Carroll County Overdose Prevention Plan Interventions and Initiatives Need Focus Area Intervention/Initiative Identified Partners Performance Measure Progress 1. Educate parents and CCPS Staff of the growing issue surrounding opiates. Educate Law Enforcement, Community School Resource Officers Education and Advocacy -Provide education to CCPS staff including health teachers, nurses, and student services personnel. -Discuss with school administration possible ways to reach families (i.e. Alert Now messages, PTA forums, etc.) Education to include: -General information on opiates including prescription and illegal -Lock it up message -Warning signs Carroll County Public Schools staff and Carroll County Health Department Prevention Services Complete a minimum of four trainings to CCPS by the end of the calendar year. By September 2013 one educational presentation will completed with CCPS personnel. By September 2013 one educational presentation will completed with McDaniel College personnel. All CCPS health teachers were educated by CCHD Prevention staff in August 2013. CCHD Prevention staff attended back to school nights at Westminster and Liberty high schools in August of 2013. CCHD Prevention staff attended parent conference night at Century High School in October 2013. CCHD Prevention completed a parent presentation at Westminster High school on 10/2/13. On 10/30/13 all Westminster and Century High School Counseling will attend a presentation.
3. Have prescription drug drop-off sites available throughout the community. Education and Advocacy Maintain the number of available drop-off to improve access for the community. Carroll County Health Department and Department of Citizens Services Law enforcement -Drop-off sites will be maintained throughout the county to ensure adequate access by county residents for prescription medication disposal. Local Law Enforcement will explore expansion of the drop off containers at two of the established sites to address the increase in demand as evidenced by frequently full containers at two sites. Sykesville does not want to add another box as the current box is sufficient. Westminster City police department purchased a second drop box for their location in October 2013 and it began using it immediately. Maryland State Police are interested in having a box at the Westminster Barracks and are exploring funding sources for the purchase of the box. 4. Encourage the provision of opiate abuse education in the medical setting and engage physicians in discussions of appropriate pain Education /Advocacy and Clinical -Work with the local ASAM Chapter to have a Risk Evaluation and Mitigation Strategy (REMS) training provided for all extended-release/long acting opioid analgesic drug products. Partner with CHC to provide CME availability for physicians. -Sponsor and/or support trainings that will provide prescribers with the information necessary to treat those with chronic pain. This training may include on-site education from ADAA and Local ASAM Chapter Carroll County Health Department, Carroll Hospital Center and Physician Champions Work with CHC personnel and Library personnel -Host at least one REMS training during FY 14. -During FY 14 training options, beyond REMS, will be explored and a training schedule will be developed. The training was scheduled but the presenter was ill the day of. On October 8, 2013 the healthcare
management guidelines. speakers or online trainings such as opioidprescribing.com -Identify what the jurisdiction believes to be best practices and work with local providers to establish and implement those practices at local agencies. at CHC to provide CME’s professionals did receive training but it was on the efforts to combat prescription opioid diversion instead of prescribing practices due to the presenter illness. CCHD will explore the rescheduling of this event. 5. Provide anti-stigma education to professionals who work with opiate users. Education /Advocacy Substance abuse, health care, law enforcement and corrections personnel all need education and guidelines on providing respectful, user-friendly services to this stigmatized population on the realities of opiate abuse and addiction. Educational interventions should include the perceptions of users and be based on an understanding of how stigma is fostered on organizational and individual levels. Carroll County Health Department, clinical team members and peer community On Our Own and Champions of Change Anti-stigma curriculum will be identified or developed during FY 14. -On Our Own of Maryland is currently revising their program to be more representative of both mental health and substance use. This group will wait to view the new program. 6. Individuals that have experienced an overdose will be educated on overdose prevention and treatment options. Education /Advocacy and Clinical With the input of key stakeholders, such as hospital administrators and emergency department personnel, develop guidelines on overdose prevention education and follow-up procedures, including a discharge plan, for all people admitted as a result of overdose are provided overdose related information upon discharge. Carroll County Health Department and Carroll Hospital Center 75% of all individuals will receive overdose education and information about treatment at discharge. The group agreed at the September meeting to develop a universal prevention education brochure. This would be used by all providers so that the message is consistent throughout the county. At the January meeting the draft brochure was
Partner with the State’s Attorney’s Office to provide public with information on importance of seeking medical help in emergencies. Carroll County State’s Attorney’s Office reviewed by those in attendance. The draft will be sent out with the minutes for additional review and will be finalized by the end of January. The next step will be education of use to provider agencies and organizations. 7. Consistent overdose education will be developed and provided countywide. Treatment Individuals that are being discharged from treatment within the Carroll County Detention Center will have overdose education during collaboration meetings. Establish a local charter that recognizes provision of an overdose prevention plan as a best practice in Carroll County. Local providers of Substance Abuse Services will provide Overdose Prevention Planning activities to all patients entering with Opiate drug use not just publicly funded patients. Carroll County Health Department and all local substance abuse providers. Literature will be provided to at least 75% of individuals as part of their discharge from treatment. As of August 2013 all individuals in treatment at the CCDC are receiving overdose prevention materials. Universal messaging is being developed and approved as described for goal #6 and will be used for this goal as well. 8. Provide screening and intervention to individuals coming to the local Clinical and Treatment Work with the emergency department of Carroll Hospital Center to develop and implement Carroll County Health Department and Carroll Hospital Center SBIRT will be implemented in the CHC Emergency department during FY 14. CHC continues to make progress in this area. At this time the tool has been selected and policies and procedures are
