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MEETING PACKET JULY 2015 CITY OF SALEM MASSACHUSETTS BOARD OF HEALTH ���1!�L?ww�,� 120 WASHINGTON STREET,4'"FLOOR Prevent. protect. TEL. (978) 741-1800 FAx(978)745-0343 KIMBERLEY DRISCOLL tramdin@salem.com LARRY RAMDIN,RS/REHS,CHO,CP-FS MAYOR HEALTI I AGENT NOTICE OF MEETING You are hereby notified that the Salem Board of Health will hold its regularly scheduled meeting Tuesday July 14, 2015 at 7.00 PM City Hall Annex 120 Washington Street 3rd Floor Room 312 MEETING AGENDA 1. Call to order 2. Approval of Minutes 3. Chairperson Communications ' `^ c x�, r- 4. Public Health Announcements/Reports/Updates , a. PHN Report r—:* b. Health Agent D C. Administrative C50 d. Council Liaison Updates o 5. Tobacco Violation hearings: Sunoco 145 Canal St. 2nd offense Global 200 Canal Street 3`d offense Hearing requested: North Shore Vapor 300 Highland Ave -1"offense 6. Updates from Joyce Redford, M. Ed., North Shore/Cape Ann TAPP, Program Director 7. Update on North Shore Medical Center 8. Opiate use epidemic/discussion- updates on opiate use, overdose in Salem and strategies to reduce 9. New Business/Scheduling of future agenda items This notice posted on "Official Bulletin Board" City Hall, Salem, Mass. on.JUL 10 2015 Larry Ramdin at �:GCS in accordance with MGL Chap. 30A, Health Agent Sections 18-25. cc: Mayor Kimberley Driscoll, Board of Health, City Councilors Next regularly scheduled meeting is August 11, 2015 at 7pm at City Hall Annex, 120 Washington Street 3 d Floor Room 312. Know your rights under the open meeting law MGL chapter 30A ss 18-25 and City Ordinance section 2-2028 through 2-2033 CITY OF SALEM BOARD OF HEALTH MEETING MINUTES June 9, 2015 DRAFT MEMBERS PRESENT: Dr. Danielle Ledoux, Acting Chair, Mark Danderson, Janet Greene &Paul Kirby OTHERS PRESENT: Larry Ramdin Health Agent, Suzanne Doty, Public Health Nurse, Heather Lyons-Paul Clerk of the Board &Wendy Kent, Opiate Task Force Coordinator MEMBERS EXCUSED: Dr. Shama Alam(Chair), TOPIC DISCUSSION/ACTION 1. Call to Order 7:20pm 2. Minutes of Last Meeting J Greene motioned to accept the minutes. P Kirby 2"d. All (May 19, 2015) in Favor. Motion Passed 3. Chairperson Announcements Dr. Ledoux forwarded the article from the Salem Evening News on the public meeting to the members of the Board. She has submitted her resignation from the Board to the Mayor's office. 4. Monthly Reports-Updates A. Public Health Nurse's Copy available at the BOH office Report B. Health Agent's Report DEP will be installing cameras on Harmony Grove Rd due to the influx of illegal dumping in the area. The community service program has cleaned up the area. The department will be looking into purchasing four cameras to be placed at locations around the city were illegal dumping is an issue. Waste Management has taken over the trash and recycling contract from North Side Carting Copy available at the BOH office C. Administrative Report Copy available at the BOH office M. Danderson motioned to accept reports. J Greene 2"d All in favor. Motion Passed D. City Council Liaison No Council report tonight Updates P. Kirby motioned to take item 5 out of order to hear Wendy Kent V.J Greene 2"d All in favor. Motion passed 49 5. Wend Ken Opiate Task Fund for o iate overdose studies was started back in 2006 Y � P g p Force Coordinator, program in Lynn, MA. A community wide assessment was done. In overview and update 2013 the grant was expanded to a regional level adding Salem and Peabody to The Opiate Task Force. The numbers of overdoes are still growing. Although white males and females are the highest at risk population onset is getting younger do to prescription drugs. No one is immune to opiate addiction. It's a chronic brain disease. In the last year the public has become much more aware of opiate use even though it's been an issue for many years. Wendy is working with Salem Now to get more information out there. The North Shore Medical Center, Police, Fire, Schools, Boards of Health, and local businesses all on board to help educate the public. The focus for Salem is primary prevention and to educate the public in hopes that it will lead to support systems for user, families and friends and more treatment facilities. Lynn now has a residential treatment center. The Board discussed what their role is on this topic. J Greene—The Board needs a clear mission; Improve the quality of life for everyone seeking help. There is not enough post overdose care. It's as important to follow up with these people as it is for victims of violent crimes. I think we are underestimating how big the problem is. W. Kent -North Shore Medical Center is working on getting programs in place for post treatment. There is still a stigma around opiate use so a lot of data is not available because of that. L Ramdin - On Junel7th there is a Public Health Safety and Environmental Committee Meeting at Salem High School at 6:15pm. This will shed some light on the issue. As we continue to look into this the Board of Health will have a clearer path on how they can be involved. W. Kent - In closing the ground work is being laid but there is so much more work the communities need to do to lead people into recovery. Rates are climbing in the US to a great degree. This is a multilayered addiction so it's very challenging to understand. 6. New Business/Scheduling of future agenda Larry will be on vacation for the July meeting. items Keep opiate updates on agenda. MAOPC Salem working group update 7. MEETING ADJOURNED: P Kirby motioned to adjourn the meeting. M. Danderson 2nd All in favor. Motion passed 8:45pm Respectfully submitted, Heather Lyons-Paul Clerk of the Board Next regularly scheduled meeting is July 14, 2015 at 7pm At City Hall Annex, 120 Washington Street,Room 311 Salem. i 1 Suzanne Doty RN,BSN Salem Board of Health Public Health Nurse Public Health Nurse Report Reporting on June 5th, 2015 to July 9th, 2015 Disease Prevention • Investigated reportable diseases and reported case information to MDPH. • In contact with North Shore Pulmonary Clinic and MGH pulmonary clinic on current active tuberculosis cases. • In contact with NSMC Infection Control department for prevention of disease within the hospital. Health Promotion • Updated the Salem Board of Health Facebook and Twitter pages with information on the Opioid Crisis public forum held on June 171h, the opening day of the Farmers Market and food safety for the summer. • On June 91h surveyed all pharmacies in Salem on the standing Narcan orders and trainings. All CVS and Walgreens have trained employees and have at least one type of Narcan available in store, Walmart does not and Target has begun the process. • Completed 9 Camp Inspections including: o Campfire o Lynch Van Otterloo YMCA o Children's Island o Salem YMCA o Naumkeag o Forrest River o Rebel Shakespeare o Salem State University Athletic Camps o Schooner Camp Meetings/Trainings • On June 111h attended this North Shore REACT meeting where a new grant called Confronting Abuse in Later Life North Shore(CALL-NS)was discussed. This grant will help provide services for people over 50 years old who are experiencing or are at risk for abuse. • On June 241h attended there North Shore Cape Ann Emergency Preparedness coalition meeting where we were introduced to the HMCC host agent. ' s • On June 25`h attended a Foodborne illness documentation training held by MDPH regarding changes made to improve foodborne illness investigation within MAVEN. • Met with 3 candidates to assist with interviews for a summer student intern. Monthly Report of Communicable Diseases June 2015 Disease New Carry Over Discharged Total#Of Running Total for Reported Cases this Total for 2014 Month 2015 Tuberculosis 1 0 0 1 3 5 (Active) Latent 1 0 1 1 3 31 Tuberculosis* Calicivirus/No 0 0 0 0 1 1 rovirus Campylobacte 1 0 1 1 5 10 riosis Chikungunya 0 0 0 0 0 1 Ehrlichiosis 0 0 0 0 0 1 Enterovirus 0 0 0 0 0 0 Giardiasis 0 0 0 0 1 0 Group A 0 0 0 0 2 2 Streptococcus Group B 0 1 1 0 5 6 Streptococcus Haemophilus 0 0 0 0 1 0 Influenzae Hansen's 0 0 0 0 0 0 Disease Hepatitis B* 0 0 0 0 0 2 Hepatitis C* 2 0 2 2 13 37 Influenza* 0 0 29 27 e a 0 0 Legionellosis 0 0 0 0 0 0 Lyme 2 0 2 2 2 7 Disease* Malaria 0 0 0 0 0 1 Meningitis 0 0 0 0 0 2 Pertussis 0 0 0 0 0 2 r Salmonellosis 2 0 1 2 4 3 Shigatoxin 0 0 0 0 0 1 Producing Organism Shigellosis 0 0 0 0 0 4 Streptococcus 0 0 0 0 1 2 Pneumoniae Varicella* 0 0 0 0 0 3 Vibrio 0 0 0 0 0 0 West Nile 0 0 0 0 0 0 Yersoniosis 0 0 0 1 1 0 Total 9 j 1 8 10 j 71 j 148 *Notifications only, LBOH not required to follow up or investigate per DPH. Summary of Current Communicable Diseases Note: There have been 2 confirmed cases of Lyme's Disease and 2 suspect or probable cases reported in June 20 11. There is no follow up required by LBOH. Group B Streptococcus (carried over): This patient was seen in the ED with a fever and discharged after showing improvement on antibiotics and continued the medication at home. They had no history of recent travel and did not attend a supervised care setting. They are currently not working as a good handler or in a healthcare or care setting. None contacts have become ill that they are aware of. There is no further follow up required and this case is closed. Active Tuberculosis: In June, a Salem resident was diagnosed with an active Tuberculosis infection. I accompanied them and their significant other to their first appointment with the pulmonary clinic to complete an assessment, do medication teaching and to explain the process of Directly Observed Therapy and a contact investigation. I began DOT daily following that appointment. They have been very compliant with DOT and are taking their medications without any side effects at this time. They are feelings well and no longer have symptoms of Tuberculosis. I am beginning the contact investigation and planting PPDs on all household contacts this coming week,per the TSA nurse and protocol. Campylobacter: This patient has recovered from the illness. There were not able to remember specific food items that may have caused the illness and had no known shared exposure. They are not a food handler or working in a caretaker position. No contacts have become ill. There is no further follow up necessary at this time and this case is closed. Salmonella: Case#1:This patient was treated with antibiotics and has recovered from their symptoms. They are not • aware of any contacts becoming ill at this time. I collected all the information that they were able to give i e me about what they ate during the incubation period and reported it to food protection at MDPH. The town where this person ate has been notified and conducting follow up. At this time we are unaware of any linked cases. The patient is currently retired and has no household contacts.There is no further follow up necessary and this case is closed. Case#2: This case was reported recently and I was not provided with a phone number. A letter has been mailed to their house and I am following up with the medical provider at this time. This case will remain open until an interview and investigation is complete or they are lost to follow-up. • Health Dept. Clerical Report FY Burial Permits Permits Plan Reviews Certificate of Copies / Fines Revenue Permit Fees $25 Fitness $50 July-14 $450.00 $815.00 $850.00 $2,115.00 Food Service Est. <25seats $140 August $900.00 $2,415.00 $1,950.00 $5,265.00 2S-99 seats $280 >99 seats $420 September $775.00 $1,000.00 $180.00 $950.00 $200.00 $3,105.00 Retail Food <i000sq' $70 October $625.00 $1,804.00 $1,350.00 $7.00 $3,786.00 1000-10,000 $280 >10,000 $420 November $675.00 $0.00 $90.00 $1,700.00 $2,465.00 'Temp.Food 1-3 days s3oo December $850.00 $50,095.00 $3,450.00 $54,395.00 4-7 days s600 >7days $ Example of>7 day temp food permit. January-15 $725.00 $2,670.00 $180.00 $650.00 $800.00 $5,025.00 14(da s)divided bY 7=2 xs600=$1200 February $675.00 $5,895.00 $1,550.00 $100.00 $8,220.00 Frozen Desserts $25 March $1,500.00 $2,635.00 $1,350.00 $5,485.00 Mobile Food $210 April $975.00 $2,235.00 $3,100.00 $100.00 $6,410.00 Plan Reviews New s180 May Remodel sgo $550.00 $5,335.00 $1,300.00 $7,185.00 June Catering s25pereventl$200 $1,725.00 $3,470.00 $180.00 $4,050.00 $500.00 $9,925.00 catering kitchen Body Art Est. $315 Total $10,425.00 $78,369.00 $630.00 $22,250.00 $1,707.00 $113,381.00 Body Art Practitioner 13s Tobacco Vendors $135 Fiscal Year Budget 2015 Suntan Est. $140 Rec.Day Camp $10 Salary Startinq Ending Expenses Ext.Paint Removal $35 Full Time $341,229.00 $9,727.00 Startinq Ending Transport Off.Subst. s1o5 Part Time $15,997.00 $7,569.50 $17,050.00 $8,062.41 Overtime $2,000.00 $281.83 Swimming Pools Seasonal $140 Balance $359,226.00 $17,578.33 Health Clinic Revolving Account Annuals210 Nonprofit$40 $14,646.64 Title V Review s18o Well Application s18o Disposal works s225/18o Memo Date: May 26,2015 To: Larry Ramdin,Health Agent .9 2 0 1�� Cry,�-,�From: Joyce Redford,Director EGr 4p ;,HEALTH RE: Salem Tobacco Compliance Checks On May 11th and 13th,2015,the North Shore/Cape Ann Tobacco Alcohol Policy Program conducted targeted compliance checks in the City of Salem. In addition to Joyce Redford,Director,and Peter King,Inspector,two under aged youth participated in these checks. Twenty-four(24)establishments were checked and three(3)sales occurred. Statically,an 87'1 compliance rate was achieved. Violations occurred in the following establishments: Establishment: Address: Offense: Fine: Sunoco 145 Canal St. 2nd $200.00+7-day suspension Global 200 Canal St. 3rd $300.00+3o-day suspension North Shore Vapor 30o Highland Ave is, • 1st violation sale of nicotine to a minor $100.00 • 2nd violation self-service display $200.00 Enclosed you will find a copy of the violation notices that were issued to each establishment at the time of the compliance check Should you have any questions regarding these checks please do not hesitate to contact me at 781-586-6821 . t CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4T"FLOOR Ptib11C�Ie..alth Prevent.Promote.Protect. TEL. (978) 741-1800 FAZ(978) 745-0343 KIMBERLEY DRISCOLL lramdin@salem.com L,\RRY R,1MD1N,RS/RI?I1S,CIK),CY-FS MAYOR HI?,A1;I'i i AG June 24, 2015 Re: Hearing Request for Tobacco Violations Sunoco 145 Canal Street Salem, MA 01970 Dear owner: The Salem Board of Health requests your presence at the next Board of Health meeting for a discussion of the tobacco violations at Sunoco on 145 Canal Street.The meeting will be held Tuesday, July 14, 2015 at City Hall Annex 120 Washington Street 4th Floor, Salem MA 01970 If you have any questions, contact me at 978-741-1800. Sincerely, For the Board of Health Larry Ramdin, Health Agent LR/HLP cc: Dr. Shama Alam, Chairperson of the Board of Health, Board Members, &Joyce Redford, Director, North Shore/Cape Ann Tobacco Alcohol Policy Program i CITY OF SALEM, MASSACHUSETTS lu BOARD OF HEALTH S STREET, ..FLOOR PubhCHealtl>< 120 W.-�.HINGTON S ,4 Prevent.Promotes Protect. TEL. (978) 741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL Iramdin@salem.com L;1RRY ILIMDIN,RS/RIsI IS,CI IO,Cl F S MAYOR HI?;v;I'II AGI?N'I' June 9, 2015 Sunoco 145 Canal Street Salem, MA 01970 Dear Owner: On Wednesday May 13,2015 at 12:55pm personnel from the North Shore/Cape Ann Tobacco Alcohol Policy Program conducted a compliance check to determine if your permitted establishment would sell a tobacco product to a minor. A 17 year-old female purchased a tobacco product from a clerk in your store. Documentation is now on file at the Board of Health regarding that sale. North Shore Vapor is.in violation of Regulation 24 of the City of Salem Board of Health restricting the sale and use of tobacco products&nicotine delivery products. According to Section D.,tobacco and nicotine delivery product sales to minors prohibited;the sale of cigarettes, chewing tobacco, snuff, or any tobacco/nicotine in any of its forms to any person under the age of twenty-one shall be punished by a fine of($200.00 Hundred Dollar fine)for the second offense.A 7 day suspension of your tobacco permit to be determined at the next regularly scheduled Board of Health meeting held on the second Tuesday of the month @ 7pm. FOLLOWING THE THIRD(3RD)OFFENSE, THE BOARD MAY CONSIDER POSSIBLE REVOCATION OR 30 DAY SUSPENSION OF THE PERMIT. The North Shore Tobacco Control Program and the Salem Board of Health have worked with you and your employees to demonstrate methods to ensure compliance with this regulation. Therefore, you are ordered to pay a fine of$200.00 for the violations stated above. A check or money order payable to the City of Salem must be at the Board of Health office, 120 Washington Street, 4ch floor,within ten days of receipt of this notice. Should you be aggrieved by this Order,you have the right to request a hearing before the Board of Health. A request for such a hearing must be received in writing in this office of the Board of Health within seven(7)days of receipt of this Order. At said hearing,you will be given the opportunity to be heard and to present witness and documentary evidence as to why this Order should be modified or withdrawn. You may be represented by an attorney. Please also be informed that you have the right to inspect and obtain copies of all relevant inspection or investigation reports, orders,and other documentary information in the possession of this Board, and that any adverse party has the right to be present at the hearing. If you have any questions regarding this notification please call me at 978-741-1800. Sincerely yours, Larry Ra in Health Agent LR/hlp CERTIFIED MAIL: 7012 1640 0002 3313 0539 cc: North Shore/Cape Ann Tobacco Alcohol Policy Program Shama Alam, Board of Health Chairperson and Members Violation Notice City own Board of Health lic Health vent. Promote. Protect. NJ This notice is to inform you that your establishment violated the Board of Health Sale of Tobacco Products &Nicotine Delivery Products and/or Environmental Tobacco Smoke(ETS)Regulation.' Name of esta - ishment Address Date oT violation Time of violation Minor's a e/gender Minor's ID# (Ordinance,Sectpn,Regulation) A'1N Act Constituting Violation) ' information: Narrative informa , . , . fy � ,under the pains and penalties-of perjury,that the above report is true to the best of my knowledge an r.e ef. IN A Inspec r i ature) "(Print name) VE 4 S ,CEA�IE1\1T;.I acknowledge I received this Violation Notice on , 20 atd I am being given a carbon copy of this notice.I also a knowledge that I have been in ormed t a the Peabody B d 4 Health will provide additional,follow-up information to this violati n notice.,, s 1 - / 1 t -- Print name X_jWner anag /Clerk;Signature ( ) If vendor refuses this Notice or if the inspector feels unsafe in delivering it,an explanation must be written on.a note attached hereto.Mailing of this Notice is thus required. Contact the North Shore/Cape Ann Tobacco Alcohol Policy Program at 781-58676821 with questions Establishment-white NSTCP-yellow Board of Health-pink SALEM SUNOCO 1789 OPERATING ACCOUNT 145 CANAL ST." �/ 53-7054/211 SALEM,MA 01970 r' 481 . Dale O / �CHEC�K�SNOH Poyrdt�90er o he - L L-\ -, yy p 8...,, Dollars' B.cMu�.n Bank America's Most Convenient Bank® FOR ii60017139n6 1: 2 i:1370545i: 8 24747 L48.0v M 1! CITY OF SALEM, MASSACHUSIJTTS BOARD OF HEALTH 120 WASHINGTON STREET,4 FLOOR FPublicHea" romote.Protect. TEL. (978) 741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL Iramclin@salem.com L,AR.RY ILIMDIN,RS/RI?F[S,Cf-iO,Cl?-FS MAYOR I AG 13NT June 24, 2015 Re: Hearing Request for Tobacco Violations Global 200 Canal Street Salem, MA 01970 Dear owner: The Salem Board of Health requests your presence at the next Board of Health meeting for a discussion of the tobacco violations at Global on 200 Canal Street. The meeting will be held Tuesday, July 14, 2015 at City Hall Annex 120 Washington Street 41h Floor, Salem MA 01970 If you have any questions, contact me at 978-741-1800. Sincerely, For the Board of Health Larry Ramdin, Health Agent LR/HLP cc: Dr. Shama Alam, Chairperson of the Board of Health, Board Members, &Joyce Redford, Director, North Shore/Cape Ann Tobacco Alcohol Policy Program i � 5 o s CITY OF SALEM, MASSACHUSETTS IV BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR vPublicHealth TEL. (978) 741-1800 FAX(978) 745-0343 revent.Promote.Protect. KIMBERLEY DRISCOLL 1ramdin&sa1em.com L.\RRY IUMDIN,RS/RI:}IS,ClIO,CP-f�S MAYOR HF,.11.;I'H AGIiN'I' June 9, 2015 Global 200 Canal Street Salem, MA 01970 Dear Owner: On Wednesday May 13,2015 at 12:25pm personnel from the North Shore/Cape Ann Tobacco Alcohol Policy Program conducted a compliance check to determine if your permitted establishment would sell a tobacco product to a minor. A 17 year-old female purchased a tobacco product from a clerk in your store. Documentation is now on file at the Board of Health regarding that sale. North Shore Vapor is in violation of Regulation 24 of the City of Salem Board of Health restricting the sale and use of tobacco products&nicotine delivery products. According to Section D.,tobacco and nicotine delivery product sales to minors prohibited;the sale of cigarettes,chewing tobacco, snuff, or any tobacco/nicotine in any of its forms to any person under the age of twenty-one shall be punished by a fine of($300.00 Hundred Dollar fine)for the third offense. A 30 day suspension or revocation of your tobacco permit to be determined at the next regularly scheduled Board of Health meeting held on the second Tuesday of the month at 7pm. FOLLOWING THE THIRD(3RD)OFFENSE, THE BOARD MAY CONSIDER POSSIBLE REVOCATION OR 30 DAY SUSPENSION OF THE PERMIT. The North Shore Tobacco Control Program and the Salem Board of Health have worked with you and your employees to demonstrate methods to ensure compliance with this regulation. Therefore,you are ordered to pay a fine of$300.00 for the violations stated above. A check or money order payable to the City of Salem must,be at the Board of Health office, 120 Washington Street,4`h floor,within ten days of receipt of this notice. Should you be aggrieved by this Order,you have the right to request a hearing before the Board of Health. A request for such a hearing must be received in writing in this office of the Board of Health within seven(7)days of receipt of this Order. At said hearing, you will be given the opportunity to be heard and to present witness and documentary evidence as to why this Order should be modified or withdrawn. You may be represented by an attorney. Please also be informed that you have the right to inspect and obtain copies of all relevant inspection or investigation reports, orders, and other documentary information in the possession of this Board, and that any adverse party has the right to be present at the hearing. If you have any questions regarding this notification please call me at 978-741-1800. Sincerely yours, Larry Ramdin Health Agent LR/hlp CERTIFIED MAIL: 7012 1640 0002 3313 0546 cc: North Shore/Cape Ann Tobacco Alcohol Policy Program Shama Alam, Board of Health Chairperson and Members j( ? Violation Notice CGO/7'rown., " Board of Health blic Health W - vent. Promote. Protect. This notice is to inform you that your establishment violated the Board of Health Sale of Tobacco Products &Nicotine Delivery Products and/or Environmental Tobacco Smoke(ETS)Regulation. . Name of establishment rn(YN Address . Date af viola on Time of violation Minor's age/gender Minor's ID# in inane,Section Regulation) V-0br ki L Yl� (Act Constituting Violation) Narrative information: I••SaffirrmntuDdle% , r the puns aenalties o er what the above report is true to the best of m knowledge P PJry p Y g (and Belief.* eZ,r - Inspectt + ignatur`e) (Print name) }' ` `: EI\TI�O' STATEMEN : I acknowledge I received this Violation Notice on `� , 20 at AMIPM d I am being given a carbon copy of this notice.I also Acknowledge that I . E have been informed t a the Peabody Board of Health will provide additional,follow-up information to this violation notice. f 1..�.