“Nowhere is our work more urgent and nowhere is there more at stake than with our work on Opioid Crisis.” “No more. Our goal for the year ahead – which we will pursue with partners in prisons, emergency rooms, and needle exchange sites – will be to start effective care at the right place and at the right moment and to save lives.” -Mayor Miro Weinberger
Christina Nolan U.S. Attorney Christina.Nolan@usdoj.gov Joseph McNamara Chief U.S. Probation Officer Joe_mcnamara@vtp.uscourts.gov
CCOA Mis ission Reduce the burden of opioids in our community by creating a coordinated system of care to prevent addiction, treat individuals and their families suffering from substance use disorder and support recovery. CCOA Vis ision A substance abuse prevention, treatment and recovery system of care, that is timely, coordinated and comprehensive
CCOA Executive Committee Mayor Miro Weinberger and UVMMC President & COO Eileen Whalen, Co-Chairs Members: Jane Helmstetter, AHS ; Bob Bick, Howard Center ; Gary DeCarolis, Turning Point ; Jesse Bridges, United Way of Northwest Vermont ; Maureen Vinci, UVMMC ; Brian Lowe, City of Burlington ; Charlie Baker, Chittenden County Regional Planning Commission, Chief Brandon Del Pozo, Burlington Police Department
CCOA Executive Committee The Executive Committee acts as the governance body for the Alliance – reviewing annual plans and budgets, and coordinating with the Action Teams to ensure synergy with the Alliance’s mission and strategic plan.
CCOA Action Teams • Community Level Prevention • Co-Chairs: Mariah Sanderson & Heather Danis • Treatment Access and Recovery Supports • Co-Chairs: Catherine Simonson & Bill Keithcart • Working Recovery • Co-Chairs: Maureen Vinci & Ron Stankevich
• Fiscal Agent: United Way of Northwest Vermont • Backbone Support: Christine Johnson & Kayla Donohue • Collective Impact model
Backbone Support Provides Essential Functions: 1. Providing overall strategic direction 2. Facilitating dialogue between partners 3. Managing data collection and analysis 4. Handling communications 5. Coordinating community outreach 6. Mobilizing funding
5 Conditions of Collective Impact • Common Agenda = Agreed upon actions • Shared Measurement = Measuring results • Mutually Reinforcing Activities = Plan of action • Continuous Communication = Consistent communication • Backbone Support = Coordination
Collective Impact is not just a new flavor of the day, but is a “more disciplined and higher performing approach to achieving large-scale social impact.” If that is the case…how do we do it well? How do we create alignment? How do we sustain the Alliance?
What are the pre-conditions of Collective Impact? 1. Influential champions 2. Adequate financial resources 3. A sense of urgency for change Check, check, check!
Now that the pre-conditions are in place, how do we bring Collective Impact to life? Phase 1: Initiate Action Phase 2: Organize for Impact Phase 3: Sustain Action and Impact
Intangibles of Collective Impact: • Relationship and trust building • Leadership identification and development • Creating a culture of learning
On-going: Attend Opioid Coordination Council meetings and sub-committee meetings; attend Community Collaborative meetings at UVMMC; members of the Community Health Needs Assessment Steering Committee Provide backbone support for the CCOA Action Teams & Executive Committee
March: Prevention Action Team re-boot, Working Recovery Action Team formation, website freshening, newsletter planning April: Planning session with core team, confirm communication strategy, hire part-time admin/communication position
May/June: Finalize strategic goals, including outcomes, half day planning meeting with Prevention Action Team June: • Annual Retreat including Executive Committee, Action Teams, CommStat • ½ day in length • Finalize our shared agenda and outcomes • Networking • Community Conversation: Creating Healthy Communities in an Opioid Era (working title)-first of five forums county-wide
June-August: Begin implementing strategic plan, Conference preparation, plan for legislative agenda for 2019 session September: Chittenden County Opioid Conference
Upcoming Events: May 23 rd at Contois Auditorium 6:30-8:00pm Author event co-sponsored with the City of Burlington: Maia Szalavitz, author of the Unbroken Brain
Next Steps: Ask key questions: How do we keep the work moving forward? How do we include lived experience? How do we ensure we are a county-wide alliance? Provide support for our legislative agenda Solicit funding to support the strategies of the CCOA
Find and like us on Chittenden County Opioid Alliance @OpioidAlliance
Questions?
