councils in the Southeast Region of North Carolina
6. Explore ways to conserve local resources such as plants and soil, water, air quality, farming and agricultural land, local livestock, and capital

Progress on CHIPs

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. 

Morbidity and Mortality Changes Since Last CHA

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.

Emerging Issues Since Last CHA

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.

New/Paused/Discontinued Initiatives Since Last CHA

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.

​​​​​​​

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.