- ems Owner`/Manager/Clerk(Signature) (Print name) If vendor refuses this Notice or if the inspector feels.unsafe in delivering it,an explanation must be written on a note attached hereto.Mailing of this Notice is thus required. Contact the North Shore/Cape Ann Tobacco Alcohol Policy Program at 781-586-6821 with questions r ' Establishment'white NSTCP-yellow Board of Health-pink I i r PUMP N PANTRY 10 PARADISE RU 993 SAL.EM,CIA 01970 53-7054m 13 208 ate �CMECK AH ' Pay to the y Order thee / Dollars Bank 3 Most Co-enient Banc® For : 211370545l: 82511.0384In- 0993 f t June 22, 2015 North Shore VaporZ 300 Highland Ave CI Salem MA 01970 BCARp Oiz H TH This letter is in response to the fine sent to North Shore Vapors, received on June 19, 2015 by certified letter. I would like to request a hearing before the Board of Health pertaining to the fine received for a violation on May 11, 2015. Certified letter mailed June 23, 2015, to the City of Salem Board of Health 120 Washington St 4th Floor, within the required 7 days of receipt of order. Regards, Alan Kelleher NS VaporZ i • a CITY OF SALEM, MASSACHUSETTS 10 BOARD OF HEALTH 120 W ASHINGTON STREET 4"t FLOOR NbliCHedth Prevent.Promote.Protect. TEL. (978) 741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL Iramdin@salem.com L,1RRY iL1MDIN,KS/KF,HS,CHO,CP-IS MAYOR HI iU..'n-i AGUINT June 26, 2015 Re: Hearing Request for Tobacco Violations North Shore VaporZ 300 Highland Avenue Salem, MA 01970 Dear owner: The Salem Board of Health in response to your request will hold a hearing at the next Board of Health meeting for a discussion of the tobacco violations at North Shore VaporZ 300 Highland Avenue. The meeting will be held Tuesday, July 14, 2015 7:00pm at City Hall Annex 120 Washington Street 4 Floor, Salem MA 01970 If you have any questions, contact me at 978-741-1800. Sincerely, t✓ '4V'--M For the Board of Health Larry Ramdin, Health Agent LR/HLP cc: Dr. Shama Alam, Chairperson of the Board of Health, Board Members, 8t Joyce Redford, Director, North Shore/Cape Ann Tobacco Alcohol Policy Program i i • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOOR PublicHealth TEL. (978) 741-1800 FAR(978) 745-0343 Prevent.Promote.Protect. KIMBERLEY DRISCOLL 1ramdinQsa1em.com MAYOR L:1RRY ILM)IN,RS/Ri3IIS,CI IO,CP-],'� HLAL'n i A(,1?NT June 9, 2015 North Shore Vapor 300 Highland Avenue Salem, MA 01970 Dear Owner: On Monday May 11,2015 at 5:24pm personnel from the North Shore/Cape Ann Tobacco Alcohol Policy Program conducted a compliance check to determine if your permitted establishment would sell a tobacco product to a minor. A 16 year-old female purchased a tobacco product from a clerk in your store and there is a self- service display. Documentation is now on file at the Board of Health regarding that sale. North Shore Vapor is in violation of Regulation 24 of the City of Salem Board of Health restricting the sale and use of tobacco products&nicotine delivery products. According to Section D.,tobacco and nicotine delivery product sales to minors prohibited;the sale of cigarettes, chewing tobacco, snuff, or any tobacco/nicotine in any of its forms to any person under the age of twenty-one shall be punished by a fine of($100.00 Hundred Dollar fine)for the first offense. North Shore Vapors is also in violation of Section J., Self-Service displays:All self-service displays of tobacco products and/or nicotine delivery products are prohibited and shall be punished by a fine of ($200.00 Hundred Dollar fine)for the second offense within the first visit to your store. No suspension will be given at this time. FOLLOWING THE THIRD(3")OFFENSE, THE BOARD MAY CONSIDER POSSIBLE REVOCATION OR SUSPENSION OF THE PERMIT. The North Shore Tobacco Control Program and the Salem Board of Health have worked with you and your employees to demonstrate methods to ensure compliance with this regulation. Therefore, you are ordered to pay a fine of$300.00 for the violations stated above. A check or money order payable to the City of Salem must be at the Board of Health office, 120 Washington Street, 4`"floor,within ten days of receipt of this notice. Should you be aggrieved by this Order, you have the right to request a hearing before the Board of Health. A request for such a hearing must be received in writing in this office of the Board of Health within seven(7)days of receipt of this Order. At said hearing, you will be given the opportunity to be heard and to present witness and documentary evidence as to why this Order should be modified or withdrawn. You may be represented by an attorney. Please also be informed that you have the right to inspect and obtain copies of all relevant inspection or investigation reports, orders, and other documentary information in the possession of this Board, and that any adverse party has the right to be present at the hearing. If you have any questions regarding this notification please call me at 978-741-1800. Sincerely yours, Larry Ramdin Health Agent LR/hlp CERTIFIED MAIL: 7012 1640 0002 3313 0522 cc: North Shore/Cape Ann Tobacco Alcohol Policy Program Shama Alam, Board of Health Chairperson and Members ' Violation Notice City f own` Y Board of Health he Health vent. Promote. Protect. , This notice is to inform-you that your establishment violated the Board of Health Sale of Tobacco Products &Nicotine Delivery Products and/or Environmental Tobacco Smoke(ETS)Regulation. r .. No Name of establishment Ad ress Date Of viol ion Time o .viola 'on Minor's age/gender Minor's ID# (Ordinanc , ec ion, ilatto r I (Act Constituting Violation) Narrative information: f VCA .. - t I;a",under the pains d penalties of perjury,that the above report' e to the best owledge and belief. Inspec¢r ignature) (Print name) } VENDOR S�Eacknowledge I received this Violation Notice on , 20 at" d I am being given a carbon copy.of this notice.I also cknowledge that I have�teeninmed that the Peabody Board of Health will provide additional,follow-up information to 6 this violation notice. A . Cl rk(Signa ure (Print name) vendor refuses this Notice or if the irispector.feels unsafe in,delivering it,an explanation must be written on a note attached hereto.Mailing of this Notice is thus required. Contact the North Shore/Cape Ann Tobacco Alcohol Policy Program at 781-586-6821 with questions , Establishment-white NSTCP-yellow Board of Health--pink A 1Q1� NOV 13 P 1: 0.3 ` CITY OF SALEM. MA `- Regulation 24 of the City of Salem Board of Health t.�_IKS 0I FICE Restricting the Sale and Use of Tobacco Products & Nicotine Delivery Products A. Statement of Purpose: Whereas there exists conclusive evidence that tobacco smoke causes cancer, respiratory and cardiac diseases,negative birth outcomes, irritations to the eyes,nose and throat (Centers for Disease Control and Prevention(hereinafter"CDC'),Health Effects of Cigarette Smoking Fact sheet, (January 2012));whereas among the 15.7%of students nationwide who currently smoked cigarettes and were aged less than eighteen(18)years, 14.1%usually obtained their own cigarettes by buying them in a store(Le., convenience store,supermarket,or discount store)or gas station during the thirty(30)days before the survey(CDC, Youth Risk Behavior,Surveillance Summaries. 2009,MMWR 2010:59(No. SS-55)at 11);whereas nationally in 2000, sixty-nine(69%)percent of middle school age children who smoke at least once a month were not asked to show proof of age when purchasing cigarettes (CDC, Youth Tobacco, Surveillance Summaries.2000,A"R 2001:50(No.SS-w));whereas the U.S. Department of Health and Human Services has concluded that nicotine is as addictive as cocaine or heroin(U.S Department of Health and Human Services.How Tobacco Smoke Causes Disease:The Biology and Behavioral Basis for Smoking Attributable Disease:A Report of the Surgeon General,Atlanta, GA: U.S Department of Health and Human Services, Centers for Disease Control and Prevention,National Centerfor Chronic Disease Prevention and Health Promotion,Office on Smoking and Health,2010.);whereas despite state laws prohibiting the sale of tobacco products to minors, access by minors to tobacco products is a major problem;whereas according to the CDC, cigarette price increases reduce the demand for cigarettes and thereby reduce smoking prevalence, cigarette consumption, and youth initiation of smoking(U.S. Department of Health and Human Services Reducing Tobacco Use:A Report of the Surgeon General. Atlanta, GA. U.S Department of Health and Human Services, Centers for Disease Control and Prevention, National Centerfor Chronic Disease Prevention and Health Promotion,Office on Smoking and Health, 2000 at 358); Whereas the 2012 U.S. Surgeon General's Report on Preventing Tobacco.Use Among Youth and Young Adults, reports that in 2005 Ringel, Wasserman, &Andreyeva(U.S. Department of Health and Human Services,Nicotine Addiction,Atlanta,GA: U.S.Department of Health and Human Services, CDC,National Centerfor Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1988) conducted logistic regression analyses to examine whether increased cigar prices and state.tobacco control policies affected the rate of cigar use. (U.S.Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults,Atlanta GA: U.S.Department ofHealth and Human Services, Centersfor Disease Control and Prevention National Centerfor Chronic Disease Prevention and Health Promotion, Office on Smoking and Health,2012 at 706). Using the 1999 and 2000 iterations of the National Youth Tobacco Survey, Ringel and colleagues analyzed data from 33,632 adolescent participants aged nine to seventeen. They found that increased cigar prices significantly decreased the probability of male adolescent cigar use and found that a 10'/o increase in cigar prices would reduce the sample's cigar use by 3.4% (Ringel JS, Wasserman J,Andreyeva T,Effects of Public Policy on Adolescents'Cigar Use:Evidence From the National Youth Tobacco Survey, 95 Am.J. — Pub.Health 995-8(June 1,2005);whereas according to the CDC's youth risk behavior surveillance system, the percentage of high school students in Massachusetts who reported the use of cigars within the past 30 days went from 11.8% in 2003 to 14.9%in 2009 (CDC, Youth Risk Behavior.Surveillance Summaries,2009.MMWR 2010,59(No. SS-55)at 72; CDC, Youth Risk Behavior. Surveillance Summaries,2003.MMWR 2004;53(No.SS-02)at 54); whereas nicotine levels in cigars are generally much higher than nicotine levels in cigarettes. (Nat'l Cancer Institute at the Nat 7Inst. of Health, Questions and Answers About Cigar Smoking and Cancer (Oct. 27, 2010)); — Whereas commercial Roll Your Own(RYO)machines enable loose, unpackaged tobacco to be poured into a machine and placed into empty,unpackaged cigarette tubes to be inhaled by individuals who smoke them This procedure provides risk of contamination of the tobacco and unsanitary conditions in the machine and is injurious to public health; whereas commercial Roll Your Own(RYO)machines located in retail stores enable retailers to sell cigarettes without paying the federal and state excise taxes that are imposed on conventionally manufactured cigarettes (RYO FILLING STATION, www.nLofillingstation.com(Feb.27,2012). High excise taxes encourage adult smokers to quit and deter youth from starting(Kenneth E. garner,Smoking and Health Implications of a Change in the Federal Cigarettte Excise Tax,255 J.AM.MED.Ass N 1028(1986),Frank J.Chaloupka&Rosalie Liccardo Pacula, The Impact of Price on Youth Tobacco Use, in 14 SMOKING AND TOBACCO CONTROL MONOGRAPHS:CHANGING ADOLESCENT SMOKING PREVALENCE 193(U.S.Dep't Health and Human Services et al. eds., 2001)). Therefore, inexpensive cigarettes, like those produced from RYO machines,promote the use of tobacco,resulting in a negative impact on public health and increased health care costs, and severely undercut the evidence- based public health benefit of imposing high excise taxes on tobacco; Whereas the sale of tobacco products and nicotine delivery products are incompatible with the mission of health care institutions because they are detrimental to the public health and undermine efforts to educate patients on the safe and effective use of medication; Whereas educational institutions sell tobacco products to a younger population, which is particularly at risk for becoming smokers and such sale of tobacco products and nicotine delivery products are incompatible with the mission of educational institutions that educate a younger population about social, environmental and health risks and harms; Now,therefore it is the intention of the City of Salem Board of Health to regulate the access of tobacco products and nicotine delivery products. B.Authority: This regulation is promulgated pursuant to the authority granted to the City of Salem Board of Health by Massachusetts General Laws Chapter 111, Section 31 that "Boards of Health may make reasonable health regulations". C. Definitions: For the purpose of this regulation,the following words shall have the following meanings: Blunt Wrap: Any tobacco product manufactured or packaged as a wrap or as a hollow tube made wholly or in part from tobacco that is designed or intended to be filled by the consumer with loose tobacco or other fillers. 1 r NORTH SHORE Contact: Laura Fleming, NSMC MEDICAL CENTER (978) 354-2060 Email: Ifleming2@partners.org NSMC announces improved plan for better care and healthier communities Salem Hospital to expand; Former Spaulding site part of the plan (EMBARGOED for release until 3 p.m., EST,Tuesday,June 30, 2015)Salem, Mass. —North Shore Medical Center (NSMC) and Partners HealthCare announced today a revised restructuring plan that improves care and coordination across a wide spectrum of health services. This plan realigns practices and facilities to make high-quality care more effective and efficient and improves access to the community-based care that North Shore residents use most. It builds on a similar plan announced two years ago that was revised in light of Spaulding Hospital North Shore's decision to close later this year. Key elements of the plan include: • Consolidating NSMC hospital-based medical, surgical and behavioral health services on one campus at Salem Hospital and expanding and improving that facility to serve the needs of the North Shore region. All inpatient services currently based at NSMC's Union Hospital Campus will be consolidated at Salem Hospital over the course of the next three years. • Converting the current Spaulding Hospital North Shore, located on the campus of NSMC Salem Hospital,to a 100+-bed Center of Excellence in Behavioral Health that will be directly aligned with Massachusetts General Hospital and add 40-50 new beds to the region for psychiatry and behavioral health services. Spaulding's decision to close its long-term care facility presents NSMC with new opportunities for configuring its care facilities. • Expanding community-based outpatient primary, specialty, urgent care and behavioral health services throughout the North Shore at North Shore Physicians Group (NSPG) offices, and in collaboration with the Lynn Community Health Center and North Shore Community Health Center. The robust NSPG practice currently on the Union Campus will remain in Lynn and will give residents and Union neighbors access to expanded outpatient primary, specialty and behavioral health services. We remain fully committed to providing emergency care to our communities in Lynn, Salem and throughout the region. In addition to the expanded Emergency Department in Salem,we will continue to operate the current Emergency Department on the Union Campus over the transition of the next several years and will work with the city and community to ensure a long-term approach that is inclusive and meets their needs. • According to NSMC President Robert G. Norton, "We are confident that this plan succeeds in delivering the highest quality care to our patients in a comprehensive and thoughtful way. In the new heath care environment,this plan will help us better coordinate care, improve quality and more • effectively contribute to the overall health of our communities." Support for the plan was echoed by NSMC's trustees. "As members of this community, we have a special commitment to ensuring that NSMC delivers care of the highest quality and value," said Richard Holbrook, Chairman and CEO of Eastern Bank and Chairman of the NSMC Board of Trustees. "We are investing more than $200 million in our communities because we believe this is the best plan for the patients and families of the North Shore." Meeting a critical need Plans also focus on expanding services to help meet the overwhelming demand for addiction treatment, a priority shared by Governor Baker and communities across Massachusetts. The Center of Excellence in Behavioral Health will integrate addiction treatment with inpatient and outpatient psychiatry, behavioral health services and further development of community based programs. "The synergies created by bringing together the best of academic and community care will help meet the region's needs at a time when these critical services are in great demand," says Jerrold F. Rosenbaum, M.D., chief of Psychiatry at Massachusetts General Hospital. The NSMC plan also addresses the clinical and financial challenges of providing the highest level of inpatient care -- including the demand for more and more sophisticated technology and specialized clinical expertise, despite declining census-- in two inpatient facilities that are less than six miles apart. Improvements on the Salem Campus To accommodate the consolidation of medical, surgical and behavioral health services, NSMC will build a new Emergency Department and two additional family-centered inpatient units at NSMC Salem Hospital. The former Spaulding Hospital North Shore will be renovated to accommodate expanded behavioral health services for children, adolescents, adults and seniors. Key access areas such as the hospital's main entrance and green spaces will also be reconfigured and renovated to improve way finding and provide a more welcoming and efficient patient experience. "Consolidating services is vital to enhancing quality of care and improving the patient experience," says Mitchell S. Rein, M.D., NSMC Senior Vice President and Chief Medical Officer. "With a single hospital, we can provide deeper specialization, better coordination of care and enhanced safety." Robust primary, specialty and urgent care to expand in Lynn As care increasingly shifts from inpatient to outpatient settings and the role of primary care expands, NSMC will be expanding its North Shore Physicians Group (NSPG) practices in Lynn. These expanded services will include primary, specialty and urgent care and associated outpatient services that will serve a wide range of health care needs of local residents. Even with this expansion, however,the medical center will be left with a significant amount of excess property on the Union Hospital site, so it will engage with Lynn city officials and the Lynn community about the best options for reuse. • Continued investment in community health The plan includes continued investment in community health that builds on years of collaboration with community organizations,the Lynn Community Health Center and the North Shore Community Health Center to increase access to a spectrum of care. In addition to providing support for vulnerable populations, NSMC will be collaborating to address obesity, addiction and teen pregnancy in local communities. More integrated care improves quality,coordination Integral to the plan are new models of care at NSMC that improve coordination, efficiency and safety. One example is the Integrated Care Management Program that is helping NSMC to manage its most complex patients, by using early intervention and better care coordination to prevent admissions and unnecessary emergency room visits. And NSMC is investing in Partners eCare,the electronic healthcare system that enables all caregivers in the Partners system to access their patients' health information at any time, enhancing coordination, quality and safety. "By making the best use of health care resources available in the region to the greatest benefit of patients in the area, we are advancing the goals of population health management," says Norton. "Furthermore, by caring for patients within a coordinated system, we can monitor the quality of their care more effectively and avoid repetitive procedures, such as tests and imaging that can happen when a patient sees a number of disconnected providers." Mission remains unchanged "Our mission to provide the finest care to the patients of greater Lynn, Salem and throughout the North Shore will never change," says Norton. "We believe that this consolidation coupled with the • investments in primary, urgent, and specialty care, behavioral health services, care coordination and community health resources is in the best long-term interests of the communities we serve. In short, we will offer increased access, better care, and lower costs." NSMC(North Shore Medical Center)is a multi-site health system headquartered in Salem, Mass., which includes NSMC Salem Hospital, NSMC Union Hospital in Lynn, MassGeneral for Children at North Shore Medical Center, NSMC Heart Center and the physician network known as North Shore Physicians Group. NSMC and Massachusetts General Hospital together provide care at the Mass General/North Shore Center for Outpatient Care and the Mass General/North Shore Cancer Center in Danvers. NSMC is a member of Partners HealthCare. For more information, please visit our website at nsm c.partn ers.org Partners HealthCare is an integrated health system founded by Brigham and Women's Hospital and Massachusetts General Hospital. In addition to its two academic medical centers, the Partners system includes community and specialty hospitals(including NSMC and Spaulding), a managed care organization, community health centers, a physician network, home health and long-term care services, and other health-related entities. Partners HealthCare is one of the nation's leading biomedical research organizations and a principal teaching affiliate of Harvard Medical School. Partners HealthCare is a non-profit organization. For more information, please visit http://Www.partners.orgl. To: NSMC Physicians, Employees and Volunteers • From: Robert G.Norton, President Date: June 30, 2015 Subject: Moving forward with plans for NSMC's future I have the great privilege of representing NSMC at many forums where I often hear firsthand about the many ways each of you has profoundly affected the lives of local patients and families. These stories reinforce how vital our mission remains to the communities we serve. Today I am reaching out to you to share important steps for advancing that mission for decades to come. As many of you recall, two years ago we announced a plan to reconfigure the way we provide care in our communities, improve clinical quality, expand access to vital services and maximize our resources for greater impact. That plan included medical and surgical consolidation of our Lynn and Salem campuses as well as significant investment in community and behavioral health, primary care expansion, and chronic disease management—all reflecting a new model of care designed to meet the needs of North Shore patients and families more effectively. Despite the delay in our inpatient construction, essential elements of the plan have advanced significantly over the past two years including the opening of North Shore Urgent Care in Danvers to provide a more efficient model for emergency care. We have also expanded our primary care network--a key building block to increasing access to care--welcoming 18 primary care physicians to North Shore Physicians Group (NSPG)and our affiliated practices and community health centers since 2013. Additionally, 10 of our NSPG primary care practices have earned • certification as Patient Centered Medical Homes, by focusing on disease prevention and highly-coordinated care management while meeting exceptional standards for patient care and service. We have continued to fortify important programs with community health centers and organizations including high- risk patient management programs for our most vulnerable patients and increased access to addiction care. Within our hospitals, a new approach to performance improvement has advanced patient care quality, safety, and performance, and helped us tackle some of the most vexing challenges in our facilities today. Your insights and experience are vital to this work and our journey to more effective and patient-centered care. More recently, the decision that Spaulding North Shore would close its inpatient facility on the Salem Campus has opened new opportunities for us to further improve our original plan. We are now prepared to move forward and are confident that the revised plan is even more effective in delivering high quality care in a thoughtful and comprehensive way. Our updated plan calls for consolidating all hospital-based medical, surgical, and behavioral health services on one regional campus in Salem. All inpatient services currently on the Union Campus will be consolidated at Salem over the course of the next three years.The Center of Excellence in Behavioral Health originally planned for the Union Campus now will be located in Salem in the current Spaulding North Shore building. To ensure that we have the capacity to care for all of the patients and communities we serve, we are making a significant investment in a new state-of-the-art Emergency Department and two additional family-centered • inpatient units on the Salem Campus. The new construction will be sited on the Spaulding/Dove Ave. side of the campus between the current Davenport and Spaulding North Shore buildings. To ease traffic flow, plans also include construction of an access road from the Highland Avenue side of the campus to the Spaulding/Dove Ave. side. Key access areas including the hospital's main entrance and green spaces will be reconfigured to improve way finding and provide a more welcoming patient experience. The robust NSPG practice on the Union Campus will remain in Lynn and will give residents and Union neighbors access to expanded outpatient primary, specialty and behavioral health services, keeping these services convenient and close to home. We remain fully committed to providing emergency care to our communities in Lynn, Salem and throughout the region. In addition to the expanded Emergency Department in Salem, we will continue to operate the current Emergency Department on the Union Campus over the transition of the next several years and will work with the city and community to ensure a long-term approach that is inclusive and meets their needs. Even with expanded NSPG services, this plan will leave us with a significant amount of excess property on the Union Campus, so we will engage with Lynn city officials and community members about the best options for reuse. As we define the future vision for the Union Campus, we will readdress the question about where to locate our Lynn-based services to best meet the needs of our communities. As always, we will continue to support and collaborate with our affiliated community health centers,to ensure access to a robust spectrum of care in Lynn, Salem and beyond. The Center of Excellence in Behavioral Health will include inpatient and outpatient psychiatry, behavioral health and addiction care for adults, children, adolescents and seniors and be directly aligned with Massachusetts General Hospital. We will expand inpatient care to more than 100 beds, adding 40-50 to our current capacity and developing specialized services on these units. The current Adult Psychiatry unit on Axelrod 7 East will relocate to the renovated floors in Spaulding as well. Plans also call for expanding services to help meet the overwhelming demand for addiction treatment, a priority we share with Governor Baker and communities throughout the . Commonwealth. By integrating behavioral, medical and surgical facilities on one campus we will be better equipped to manage the complex needs of our patients. Furthermore, the synergies created by bringing together the best of academic and community care will help meet the region's need at a time when critical services are in great demand. We expect that this plan will take a total of three years to implement fully, during which time Union Hospital will remain open. Construction will be staged, however, which may enable some inpatient services to move sooner within that time frame. We recognize that this is a significant turning point for NSMC and that these decisions affect the lives and livelihoods of our nurses, staff, physicians and patients, so we will work with all affected staff members to help with the transition. Our commitment to you in the months ahead is to provide communication, support and opportunities for input and open dialogue. We have scheduled Town Meetings on both campuses (details below) and encourage you to come hear more details and discuss your concerns. In the meantime, please talk with your directors and vice presidents to share your questions and thoughts. In all of the stories I hear about NSMC, it is clear that each of you makes an extraordinary difference in caring for your communities and advancing our important mission. We believe that this plan is the best way for your important work to continue and that consolidation, coupled with continued development of primary, urgent and specialty care, behavioral health, care coordination and community health resources is in the best interest of the communities we serve. Thank you for your continued dedication, service and compassion. Town Meetings: Union: Today,3:30 p.m. in the Cafeteria Salem: Today, 5:30 p.m. in D102 i Overdose variables-Salem Calendar Year 2015 2013 87 11 FATALS 95 ods 2014 124 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 #Overdoses 16 10 10 10 15 9 14 6 13 #Fatal 1 1 1 0 2 3 2 1 2 Gender Male 9 4 8 5 11 8 10 3 3 Female 6 5 1 4 41 1 4 3 1 Age <25 3 1 1 2 4 1 2 4 25-30 4 4 2 4 1 2 5 1 1 31-40 4 3 4 2 8 3 4 2 41-50 3 1 1 1 2 3 1 51+ 1 1 1 1 1 2 1 1 Race/Ethnicity White/Non-Hisp 15 9 8 9 14 7 14 6 2 African American 1 Hispanic 1 2 Asian Unknown Mode of use 11V 7 5 5 4 4 Sniffing 1 2 3 1 Mixing* 5 1,ALC 3,alc Rx Opiates 1 2 1 1 Relapse/Low tolerance 1 WEEK 1 6M, 2 J 13M, 1m crushed percocet and *If indiviudal admits to mixing opiates and other drugs,what were they? r 9 MASSACHUSETTS Ott- <a HEALTH COUNCIL �Cfi ^^� • Y` '' Yam'..' r. _ w,,._ ;�? 