Monitoring Program about outreach to local pharmacists and at this time no support has been requested. 12. Review cases of fatal overdoses. Clinical, treatment, education, and law enforcement Establish a committee that will review all cases of fatal overdose as directed the state. Carroll County Health Department and community partners If chosen as a pilot site the committee will begin reviewing cases as soon as possible. CCHD will complete necessary applications to establish a team by August 2013. The local charter, member list, and signed confidentiality forms were forwarded to ADAA. In November CCHD was advised they will not be a pilot site from ADAA. As a local health department the Health Officer has the authority to convene a medical review committee under health general regulations. Based on these regulations the CCHD will convene a review committee and the first meeting is scheduled for 1/15/14 and the Deputy Health Officer will be chairing this committee. 13. Appropriate Clinical, treatment, and law enforcement Establish a mechanism to review guidelines for OCME referral Carroll County Health Department, clinical and During FY 14 identified partners will review the concerns that were brought to light during the planning period and discuss Data is discussed at the over workgroup on a basis and monthly
address the prescription drug epidemic. Enforcement Liaison and Education Unit). Partner with the local drug task force and it’s prescription drug diversion unit. enforcement agencies During FY 14 the prescription drug diversion unit will educate a minimum of 10 local pharmacies on a “bad prescription.” need of additional education. As the locality makes changes training may be needed. The Diversion unit of the local task force has been meeting with local pharmacies and distributes the attached card. The response from pharmacies has been positive and overwhelming to the task force. 16. Ensure there is treatment capacity to serve the community need. Treatment -Treatment providers will have access to data for the purpose of assessing the local need. -Treatment providers will utilize local data to plan for services. Carroll County Health Department and local treatment providers Treatment providers will participate in the local data meetings with a participation rate of 80%. Providers are participating with the monthly provider council. 17. Raise awareness and change the public’s attitude and behavior in reference to opiate use and overdoses. Education and Advocacy Implement a public service campaign using multiple media outlets (i.e. electronic media, print, radio, etc.). Carroll County Health Department Champions of Change, On Our Own During FY 14 the Prevention, Wellness, and Early Intervention Workgroup will develop a campaign. In early stages. This will be addressed further during the second half of FY 14.
18. Provide treatment providers and community partners with the necessary tools to provide effective treatment. Education /Advocacy, Treatment, and Clinical. -Develop a schedule that will include relevant trainings (i.e. Motivational Interviewing, Person-Centered Planning, Strengths based assessments, etc). - Identify what the jurisdiction believes to be best practices and work with local providers to establish and implement those practices at local agencies. Carroll County Health Department Recovery Services- Change Agent Committee Provide a minimum of one training per year. A five year training plan is currently in development. Concurrently, trainings are being offered free of charge to the community and include the following: *Coding and Coaching as a to Motivaltional Interviewing January 14th & 15th, 2014. *ASAM-Spring 2014 19. Have access to local data that will assist in identifying non-fatal overdoses. Law Enforcement, Treatment and Clinical Develop a committee that will review current practices and identify ways to improve local data collection efforts that will be consistent and valid. Develop an emergency room monitoring system to gather basic information on overdoses in order to get a better understanding of the nature and extent of the problem. Carroll County Health Department, Law Enforcement, Carroll Hospital Center, EMS, etc. During FY 14 a committee with all community partners will meet and identify data needs, possible resources, and then develop the system to begin tracking and reviewing. Some data has been collected via EMS reports. Additionally, some law enforcement has begun tracking responses. Local law enforcement informed the group at the September meeting that they are working on a local data base that we could, one it in place, begin to use for data tracking. The overall group was asked to identify the data points we want to track.
The Sheriff’s department is now tracking law enforcement data related to overdoses for their office, Westminster City Police and Hampstead Police. This is being distributed on a monthly basis and is shared with the Overdose Prevention Workgroup. The other localities have been outreached to and it is possible they may begin to participate in the report as well. 20. Educate individuals that are prescribed opiate medications. Pharmacy and Provide literature describing appropriate use and disposal of opiate medications at the time of medication dispensing. Carroll County Health Department and local pharmacies 75% of individuals will receive overdose prevention education materials with pick-up of their prescription. Needs to be addressed 21. Outreach to pregnant women that are prescribed methadone Clinical and treatment Outreach and education to pregnant that are prescribed methadone regarding possible neonatal abstinence syndrome. Carroll County Health Department and project partners During FY 14 a targeted effort will be made, through partnership with the methadone providers, to educate all pregnant women that are enrolled in MAT services. CCHD has responded when requested by a provider that has pregnant women. The methadone providers have also been invited to our SART meeting that specifically targets
the needs of pregnant women. 22. Outreach to methadone clinics Clinical, treatment, education Encourage methadone clinics to participate in provider forums. Carroll County Health Department During FY 14 all three local methadone clinics will be asked to participate in regular provider forums as well as specialty projects such as SART and the overdose prevention workgroup. Additional outreach will be conducted prior to the next workgroup meeting.