Contact Information Christine Johnson Executive Director (802) 777-9066 Christine@unitedwaynwvt.org Kayla Donohue Data Analyst Kayla@unitedwaynwvt.org
Data
Recap from March: • Data for Action and Data for Impact • Outline of what we need (on next slide) • Overview of the data we are currently collecting/have access to • Data visualization • Data presentation and discussion Plan for April/May: • Review the feedback • Present some data • Gain access to additional data (spokes*) • Get acclimated to the police data queries • Set some priorities & continue the conversation
What do we need? • Access to accurate data • Measurable research questions o Ex. How do burglary rates correlate with opioid use in Chittenden County from 2013-2017? • Priorities • Prevention • Enforcement • Treatment • Recovery • Desired outcomes or targets • Ex. Reduce burglaries by 20% by 2020.
Overview of Feedback: Prevention: • Entry into addiction • Historic rates of addition and how the opioid “epidemic” is effecting addiction overall Enforcement: • Number of drug seizures • Police and SIREN data pre and post widespread Narcan distribution Treatment: • Assess movement between levels of care • Get a better sense of how many individuals are in treatment • Treatment retention • Hub/Spoke capacity • Workforce turnover rates as they relate to treatment access • Understand incidence of opioid-related health impacts beyond overdoses
2018 ED Encounters coded as “Opioid OD” & “Opioid Poisoning” dip below the historic average in March 30 25 20 15 15 15 14 13 12 11 11 11 10 9 9 10 9 8 8 7 5 0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2018 2015-2017 Average 2015-2017 Min 2015-2017 Max Data Source: University of Vermont Medical Center
A higher percentage of males than females are seen in the UVM Medical Center ED for “Opioid OD” & “Opioid Poisoning” in more recent years 100% 2018 75% 33% 50% 67% 25% Female Male 0% Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 2015 2016 2017 2018 Data Source: University of Vermont Medical Center
20-40 year olds were seen in the UVM Medical Center ED for “Opioid OD” & “Opioid Poisoning” more frequently than other age categories in 2017 70 63 60 50 45 40 30 18 20 12 11 11 10 2 0 0-10 11-20 21-30 31-40 41-50 51-60 >60 Age Category (years) Data Source: University of Vermont Medical Center
Individuals are mostly arriving by ambulance when at the UVM Medical Center ED for “Opioid OD” & “Opioid Poisoning” from 2015 through March 2018 (blank) A total of 433 people 11% were seen between Walk-in 2015 and March 2018 7% Police **Other and Public 1% Transportation were excluded because made up <1% Car 10% Ambulance Assist From 70% Vehicle 1% Data Source: University of Vermont Medical Center
UVM Medical Center Opioid Prescribing Practices Jan 2018- Mar 2018 Data Source: University of Vermont Medical Center
Detailed reporting of the quantity of prescriptions of over 50 pills per prescription at the provider level per quarter Data Source: University of Vermont Medical Center
Opioid Prescriptions over 50 pills per provider by quarter Data Source: University of Vermont Medical Center
Opioid Prescriptions over 50 pills by provider Data Source: University of Vermont Medical Center
SubStat Opioid-Related Overdose Incidents 24 Non-Fatal Opioid-Related Overdose Incidents Among SubStat Partners Since Jan. 4 th 2 Fatal Opioid-Related Overdose Incidents Among SubStat Partners Since Jan. 4 th Data Source: Valcour Incident Report
Challenges with the Data and Caveats • Mislabeled “Classification” • Medical assist vs. overdose; overdose vs. untimely • Duplicates due to additional police response • A second police department arrives to assist • Misleading narrative • When searching for “dead” it doesn’t mean the person is deceased • Inconsistent labeling of “Person Involvement” • POI vs. other vs. victim Data Source: Valcour Incident Report
Preliminary Look at Overdoses Reported to Police April 19, 2017-Today from BPD, SBPD, WPD, CPD, MPD, UVMPD Data Source: Valcour Incident Report
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