4.'s ,,.: 1,71` tr 'ay 3e� C4 �i,� y,C Y• 's' � a k' .�..1 ll '+ r ;t6° +` # xq' r''i'1`•1kx e "3 n '#,i, i ',� f_'a* ,.' w• �Y{< ,�d:.s�''�"�`�:�'`S. g'c u'"°Y{ ��{ �r�s>�'.✓�' ..��gy�... .,tea. �.t,ya's.t�R"s,H�''�`�s' J�. �•-��*.� �"��+ d< +n; ^F'° �n� � ,� s."'' *4 yA �.� a a r.� -1 'Y p� Y t�•l ��'g F`i �`y � +.�,.w '.�a3. � t� �%,j � '2�i i�- �'.�,Y L v-:� _ +...:-`ii# tT,s � s� �3 - 'F<� '� �.�a :�� M"3. htiC f". 'v�� w E y` '�` .�i::.. i $. ��e��' 3 �a�'P�h de'��l � •�y4 ]-, r� 1' '�� i'' s,.. t,#e`:. _.ar. -vr��,.yt�3.. st ...itf � i i_y __+�;� b �... ,.s.,. `�.,:�e:tL•�73:„�:::�..�..:.;�.xa;. ti 40 TABLE OF CONTENTS I.ABSTRACT.......................... II. REPORT TEAM .................................................................... III. INTRODUCTION ..................... IV.THE COMMUNITY MOBILIZATION LANDSCAPE ........................................ V. SCENARIO FOR A NEW COMMUNITY SUBSTANCE ABUSE COALITION....................... VI. RECOMMENDATIONS FOR POLICY MAKERS AND HEALTH OFFICIALS 1. Support Local and Regional Coalitions to Enhance Collective Impact.......................8 a. Fund Start-Up Grants for Local Coalitions and Expand Regional Efforts b. Improve Statewide Coalition Coordination and Information Dissemination c. Convene More In-Person Meetings d. Create an Online Resource Repository 2. Develop Prevention Curricula for Students and Parents............................. 1 3. Make Available More Timely, Comprehensive Data .................................................... 11 4. Provide More Treatment Resources, Including Beds ...................................................1 I S. Change Practices in Prescription of Pain Medications ....................... 6. Don't Lose Focus on Non-Opioid Substances 11 ..............................................................12 7. Use Media Campaigns to Create Public Aware 12 ness and Action ................................. 8. Encourage Policy Makers to Become Better Informed ................................................ 12 VII.APPENDICES A. SUCCESSES, CHALLENGES AND LESSONS LEARNED • What's Worked Well .....................................................14 • Challenges ...................................................... • Most Important Factors for Effectiveness ................. 18 • Advice for Other Communities ....................................19 B. 152 PROGRAMS AND ACTIVITIES .......................:....................................................: C. RESPONDENT AND COMMUNITY THUMBNAILS 3 D. ACKNOWLEDGMENTS ....................... E. MASSTAPP DESCRIPTION �••�••�����•..••.•....•.•.•..•....'.•" 0 .................................................................................................41 F. ABBREVIATIONS Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham,MA 02494 U"'° 617-965-3711 • www.mahealthcouncil.org �K 2 BMWs TABLE OF CONTENTS I.ABSTRACT.................................................................... II. REPORT TEAM ...................... III. INTRODUCTION IV.THE COMMUNITY MOBILIZATION LANDSCAPE ........................................ V. SCENARIO FOR A NEW COMMUNITY SUBSTANCE ABUSE COALITION ............................7 VI. RECOMMENDATIONS FOR POLICY MAKERS AND HEALTH OFFICIALS 1. Support Local and Regional Coalitions to Enhance Collective Impact.......................8 a. Fund Start-Up Grants for Local Coalitions and Expand Regional Efforts b. Improve Statewide Coalition Coordination and Information Dissemination i c. Convene More In-Person Meetings d. Create an Online Resource Repository 2. Develop Prevention Curricula for Students and Parents ............................................. 10 3. Make Available More Timely, Comprehensive Data .................................................... 11 4. Provide More Treatment Resources, Including Beds ................................... S. Change Practices in Prescription of Pain Medications """'' 11 6. Don't Lose Focus on Non-Opioid Substances ......• 11 7. Use Media Campaigns to Create Public Awareness and Action ........................... 8. Encourage Policy Makers to Become Better Informed VII.APPENDICES A. SUCCESSES, CHALLENGES AND LESSONS LEARNED • What's Worked Well .....................................................14 • Challenges ......................................... • Most Important Factors for Effectiveness ................. 18 • Advice for Other Communities....................................19 B. 152 PROGRAMS AND ACTIVITIES .......................:.......................................... C. RESPONDENT AND COMMUNITY THUMBNAILS 3 D. ACKNOWLEDGMENTS ...................................................................... E. MASSTAPP DESCRIPTION """"••••••••••••••••••••••• 40 .................................................................................................41 F. ABBREVIATIONS Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham,MA 02494 UZI@ 617-965-3711 • www.mahealthcouncil.org 2 Community substance abuse prevention coalitions are reflections of a growing understanding that multi-sector, multi-pronged approaches are needed for collective impact in order to address an epidemic in Massachusetts of overdose deaths from heroin and other opiates. Coalitions vary greatly, however, in funding, leadership, member makeup, level of participation, programs and effectiveness. A diverse sample of local and regional coalition coordinators across the state were interviewed. They were passionate and hard-working but some felt isolated with insufficient support and are running a risk of burn-out. They expressed a need for reliable funding, technical assistance, better information about what's happening around the state and more opportunities to meet with statewide peers. Recommendations for policy makers involve funding, the creation of an online resource repository and more opportunities for interaction among coalition leaders. Additional recommendations involve school prevention curricula, media campaigns, prescribing practices, expanding access to treatment and suggestions for how legislators can become better informed. Also included are successes and challenges described by respondents, advice for other communities and a list of 152 reported coalition initiatives and activities. d t. Jeffrey R. Stone, MBA Director of Programs Principal Researcher Susan H. Servais Executive Director Carol Pryor, MPH Editorial Consultant Liana Jaeger Research Assistant Massachusetts Health Council,200 Reservoir Street,Suite 101,Needham,MA 02494 U 617-965-3711 • www.mahealthcouncii.org 3 f 'y CI In late 2012, the Massachusetts Health Council published the 7th edition of our health status indicators report, "Common Health for the Commonwealth."The report documented a dangerous spike in opioid addiction and overdose deaths, particularly in several hard hit areas of the state. Media coverage of our report and subsequent news stories about opioid overdoses in various cities set off an alarm that immediate action was needed to address the issue statewide. Two years later, our 2014 indicators report documented that the opioid addiction and overdose problem had gotten worse... except in a few cities and towns that were addressing the problem head on and seeing positive results. In the same year, the opioid overdose epidemic in Massachusetts was declared a public health emergency.A key component of the statewide effort is promoting effective community mobilization through the formation of multi-sector task forces and coalitions at both the local and regional levels, with roles for everyone in helping to promote awareness, prevention, intervention, treatment and recovery. The term "multipronged effort" has never been more appropriate. Many city and towns across the Commonwealth have taken up the challenge and are doing important work to address the issue of substance abuse within their communities. The Massachusetts Health Council wanted to know what they are doing and what successes they have achieved in the hope that others can replicate some of these efforts to respond to the opioid problem in their own communities. Our desire to bring that information forward was the impetus for this research paper. This report focuses particularly on the formation,organization,and coordination of local coalitions and task forces.Through telephone and in-person interviews with community coordinators and collaborating agencies, we collected data to assess what coalitions are doing at the local level and what they view as their successes. We conducted the interviews with coordinators of 21 local and regional substance abuse prevention coalitions across the state in February and March of 2015. Our sample includes large and small communities and long- established and new coalitions. We gathered information from at least one group in each of the 14 counties in the Commonwealth. We delved into the "who, how, what, when, where and why"of these coalitions, including current activities, challenges they face and recommendations for other communities. We wish to spotlight the critical role community substance abuse prevention coalitions can play -whether they are based in cities,towns, neighborhoods or regions-and the need to support them in multiple ways to enhance their effectiveness and sustainability.Their coordinators, collaborating partners and volunteers are the people on the ground doing the intense) personal work of mobilizing the whole community. They are pounding the pavement; collecting data; doing strategic planning;and working with people with Substance Use Disorders, local police, district attorneys, drug courts, high schools, middle schools, elected officials, parent groups,treatment centers, houses of worship, support groups, prescribers and pharmacies, the business community, councils on aging, civic groups and many others. Massachusetts Health Council, 200 Reservoir Street,Suite 101, Needham,MA 02494 �m 617-965-3711 • www.mahealthcouncil.org 4 - i In late 2012, the Massachusetts Health Council published the 7th edition of our health status indicators report, "Common Health for the Commonwealth."The report documented a dangerous spike in opioid addiction and overdose deaths, particularly in several hard hit areas of the state. Media coverage of our report and subsequent news stories about opioid overdoses in various cities set off an alarm that immediate action was needed to address the issue statewide. Two years later, our 2014 indicators report documented that the opioid addiction and overdose problem had gotten worse... except in a few cities and towns that were addressing the problem head on and seeing positive results. In the same year,the opioid overdose epidemic in Massachusetts was declared a public health emergency.A key component of the statewide effort is promoting effective community mobilization through the formation of multi-sector task forces and coalitions at both the local and regional levels, with roles for everyone in helping to promote awareness, prevention, intervention,treatment and recovery. The term "multipronged effort"has never been more appropriate. Many city and towns across the Commonwealth have taken up the challenge and are doing important work to address the issue of substance abuse within their communities. The Massachusetts Health Council wanted to know what they are doing and what successes they have achieved in the hope that others can replicate some of these efforts to respond to the opioid problem in their own communities. Our desire to bring that information forward was the impetus for this research paper. This report focuses particularly on the formation,organization,and coordination of local coalitions and task forces.Through telephone and in-person interviews with community coordinators and collaborating agencies,we collected data to assess what coalitions are doing at the local level and what they view as their successes. We conducted the interviews with coordinators of 21 local and regional substance abuse prevention coalitions across the state in February and March of 2015. Our sample includes large and small communities and long- established and new coalitions. We gathered information from at least one group in each of the 14 counties in the Commonwealth. We delved into the "who, how, what, when, where and why"of these coalitions, including current activities, challenges they face and recommendations for other communities. We wish to spotlight the critical role community substance abuse prevention coalitions can play -whether they are based in cities,towns,neighborhoods or regions-and the need to support them in multiple ways to enhance their effectiveness and sustainability.Their coordinators, collaborating partners and volunteers are the people on the ground doing the intense) y personal work of mobilizing the whole community. They are pounding the pavement;collecting data; doing strategic planning; and working with people with Substance Use Disorders, local police,district attorneys, drug courts, high schools, middle schools, elected officials, parent groups,treatment centers, houses of worship, support groups, prescribers and pharmacies, the business community, councils on aging, civic groups and many others. Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 a 617-965-3711 • www.mahealthcouncil.org 4 Many of our substance use prevention coalitions have existed for a long time, usually targeting youth and usually focusing on alcohol and marijuana, rather than heroin and other opioids. In the past two or three years,they have responded to the dramatic increase in heroin use and overdoses. In addition, many new coalitions have formed.Their coordinators and directors are invariably passionate and willing to share everything they know about what works, but concerned about sustainability if their coalition runs out of funding.Some coalitions are unfunded and this is not the kind of work that unpaid volunteers can shoulder for very long. We offer this research paper to policy makers, health officials and Massachusetts communities as an informative snapshot of varied community approaches in early 2015. It is our hope that community coalitions will utilize some of organizing tips, program ideas and moral support offered by their peers in this report as they set up their own coalitions to fight opioid abuse and other substances on the local level. We also hope that policy makers will consider the funding and policy recommendations to support the coalitions themselves and to effect environmental changes that will prevent substance abuse and help those with Substance Use Disorder to get treatment and move to recovery. Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham,MA 02494 617-965-3711 • www.mahealthcouncii.org (—j—jg 5 The substance use prevention coalitions in Massachusetts that we studied are organized in a variety of ways. Some that have existed autonomously for years within a single community are now becoming part of the Massachusetts Overdose Abuse Prevention Collaborative (MOAPC) coalitions of contiguous communities,funded by the Massachusetts Department of Public Health's (DPH) Bureau of Substance Abuse Services (BSAS). Others are collaborating, at least on the level of information-sharing, via local Community Health Network Areas (CHNA's), District Attorneys' regional initiatives or other multi-community efforts..Some are involved in several overlapping collective efforts.There is, however, a distinct ethos of sharing among those working hard to address the crisis and they find invaluable the multiple opportunities to network with peers and exchange information and best practices. There are also a variety of funding streams for substance abuse prevention coalitions. Some coalitions receive funding from multiple sources, while some are unfunded and depend on volunteer efforts and in-kind contributions of time, media, materials and so on. Federally supported Drug-Free Communities (DFC)grants,which supply up to$125,000 per year for up to ten years, have had a huge impact.These grants require adherence to the Strategic Prevention Framework(SPF), a deliberate, step-by-step process designed to achieve sustained, community- level impacts. They also require that coalitions recruit members from 12 community sectors to ensure broad-based input and participation in prevention efforts.Almost all coalitions include as core members municipal police, fire and health departments, as well as the local public schools. State-funded MOAPC cluster grants require regional coalitions to follow a clear process as well. MOAPC grants pay for technical assistance to participating communities from the Massachusetts Technical Assistance Partnership for Prevention (MassTAPP), an agency that contracts with BSAS to guide community coalitions in key functions such as planning, capacity building, and use of data. While most long-established substance use prevention coalitions in Massachusetts have been focused on youth and on alcohol, marijuana and tobacco, a few have focused for many years on heroin. Although they are experienced in this area, the dramatic increase in heroin overdoses in the past two to three years has been a huge challenge for them. Thus longstanding coalitions as well as brand-new ones are grappling with the unexpected surge in both fatal and non-fatal overdoses. Coalitions are taking on this challenge while simultaneously preparing for the opening of medical marijuana facilities in their communities. Once established,groups typically meet monthly or every other month.They organize a wide range of prevention-related activities—listed in this report—that typically involve working with school-age youth,the general community,those who prescribe potentially addictive prescription painkillers,and pharmacists who fill those prescriptions. Many coalitions go beyond prevention and try to help those with Substance Use Disorders (SUDS) identify treatment and recovery services. They also may advocate for greater resources for these services, which are currently not sufficient to meet the dramatically increased need. • Massachusetts Health Council, 200 Reservoir Street,Suite 101, Needham, MA 02494 617-965-3711 ! www.mahealthcouncil.org uK 6 The substance use prevention coalitions in Massachusetts that we studied are organized in a variety of ways. Some that have existed autonomously for years within a single community are now becoming part of the Massachusetts Overdose Abuse Prevention Collaborative (MOAPC) coalitions of contiguous communities,funded by the Massachusetts Department of Public Health's (DPH) Bureau of Substance Abuse Services (BSAS). Others are collaborating, at least on the level of information-sharing, via local Community Health Network Areas (CHNA's), District Attorneys' regional initiatives or other multi-community efforts..Some are involved in several overlapping collective efforts.There is, however,a distinct ethos of sharing among those working hard to address the crisis and they find invaluable the multiple opportunities to network with peers and exchange information and best practices. There are also a variety of funding streams for substance abuse prevention coalitions. Some coalitions receive funding from multiple sources, while some are unfunded and depend on volunteer efforts and in-kind contributions of time, media, materials and so on. Federally supported Drug-Free Communities (DFC)grants, which supply up to$125,000 per year for up to ten years, have had a huge impact. These grants require adherence to the Strategic Prevention Framework(SPF), a deliberate, step-by-step process designed to achieve sustained,community- level impacts. They also require that coalitions recruit members from 12 community sectors to ensure broad-based input and participation in prevention efforts.Almost all coalitions include as i core members municipal police, fire and health departments, as well as the local public schools. State-funded MOAPC cluster grants require regional coalitions to follow a clear process as well. MOAPC grants pay for technical assistance to participating communities from the Massachusetts Technical Assistance Partnership for Prevention (MassTAPP), an agency that contracts with BSAS to guide community coalitions in key functions such as planning, capacity building, and use of data. While most long-established substance use prevention coalitions in Massachusetts have been focused on youth and on alcohol, marijuana and tobacco, a few have focused for many years on heroin. Although they are experienced in this area, the dramatic increase in heroin overdoses in the past two to three years has been a huge challenge for them. Thus longstanding coalitions as well as brand-new ones are grappling with the unexpected surge in both fatal and non-fatal overdoses. Coalitions are taking on this challenge while simultaneously preparing for the opening of medical marijuana facilities in their communities. Once established,groups typically meet monthly or every other month. They organize a wide range of prevention-related activities—listed in this report—that typically involve working with school-age youth, the general community,those who prescribe potentially addictive prescription painkillers, and pharmacists who fill those prescriptions. Many coalitions go beyond prevention and try to help those with Substance Use Disorders (SUDS) identify treatment and recovery services.They also may advocate for greater resources for these services,which are currently not sufficient to meet the dramatically increased need. Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 8 617-965-3711 • www.mahealthcouncil.org 6 ' Me 7e Based on data and survey results collected for this research paper, a set of"best practices" has emerged for mobilizing a substance abuse coalition. Each community is unique, of course, and the following scenario combines elements from all of the communities we studied. In 2012,two deaths by opioid overdose of residents in the 25-35 age range occur in a Massachusetts town, and two high school students in the town have had non-fatal opioid overdoses.An anonymous student survey conducted every two years indicates a slight increase in use of prescription painkillers by high school students. The principal of the high school and the head of the town's health department touch base informally and decide to request a meeting with the police chief.They all agree that a larger meeting should be convened among adults to discuss opioid use among the town's youth.The high school has a Students Against Destructive Decisions (SADD) chapter that has not been very active in recent years. A new core group emerges.The principal, health department head, and police chief invite a variety of people to an initial meeting: a selectman,the superintendent of schools, residents involved in youth sports, health education teachers, a popular coach, a school-based police officer, and several others.At the meeting, some people report that three nearby towns have recently formed coalitions on the same issue and a regional meeting is coming up. The group agrees to reach out to their contacts in nearby towns to find out what they are doing, who is leading the effort, and if they have funding to support their efforts. From this outreach, they learn about grant programs available to communities willing to mobilize themselves to address substance and opioid abuse by engaging all "sectors" in their communities and following a prescribed strategic planning process. Members of the new working group attend a meeting of the regional information-sharing group, where they meet peers from other towns.They learn how existing coalitions got started and how they secured state grants and applied for other funding.The informal working group officially chooses a name for itself and commits to work on the perceived threat to the lives and health of people in their town. The health department initially commits a staff person part-time to coordinating meetings.This person diligently sends out frequent and timely communications and reminders.The group secures a state grant and begins a process of outreach, engaging anyone and everyone who is affected by substance abuse or can provide data or participate in town-wide efforts to promote awareness and prevention. It builds an active membership of 50 people,of whom about 25 attend meetings every two months. New subcommittees work on specific tasks and report back at meetings.The high school begins a new substance abuse prevention group, following a successful • model in a nearby town. With the funds it has secured,the coalition recruits a full-time coordinator to help plan and implement an effective, multi-pronged prevention program. Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham,MA 02494 Um 617-965-3711 • www.mahealthcouncii.org 7 Recommendations for Policy Makers and Health Officials From Survey Respondents NIV EA: DO MU a. Fund Start-Up Grants for Local Coalitions and Expand Regional Efforts b. Improve Statewide Coalition Coordination and Information Dissemination C. Convene More In-Person Meetings d. Create an Online Resource Repository Mobilizing communities to form substance abuse prevention coalitions to support joint action is as essential to this fight as the work of the coalitions' individual members from various sectors.As critical as police, EMTs, hospitals, school personnel, courts, health departments and others are, they would not be nearly as effective in the battle against opioid overdoses if they were not working strategically together. The whole is truly greater than the sum of the parts. . Although org anizing,ganizing, coordinating and maintainingsubstance a abuse coalition is rewarding work, it can also be personally intense and emotionally demanding. Underage drinking coalitions have been around a long time but many have added new areas of focus on the opioid epidemic and the arrival of medical marijuana. New coalitions in particular are engaged in outreach to community members who may not be r Y receptive or cooperative. Their soldiers eir founders and coordinators are the foot who drive the work and need support. According to some of our survey respondents: "Infor mation shar ing needs to be improved across state-funded, federally-funded agencies and unfunded coalitions- and there are lots of unfunded coalitions. Some groups have no training at all. People need training." Everyone in the fight is working really hard and they sometimes forget they themselves need help to stay effective and avoid the real risk of burn-out. Prevention advocates can feel isolated within their communities as they try to change policy and social norms.The high intensity of the work necessitates a correspondingly high level of support both for those interacting directly with people with Substance Use Disorders as well as those doing outreach and organizing. a. Provide Start-Up Grants for Local Coalitions and Expand Regional Efforts Establish and publicize an easily accessible start-up grant program to communities for substance abuse prevention activities. Many communities in the Commonwealth started their coalitions successfully with small grants of around$2,500 from such funding sources as Mass in Motion or CHNAs. Availability of such sources, however, is inconsistent.Also, expand and promote the • MOAPC cluster grant program: • Massachusetts Health Council, 200 Reservoir Street,Suite 101, Needham,MA 02494 VK 617-965-3711 • www.mahealthcouncil.org �m 8 o Recommendations for Policy Makers and Health Officials From Survey Respondents a. Fund Start-Up Grants for Local Coalitions and Expand Regional Efforts b. Improve Statewide Coalition Coordination and Information Dissemination c. Convene More In-Person Meetings d. Create an Online Resource Repository Mobilizing communities to form substance abuse prevention coalitions to support joint action is as essential to this fight as the work of the coalitions' individual members from various sectors.As critical as police, EMTs, hospitals,school personnel, courts, health departments and others are, they would not be nearly as effective in the battle against opioid overdoses if they were not . working strategically together.The whole is truly greater than the sum of the parts. Although organizing, coordinating and maintaining a substance abuse coalition is rewarding work, it can also be personally intense and emotionally demanding. Underage drinking coalitions have been around a long time but many have added new areas of focus on the opioid epidemic and the arrival of medical marijuana. New coalitions in particular are engaged in outreach to community members who may not be receptive or cooperative. Their founders and coordinators are the foot soldiers who drive the work and need support. According to some of our survey respondents: "Information sharing needs to be improved across state-funded, federally-funded agencies and unfunded coalitions-and there are lots of unfunded coalitions. Some groups have no training at all. People need training." Everyone in the fight is working really hard and they sometimes forget they themselves need help to stay effective and avoid the real risk of burn-out. Prevention advocates can feel isolated within their communities as they try to change policy and social norms. The high intensity of the work necessitates a correspondingly high level of support both for those interacting directly with people with Substance Use Disorders as well as those doing outreach and organizing. a. Provide Start-Up Grants for Local Coalitions and Expand Regional Efforts Establish and publicize an easily accessible start-up grant program to communities for substance abuse prevention activities. Many communities in the Commonwealth started their coalitions successfully with small grants of around $2,500 from such funding sources as Mass in Motion or CHNAs. Availability of such sources, however, is inconsistent.Also, expand and promote the MOAPC cluster grant program. Massachusetts Health Council, 200 Reservoir Street,Suite 101, Needham,MA 02494 a 617-965-3711 • www.mahealthcouncii.org 8 b. Improve Statewide Coordination and Information Sharing Among Coalitions Support more statewide coordination and information-sharing between and among ALL existing community and regional substance abuse coalitions. • Include BSAS-funded and federally funded Drug-Free Communities (DFC) coalitions, as well as locally funded (CHNAs, District Attorney programs, etc.) and unfunded groups • Increase regular communication to coalitions about legislative and policy changes, like: o The 2014 DPH Opiate Task Force (40 pages of recommendations)along with the disposition of each proposal and contacts for following up o A compilation of the 2015 legislative proposals to deal with substance abuse issues,to allow groups to publicize and advocate for them c. Convene More In-Person Conferences and Meetings • Organize more in-person conferences and workshops around the state where people from coalitions in Massachusetts can meet each other,share ideas, and gain support. Facilitating contact among prevention people is very valuable. • Develop workshops and materials to share resources and best practices.Workshops and materials should be aimed at: o both brand-new and more experienced coalition members o rural, urban and suburban coalitions Different types of geographical areas can have very different needs. For example, one coalition leader reported attending a national substance abuse conference and realizing that her rural Massachusetts area had more in common with communities in Appalachia than with most communities in Massachusetts. • Organize other convenings during the year using other modes of communication, such as bimonthly or monthly call-ins or webinars. For example, Michael Morrissey, District Attorney of Norfolk County, holds regular regional meetings that provide community members a chance to meet peers, network and share new ideas, and learn about substance abuse education, advocacy and policy change.These meetings provide training for new members and are re-energizing for veteran coordinators. The district attorney also uses drug forfeiture funds to support school-based prevention events, Naloxone grants, and workshops where community activists can mentor one another. • Organize regular conference calls for Drug-Free Communities coalitions (DFC). The approximately 35 DFC coalitions would benefit from enhanced communication and collaboration. • Expand regional task forces to develop and implement opioid-specific strategies. In this way, the many communities without grassroots coalitions will not be left behind. Follow models like those that already exist in Franklin County, Norfolk County and now Worcester County.These regional efforts can implement a top-down roll-out of programs such as outreach to individual pharmacies in the Prescription Drug Monitoring Program (PDMP). County-level structures help ensure that every community has some representation in the work. Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham,MA 02494 „� 617-965-3711 • www.mahealthcouncii.org !Iif� 9 d. Create an On line Repository of Resources Many coalitions feel pressure to unnecessarily"re-create the wheel." MassTAPP should serve as leader and coordinator of an effort to create an online repository of resources, which could include, for example, Power Points, event flyers, write-ups, and news articles that people in different communities have already developed. In WrJz Fund evidenced-based prevention curricula in all public schools, with varying curricula for peo, le of different ages. Respondent: "There needs to be a e-a p g ppropriate health education/substance abuse education programming in every grade level for public schools." Our kids need to be informed at an early age in order to make better,safer decisions. Adolescence and pre-adolescence are critical times for preventing drug addiction. Groups should bring back the Drug Abuse Resistance Education (DARE) program or other tested programs that accomplish the same goals. Substance abuse prevention education in schools for children at even younger ages is also critical. Families should be engaged through students' homework assignments as part of health and wellness education. Such an effort should: • Fund training and staff for both public and private schools to deliver curricula based on best- practice recommendations, such as LifeSkills or other programs rated by SAMHSA's National Registry of Evidence-based Programs and Practices. • Extend curriculum ideas to ALL schools. Cross-promote community substance abuse prevention forums that include families with children in private schools because private elementary and secondary schools generally provide NO health education. • Require parents to attend a class to help them understand the realities of substance abuse on adolescent brain development and recognize the warning signs of abuse. Respondent: "This class should not be voluntary or it is just preaching to the choir; it needs to be a mandatory part of education in our state. Not my kid" is just not an acceptable excuse for parents anymore. This class should be offered in every school in the state. Parenting classes for elementary and middle school kids are also much needed. • Consider developing a program in conjunction with the Sheriff's and District Attorney's offices that provide parolees in recovery to speak to middle school or high school students. Parolees can talk about their experiences and tell kids what their addiction has cost them. • Renew funding for competitive grants for substance abuse counselors, which have been cut. The Massachusetts Department of Elementary and Secondary Education (DESE) managed the application process when these grants existed. Massachusetts Health Council,100 Reservoir Street,Suite 101,Needham, MA 02494 617-965-3711 • www.mahealthcouncil.org 10 f d. Create an Online Repository of Resources Many coalitions feel pressure to unnecessarily"re-create the wheel." MassTAPP should serve as leader and coordinator of an effort to create an online repository of resources, which could include,for example, Power Points, event flyers,write-ups,and news articles that people in different communities have already developed. a Fund evidenced-based prevention curricula in all public schools, with varying curricula for people of different ages. Respondent: "There needs to be age-appropriate health education/substance abuse education programming in every grade level for public schools." Our kids need to be informed at an early age in order to make better,safer decisions. Adolescence and pre-adolescence are critical times for preventing drug addiction. Groups should bring back the Drug Abuse Resistance Education (DARE) program or other tested programs that accomplish the same goals. Substance abuse prevention education in schools for children at even • younger ages is also critical. Families should be engaged through students' homework assignments as part of health and wellness education. Such an effort should: • Fund training and staff for both public and private schools to deliver curricula based on best- practice recommendations, such as LifeSkills or other programs rated by SAMHSA's National Registry of Evidence-based Programs and Practices. • Extend curriculum ideas to ALL schools. Cross-promote community substance abuse prevention forums that include families with children in private schools because private elementary and secondary schools generally provide NO health education. • Require parents to attend a class to help them understand the realities of substance abuse on adolescent brain development and recognize the warning signs of abuse. Respondent: "This class should not be voluntary or it is just preaching to the choir; it needs to be a mandatory part of education in our state." "Not my kid" is just not an acceptable excuse for parents anymore.This class should be offered in every school in the state. Parenting classes for elementary and middle school kids are also much needed. • Consider developing a program in conjunction with the Sheriff's and District Attorney's offices that provide parolees in recovery to speak to middle school or high school students. Parolees can talk about their experiences and tell kids what their addiction has cost them. • Renew funding for competitive grants for substance abuse counselors, which have been cut. The Massachusetts Department of Elementary and Secondary Education (DESE) managed the • application process when these grants existed. Massachusetts Health council,200 Reservoir Street,Suite 101, Needham, MA 02494 �11C 617-965-3711 ! www.mahealthcouncil.org 10 �Jk=0S- j=ft-N=VGW=,-,'0f • Continue to monitor and respond to problems related to underage drinking and marijuana and tobacco use-don't let them fall through the cracks. o Regarding marijuana use: ■ Do not recreationalize marijuana. ■ Have tighter regulations on medical marijuana facilities; ban the sale of EDIBLES containing marijuana. ■ Encourage politicians to inform themselves about the facts of marijuana legalization. For example, politicians need to know how legalization will affect our youth. They should study reports documenting the impact of legalization in Colorado,some of which include upsetting and frightening impacts on youth. ■ Decide how to respond to a possible referendum on legalizing the social use of marijuana. One respondent commented, "I would like to see legislators in that case [passage of such a referendum] REFUSE to allow it to take effect until the research has been done. I think laws should not be passed by the vote of an uneducated public who are not experts in the topic under consideration." o Regarding alcohol use: ■ Ban powdered alcohol. o Regarding tobacco use: ■ Make 21 the age of legal purchase statewide. • ■ Ban e-cigarette sales to all 18 year olds. i Currently,the research on the impact of e-cigarettes is not adequate. • Continue to monitor and respond to the use of other substances, including steroids, MDMA (ecstasy or"Molly"), Flakka, bath salts, spice, K2,Scooby Snax, N-Bomb, Kryptonite, Cloud 9, Bliss,and Adderall.A growing number of teens are abusing Adderall, an AND stimulant,to help them study or lose weight. WE • Create and launch public awareness media campaigns about the substance abuse epidemic. Use them in communities, schools, and news programs. • Launch a LOCK IT UP safe storage of medications campaign to decrease youth access to opiates and prescription medicines. xsa✓=:�. '��z���r'�'+�,s":Y�^�s fix, �v- �- .o r� �tt'„t za4ltt'�.Y,:�.:"3�'Y�.:wtt,.'S:+k�a.nzalc�'aBatv,Tr'.v�i.fr t Jxdi« as a +t;`a'4.-r .�5�.s .' c�Y..�• rsY'3xa"Y 1k'a.. �s+.YaK{t*1x�:M?a xY '�`stsl H7:. Policy makers need to become better educated on issues related to Substance Use Disorder, including the continuum of care,treatment barriers, and likelihood of relapses with opiates. Legislators need to back up proposed legislation with solid public health data. • • Attend community and regional coalition meetings. It is an excellent way for policy makers to get this education and inform their legislative priorities.As one respondent said, "Instead of Massachusetts Health Council,200 Reservoir Street,Suite 101,Needham,MA 02494 8617-965-3711 • www.mahealthcouncii.org 12 S • Universally screen for substance use in public schools, i.e.the SBIRT model (Screening, Brief Intervention and Referral to Treatment) o Make SBIRT a state mandate, like health screenings for scoliosis or eye problems. o Train staff, such as school nurses,to do screenings. Provide and encourage more comprehensive and timelier data on fatal and non-fatal opioid overdoses and non-fatal reversals(from hospitals, EMTs, police, towns,the state, etc.) at the community level, so that local communities can better track and respond to the problem. m N ffllffi���� �` • Respond to these common problems families face when dealing with substance abuse treatment and create enforceable guidelines: o Lack of available beds in detox and longer-term or other treatment facilities o Lack of or inadequate insurance coverage • Study BSAS-funded treatment outcomes to evaluate what is working and why o Work with the Treatment Research Institute in Philadelphia and John Kelly at Massachusetts General Hospital o Direct money to programs that have proven results to avoid re-creating the wheel . • Fund Vivitrol for inmates o Vivitrol reduces the craving for heroin and facilitates addiction remission. • Fund more Recovery Community Centers (nine now exist in Massachusetts) o Create a center demonstrating best practices • Fund an intensive Recovery Coach pilot o Follow post-inpatient stays with aggressive support (Gosnold model) o Follow up on Senator Therese Murray's Section 35 study about triaging patients to appropriate levels of care— Respondent: "Most patients stay only 17 out of possible 90 days of care." • Target interventions for those at high risk for Substance Use Disorder. o Reduce risk factors for all ages, not just youth �� .tp � .r't,�t'`ts Y' a"�f.5j"�.,4q �Y+�ex%�a�r.+srok �°�+•.rY,r �,�".�y�r�+i rS.4 a�5�� ti-�Jrt � .e'3,'�t�'�3"�;`' -�`' ' �ti • Mandate and enforce usage of the Prescription Drug Monitoring Program by all prescribers. • Establish prescriber guidelines for hospital Emergency Departments. • Respondent: Remove Press Ganey-type patient satisfaction ratings from the compensation structures of all prescribers.These ratings create an inherent `perverse incentive' by financially motivating doctors to appease patients seeking prescription pain relief." Massachusetts Health Council, 200 Reservoir Street,Suite 101, Needham, MA 02494 UN w--"% 617-965-3711 • www.mahealthcouncii.org 11 • Continue to monitor and respond to problems related to underage drinking and marijuana and tobacco use-don't let them fall through the cracks. o Regarding marijuana use: ■ Do not recreationalize marijuana. ■ Have tighter regulations on medical marijuana facilities; ban the sale of EDIBLES containing marijuana. ■ Encourage politicians to inform themselves about the facts of marijuana legalization. For example, politicians need to know how legalization will affect our youth.They should study reports documenting the impact of legalization in Colorado,some of which include upsetting p g and frightening impacts on youth. ■ Decide how to respond to a possible referendum on legalizing the social use of marijuana. One respondent commented, "I would like to see legislators in that case [passage of such a referendum) REFUSE to allow it to take effect until the research has been done. I think laws should not be passed by the vote of an uneducated public who are not experts in the topic under consideration." o Regarding alcohol use: ■ Ban powdered alcohol. • o Regarding tobacco use: ■ Make 21 the age of legal purchase statewide. ■ Ban e-cigarette sales to all 18 year olds. Currently,the research on the impact of e-cigarettes is not adequate. • Continue to monitor and respond to the use of other substances, including steroids, MDMA (ecstasy or"Molly"), Flakka, bath salts, spice, K2,Scooby Snax, N-Bomb, Kryptonite, Cloud 9, Bliss, and Adderall.A growing number of teens are abusing Adderall, an ADHD stimulant,to help them study or lose weight. OAKEN M- 1 • Create and launch public awareness media campaigns about the substance abuse epidemic. Use them in communities, schools, and news programs. • Launch a LOCK IT UP safe storage of medications campaign to decrease youth access to opiates and prescription medicines. .i`i �.'StIT i.•.--ice _ �t�.t��4��L..,19�s��..'.'`�.-,.'..•. Policy makers need to become better educated on issues related to Substance Use Disorder, • including the continuum of care, treatment barriers, and likelihood of relapses with opiates. Legislators need to back up proposed legislation with solid public health data. • Attend community and regional coalition meetings. It is an excellent way for policy makers to get this education and inform their legislative priorities.As one respondent said, "Instead of Massachusetts Health Council,200 Reservoir Street,Suite 101,Needham, MA 02494 a 617-965-3711 • www.mahealthcouncil.org 12 creating new organizations and committees,the senators and representatives need to take an active role in the groups currently doing the work in their communities. • The state should produce a master status report on government activities related to the opioid overdose crisis for use by community coalitions.According to one respondent, "So much is already happening at the State House- Mental Health Subcommittee,Opioid Task Force,etc. - coalitions can't keep up with all the information. It needs to be collated into a master status report." Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham,MA 02494 „� .� 617-965-3711 • www.mahealthcouncii.org QK 13 ell I Please see Appendix F for Abbreviations and Acronyms What has worked well with regard to building and sustaining. . 9 nin coalition and addressing the substance use issues? g the DIVERSE INVOLVEMENT • We're able to include the 12 sectors • Getting all partners on the same page, working on the same problem • Buy-in from schools and police • Having the right people at the table right from the get go.The ability to get them there, whether it's about drinking,the opioids,the MOAPC.The right people can provide the right data (schools, etc.) • Having the county convene it in a neutral convening role and having county staff researchers. It was helpful that I already had an existing advisory group • Having treatment providers involved [e.g. Gosnold, Brien Center,pec umshospital, health center] • Individuals stepping up when needed, including • From Day One, all players and stakeholders were included in the conversation • My connection with the CHNA work • Passionate residents that want to be involved: harness that energy EDUCATION,AWARENESS AND DISPELLING STIGMA • Having a visible community dialogue • Making people aware that it affects everyone • Media campaigns • Constant reaching out,emailing, schmoozing them—keeping them interested and that we want them. All our communications—the newsletters are helpful to parents. • We saturated the town with education and awareness • Coalition development: marketing, outreach • Getting people to know who you are-Website, Facebook,twitter, newspapers PROGRAMS AND ACTIVITIES • Speaker series, symposiums • Reducing high school use rates for alcohol by 15% • Policy Changes: prescription practices at the emergency rooms,getting the police to carry Narcan,drop boxes, changing the norms here • Our Drug Awareness Week is successful -getting other communities doing the same thing during the same period works well Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 """"""°'r°' 617-965-3711 • www.mahealthcouncil.org �K arum muxoi 14 , Please see Appendix F for Abbreviations and Acronyms What has worked well with regard to building and sustaining the coalition and addressing the substance use issues? DIVERSE INVOLVEMENT • We're able to include the 12 sectors • Getting all partners on the same page, working on the same problem • Buy-in from schools and police • Having the right people at the table right from the get go.The ability to get them there, whether it's about drinking, the opioids, the MOAPC.The right people can provide the right data (schools, etc.) • Having the county convene it in a neutral convening role and having county staff researchers. It was helpful that I already had an existing advisory group existing • Having treatment providers involved [e.g. Gosnold, Brien Center,Spectrum, hospital, health center] • Individuals stepping up when needed, including youth who have stepped up • From Day One, all players and stakeholders were included in the conversation • My connection with the CHNA work • Passionate residents that want to be involved: harness that energy EDUCATION,AWARENESS AND DISPELLING STIGMA • Having a visible community dialogue • Making people aware that it affects everyone • Media campaigns • Constant reaching out,emailing, schmoozing them—keeping them interested and that we want them. All our communications—the newsletters are helpful to parents. • We saturated the town with education and awareness • Coalition development: marketing, outreach • Getting people to know who you are-Website, Facebook,twitter, newspapers PROGRAMS AND ACTIVITIES • Speaker series, symposiums • Reducing high school use rates for alcohol by 15% • Policy Changes: prescription practices at the emergency rooms,getting the police to carry Narcan, drop boxes, changing the norms here • Our Drug Awareness Week is successful -getting other communities doing the same thing • during the same period works well Massachusetts Health Council, 200 Reservoir Street,Suite 101, Needham, MA 02494 K 617-965-3711 • www.mahealthcouncil.org 14 • laminated card is very helpful for first responders. It has signs of overdose, risk factors, numbers to call for treatment, and Learn to Cope information. • Medication drop-off boxes • Parents' social marketing campaign regarding underage drinking • Safe Homes Directory—parents who agree to be listed • "Last Night" high school graduation night program has worked tremendously. It eliminated the fights and other problems on that night. 95%of kids come to it.The parents are big into that.The cost was$25,000 to run for entertainment, card tables,games, basketball, arts, etc. • Chris Herren speaking and Project Purple (an initiative of former NBA player Chris Herren to assist individuals and families dealing with addiction) • Drug Court • Rewriting the health curriculum for entire district K-12 • Working with hospital to hand out Narcan at emergency room • Making presentations that bring people in PROCESS,TECHNICAL ASSISTANCE AND STRUCTURE • Having MassTAPP's help • The assessment and building partnerships • Using environmental strategies • That we applied as a countywide entity • Implementing at population level change OUTREACH, FACT-FINDING, RELATIONSHIP-BUILDING • Listening and asking questions • Going to community partners and not saying this is how it will be but asking how they see the problem • Meeting with police chief and each school principal • Relationship building approach • Events at a local school in the neighborhood with the most issues and most arrests, reaching people that can't travel easily • Having a good perspective of who/what the community is: unspoken rules and how things operate, work with someone who is established in the community, knowing who needed to be at the table • Being flexible about where and when you meet and how you communicate • Not pigeon-holing concepts: think outside of the box • High regard for coalition members: not leaving anyone out... I went to everyone • Having data that reflects the actual situation in the community; doing data-driven initiatives • COORDINATION AND STAFFING • Having a really committed person working on it,whether paid or not • That it's part of my job at the police department.The PD deals heavily with substance abuse and it's my paid job to be involved and also the school department and board of health. It's part of our jobs lddwbk Massachusetts Health Council, 200 Reservoir Street,Suite 101, Needham,MA 02494 ,., 617-965-3711 9 www.mahealthcouncii.org ►ItC 15 • • Endless amounts of energy • We have a paid person who moves it forward • That the lead person was trained to elicit and grow leadership from the community What have the challenges been? GETTING AND KEEPING PEOPLE INVOLVED • Always trying to get more members and keep all 12 sectors involved • Keeping folks engaged and motivated • Getting people who understand the problem -therapist, addiction therapists- in core group • Getting people to come to the meetings • Dependable volunteers not there • Staff turnover among your partner organizations • Keeping the same energy • Competing topics and priorities for the city. There are only so many people in a town of 40,000 who will come to the table. We see the same people at groups on many different topics. • Community responsiveness to some of our strategies -a theater donated space to show The Hungry Heart film over seven days and only 75 people showed up. Discouraging. • Maintaining energy—feel like if I let up at all,things start to slip. • Showing the community it's really an issue here • Maintaining commitment, attendance, proper subgroups, using strengths: making sure people feel useful • Doing too much stuff yourself because you are not engaging the community • We haven't developed an active steering committee: a big struggle ORGANIZING IT ALL • Where do we go from here: organizational,goals • So many people involved: everyone has a different idea of what's best • Initiated by mayor: but don't want to be political FUNDING AND GETTING ATTENTION FROM GOVERNMENT • Funding for adequate paid staff • Grant reporting requirements can be cumbersome • Funding is always a challenge-there's no guarantee of it. We have a good relationship with BSAS fortunately. To build financial sustainability into everything we do. • A lot of work to do, not enough resources:financial, and human • Have three years left on DFC grant- figuring how to sustain it without that money • • Massachusetts Health Council, 200 Reservoir Street,Suite 101, Needham,MA 02494 617-965-3711 • www.mahealthcouncil.org(j:7* 16 • Endless amounts of energy • We have a paid person who moves it forward • That the lead person was trained to elicit and grow leadership from the community What have the challenges been? GETTING AND KEEPING PEOPLE INVOLVED • Always trying to get more members and keep all 12 sectors involved • Keeping folks engaged and motivated • Getting people who understand the problem-therapist,addiction therapists-in core group • Getting people to come to the meetings • Dependable volunteers not there • Staff turnover among your partner organizations • Keeping the same energy • Competing topics and priorities for the city. There are only so many people in a town of 40,000 who will come to the table. We see the same people at groups on many different topics. • Community responsiveness to some of our strategies-a theater donated space to show The Hungry Heart film over seven days and only 75 people showed up. Discouraging. • Maintaining energy-feel like if I let up at all, things start to slip. • Showing the community it's really an issue here • Maintaining commitment,attendance, proper subgroups, using strengths: making sure people feel useful • Doing too much stuff yourself because you are not engaging the community • We haven't developed an active steering committee: a big struggle ORGANIZING IT ALL • Where do we go from here: organizational,goals • So many people involved: everyone has a different idea of what's best • Initiated by mayor: but don't want to be political FUNDING AND GETTING ATTENTION FROM GOVERNMENT • Funding for adequate paid staff • Grant reporting requirements can be cumbersome • Funding is always a challenge-there's no guarantee of it. We have a good relationship with BSAS fortunately.To build financial sustainability into everything we do. • A lot of work to do, not enough resources:financial, and human • • Have three years left on DFC grant- figuring how to sustain it without that money LD Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham,MA 02494 617-965-3711 • www.mahealthcouncii.org E 16 GETTING AND USING ACCURATE DATA • • Getting people to understand what effective prevention really is; based on data • People get all riled up when something happens and want action now, based on emotions, not data • Keeping people engaged but patient at the same time. Getting them on board with the SPF (Strategic Prevention Framework). They see headlines,feel a sense of urgency, and want to do something without really having an organized plan in place. • Data collection: no crisis when started and people would give data; now, hard to get data because of all the new red tape- People call trying to get the data from hospital, and I can't get it-When I finally get data, it's like a year later • People are so eager to do things that communication is lost, redoing things that are already done What do you consider the most important factor that allows (or will allow) your coalition to be effective? OUTREACH, FACT-FINDING, RELATIONSHIP-BUILDING • Community outreach - being able to get to the people that need help or resources • Finding people that care about youth • Capacity,forming relationships • Communication: letting people talk,feel heard, asking for input • • Be appreciative, acknowledging 0 RELATIONSHIPS AND TRUST • Collaborative partnerships-we wouldn't exist if we didn't have them • Having the trust and confidence of the town to do the right thing • Having the police and schools and residents working with you • No infighting! Coalitions can have that problem. New communities don't know each other. Building relationships. • Thoughtful process that engages a lot of people • Strong relationships throughout the region • Collaborating groups have been open and honest about what they can do and would like to do. COMMITMENT • That many of us are closely tied and dedicated to kids-either as parents or in the schools • Acknowledgement from others that there is a problem and there are ways to work with it • Getting a group of educated, dedicated volunteers, willing to roll their sleeves up and work • Passion:they want to help the young people in the community, like a community mom that cares because of her past or a math teacher who gives tech support • Collaboration and commitment of leadership team • Need diverse (with all sectors)group that is passionate • • Know what your resources are • Harnessing energy from community: residents need to want change Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 617-965-3711 • www.mahealthcouncii.org�K 18 • STIGMA/DENIAL , • Some people don't want to be affiliated because it's like they'd have to admit they know somebody with these issues. • The idea that "it won't happen to my child - it's the other kid." Drugs don't discriminate between good students and bad students. • The "not my kid" attitude—those parents are the last ones to know. • Reaching young adults, age 18 to 35. There's a gap in our ability to reach and intervene with people in their twenties, post-high school,who don't think their substance use is a problem. • Addressing stigma - people that don't want to come out to these meetings because of the attitude that"the people that use are junkies" • Overcoming the attitude that nobody in our town will be open to this discussion,that people are too closed and private—in the end,the coalition was actually well received! REACHING AND EDUCATING PEOPLE • Educating the community about the actual issues whether it's alcohol, marijuana or other substances • Getting people to understand what the issue is. For example the police department may see people as criminals. Physicians are reluctant to implement the three-day prescription supply guideline and use the PDMP program,which has a 10-day lag time. • Educate general public on disease of addiction and normalizing the discussion of it • Fighting the attitude that it's expected and OK to be wild as a teenager • Hard to reach parents- language barriers, Haitian creole, other African backgrounds, poverty,violence • Still a very segregated community: so need to go to all corners—conflict and tension, both racially and economically • Addiction can be concealed fairly easily CONNECTING PEOPLE WITH RESOURCES • Transportation issues getting people to counseling and treatment at distant locations • Access to treatment and not having a full continuum of care MAKING CHANGES IN BEHAVIOR AND NORMS • Changing community norms around drinking • Adult substance abuse is a challenge, whether it's parents or other adults • Substances are constantly changing. New ones come up or become popular especially with the youth. • The marijuana situation is completely out of control among youth.They think it's now an OK thing to do. • It's hard for us to move away from just opiate-focused work because it is such a huge issue: It's hard to address underage drinking in the community; people think less about drinking or"lesser" drugs • We're really worried about the medical marijuana plant that is coming into our community • Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham,MA 02494 617-965-3711 • www.mahealthcouncii.org a 17 • GETTING AND USING ACCURATE DATA • Getting �people to understand what effective prevention really is;based on data • People get all riled up when something happens and want action now, based on emotions, not data • Keeping people engaged but patient at the same time. Getting them on board with the SPF (Strategic Prevention Framework). They see headlines,feel a sense of urgency, and want to do something without really having an organized plan in place. • Data collection: no crisis when started and people would give data; now, hard to get data because of all the new red tape- People call trying to get the data from hospital, and I can't get it-When I finally get data, it's like a year later • People are so eager to do things that communication is lost, redoing things that are already done What do you consider the most important factor that allows (or will allow)your coalition to be effective? OUTREACH, FACT-FINDING, RELATIONSHIP-BUILDING • Community outreach- being able to get to the people that need help or resources • Finding people that care about youth • Capacity,forming relationships • Communication: letting people talk, feel heard, asking for input • Be appreciative,acknowledging RELATIONSHIPS AND TRUST • Collaborative partnerships-we wouldn't exist if we didn't have them • Having the trust and confidence of the town to do the right thing • Having the police and schools and residents working with you • No infighting! Coalitions can have that problem. New communities don't know each other. Building relationships. • Thoughtful process that engages a lot of people • Strong relationships throughout the region • Collaborating groups have been open and honest about what they can do and would like to do. COMMITMENT • That many of us are closely tied and dedicated to kids- either as parents or in the schools • Acknowledgement from others that there is a problem and there are ways to work with it • Getting a group of educated, dedicated volunteers, willing to roll their sleeves up and work • Passion:they want to help the young people in the community, like a community mom that cares because of her past or a math teacher who gives tech support • • Collaboration and commitment of leadership team • Need diverse (with all sectors)group that is passionate • Know what your resources are • Harnessing energy from community: residents need to want change Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 �K 617-965-3711 • www.mahealthcouncil.org 18 • FUNDING • Champions: working with legislators, people that can make decisions; legislator found money in State House to help this coalition and hosted forums at local hospital • Support of town for being our fiscal agent;the town now funds her job • Support from community, including hospital PROCESS AND PLAN • Strategic planning: next steps UNDERSTANDING THE COMMUNITY AND DATA • Be mindful of where people are coming from and what's appropriate for the community • First-hand knowledge of the police department based on our calls for service • Being open-minded and listening to others who have been affected • Need the data and hard facts so that people can't ignore the issues FUNDING • Long-term funding. You need staff.Without staff, our volunteers would have burned out a long time ago. Brandeis University told us it will take at least 10 years of prevention activities and work on environmental and community norms to see a change and they were right. • The county's investment got us off the ground EDUCATING AND RAISING AWARENESS • The concept of substance abuse as a public health issue is important • Publicity of what we're doing • The commitment to addressing substance abuse as a whole:the agencies and organizations that work with these ignored people know that these people can also have other diseases that make them stigmatized. What advice or tips would you give to other communities thinking about forming a substance abuse task force or coalition? DIVERSE INVOLVEMENT • Following the DFC model with 12 sectors gets you a well-rounded group. Even add other sectors and get them to bring people. Different members bring different skills. Have a well-rounded and diverse membership. • Get a wide range of people involved-- Police,fire, clergy, residents, students. • Build relationships- have key players as part of your team-get community buy in—get non-professionals in neighborhoods, leverage religious institutions, health fair. • Find like-minded people and start, because it's overwhelming for one person. • Don't only speak to providers: you need patients, consumers,youth, parents. • You need volunteers. Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 ., ... 617-965-3711 • www.mahealthcouncii.org BRICE 19 • Get a diverse representation of community stakeholders, leaders and members at the table ' to understand what you're trying to do. • Try to reach every facet of the community—police, fire but also the mom of three teenaged boys and even a new mom. • Recruit well-known local people like local store owners, restaurant owners, pizza places. If they're well known, it helps. • Find your community champions. Go to schools, Police, local parents are, community service organizations. Get them all to sit clergy, d and brainstorm ve how to start and get funding. • Need the 12 sectors represented. And we use them throughout the year. • Make sure you have as man y people from as many stakeholders, schools, police department,fire, parents,students, nonperent areas as rofits. s. —key DON'T RE-CREATE THE WHEEL • Try not to re-create the wheel. Ask for help or resources from other coalitions. • Need structure,talk to other communities, see who has been successful, no need to re- create the wheel,find what has and hasn't worked to tap your resources and learn from others' mistakes. • Don't reinvent the wheel. Piggyback on other good things already ha ppeing in the community.Ask questions of other coalitions regarding what they do and if it worked. • We used the experience of the Town of Falmouth -they had a DFC grant and had expertise on the SPF and were very helpful. • Reach out to pre-existing coalitions in other communities for guidance. Don't need to reinvent the wheel. Learn what works and what doesn't work elsewhere. • See what coalitions are nearby and ask them directly. There are some funds for mentoring. START SLOWLY, HAVE A PLAN, BUILD GRADUALLY • Tread lightly-don't go out suddenly with a big opiate coalition and a "rah, rah"attitude. • Start slowly and do a few good things. • Don't worry about funding in the beginning. Can get space and resources from schools, etc. Grants can come later. • Recruit a core group so you are not dependent on one or two people. • Important to have a smaller group of planning advisors and not name a steering committee off the bat. • Having a clear agenda is important: HUGE. • People like to come in and know what they will do, have time planned. • Connect with a local CHNA and with MassTAPP-they have real) analysis. Y good trainings and data • Build relationships; everything else will come. • Don't get bogged down by so many opinions and ideas: but utilize them and stay focused. • Use your data, be strategic. • Get all sectors on board early: school principals,selectman, etc. • Plan, and have a timeline. • Manage meetings effectively; do agendas, send out minutes. Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 K 617-965-3711 • www.mahealthcouncil.org 20 Get a diverse representation of community stakeholders, leaders and members at the table ' to understand what you're trying to do. • Try to reach every facet of the community—police, fire but also the mom of t teenaged boys and even a new mom. three • Recruit well-known local people like local store owners, restaurant owners, pizza places. If they're well known, it helps. • Find your community champions. Go to schools, police, local clergy, find out who the active parents are, community service organizations. Get them all to sit around and brainstorm how to start and get funding. • Need the 12 sectors represented. And we use them throughout the year. • Make sure you have as man y people from as many stakeholders, schools, police department,fire, parents,students, nonerent areas aspr Pofi s.ssibl —key DON'T RE-CREATE THE WHEEL • Try not to re-create the wheel. Ask for help or resources from other coalitions. • Need structure,talk to other communities,see who has been successful, no need to re- create the wheel,find what has and hasn't worked to tap your resources and learn from others' mistakes. • Don't reinvent the wheel. Pi g ood things community.Ask questions of Piggyback coalitions regarding what rthey ydo and if i happening t the • We used the experience of the Town of Falmouth -they had a D C grant and had expertise on the SPF and were very helpful. • Reach out to pre-existing coalitions in other communities for guidance. Don't need to reinvent the wheel. Learn what works and what doesn't work elsewhere. • See what coalitions are nearby and ask them directly. There are some funds for mentoring. START SLOWLY, HAVE A PLAN, BUILD GRADUALLY • Tread lightly-don't go out suddenly with a big opiate coalition and a "rah, rah"attitude. • Start slowly and do a few good things. • Don't worry about funding in the beginning. Can get space and resources from schools,etc. Grants can come later. • Recruit a core group so you are not dependent on one or two people. • Important to have a smaller group of planning advisors and not name a steering committee off the bat. • Having a clear agenda is important: HUGE. • People like to come in and know what they will do, have time planned. • Connect with a local CHNA and with MassTAPP-they have analysis. e really good trainings and data • Build relationships; everything else will come. • Don't get bogged down by so many opinions and ideas: but utilize them and stay focused.• Use your data, be strategic. • Get all sectors on board early: school principals, selectman, etc. • Plan, and have a timeline. • Manage meetings effectively; do agendas, send out minutes. Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 K 617-965-3711 • www.mahealthcouncil.org 20 I • Use social media: get people to like you. • Publicize it with Facebook and a website as quickly as possible. • Public awareness: We spent a lot of time branding:t-shirts, logos,wrist bands. • Having MassTAPP at the table also-follow evidence-based activities. • Ask for MassTAPP's help in identifying another coalition that could mentor you. • Be patient. You may be doing things that bear fruit later on. You may think you're not doing very much but you may be doing quite a lot. • Be open and receptive to people who have problems that you may think fall out of your scope. If you help them, it will help the relationship and the coalition later. • Just because another community does something one way,that doesn't mean you have to do it that way in your community. One of the challenges of the regional coalitions, like MOAPC, is that the different stages of different communities can be a challenge. It takes a while to get it up and running to everyone's satisfaction. • Start small and work big. Do planning and discussion and identify where the problems are. • If you get too big too fast, if you falter it will fall apart. RESPECT THE COMMUNITY AND GATHER DATA • Don't go into it blind. • As soon as you can, access local data. • So many coalitions that have popped up that are giving people poor/wrong data. • How,where, why:what treatment is available. • Utilize people's lived experience to provide context to the factual history. • Be genuine: make good relationships with the townies. • Know your environment:talk with people in diverse neighborhoods. • Read the paper,go to community police meetings. • Understand that your community is unique. Ask questions or do focus groups before investing a large amount in a campaign or initiative. • Understand your community and population for what it is. Start with places where people are working with active users, like clinics, and then work your way back. • Spend time talking to people individually first to see what their agenda is, what have they already done instead of making people come join something new. • Getting out there, pounding pavement, what does community want: start where the community is at. • Find natural stakeholders. • Do your homework:go and understand what the issue is, understand where it started, what services are available,who it is impacting and how • Data, data, data. Before you take the first step get the right people at the table and collect the data. Funders will require hard data on the extent of the problem. People who can get the data are people from the schools and the rest of the 12 sectors. • Use the police department to find out the calls they're getting,talk to the schools and the parents about what's going on in their neighborhoods. • Share information and data responsibly. • From the assessment and key informant interviews, we learned we need to do a better job of engaging youth in this effort. Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 ,� „� 617-965-3711 • www.mahealthcouncii.org utc 21 TAKE ACTION TO SAVE LIVES • Do it! Do it! It takes a village. These are our children. It's our community. • Do it! People want to help and get involved. • Have passion to pull community together. • Having personal experience with substance use, like having lost a family member, can sometimes help in this work but sometimes it can also cloud your judgment. Massachusetts Health Council, 200 Reservoir Street,Suite 101, Needham,MA 02494 �K 617-965-3711 • www.mahealthcouncil.org 22 TAKE ACTION TO SAVE LIVES • Do it! Do it! It takes a village. These are our children. It's our community. • Do it! People want to help and get involved. • Have passion to pull community together. • Having personal experience with substance use, like having lost a family member, can sometimes help in this work but sometimes it can also cloud your judgment. • Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 �K 617-965-3711 0 www.mahealthcouncil.org 22 1 jB _5,� Nia Please see Appendix F for Abbreviations and Acronyms This section lists the range of programs and activities that substance abuse prevention coalitions have initiated, implemented,funded, publicized, planned or advocated for. Repetition of an idea indicates that multiple respondents reported it. SCHOOL-BASED AND OTHER YOUTH PROGRAMS • Youth at Risk-we pay high school students to work in bullying prevention,substance abuse workshops and a documentary is being done • Youth Pride/Tolerance Day annually in June • Youth Dance • Winter"Happy, Healthy Drug-free Evening"-we have a police officer as DJ • Movie nights • Last Night program on high school graduation night has worked tremendously. 95%of kids come and the parents are big into that. It eliminated the fights and other problems on that night.The cost was$25,000 for entertainment, card tables,games, basketball, etc.,arts. • Kids Talent Night fundraiser • Event at YMCA,any middle school/high school for a play night • Youth diversion programs • Project Purple/Chris Herren - PSA's,school announcements, tee shirts,awareness campaigns for drugs and opiates for the kids and parents. We have 100 to 200 kids involved. • Safe Prom—substance-free after-prom party • School resource officer in the regional high school • Healthy prom and graduation • Partnering senior athletes in high school with freshman athletes: healthy decision mentoring • Mental health work: advisor program in school-advisor/advisee • Campaigns with youth focus: a week of training on social marketing • "Opi-ODDS" (Defy The Opi-Odds,which raises teen awareness around the opioid epidemic) • Campaigns: around prom/graduation, social hosts • Primary education with teens at health center on weekly basis,then population-level change • Annual "Town Hall Meeting" led by youth after training • Youth prevention group: school kids that work with the volunteers • Raise money for"5th Quarter" after football games • Kids events • Lunches in high school: provide students with SUDs with lunch, support them with any services, separate cafeteria • "Turn It Around" student campaign to raise awareness about dangers of prescription drug abuse- kids love it • Fourth-grade "Rad Kids" program—keep yourself safe-discussed drugs and medications • Advisee/advisor program at high school: connectedness within school, if a young person is connected,won't use substances as much Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 (j9m 617-965-3711 • www.mahealthcouncii.org 23 I i • Experts coming in for grades 8-9 to do substance abuse screening- identify at risk kids-all kids screened unless parents opt out- if people are rated high,they will be referred • SBIRT screening in school nursing • Train high school and middle school teachers to recognize signs of substance use • Youth activities at Boys and Girls Club PARENT/ADULT TRAININGS AND CONVERSATIONS • Parent trainings and trainings for caregivers • Risk and protective factors training • Operation Parent-due to a lot of overdoses in suicides • Conversations on risky behaviors and preventing and delaying alcohol use • Safe Ride Contract where parents must talk to their kids about expectations and a way out, a written agreement • Parent Survey as part of our social norms promotion campaign-e.g. "93%of parents talk to their kids about substance use" • This year we put out a new edition of the Safe Homes Directory.A list of parents who are willing to be listed. It facilitates communication between parents and you agree you will not serve alcohol to kids and will monitor what kids are doing at your home. • Table Talks for educating parents. Held at 12-15 private homes. Reaches parents who hide their heads a lot when schools notify them. • Facilitate "Guiding Good Choices," also for parents, held at a church hall. • Parent dinners-age-specific to their kids and discuss the YRBS (Youth Risk Behavior Survey) • Alcohol awareness • Social Hosting legal responsibilities and liabilities • Working with drivers'education people • Connecting individuals with providers- unofficial refer rals • "Above the Influence"-adapted national campaign: "talk-they hear you" • Community programing to strengthen families • Learn to Cope chapter meets weekly and the police department is sometimes invited • Narcan training every 3 months for community members • Training for overdose prevention for everybody • Parent education going through a mock youth bedroom • Community Education on Good Samaritan Law-calling 911 and legal issues PRESCRIBERS AND DISPENSERS OF PRESCRIPTION PAINKILLERS • Prescription practices at the emergency rooms • Scope of Pain Training for Physicians and other prescribers • Created network of prescribers to alert them to Scope of Pain trainings • Created brochure for all prescribers in county titled Prevent Misuse of Prescription Drugs and they also give it to people who get a prescription • Reach out to dentists • Reach out to pharmacists so they can give out the misuse brochure. • Working with the prescribers to reevaluate their practices • Engaging prescribers to educate their patients Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 88 617-965-3711 • www.mahealthcouncil.org uK 24 • Experts coming in for grades 8-9 to do substance abuse screening- identify at risk kids-all kids screened unless parents opt out- if people are rated high, they will be referred • SBIRT screening in school nursing • Train high school and middle school teachers to recognize signs of substance use • Youth activities at Boys and Girls Club PARENT/ADULT TRAIN INGS AND CONVERSATIONS • Parent trainings and trainings for caregivers • Risk and protective factors training • Operation Parent-due to a lot of overdoses in suicides • Conversations on risky behaviors and preventing and delaying alcohol use • Safe Ride Contract where parents must talk to their kids about expectations and a way out,a written agreement • Parent Survey as part of our social norms promotion campaign -e.g. "93%of parents talk to their kids about substance use" • This year we put out a new edition of the Safe Homes Directory.A list of parents who are willing to be listed. It facilitates communication between parents and you agree you will not serve alcohol to kids and will monitor what kids are doing at your home. • Table Talks for educating parents. Held at 12-15 private homes. Reaches parents who hide • their heads a lot when schools notify them. • Facilitate "Guiding Good Choices," also for parents, held at a church hall. • Parent dinners-age-specific to their kids and discuss the YRBS (Youth Risk Behavior Survey) • Alcohol awareness • Social Hosting legal responsibilities and liabilities • Working with drivers' education people • Connecting individuals with providers- unofficial referrals • "Above the Influence"-adapted national campaign: "talk-they hear you" • Community programing to strengthen families • Learn to Cope chapter meets weekly and the police department is sometimes invited • Narcan training every 3 months for community members • Training for overdose prevention for everybody • Parent education going through a mock youth bedroom • Community Education on Good Samaritan Law-calling 911 and legal issues PRESCRIBERS AND DISPENSERS OF PRESCRIPTION PAINKILLERS • Prescription practices at the emergency rooms • Scope of Pain Training for Physicians and other prescribers • Created network of prescribers to alert them to Scope of Pain trainings • Created brochure for all prescribers in county titled Prevent Misuse of Prescription Drugs and they also give it to people who get a prescription • • Reach out to dentists • Reach out to pharmacists so they can give out the misuse brochure. • Working with the prescribers to reevaluate their practices • Engaging prescribers to educate their patients Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham,MA 02494 8""'"'"""' 617-965-3711 • www.mahealthcouncii.org �K 24 I • Talking with pharmacies to do safe disposal and how to keep medications out of the hands of young people and people with addiction • Pharmacy- information distribution to customers • Promoting awareness and use of PDMP- practitioners and pharmacists either don't know about it or don't use it; identifying repeat users • Scope of Pain: educating providers-want to include dentists • Now pulling in others from MOAPC for prescriber education-dentistry is huge current focus OTHER ACTIVITIES SUPPORTING PREVENTION • Expanded substance abuse to look at behavioral health and mental health first aid. Very well received.Adults are signing up to be trained re mental health issues. • Involvement in Shannon Grant Community Safety Initiative regarding risky behaviors • Pushed for regulating e-cigarettes like tobacco, and limiting tobacco and alcohol signage • We were one of the first communities in Massachusetts to ban sales of tobacco products in pharmacies. • After-school program • Before-school program (meals) • Doing prevention for all ages: "healthier community" • Limit access and availability of tobacco—can't buy cigarettes here under age 21 • Doing fuel,food assistance • Ban flavored tobacco products • Work with Parks and Recreation to make parks more family friendly: concert in the summer for teens, chemical free, Splash Pad for little kids in the summer. Park Is notorious for drug dealing:trying to get more power in numbers for parents. • Tobacco Day at school COMMUNITY EVENTS AND ENGAGEMENT • Annual candlelight vigil and lantern release for remembrance, prevention and recovery. We got the idea from an annual national prescription abuse summit conference,the NOPE (Narcotics Overdose Prevention and Education)Task Force. • Week-long Stand Up to Substance Abuse • Health Fair with treatment providers • Tables at community events • Engage businesses to spread message • Held event at a school in the neighborhood with most issues and arrests, reaching people who can't travel easily • Drug Awareness Week in October • Summer:tabling, health fairs • Our Drug Awareness Week is successful getting other nearby communities doing the same thing during the same week for more awareness • Public forum at school with resource tables • Event at library:watching Anonymous People video with panel discussion • Event at senior center regarding their prescriptions Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham,MA 02494 Mc 617-965-3711 0 www.mahealthcouncii.org m� 25 SOCIAL NORMS MEDIA CAMPAIGNS • • PSA's regarding overdose prevention on cable TV,twitter,e-mail, etc. • Billboards • Parents developing social marketing campaign focused on underage drinking • Social norms marketing campaigns, correcting misperceptions on behalf of high school and middle school students and the general public-posters on buses,on ferries, at doctors' offices • PSA's with local radio stations on top four issues • Publication -putting together ads with local newspaper on making good choices • Press conference • Create TV show for local TV channel related to opiates, posted on YouTube • Photo voice project that displays throughout community POLICY CHANGE ADVOCACY • Drug Court to address revolving door of arrests with substance abuse • Reduce drug sales in local parks • Increase size of police force • At council meetings, advocating for environmental changes • Environmental scans: of neighborhoods, what areas could be used for drug usage, report back to youth committee to eliminate • Advocacy walks • Narcan (Naloxone) o Getting police and fire depts to carry Narcan -we did everything: funding, education, advocacy o Narcan training o Work with Walgreens to carry Narcan o Working with hospital to hand out Narcan at emergency room o Work to get more Narcan out if there is a bad batch of heroin out WORKING WITH ALCOHOL SERVERS AND RETAILERS • Alcohol compliance checks for bars, restaurants and stores. We supported police in that. Police officer goes with young person to local market to see if they can buy cigarettes or alcohol underage. • "21-Proof"training for anyone who sells or serves alcohol • Responsible beverage-serving trainings at restaurants • Sticker Shock program with all liquor stores and Sticker Shock ads at movie theaters • Worked with the selectmen of the various towns to get responsible beverage policies ADDING SCHOOL CURRICULUM • School curriculum changes • Working with schools on standardizing the health curriculum at middle and high schools • Rewriting the health curriculum for entire district, K-12 • Prevention curriculum in middle school • Trying get better curriculum to fit into K-12 Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham,MA 02494 �K 617-965-3711 0 www.mahealthcouncii.org 26 SOCIAL NORMS MEDIA CAMPAIGNS • PSA's regarding overdose prevention on cable TV,twitter,e-mail, etc. • Billboards • Parents developing social marketing campaign focused on underage drinking • Social norms marketing campaigns, correcting misperceptions on behalf of high school and middle school students and the general public-posters on buses,on ferries, at doctors' offices • PSA's with local radio stations on top four issues • Publication -putting together ads with local newspaper on making good choices • Press conference • Create TV show for local TV channel related to opiates, posted on YouTube • Photo voice project that displays throughout community POLICY CHANGE ADVOCACY • Drug Court to address revolving door of arrests with substance abuse • Reduce drug sales in local parks • Increase size of police force • At council meetings, advocating for environmental changes • Environmental scans:of neighborhoods,what areas could be used for drug usage, report back to youth committee to eliminate • Advocacy walks • Narcan (Naloxone) o Getting police and fire depts to carry Narcan-we did everything:funding,education, advocacy o Narcan training o Work with Walgreens to carry Narcan o Working with hospital to hand out Narcan at emergency room o Work to get more Narcan out if there is a bad batch of heroin out WORKING WITH ALCOHOL SERVERS AND RETAILERS • Alcohol compliance checks for bars, restaurants and stores. We supported police in that. Police officer goes with young person to local market to see if they can buy cigarettes or alcohol underage. • "21-Proof"training for anyone who sells or serves alcohol • Responsible beverage-serving trainings at restaurants • Sticker Shock program with all liquor stores and Sticker Shock ads at movie theaters • Worked with the selectmen of the various towns to get responsible beverage policies ADDING SCHOOL CURRICULUM • School curriculum changes • Working with schools on standardizing the health curriculum at middle and high schools • Rewriting the health curriculum for entire district, K-12 • Prevention curriculum in middle school • Trying get better curriculum to fit into K-12 Massachusetts Health Council,200 Reservoir Street,Suite 101,Needham,MA 02494 ED 617-965-3711 • www.mahealthcouncii.org 26 • Focus on preventing first-time use awareness • Changing school curriculum to include more drug LAW ENFORCEMENT • We responded to home break-insto mont py • District Attorney's t escription drugs. ask force me project • Participating in community policing pro 1 DATA GATHERING • Work with first responders to get data from entat ve fornbetter overdose reporting regarding state • We advocate with our state repre police,hospitals, DPH, and local police and boards of health teachers survey done by Health • Other surveys in addition to YRBS: law enforcement survey, Imperatives, high school focus group attitude and belief surveys • Surveying: anyone attending FORUMS AND SPEAKERS • Public forums of all kinds • Forum on depression,suicide and addiction with a doctor from MGH • Sheriff came and talked to high school • Panel to answer any community questions • Speaker series with different topics 0 • Monthly library speakers FILMS • "What Happened Here" -movie on recovery • "Unguarded" by Chris Herren • "Anonymous People" SAFE STORAGE AND SAFE DISPOSAL OF PRESCRIPTION DRUGS • Prescription medication drop-boxessetting up table,education • Drug Take-Back days-presenting, • Medication drop boxes at the four police departments • DEA National Drug Take-Back days • Kiosk at police station for drug take-back• Educate people at senior center regarding medication and drop off locations SUPPORT GROUPS IN MIDDLE SCHOOL ected by someonOeOelse's substance abuse -10 week • Kids of Promise program kid with own substance use.They are 8 • Insight Group for high school students dealing ing school day which is very important. groups. Principals allow them to attend de s and kids both go to overdose prevention training • Loved Ones Raising Loved One for the public Massachusetts Health Council,200 Reservoir Street,Suite 101,Needham, MA 02494 617-965-3711 • www.mahealthcouncil.org 27 �K FAMILY SUPPORT AND RECOVERY SUPPORT • Learn to Cope chapter • Funding parent support groups for parents of chronic users- licensed social worker • Training Recovery Coaches-follow-up pilot program with police and recovery coaches to do home visits after Narcan reversals. The training recovery coach is provided at a free family support meeting. Gosnold will pay for it. PRINTED MATERIALS • South Shore guide to treatment providers available to schools, on town website,on our website, at all our events, available to nearby towns and we mail it to all households • Well-Being Books we created to help the public understand their community based on data • Laminated cards with signs of overdose, resources and phone numbers are very helpful for first responders Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 VK 617-965-3711 • www.mahealthcouncil.org wum muxai 9Q • FAMILY SUPPORT AND RECOVERY SUPPORT • Learn to Cope chapter • Funding parent support groups for parents of chronic users- licensed social worker • Training Recovery Coaches-follow-up pilot program with police and recovery coaches to do home visits after Narcan reversals. The training recovery coach is provided at a free family support meeting. Gosnold will pay for it. PRINTED MATERIALS • South Shore guide to treatment providers available to schools,on town website, on our website, at all our events,available to nearby towns and we mail it to all households • Well-Being Books we created to help the public understand their community based on data • Laminated cards with signs of overdose, resources and phone numbers are very helpful for first responders Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 617-965-3711 • www.mahealthcouncii.org �d ^►o F 7 ¢ fY? Ya .? * � -4Sf � .€. .,+:, •4 r"r a- {rye �- a � e} 35 Y$• a t Please see Appendix F for Abbreviations and Acronyms The responsibility for any inaccuracies in Appendix C is entirely ours and we welcome corrections. BARNSTABLE GROUP NAME Barnstable County Public Health District RESPONDENT Beth Albert, Barnstable MOAPC Coordinator COUNTY Barnstable REGIONAL PARTICIPATION MOAPC and Barnstable County Regional Substance Abuse Council POPULATION(APPROXIMATE) 214,990(county) DATE BEGAN 2014 REASON FOR FOUNDING We knew we needed to be organized to get grants and address the issues. WHO FOUNDED County Department of Human Services and the chief of police MAIN FOCUS Following the SPF model and doing assessment to determine focus #OF MEMBERS 12 of 15 towns actively participating COORDINATION/STAFF 1 FT Senior Program Manager(50%on the substance abuse council), 1 PT coordinator FUNDING SOURCES DFC,MOAPC,SAPC(underage drinking grant) OTHER RESOURCES RECEIVED HRiA helped us with epidemiological data pulls. Cape Cod Healthcare also helped with data. TIP Important to have a smaller group of planning advisors and not name the steering committee off the bat. BARRE/QUABBIN GROUP NAME Quabbin Drug Resistance Unifying Group(Q-DRUG) RESPONDENT Nekr Jenkins,Athol Area YMCA Project Purple Coordinator COUNTY Worcester REGIONAL PARTICIPATION Q-DRUG—see towns below POPULATION(APPROXIMATE) Barre—5,398; Hubbardston—4,382;Oakham—1,902; Hardwick—2,990; New Braintree-999 DATE BEGAN 2014 REASON FOR FOUNDING Had experienced heroin fatalities for a decade;400 people responded to survey to see if community felt it was a problem WHO FOUNDED Chief of police, administration of high school and a town minister MAIN FOCUS All ages but more on middle school and high school;focus is mostly on opioid prevention #OF MEMBERS About 50 at meetings,mostly adults MEETINGS Monthly at senior center COORDINATION/STAFF Purple Project Coordinator and a town selectman;Coordinator is funded by grants from YMCA and Chris Herren/Project Purple FUNDING SOURCES YMCA grant OTHER RESOURCES RECEIVED Technical assistance,data,staff 'i TIP Find like-minded people to start; it's overwhelming for one person Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 617-965-3711 • www.mahealthcouncil.org ►�/EC 29 BERKSHIRE(NORTHERN BER KSHIRE COUNTY) GROUP NAME Berkshire Opioid Abuse Prevention Collaborative(BOAPC) RESPONDENT Lois Daunis, Northern Berkshire Community Coalition(NBCC) Prevention Coordinator and Grants Manager COUNTY Berkshire REGIONAL PARTICIPATION MOAPC,since 2013,county-wide-32 communities broken into 3 sections,one of which is Northern Berkshire POPULATION(APPROXIMATE) North Adams-13,708;Adams—8,485;Clarksburg—1,702 Florida—752;Savoy—692;Williamstown—7,754; New Ashford-228 DATE BEGAN 1999;attention to opioids began 2011 REASON FOR FOUNDING In 2011 NBCC members heard about people who died from or were addicted to opioids WHO FOUNDED Our executive director and staff MAIN FOCUS 50%opioids COORDINATION/STAFF 1 FT and 3 PT FUNDING SOURCES 1999 DPH funding for youth substance abuse prevention (alcohol, marijuana and tobacco),DFC, MOAPC OTHER RESOURCES RECEIVED Technical assistance for online reporting on environmental factors, number of people impacted,etc. And technical assistance for data collection for the strategic prevention framework from MassTAPP. TIP Ask for MassTAPP's help in identifying another coalition that could mentor you. There is some mentoring funding. BROCKTON GROUP NAME Brockton Mayor's Opioid Overdose Prevention Coalition RESPONDENT Hilary Dubois,Coordinator COUNTY Plymouth REGIONAL PARTICIPATION MOAPC EEEE� POPULATION(APPROXIMATE) Brockton—93,810;E. Bridgewater—13,794; Rockland—17,489 Whitman—14,489 DATE BEGAN 2007 REASON FOR FOUNDING Brockton was 51h-highest in state in overdoses WHO FOUNDED Person from High Point Treatment Center and former Mayor MAIN FOCUS 90%opioids #OF MEMBERS 25 regulars at meetings;40 at MOAPC regional meetings COORDINATION/STAFF 1 FT FUNDING SOURCES MassCALL II, MOAPC, DFC OTHER RESOURCES RECEIVED Support in data analysis,communications TIP Do your homework: understand what the issue is,where it started, what services are available,who and how this is impacting the community.As soon as you can,access local data. Massachusetts Health Council, 200 Reservoir Street,Suite 101, Needham,MA 02494 617-965-3711 • www.mahealthcouncil.org ufc 30 BERKSHIRE(NORTHERN BERKSHIRE COUNTY) GROUP NAME Berkshire Opioid Abuse Prevention Collaborative(BOAPC) RESPONDENT Lois Daunis, Northern Berkshire Community Coalition(NBCC) Prevention Coordinator and Grants Manager COUNTY Berkshire REGIONAL PARTICIPATION MOAPC,since 2013,county-wide-32 communities broken into 3 sections,one of which is Northern Berkshire POPULATION(APPROXIMATE) North Adams-13,708;Adams—8,485;Clarksburg—1,702 Florida—752;Savoy—692;Williamstown—7,754; New Ashford-228 DATE BEGAN 1999;attention to opioids began 2011 REASON FOR FOUNDING In 2011 NBCC members heard about people who died from or were addicted to opioids WHO FOUNDED Our executive director and staff MAIN FOCUS 50%opioids COORDINATION/STAFF 1 FT and 3 PT FUNDING SOURCES 1999 DPH funding for youth substance abuse prevention(alcohol, marijuana and tobacco),DFC, MOAPC OTHER RESOURCES RECEIVED Technical assistance for online reporting on environmental factors, number of people impacted,etc. And technical assistance for data collection for the strategic prevention framework from MassTAPP. TIP Ask for MassTAPP's help in identifying another coalition that could mentor you. There is some mentoring funding. BROCKTON GROUP NAME Brockton Mayor's Opioid Overdose Prevention Coalition RESPONDENT Hilary Dubois,Coordinator COUNTY Plymouth REGIONAL PARTICIPATION MOAPC POPULATION(APPROXIMATE) Brockton—93,810;E. Bridgewater—13,794;Rockland—17,489 Whitman—14,489 DATE BEGAN 2007 REASON FOR FOUNDING Brockton was 5th-highest in state in overdoses WHO FOUNDED Person from High Point Treatment Center and former Mayor MAIN FOCUS 90%opioids #OF MEMBERS 25 regulars at meetings;40 at MOAPC regional meetings COORDINATION/STAFF 1 FT FUNDING SOURCES MassCALL II, MOAPC, DFC OTHER RESOURCES RECEIVED Support in data analysis,communications TIP Do your homework: understand what the issue is,where it started, what services are available,who and how this is impacting the community.As soon as you can,access local data. Massachusetts Health Council, 200 Reservoir Street,Suite 101, Needham,MA 02494 617-965-3711 • www.mahealthcouncil.org�K 30 CHARLESTOWN(Boston neighborhood) GROUP NAME Charlestown Substance Abuse Coalition RESPONDENT Sarah Coughlin, Director COUNTY Suffolk POPULATION(APPROXIMATE) 17,052 DATE BEGAN 2004 REASON FOR FOUNDING In 2003 Charlestown had highest heroin overdose rates in Massachusetts WHO FOUNDED Concerned residents,social worker, Massachusetts General Hospital people, police officer, head of Charlestown Against Drugs (a collaborating group) MAIN FOCUS 60%opioids;all ages, 18-25 males were most affected #OF MEMBERS 25 at monthly meetings, plus task forces;total of about 80 in all MEETINGS Weekly COORDINATION/STAFF 4 paid: all full time,3 funded through MGH, 1 through DFC FUNDING SOURCES DFC,MGH, MassCALL II, Boston Public Health Commission, Boston Alliance for Community Health, Determination of Need OTHER RESOURCES RECEIVED Office at Boys&Girls Club(also fiscal agent);MGH Center for Community Development:use their evaluation teams to look at all surveys;Charlestown Health Center(of MGH)to spread word; Schools:allow students to use school time,survey distribution TIP Get out there and pound the pavement. Find out what the community wants.Start where the community is at. Find your natural stakeholders COHASSET GROUP NAME Safe Harbor Cohasset Coalition RESPONDENT Christine Murphy of the Social Service League COUNTY Norfolk REGIONAL PARTICIPATION Norfolk County DA Meetings,CHNA-20,South Shore FACTS POPULATION(APPROXIMATE) 7,542 DATE BEGAN 2014 REASON FOR FOUNDING Several overdoses in town and just outside town WHO FOUNDED Concerned resident(Christine) MAIN FOCUS Combination of cannabis,alcohol and opioids;all ages #OF MEMBERS Number of attendees at first three meetings:60, 68 and 36 COORDINATION/STAFF Christine,who is volunteering FUNDING SOURCES Small grants from Social Service League,CHNA-20, Rotary OTHER RESOURCES RECEIVED One person provided technical assistance for a couple of months, paid for by CHNA paid TIP Get all sectors on board early:school principals,selectman,etc.,a core group and steering committee not dependent on 1 or 2 people I Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham,MA 02494 FFIK 617-965-3711 9 www.mahealthcouncil.org i GROUP NAME DANVERS RESPONDENT DanversCARES COUNTY Jason Verhoosky REGIONAL PARTICIPATION Essex MOAPC with Gloucester and Beverly POPULATION(APPROXIMATE) 26,493 DATE BEGAN 2007;opiate work,2012;earlier used Communities That Care mod REASON FOR FOUNDING YRBS showed increase in usage of prescription painkillers el WHO FOUNDED Public health person and person from the schools MAIN FOCUS # Youth;25%on opioids since MOAPC MEETINGS MEMBERS 30-40 attend meetings;80 total Monthly COORDINATION/STAFF 2 FT, 117 FUNDING SOURCES DFC, BSAS Underage Drinking Grant, Community mental health grants,American Heart Association grants OTHER RESOURCES RECEIVED In-kind matches-tech support and space-from school department TIP and town.support from school committee and town government Do it!Talk to other communities and see who has been successful find what has and hasn't worked to tap your resources and learn from others'mistakes. Have perspective on who/what the community is, unspoken rules and how things operate. Have the Passion to pull community together. GROUP NAME EVERETT RESPONDENT Everett Community Health Partnership-Substance Abuse Coalition Jean Granick, Director COUNTY Middlesex REGIONAL PARTICIPATION MOAPC(Cambridge is lead municipality) POPULATION(APPROXIMATE) Everett-42,935 DATE BEGAN REASON FOR FOUNDING Around 2003 Cambridge Health Alliance acquired Whidden Memorial Hospital;a comprehensive community needs assessment identified substance abuse as a public health priority. � WHO FOUNDED Cambridge Health Alliance in partnershi partners. P wit h city and community MAIN FOCUS Alcohol,tobacco and other drugs,adults and youth; now 25%on #OF MEMBERS opioids. Core group of 50-60 strongly connected and inner core of 15;very MEETINGS large youth sector(Teens in Everett Against Substance Abuse) 2 large meetings a year for entire coalition membership plus working groups on opioids,Youth Networkers, etc. COORDINATION/STAFF 1 FT director, 1 FT coordinator plus an evaluation person FUNDING SOURCES 2-year Robert Wood Johnson Foundation Demand Treatment Grant thru Boston Univ., DFC, MOAPC, HRiA for tobacco efforts,TriCAP (antipoverty agency),federal STOP(Sober Truth on Prevention) OTHER RESOURCES RECEIVED MassTAPP, CADCA, Institute for Community Health provides TIP evaluators,office space/phones from Cambridge Health Alliance Be patient. You may think you're not doing much but doing quite a lot. You maybe doing thing You may be s that bear fruit later on. Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 ►�JK 617-965-3711 • www.mahealthcouncil.orR 1 GROUP NAME DANVERS RESPONDENT DanversCARES COUNTY Jason Verhoosky REGIONAL PARTICIPATION Essex POPULATION(APPROXIMATE) 26,493C with Gloucester and Beverly DATE BEGAN 2007; REASON FOR FOUN opiate work,2012;earlier used Communities That Care model DING YRBS showed increase in usage of prescription painkillers NDED WHO FOU MAIN FOCUS Public health person and person from the schools Youth;25%on opioids sinc M e OAPC MEETINGS# MEMBERS 30-40 attend meetings;80 total COORDINATION/STAFF Monthly FUNDING SOURCES 2 FT, 1 PT DFC, BSAS Underage Drinking Grant,Community mental health grants,American Heart Association grants OTHER RESOURCES RECEIVED In-kind matches-tech support and space-from school department TIP and town.support from school committee and town government Do it!Talk to other communities and see who has find what has and hasn't worked to to s been successful, , from others'mistakes. Have perspective on who/what the ources and from community is,unspoken rules and how things operate. Have the passion to pull community together. GROUP NAME EVERETT RESPONDENT Everett Community Health Partnership-Substance Abuse Coalition COUNTY Jean Granick, Director REGIONAL PARTICIPATION Middlesex MOAPC POPULATION(APPR (Cambridge is lead municipality) ATE BEGAN OXIMATE) Everett-42,935 D Around 2003 REASON FOR FOUNDING Cambridge Health Alliance acquired Whidden Memorial Hospital;a comprehensive community needs assessment identified substance WHO FOUNDED abuse as a public health priority. Cambridge Health Alliance in partnership with city and community MAIN FOCUS Partners. Alcohol,tobacco and other drugs,adults and youth;now 25%on #OF MEMBERS opioids. Core group of 50-60 strongly connected and inner core of 1S;very MEETINGS large youth sector(Teens in Everett Against Substance Abuse) 2 large meetings a year for entire coalition membership plus COORDINATION/STAFF working groups on opioids,toYouth Networkers,etc. FUNDING SOURCES 1 FT director, 1 FT coordinar plus an evaluation person 2-year Robert Wood Johnson Foundation Demand Treatment Grant thru Boston Univ.,DFC, MOAPC, HRiA for tobacco efforts,TriCAP OTHER RESOURCES RECEIVED (antipoverty agency),federal STOP(Sober Truth on Prevention) MassTAPP, CADCA, Institute for Community Health provides the TIP evaluators,office space/phones from Cambridge Health Allia ' Be patient.You may think you're not doing much b nce be doing quite a lot. You may be doing things that bear fruit later on. Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham,MA 02494 nalc 617-965-3711 0 www.mahealthcouncii.orF r FALL RIVER GROUP NAME BOLD(Building Our Lives Drug-free)at SSTAR(Stanley Street Treatment And Resources) RESPONDENT Mike Aguiar, BOLD Coalition Coordinator COUNTY Bristol REGIONAL PARTICIPATION New MOAPC POPULATION(APPROXIMATE) Fall River—88,857;Taunton—55,874; Dighton—7,086 DATE BEGAN 2004 REASON FOR FOUNDING We had a heroin problem—the price went down,quality went up and high school kids started using and experimenting WHO FOUNDED One of our therapists ran across the DFC grant opportunity MAIN FOCUS Youth and parents,today it's 2/3 focus on opioids #OF MEMBERS 200 people attend at least one meeting during the year COORDINATION/STAFF 2 FT,2 PT FUNDING SOURCES DFC, BSAS PFS2(age 18-25 prescription drug abuse prevention), family strengthening grant OTHER RESOURCES RECEIVED MassTAPP provides technical assistance and we will learn from Quincy's MOAPC how to organize the regional coalition TIP Before you take the first step,get the right people at the table and collect the data.Funders will require hard data on the extent of the problem . GREENFIELD GROUP NAME Greenfield Safe Schools,Safe Streets Coalition RESPONDENT Maureen Donovan,Safe Streets Coordinator COUNTY Hampden POPULATION(APPROXIMATE) 1531060 DATE BEGAN 2009,Communities That Care,SAMHSA mentoring grant REASON FOR FOUNDING Substance use prevention in youth WHO FOUNDED Youth Commission person,team from schools appointed by Superintendent MAIN FOCUS Youth; 20%on opioids,80%on alcohol,marijuana,tobacco #OF MEMBERS 25-30 meeting attendees,70 on list MEETINGS Full meeting every other month and steering committee meets in the off-month COORDINATION/STAFF 2 FT,2 PT FUNDING SOURCES DFC,Communities That Care OTHER RESOURCES RECEIVED Mini-grant from The 84 project:$2,000 for tobacco;grant-writing from grant manager who works for schools;volunteering: had over 15,000 volunteer hours in-kind time from coalition members G TIP Having a clear agenda is important: HUGE. People like to come in and know what they will do, have time planned. Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 ni"`� 617-965-3711 0 www.mahealthcouncil.org GROUP NAME HAVERHILL RESPONDENT Haverhill Overdose Prevention and Education Task Force Kim Boisselle, LICSW, Program Director,Structured Outpatient COUNTY Addiction Program,Team Coordinating Agency Essex REGIONAL PARTICIPATION Recently collaborating with Methuen, Lawrence,Andover POPULATION(APPROXIMATE) 60,879 DATE BEGAN 2014 REASON FOR FOUNDING High number of opioid overdoses in city in 2014 WHO FOUNDED Mayor Fiorentini made calls to people to come to meeting MAIN FOCUS 100%on opioids;all ages #OF MEMBERS Average 40 at meetings; 75 on list COORDINATION/STAFF Part-time co-chairs are Kim and Karen Pugh(community member Who works in health care) FUNDING SOURCES None yet—collaborating with Lawrence,Methuen,Andover to get grant OTHER RESOURCES RECEIVED Police Department data; Mayor's office resources;local access TV station to film;grassroots group of family members of those who have died from heroin:they share information on their Facebook group;Greater Lawrence Family Health Center provides Narcan at no cost TIP Do it! People want to help and get involved. GROUP NAME LOWELL RESPONDENT TeenBLOCK Program, Lowell Community Health Center Linda Sopheap Sou, Director COUNTY Middlesex REGIONAL PARTICIPATION Greater Lowell Health Alliance MOAPC POPULATION(APPROXIMATE) 106,519 DATE BEGAN 2007 as Lowell Roundtable on Substance Abuse Prevention REASON FOR FOUNDING Underage drinking and tobacco use WHO FOUNDED Person who worked at Greater Lawrence Healt h Center MAIN FOCUS 50%underage alcohol;50%#OF MEMBERS - opioid overdose prevention Lowell members MEETINGS Meets every other month with regional group;subcommittees COORDINATION/STAFF meet the other month Lowell CHC—1.5 staff FUNDING SOURCES MassCALL II; DFC,Massachusetts Youth Against Tobacco; DA's Office OTHER RESOURCES RECEIVED MassTAPP:training,technical assistance through MOAPC;CADCA: technical assistance, resources, Office of National Drug Control Policy: up to date things that are happening at federal level, we pay for some of it but then get a lot of free things; "High intensive drug trafficking area":focused on law enforcement,federal data sharing; local police department:crime analysis TIP Spend time talking to people individually first to see what their agenda is and what they have already done. Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 now 617-965-3711 9 www.mahealthcouncil.ore r GROUP NAME HAVERHILL RESPONDENT Haverhill Overdose Prevention and Education Task Force Kim Boisselle, LICSW,Program Director,Structured Outpatient COUNTY Addiction Program,Team Coordinating Agency Essex REGIONAL PARTICIPATION Recently collaborating with Methuen, Lawrence,Andover POPULATION(APPROXIMATE) 60,879 DATE BEGAN 2014 REASON FOR FOUNDING High number of opioid overdoses in city in 2014 WHO FOUNDED Mayor Fiorentini made calls to people to come to meeting MAIN FOCUS 100%on opioids;all ages #OF MEMBERS Average 40 at meetings; 75 on list COORDINATION/STAFF Part-time co-chairs are Kim and Karen Pugh(community member who works in health care) FUNDING SOURCES None yet—collaborating with Lawrence,Methuen,Andover to et grant OTHER RESOURCES RECEIVED Pol lice Department data;Mayor's office resources; cessg TV station to film;grassroots group of family members of those who have died from heroin:they share information on their Facebook group;Greater Lawrence Family Health Center provides Narcan at no cost TIP Do it! People want to help and get involved. GROUP NAME LOWELL RESPONDENT TeenBLOCK Program, Lowell Community Health Center Linda Sopheap Sou, Director COUNTY � REGIONAL PARTICIPATION Middlesex Greater Lowell Health Alliance MOAPC POPULATION(APPROXIMATE) 106,519 DATE BEGAN 2007 as Lowell Roundtable on Substance Abuse Prevention REASON FOR FOUNDING Underage drinking and tobacco use WHO FOUNDED Person who worked at Greater Lawrence Health Center MAIN FOCUS 50%underage alcohol;50%opioid ov #OF MEMBERS 30 Lowell members erdose prevention MEETINGS Meets every other month with regional group;subcommittees COORDINATION/STAFF meet the other month Lowell CHC—1.5 staff FUNDING SOURCES MassCALL II; DFC, Massachusetts Youth Against Tobacco; DA,s Office OTHER RESOURCES RECEIVED MassTAPP:training,technical assistance through MOAPC;CADCA: technical assistance, resources, Office of National Drug Control Policy:up to date things that are happening at federal level,we pay for some of it but then get a lot of free things;"High intensive drug trafficking area":focused on law enforcement,federal data sharing; local police department:crime analysis TIP Spend time talking to people individually first to see what their agenda is and what they have already done. Massachusetts Health Council,200 Reservoir Street,Suite 101,Needham, MA 02494 617-965-3711 • www.mahealthcoi,nrii nim II LOWELL(GREATER LOWELL) GROUP NAME MOAPC Greater Lowell Collaborative RESPONDENT Peter Saing,Outrea Worker at Lo ch well Health Dept. COUNTY Middlesex REGIONAL PARTICIPATION Lowell is lead on MOAPC which includes Billerica,Chelmsford, Dracut,Tewksbury,Westford,and Wilmington POPULATION(APPROXIMATE) Billerica—40,243;Chelmsford—33,802; Dracut—29,457 Lowell—106,519;Tewksbury—28,961;Westford—21,951 Wilmington—22,325 DATE BEGAN 2007, now a MOAPC cluster MAIN FOCUS overdose prevention #OF MEMBERS 1 or 2 from each participating MOAPC community MEETINGS Usually meet monthly COORDINATION/STAFF Lowell Health Educator and Lowell Outreach Worker coordinate the MOAPC FUNDING SOURCES Lowell Health Department;MassCALL, MOAPC TIP Build relationships,get key players on your team,have community buy-in. MARTHA'S VINEYARD GROUP NAME Martha's Vineyard Youth Task Force, Dukes County Health Council RESPONDENT k2004 mie Vanderloop COUNTY kes POPULATION(APPROXIMATE) ,535 DATE BEGAN REASON FOR FOUNDING Series of alcohol-related youth fatalities WHO FOUNDED A member of the Dukes County Health Council got a one-year planning grant from Health Imperatives Outcomes Project MAIN FOCUS Youth and also ages 18-26 re alcohol and substance abuse #OF MEMBERS 50 on email list,20-25 attend meetings MEETINGS Monthly coalition meetings and Steering Committee meets weekly COORDINATION/STAFF 2 FT and 10-hour Project Next person FUNDING SOURCES Attorney General Underage Drinking Grant in 2006, BSAS underage drinking grant in 2007, DFC in 2008,Tower Foundation (Project Next) OTHER RESOURCES RECEIVED In-kind from county:office space at county building, MassTAPP technical assistance,CADCA(conferences,evaluation resources) 0 TIP Piggyback on good things already happening in the community. Massachusetts Health Council, 200 Reservoir Street,Suite 101 Needham MA 02 494 617-965-3711 • www.mahealthcouncil.org GROUP NAME NANTUCKET RESPONDENT Alliance for Substance Abuse Prevention(ASAP)COUNTY Catherine Kelly, DFC Grant Director Nantucket POPULATION(APPROXIMATE) 10,399 DATE BEGAN 1995 REASON FOR FOUNDING To deal with alcohol problems on the island WHO FOUNDED Local citizens MAIN FOCUS DFC funding primarily is for youth-focused prevention but 50%of our#OF MEMBERS 20 resources are on opioid crisis COORDINATION/STAFF 1 FT and consultant for TA and data FUNDING SOURCES DFC,a community foundation,Town of Nantucket,golf club OTHER RESOURCES RECEIVED Volunteer help,space at the police department and at the schools TIP Try to reach every facet of the community ce,fire ut also the mom of three teenage boys and even a new mol'm plus well-known local people like local store and restaurant owners. GROUP NAME AIEEDHAM Needham Coalition for RESPONDENT Youth Substance Abuse Prevention Carol Read, Program Director COUNTY Norfolk REGIONAL PARTICIPATION Norfolk County DA meetings POPULATION(APPROXIMATE) 28,88o DATE BEGAN 2009(was off-shoot of suicide prevention coalition) REASON FOR FOUNDING To deal with alcohol and marijuana but later, in 2010,heard ioids from anecdotes about o P WHO FOUNDEDyoung adult surveys State Rep. Denise Garlick,a Needh a��resi�ent,founded the suicide prevention coalition;a consultant and Carol founded the substance abuse coalition MAIN FOCUS All youth through high school. Main focus is alcohol and marijuana but some focus on opioids as well. #OF MEMBERS 20 attend monthly meetings,active communications with 45 and total list of 120 MEETINGS Monthly COORDINATION/STAFF 1 FT, 1 PT and non-paid leadership team FUNDING SOURCES DFC,donations—we put it in a 501c3 OTHER RESOURCES RECEIVED Town provides office space(and is the fiscal agent),office assistant gives her time, Beth Israel Deaconess Needham hospital did survey, free cable production, meeting space at Needham Public Library,all office supply materials, and we get food donations TIP There isn't a quick fix to this:that's why the DFC grants are for u to 10 years(2 five-year periods). p Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 617-965-3711 0 www.mahealthcotinrii pro GROUP NAME NANTUCKET RESPONDENT Alliance for Substance Abuse Prevention(ASAP)COUNTY Catherine Kelly,DFC Grant Director Nantucket POPULATION(APPROXIMATE) 1 ant DATE BEGAN 399 1995 REASON FOR FOUNDING To de;!, with alcohol problems on the island WHO FOUNDED MAIN FOCUS Local citizens DFC funding primarily is for youth-focused prevention but 50%of our resources are on opioid crisis #OF MEMBERS 20 COORDINATION/STAFF 1 FT and consultant for TA and data FUNDING SOURCES DFC,a community foundation,Town of Nantucket,golf club OTHER RESOURCES RECEIVED Volunteer help,space at the police department and at the schools TIP Try to reach every facet of the Community mom of three teenage boys and even a new mol'm plus well-known ce,fire but also e local people like local store and restaurant owners. • NEEDHAM GROUP NAME Needham Coalition for Youth Substance Abuse Preventio t RESPONDENT nCarol Read,Pro COUNTY Norfolk gram Director REGIONAL PARTICIPATION Norfolk County DA meetings POPULATION(APPROXIMATE) 28,886 DATE BEGAN 2009(was off-shoot of suicide prevention coalition) REASON FOR FOUNDING To deal with alcohol and marijuana but later, in 2010,heard WHO FOUNDED anecdotes about opioids from young adult surveys State Rep. Denise Garlick,a Needham resident,founded the suicide prevention coalition;a consultant and Carol founded the substance abuse coalition MAIN FOCUS All youth through high school. Main focus is alcohol and marijuana but some focus on opioids as well. #OF MEMBERS 20 attend monthly meetings,active communications with 45 and total list of 120 MEETINGS Monthly COORDINATION/STAFF 1 FT, 1 PT and non-paid leadership team FUNDING SOURCES DFC,donations—we put it in a 501c3 OTHER RESOURCES RECEIVED Town provides office space(and is the fiscal agent),office assistant gives her time, Beth Israel Deaconess Needham hospital did survey, free cable production, meeting space at Needham Public Library,all office supply materials,and we get food donations TIP There isn't a quick fix to this:that's why the DFC grants are fo 10 years(2 five-year periods). r up to Massachusetts Health Council,200 Reservoir Street,Suite 101,Needham, MA 02494 nft 617-965-3711 0 www.mahealthcoiinril n,n SCITUATE GROUP NAME Scituate FACTS (Families,Adolescents and Communities Together against Substances) RESPONDENT Annmarie Galvin,Co-chair COUNTY Norfolk REGIONAL PARTICIPATION Working with nearby towns,CHNA 20,South Shore FACTS POPULATION(APPROXIMATE) 18,133 DATE BEGAN 2011 REASON FOR FOUNDING Heard whispers about heroin use and heard about a death WHO FOUNDED Annmarie(resident)reached out to police chief,selectman and schools superintendent MAIN FOCUS Youth and young adults,50%opiates,50%other substances #OF MEMBERS 40 people regularly attend or volunteer COORDINATION/STAFF 1 FT and 1 PT staff person plus trainings,equipment rFUNDINGSOURCES DFC SOURCES RECEIVED Town provides office space, phone, IT,payroll accounting Start slowly and do a few good things. Don't worry about funding in the beginning. Can get space and resources from schools,etc. Grants can come later. SOUTH HADLEY GROUP NAME South Hadley Drug and Alcohol Prevention Coalition RESPONDENT Karen Walsh-Pio, Coalition Coordinator COUNTY Hampshire REGIONAL PARTICIPATION MOAPC(Northampton is lead municipality) POPULATION(APPROXIMATE) 17,514 DATE BEGAN Formed in 2005 as task force and became coalition in 2012 REASON FOR FOUNDING A young man who was a high school senior died two weeks before Christmas of a heroin overdose WHO FOUNDED The superintendent of schools called for a task force. Had 300 people at the first meeting. A lot of upset parents were unaware that heroin was in town. MAIN FOCUS Youth;alcohol,marijuana and now 50%focus on opiates #OF MEMBERS About 60 members. 50 came to a retreat and 12 kids came. 15 to 20 come to monthly meetings. MEETINGS Monthly COORDINATION/STAFF 1 FT coordinator, project director who works for the schools, evaluators from Collaborative for Educational Services in Northampton (paid under the DFC) FUNDING SOURCES DFC TIP Do it! It takes a village.These are our children. It's our community. Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 617-965-3711 • www.mahealthcouncil.org 11 Ric GROUP NAME SPRINGFIELD RESPONDENT SCOOP:Springfield Coalition for Opioid Overdose Prevention COUNTY Marie Graves, Project Director REGIONAL PARTICIPATION Hampden POPULATION(APPROXIMATE MOAPC ) DATE BEGAN Springfield-153,060;Chicopee—55,298; Holyoke—39,880 REASON FOR FOUNDING 2008 WHO FOUNDED Opioid overdoses in Springfield MAIN FOCUS Man at city Department of Health and Human Services wrote grant #OF MEMBERS 18-35 year-olds; 100%on opioids 20 consistent collaborative partners;50 others who are"here and MEETINGS there members" Every two-three months COORDINATION/STAFF 1 FT and she could use more coordinators: "if the funding away,the program could go away"because she would be gone and her providing direction would be gone FUNDING SOURCES MaSSCALL2, Partnerships for Success, MOAPC,appl in c OTHER RESOURCES RECEIVED for DFC grant y g urrently MassTAPP technical assistance, meeting space,transportation,food -can get most things because of her relationships with people(first TIP two months,she just visited places and formed relationships) Build relationships. Understand the community what it is. Go to clinics where people are working with act eIon users and then work your way back. Everything else will come. GROUP NAME TEWKSBURY RESPONDENT Greater Lowell MOAPC and Tewksbury CARES COUNTY Police Officer Jenny Welch,Tewksbury Police Department REGIONAL PARTICIPATION Middlesex Greater Lowell MOAPC POPULATION(APPROXIMATE DATE BEGAN � 28,961 Tewkbury CARES started around 2007 and is trying to revamp. Police Department and Board of Health became part of a Greater Lowell Health Alliance Task Force and now,MOAPC REASON FOR FOUNDING In 2012,we went to an event in a nearby community ono ' WHO FOUNDED and we decided to do something in our town. plates MAIN FOCUS Police Department and School Department started latest efforts MEETINGS Mainly youth, 759�on opiates Most meetings are with MOAPC collaborative COORDINATION/STAFF Part-time for Officer Welch,School Department and Healt Department people—it's part of their jobs. h FUNDING SOURCES Put in for a BSAS grant for a FT substance abuse coordinato OTHER RESOURCES RECEIVED Lowell Board of Health materials r TIP People sometimes don't feel comfortable going topic ings in their hometown,so events in nearby towns can be hon this elpful. Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham,MA 02494 �H.' 617-965-3711 0 www.mahealthcouncil.ore GROUP NAME SPRINGFIELD RESPONDENT SCOOP:Springfield Coalition for Opioid Overdose Prevention COUNTY Marie Graves, Project Director REGIONAL PARTICIPATION Hampden MOAPC ) POPULATION(APPROXIMATE)DATE BEGAN Springfield-153,060;Chicopee—55,298;Holyoke—39,880 REASON FOR FOUNDING 2008 WHO FOUNDED OPioid overdoses in Springfield MAIN FOCUS Man at city Department of Health and Human Services wrote grant #OF MEMBERS 18-35 year-olds;100%on opioids 20 consistent collaborative partners;50 others who are"here and MEETINGS there members" Every two-three months CO Every 1 FT and she could use more coordinators:"if the funding away,the program could go away"because she would be gone and FUNDING SOURCES her providing direction would be gone MassCALL2, Partnerships for Success, MOAPC,applying currently for DFC grant OTHER RESOURCES RECEIVED MassTAPP technical assistance,meeting space,transportation,food -can get most things because of her relationships with people(first IF. TIP two months,she just visited places and formed relationships) Build relationships. Understand the community laon what it is. Go to clinics where people are working with c t ve useors and then work your way back. Everything else will come. GROUP NAME TEWKSBURY RESPONDENT Greater Lowell MOAPC and Tewksbury CARES COUNTY Police Officer Jenny Welch,Tewksbury Police Departmen REGIONAL PARTICIPATION Middlesex t POPULATION(APPROXIMATE Greater Lowell MOAPC� 28 DATE BEGAN ,961 Tewkbury CARES started around 2007 and is trying to revamp. Police Department and Board of Health became part of a Greater Lowell Health Alliance Task Force and now,MOAPC REASON FOR FOUNDING In 2012,we went to an event in a nearby community o WHO FOUNDED and we decided to do something in our town. n opiates MAIN FOCUS Police Department and School Department started latest efforts MEETINGS Mainly youth, 75%on opiates Most meetings are with MOAPC collaborative COORDINATION/STAFF Part-time for Officer Welch,School Department and H FUNDING SOURCES Department people—it's part of their jobs. ealth Put in for a BSAS grant for a FT substance abuse coordinator • OTHER RESOURCES RECEIVED Lowell Board of Health materials TIP People sometimes don't feel comfortable going topic in their hometown,so events in nea by towns cant ings be helpful, Massachusetts Health Council 200•+ Reservoir Street,Suite 101,Needham, MA 02494 �K 617-965-3711 • WWw,mahealthcouncil.ore GROUP NAME WESTFORDWestford Health Department and WASA(Westford Against Substance Abuse) RESPONDENT Ray Peachey,Substance Abuse Coordinator for Health Department COUNTY and board member of WASA Middlesex REGIONAL PARTICIPATION Greater Lowell Health Alliance MCAPC POPULATION(APPROXIMATE) 21,951 DATE BEGAN WASA began in 1986 REASON FOR FOUNDING We had a big underage alcohol and marijuana problem. WHO FOUNDED Health Department,School Department and Police Department MAIN FOCUS All residents but mostly youth; Health Department focus is 30%on opioids and WASA is 50%on opioids #OF MEMBERS 13-member board and 10 show up at regular meetings MEETINGS Monthly COORDINATION/STAFF 1 PT coordinator—Ray—who shares coordination with WASA president who is not paid FUNDING SOURCES MOAPC, Nashoba Valley Health Care,one-time SAMHSA grant OTHER RESOURCES RECEIVED In-kind information technology,office space TIP First,do planning and discussion and identify where the problems are. If you get too big too fast, if you falter it will fall apart. Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 EK 617-965-3711 • www.mahealthcouncil.org ( 6wa5 7,4 In addition to the survey respondents from individual and regional coalitions, we wish to thank these individuals for the information, insights and referrals they generously provided. Jennifer Bastille, Crime Analyst/Community Outreach Specialist Taunton Police Department Donald Gallagher, Director Of Community Outreach and Education Northwestern District Attorney's Office Dr. William R. Geary, Deputy Director, Evaluation and Research Community Anti-Drug Coalitions of America (CADCA) Marisa Hebble, MPH, Coordinator Opioid Task Force of Franklin County and the North Quabbin Region Carol Ireland, Co-advisor Violence Intervention and Prevention (VIP) program, Haverhill High School Edward G.Jacoubs, MSW, Director of Grants and Sponsored Programs Plymouth County District Attorney's Office Deborah Milbauer, LCSW, MPH, Community Health Specialist MassTAPP, Education Development Center Jose Morales, Director of Prevention Bureau of Substance Abuse Services, Massachusetts Department of Public Health Paul Muzhuthett, Regional Director Northeast Regional Health Office, Massachusetts Department of Public Health Kate-Marie Roycroft, MSPA, Director of Public Policy Alliance of Massachusetts YMCAs Donald Thompson, Deputy Chief Haverhill Police Department Ryan Walker, Community Coalition Coordinator Norfolk District Attorney's Office Laura Washington, Program Director, BOLD Coalition Stanley Street Treatment and Resources (SSTAR) Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 Ull}� 617-965-3711 0 www.mahealthcouncil.org • r n _ In addition to the survey respondents from individual and regional coalitions, we wish to thank these individuals for the information, insights and referrals they generously provided. Jennifer Bastille, Crime Analyst/Community Outreach Specialist Taunton Police Department Donald Gallagher, Director of Community Outreach and Education Northwestern District Attorney's Office Dr. William R. Geary, Deputy Director, Evaluation and Research Community Anti-Drug Coalitions of America (CADCA) Marisa Hebble, MPH, Coordinator Opioid Task Force of Franklin County and the North Quabbin Region Carol Ireland, Co-advisor Violence Intervention and Prevention (VIP) program, Haverhill High School Edward G.Jacoubs, MSW, Director of Grants and Sponsored Programs Plymouth County District Attorney's Office Deborah Milbauer, LCSW, MPH, Community Health Specialist MassTAPP, Education Development Center Jose Morales, Director of Prevention Bureau of Substance Abuse Services, Massachusetts Department of Public Health Paul Muzhuthett, Regional Director Northeast Regional Health Office, Massachusetts Department of Public Health Kate-Marie Roycroft, MSPA, Director of Public Policy Alliance of Massachusetts YMCAs Donald Thompson, Deputy Chief Haverhill Police Department Ryan Walker, Community Coalition Coordinator Norfolk District Attorney's Office Laura Washington, Program Director, BOLD Coalition Stanley Street Treatment and Resources (SSTAR) Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham,MA 02494 nalc 617-965-3711 0 www.mahealthcouncil.org tom# The Massachusetts Technical Assistance Partnership for Prevention (MassTAPP) provides valuable technical assistance to substance abuse coalitions across the state. MassTAPP has provided the following descriptive information: The Massachusetts Technical Assistance Partnership for Prevention is funded by the Massachusetts Department of Public Health's Bureau of Substance Abuse Services (BSAS) to support communities across the Commonwealth of Massachusetts in addressing substance abuse prevention. Expert staff offers technical assistance, capacity building, and resources BSAS-funded programs and other communities across the state. Critical to successful coalition work is a thoughtful and comprehensive prevention planning process which is data-driven and employs evidence-based strategies.The Strategic Prevention Framework(SPF), developed by the Substance Abuse and Mental Health Services Administration (SAMHSA), is a model planning process that can help communities . achieve high levels of effectiveness and have long-lasting impact.The SPF consists of five steps:Assessment(data gathering to define the local problem), Capacity Building(engaging • coalition partners and securing resources), Planning(using data to identify evidence-based strategies known to be effective), Implementation (enacting chosen strategies), and Evaluation (measuring the impact of the strategies). Important components also include attention to issues of cultural competency and sustainability. The most successful coalitions utilize a community-driven planning process that engages a broad range of voices to make long-lasting community change. • For more information about MassTAPP: www.masstapp.edc.org • For more information on SAMHSA's SPF: http://captus.samhsa.gov/prevention- practice/strategic-prevention-framework • • Massachusetts Health Council, 200 Reservoir Street,Suite 101, Needham, MA 02494 VK 617-965-3711 • www.mahealthcouncil.org -- • AI .F.. ;IVOa t BSAS Bureau of Substance Abuse Services CADCA Community Anti-Drug Coalitions of America CHNA Community Health Network Area (a DPH-established program) DESE Massachusetts Department of Elementary and Secondary Education DFC Drug-Free Communities DPH (or MDPH) Massachusetts Department of Public Health MassTAPP Massachusetts Technical Assistance Partnership for Prevention MassCALL Massachusetts Collaborative for Action, Leadership, and Learning MOAPC Massachusetts Opioid Abuse Prevention Collaborative PDMP Prescription Drug Monitoring Program SADD Students Against Destructive Decisions SAPC Massachusetts Substance Abuse Prevention Collaborative SBIRT Screening, Brief Intervention, and Referral to Treatment SOAP Structured Outpatient Addiction Program SPF Strategic Prevention Framework RWJF Robert Wood Johnson Foundation South Shore FACTS South Shore Families,Adolescents& Communities Together Against Substances SUD Substance Use Disorder SAMHSA Substance Abuse and Mental Health Services Administration • YRBS Youth Risk Behavior Survey • 1 Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 norm 617-965-3711 9 www.mahealthcouncil.org BSAS Bu reau au of Substance Abuse Services CADCA Community Anti-Drug Coalitions of America CHNA Community Health Network Area (a DPH-established program) DESE Massachusetts Department of Elementary and Secondary Education DFC Drug-Free Communities DPH (or MDPH) Massachusetts Department of Public Health MassTAPP Massachusetts Technical Assistance Partnership for Prevention MassCALL Massachusetts Collaborative for Action, Leadership, and Learning I' • MOAPC Massac husetts Opioid Abuse Prevention Collaborative l PDMP Prescription Drug Monitoring Program SADD Students Against Destructive Decisions SAPC Massachusetts Substance Abuse Prevention Collaborative SBIRT Screening, Brief Intervention,and Referral to Treatment SOAP Structured Outpatient Addiction Program SPF Strategic Prevention Framework RWJF Robert Wood Johnson Foundation South Shore FACTS South Shore Families,Adolescents&Communities Together Against Substances SUD Substance Use Disorder • SAMHSA Substance Abuse and Mental Health Services Administration YRBS Youth Risk Behavior Survey I Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham,MA 02494 na% 617-965-3711 0 www.mahealthcouncil.org • • j • MASSACHUSETTS HEALTH COUNCIL • The Massachusetts Health Council is a 501(c)(3) non-profit organization whose mission is to improve and protect the health of the Commonwealth's residents through education, advocacy and policy change,engaging our members in critical discussions and cooperative action. -6 Massachusetts Health Council,200 Reservoir Street,Suite 101, Needham, MA 02494 e 61617-965-3711 • www.mahealthcouncii.org �K of Oa[em. ImaggaCfjUg4ttg Otticc of trye Citp Cnuneil Cftp *aU �clu1ZG� Avve-o 7D CITY OF SALEM BOARD OF HEALTH MEETING MINUTES July 14, 2015 DRAFT MEMBERS PRESENT: Dr. Shama Alam, Chair, Mark Danderson, Janet Greene, &Paul Kirby OTHERS PRESENT: Suzanne Doty, Public Health Nurse, Council Liaison Beth Gerard, David Greenbaum, Sr. Sanitarian, Heather Lyons-Paul Clerk of the Board&Joyce Redford, Dr. NSTAPP EXCUSED: Dr. Danielle Ledoux &Larry Ramdin, Heath Agent TOPIC DISCUSSION/ACTION 1. Call to Order 7:23pm 2. Minutes of Last Meeting Add to minutes discussion Larry or Suzanne will collect (June 9, 2015) data about people entering the hospitals and arrest records for Opiate overdose. P. Kirby motioned to accept the minutes with corrections M. Danderson 2"d All in Favor. Motion Passed J. Greene motioned to take the agenda out of order. P. Kirby 2"d all in favor 3. Chairperson Announcements The status of the home rule petition that will reduce the Board to 5 members is still in state committee. Dr. Alam would like to coordinate the packets getting out in the mail earlier. Some members are not getting theirs until the Monday before the meeting. Dr. Alam would like to keep a direct line of communication open with the Mayor. 4. Monthly P P Re orts-U dates A. Public Health Nurse's *Suzanne Doty updated dated the Board on the MAOPC Salem Report working group meeting. Topics discussed were, current opioid overdose statistics in Salem, plans for community education and outreach and planning for Anonymous People movie viewing in Salem this fall. *The Middleton Jail has started a voluntary Vivitrol injections program These injections will help reduce opioid addictions. *Healthy Street coordinator will be with Suzanne at the Farmers Market next week. Copy available at the BOH office Rodent issue concerns are being address throughout the city. B. Health Agent's Report Copy available at the BOH office • C. Administrative Report Copy available at the BOH office J. Greene motioned to accept reports. P Kirby 2"d All in favor. Motion Passed L D. City Council Liaison Public Safety Council will be keeping the opiate subject on Updates the table as a topic of discussion. 5. Tobacco Hearings Joyce Redford addressed the Board about the violations listed below. a) Sunoco 145 Canal Street 2"d The owner addressed the Board asking that there should be Offense discretions made for the businesses in cases that the suspension will bankrupt the business. He has lost 70%of business due to construction on Canal Street already. The owner runs trainings in house so his staff is trained. Paul Kirby said the Board has no discretionary powers on these regulations. Janet asked if there is there an appeal process. Joyce Redford replied that the Board has 21 days to enact the penalty. Also the owner can appeal the fine at Superior Court but not the suspension. P. Kirby motioned that the permit for Sunoco be suspended for a period of 7 days for repeat violations of Salem Board of Health regulation #24 in accordance with section P, violations. 2"d M Danderson Discussion M. Danderson requested the Board amend the motion to add the dates of suspension. J. Greene motioned that the tobacco permit for Sunoco be suspended for a period of 7 days for repeat violations of Salem Board of Health regulation#24 in accordance with section P,violations for the following dates of • August 4, 2015 to August 10, 2015. 2"d M. Danderson. All in favor. Motion passed b) Global 200 Canal Street 3rd Owner stated The Board should conceder penalizing the Offense store employees for these violations. Joyce Redford discussed with the Board how the inspections are done by her department. Dr. Alam would like to have educational classes available for tobacco control throughout the year for establishments that hold tobacco permits. M. Danderson motioned that the permit for Global be suspended for a period of 30 days for repeat violations starting Aug 1 and ending Aug 30 in accordance with The Salem Board of Health regulation#24 in section P, violations. P. Kirby 2"d All in favor. Motion passed c) North Shore VaporZ 300 North Shore VaporZ did not show for the hearing. Highland Avenue—Request P. Kirby motioned that we issue a fine of$200 for North Shore Vapors for 2 separate violations received on the same day. J. Greene 2"d All in favor motion passed 6. Updates from Joyce Redford *J. Redford addressed the Board about restricting flavored tobacco. She stated that Danvers has regulations against • sales of flavored tobacco now; Beverly and Saugus are considering restrictions as well. The Board is interested in having Joyce come back for a presentation on flavored tobacco/nicotine delivery products. *In 2014, 30 communities in Massachusetts went to the age f restriction of 21+ for tobacco sales. There are now 65 communities that have adopted this age restriction in their regulations. *Joyce will coordinate training programs for the Tobacco Vendor in Salem with Larry Ramdin. 7. Update on North Shore Medical Concerns of emergency preparedness came up in the events Center— emergency preparedness that Spalding is closing and new plans are in place for the vacancy of the building. David Greenbaum informed the Board that NSMC is state mandated to have their own emergency plans in place and because of the state mandate the plans will be updated to reflect the changes happening at the hospital. The City of Salem Board of Health also has their own emergency preparedness plans in place along fire and police. All members of the Board of Health department are certified in ICS and NIMS. Drills are done and overseen by the state for the hospital and the city on a regular basis. If an emergency dispensing sight is needed due to a localized outbreak, plans are in place and if volunteers are needed they will be pulled off a list provide by the Medical Reserve Core (MRC). Anyone can sign up as a volunteer for the MRC. They are always looking for medical and nonmedical volunteers as staff during emergencies and emergency operations. Memorandums of understanding are also signed and on file in case we need more supplies during an emergency. Salem is part of The Regional North Shore/Cape Ann Emergency Preparedness Coalition which is now called Health and Medical Coordinating Coalition(HMCC). The change in the name is due to changes in the way the state is now funding the coalitions. The Board is interested in meeting with the coalition coordinator to discuss more on emergency preparedness. 8. Opiate use epidemic/discussion Suzanne Doty, Public Health Nurse, updated the Board on updates on opiate use, overdose in the MAOPC Salem working group during her report earlier Salem and strategies to reduce in the meeting. 9. New Business/ Scheduling of future Keep opiates on agenda. agenda items Local Board of Health Emergency Preparedness - Invite Coalition Coordinator. 10. MEETING ADJOURNED: J. Greene motioned to not hold an August meeting. M. Danderson 2"d all in favor motion passed. Meeting adjourned 10:00pm Respectfully submitted, Heather Lyons-Paul Clerk of the Board Next regularly scheduled meeting is September 11, 2015 at 7pm At City Hall Annex, 120 Washington Street,Room 312 Salem. i T ' Health Agent report September 2015 Announcements • The City is saddened by the death of City Council Dean and former state Fire Marshal, Councillor Joseph O'Keefe. Community Outreach • Larry Ramdin provided advice on selection of Noise meters , training in use of meters and background noise sampling protocols to the Police Department • We are continuing to plan for the screening of the "Anonymous People"to that end we have acquired 2 copies of the video. • The Health Agent met with representatives of Girls Inc. to discuss the SAPC grant and moving the project forward in Salem Public Health Highlights • Household Hazardous waste day was held on September 26 and over 300 cars brought waste to dispose of at the various collection sites. We collected, hazardous chemicals, batteries, tires, white goods, mercury containing devices,propane cylinders and non-latex paint. • The Department will be pre-occupied with events related to Haunted happenings Meetings and Trainings • Larry Ramdin, David Greenbaum, Elizabeth Gagakis and Jefrey Barosy attended the 53ra Annual Yankee Conference that was held at the Hawthorne Hotel. The Conference brought Environmental Health practitioners from all over New England to Salem. • Larry Ramdin, Health Agent presented at the Yankee Conference on "What's Happening in Food Safety" • Jeffery Barosy and Elizabeth Gagakis completed their Food Inspector training program that was sponsored by the MA Local Public Health Institute. • Larry Ramdin attended the Opioid Summit that was held at the Massachusetts Medical Society, in Waltham MA. The conference discussed the current opiate issue facing the nation and recognized it as a Public Health problem. They discussed strategies including increasing treatment and other tools to treat this public health epidemic. • The Health Agent met with representatives of Girls Inc. and the Lynn Health Director to discuss the SAPC grant and moving the project forward in Salem Inspections Item Monthly Total YTD 2014 Total i i Certificate of Fitness 57 432 559 Inspection Certificate of Fitness 0 4 17 reinspection Food Inspection 18 157 384 i� Food Re-inspections 9 49 124 Retail Food 0 9 23 Inspections Retail Food 0 1 7 reinspection General Nuisance 1 21 14 Inspections Food— 0 0 1 Administrative Hearings Housing Inspections 14 145 183 Housing re- 3 25 39 inspections Rodent Complaints 3 19 23 Court 0 6 10 Hearings/filings Trash Inspections 15 86 218 • Orders served by 0 0 2 Constable Tanning Inspections 0 1 1 Body Art 0 0 1 Swimming pools 0 17 23 Bathing Beach 7 106 100 Inspection/testing Recreational Camps 0 12 14 Lead Determination 0 0 1 Septic Abandonment 0 0 1 • Septic System Plan 0 0 1 Review Soil Evaluation 0 0 1 Percolation tests 0 0 2 Total 128 1318 1739 Suzanne Doty RN, BSN Salem Board of Health Public Health Nurse Public Health Nurse Report Reporting on June 10th, 2015 to September 3rd, 2015 Disease Prevention • Investigated reportable diseases and reported case information to MDPH. • In contact with North Shore Pulmonary Clinic and MGH pulmonary clinic on current active tuberculosis cases. • In contact with NSMC Infection Control department for prevention of disease within the hospital. • Monitored 3 very low risk travelers who came to Salem from Ebola affected countries, temperatures were reported twice daily every day for 21 days and all were compliant and had no signs and symptoms during the potential incubation period. Health Promotion • Updated the Salem Board of Health Facebook and Twitter pages with information on the Farmers Market including a week we would be having Narcan teaching and dispensing and opiate/overdose education and another post for presenting the Bite Lab at our tent. Also posted information about the North Shore Community Health Centers Block Party/Health Fair, International Overdose Awareness day including the observance in Salem and information on the MIIS for vaccine records. • Participated in Public Safety day at the Salem Willows on August 2"d by giving away MyPlates to children and families which teach food proper groups and portions for meals. • Participated in the North Shore Community Health Centers Block Party/Health Fair on August 151h with Mary from the Health Streets Outreach Program, our table featured Narcan, overdose prevention and abuse information, healthy eating and drink magnets, hypertension pamphlets and fast food guides. Meetings/Trainings • On July 16`h attended the Salem REACT meeting to collaborate with Public Safety, the Council on Aging and North Shore Elder services to promote health and wellness for seniors in our community. • On July 281h attended a MIIS Training for updates on the data base and roster entry of vaccinated patients. • On August 111h attended the MAOPC Salem Working Group meeting where we discussed numerous ideas for outreach for overdose prevention. • • On August 20th completed a vaccine reimbursement webinar training to maximize our • reimbursement for vaccine purchasing and administration. • On August 21St met with Dennis Levasseur from Emergency Management to assess the items stored on Emergency Dispensing Site trailer at the High School. • On August 26th met with the activities director at the Council on Aging for wellness clinic planning, I will begin holding a wellness clinic for the seniors on Wednesdays starting September 23�d • On August 3 1"attended the International Overdose Awareness Day observance at Derby Square. We represented the 91 overdoses in Salem by wearing purple shirts and 10 of those people wore black arm bands for those that have passed away. The Mayor and several others spoke about the crisis and coming together to combat it. • On September 2"d met with a student nurse who will be completing her clinical hours for public health with our department beginning in mid-September. She is currently a pediatric nurse and a Salem Resident. Monthly Report of Communicable Diseases July/August 2015 Disease New Carry Over Discharged Total#Of Running Total for Reported Cases this Total for 2014 Month 2015 Tuberculosis 1 1 0 2 3 5 (Active) Latent 2 0 2 2 5 31 Tuberculosis* Babesiosis 1 0 1 1 1 0 Calicivirus/No 0 0 0 0 1 1 rovirus Campylobacte 2 0 2 2 7 10 riosis Chikungunya 0 0 0 0 0 1 Ehrlichiosis 0 0 0 0 0 1 Enterovirus 1 0 1 1 1 0 Giardiasis 0 0 0 0 1 0 Group A 1 0 1 1 3 2 Streptococcus Group B 1 0 1 1 6 6 Streptococcus Human 1 0 1 1 1 0 Granulocytic Anaplasmosis • Haemophilus 0 0 0 0 1 0 Influenzae • Hansen's 0 0 0 0 0 0 Disease Hepatitis B* 0 0 0 0 0 2 Hepatitis C* 5 0 5 5 18 37 Influenza* 0 0 0 0 29 27 Legionellosis 0 0 0 0 0 0 Lyme 0 0 0 0 2 7 Disease* Malaria 0 0 0 0 0 1 Meningitis 0 0 0 0 0 2 Pertussis 0 0 0 0 0 2 Salmonellosis 1 0 1 1 5 3 Shigatoxin 0 0 0 0 0 1 Producing Organism Shigellosis 0 0 0 0 0 4 Streptococcus 1 0 1 1 2 2 Pneumoniae . Varicella* 0 0 0 0 0 3 Vibrio 0 0 0 0 0 0 West Nile 0 0 0 0 0 0 Yersoniosis 0 0 0 0 1 0 Total 17 1 16 18 87 148 *Notifications only, LBOH not required to follow up or investigate per DPH. Summary of Current Communicable Diseases Note: There have been no confirmed cases of Lyme's Disease but 16 suspect or probable cases reported in July and August 2015. There is no follow up required by LBOH. Active Tuberculosis: Case#1: In June, a Salem resident was diagnosed with an active Tuberculosis infection. I accompanied them and their significant other to their first appointment with the pulmonary clinic to complete an assessment, do medication teaching and to explain the process of Directly Observed Therapy and a contact investigation. I began DOT daily following that appointment. They have been very compliant with DOT and are taking their medications without any side effects at this time. They are feelings well and no longer have symptoms of Tuberculosis. I completed a contact investigation and planted PPDs on • all household contacts per the TSA nurse and protocol, contacts with positive results were referred to the pulmonary clinic. Case#2: In August, another Salem resident was diagnosed with active Tuberculosis. They were hospitalized on proper precautions while they were contagious and started on medications. I began DOT with them after they were discharged from the hospital. Their symptoms have improved and they continue to tolerate treatment well. They have been very compliant with DOT and I accompanied them on their first visit to the pulmonary clinic. I will follow up with a contact investigation 8 weeks post exposure per protocol. Babesiosis: This person was tested by their primary care after reporting symptoms of tick borne illness and treated with antibiotics; they reported 2 recent tick bites. Case management from their primary care has been following up and states that this case is feeling well. Campylobacter: Case#1: This case had recently traveled out of state. They stated that none of their contacts have gotten ill. They are currently unemployed and their symptoms have resolved. There is no further follow up required and this case in now closed. Case#2: I was unable to reach this patient by mail or phone and this case has been lost to follow up. There have been no related cases reported. Group A Streptococcus: This case was inpatient at the hospital requiring observation but since recovered. They had not had any recent surgeries or known exposures. No known contacts became ill and preventative symptoms surveillance education was provided to the household. Per DPH there is no further follow up and this case is now closed. Group B Streptococcus: This case reported feeling better while being cared for my homecare nurses and taking an antibiotic regimen, they are homebound and retired. No contacts have become ill. There is no further follow up required and this case is closed. Enterovirus: I did not receive a return phone call after mailing a certified letter and was not able to reach by phone. This case has been lost to follow up. There have not been any other reported cases of enterovirus in Salem. Human Granulocytic Anaplosmosis: This patient was been by their primary care and treated with antibiotics. They did not need to be hospitalized and had a history of tick borne illness. They had recently traveled to Vermont. There is no further follow up required and this case is closed. Streptococcus Pneumoniae: This case was hospitalized and their conditioned improved with treatment. They had received one of the pneumococcal vaccines; I reported all vaccine information to DPH.No known contacts have become ill. There is no further follow up required and this case is now closed. Salmonella: This case had recently traveled out of the country for 2 weeks and became ill towards the end of their stay. They are currently unemployed and have no known contacts that are ill. I educated them on the prevention of spread and they said their symptoms are improving since beginning treatment. There is no further follow up necessary and this case is now closed. 0 Salem Board of Health Tobacco Permit Holder Training Sign- in Sheet Sv-*rn6r Get r 23, 2015 Name( Print) Establishment Address Signature Remarks �—r,� B��.�r� �04 e �z� hlDvocl�vo<•l "`0" �--v3 S t jvc j 1�- rlrU' / Z Lar.1� Avc ,I-e ALLO 6 Alt M e✓�11°7�J��� S � S �/ /L/6 Ix�✓o�-vs� ! ' � v s Salem Board of Health Tobacco Permit Holder Training Sign- in Sheet �23 2015 Name( Print) Establishment Address Signature Remarks os� �Jt , M. RAJ oplld 3 ffvCrfi& t6- 'S PAU � - � 6 `-^1 vAL c r✓ Cf• L �c ��e r