Minutes- April 2017

I. Welcome – District Attorney Tim Cruz
  • The DA submitted a testimony in regards to the marijuana law which included his stance on drugged driving, the number of plants for home grows as well as the potency of edibles
  • He acknowledged the work of Dr. Ruth Potee who recently spoke on the topic. He stated that her presentation really focused on the young people in the room in regards to their brain development and IQ levels being affected from marijuana use. She specifically focused on delaying use as long as possible.
  • It was also shared that Plymouth can no longer opt out of home grows, however it is mixed throughout the county because Pembroke for example has put it on their ballot to opt out
    • A representative from Senator deMacedo’s office noted that the debate was around the idea that “the people have spoken and you’re overruling the people”
II.  Sheriff Joe McDonald- Update on the Substance Abuse Program at PCCF
  • This initiative was put into place as a request of the Governor
  • Due to the fact that the criminal population is experiencing a decline, there has been a surplus in secure space including beds, food service, etc. to bolster treatment services
  • MASAC in the past has experienced overcrowding so the overflow from these units were being treated through this program
  • This however is changing within the next week – DOC is now going to house all individuals from MASAC in Bridgewater at the Massachusetts Correctional Institution in Plymouth which is a minimum security facility
  • Plymouth’s site that the Sheriff has been utilizing for overflow will be shut down entirely
  • However the Sheriff plans to keep everything as is in case things don’t go well with this new transition
  • The group discussed their concerns with this change and felt that this would not be good for individuals to be in for their first initial detox – there is a reason for some individuals to be in a secure treatment facility
  • The group noted that this framework might be good for after 2 weeks of detox, but not for the first 6 days
  • The group is interested in the elopement rate of secured detox facilities that are not locked, but alarmed
    • Some members felt that it is probably not as high as you’d think in terms of section 35
  • The DA noted that the county’s opioid fatalities have been on par with last year’s data and have reached a total of 44 since January
  • The U.S. Attorney shared that the main focus of their work recently has been drug crime and violent crime
    • He also noted that their priorities have changed over time and that they are very focused on the opioid epidemic
    • The US Attorney’s Office is comprised of 300 individuals who work with all of the federal law enforcement
    •  The office is hoping to expand their partnerships with state and local law enforcement as well as DA’s Offices
    • They mainly focus on the interdiction piece (supply side) of the issue as opposed to having a public health focus
    • He noted that they are not equipped to tackle the demand side of the issue in terms of treatment, but that they can hopefully learn from the experts at the table
    • The US Attorney noted that this is just the beginning of a partnership that he hopes will develop even further
III.  Atlanta Conference
  • Ed Jacoubs- District Attorney’s Office provided an overview of the 6th Annual National RX Drug Abuse & Heroin Summit that representatives from the county attended
    • In his first year of attending there were about 300 attendees and this year the conference reached a total of about 2400
    • He noted that the first year he attended the conference provided a “wow” factor and with this year being his third time attending, he felt that we as a county are very much so ahead of the ball
    • Attendees heard a lot from politicians and he would have rather heard more from medical professionals
  • Chief Botieri- Plymouth commented on his experience which was all new to him
    • He noted that the county submitted applications to speak and thought that we should have been presenting – next year they are hoping to present on the Plymouth County Outreach Model including Plymouth, EB & Brockton
    • One thing that he really took away from the conference was the Milwaukee presentation on drug-related homicides
    • This presentation went through the process in which they go about prosecuting drug dealers in an opioid related death
    • The DA mentioned there is no written protocol, but that they are trying to work with prosecutors on this matter
    • Chief noted that it is a challenge, but Milwaukee has been very successful and we should definitely look into this further
      • The presentation from the conference is available on the website as well: http://8d257e34b1bb24027a4c-65a58a5843cbd3f04769af604767f4c7.r27.cf2.rackcdn.com/Law%20Enforcement%20Track%205%20WEB%20VERSION%20Drug-Related%20Homicides%20Investigative%20and%20Prosecutorial%20Strategies.pdf
    • The group also noted that legislature would respond at this time in terms of a law that would address this topic – in Milwaukee the law that is in place is referred to as the Len Bias Law
  • Chief Allen- East Bridgewater, said that they are taking all of the phones in drug related cases and that this could be expanded throughout the county
  • Hillary Dubois felt that Plymouth County is already doing the majority of the work that the conference had to offer
    • She also highlighted the Brockton Area Opioid Abuse Prevention Collaborative’s presence on social media during the conference
      • They had over 1500 views on live video streams and over 8000 people engaged
      • It was evident that a variety of individuals were engaged on all of their platforms: Snapchat, Instagram and Facebook
  • Koren Cappiello- Brockton Mayor’s Office / Champion Plan highlighted the need to be utilizing the strengths of peers and those with lived experiences
    • The best session she attended was put on by 2 recovery individuals and felt that this is one of the best ways to educate others
  • Joanne Peterson mentioned that the conference was a bit redundant and that unfortunately there wasn’t anything related to families
  • Lastly, Ed noted that a large part of the conference was related to fentanyl and that the county is definitely experiencing an increase in deaths due to this factor
IV. Subcommittee Reports

A. Public Safety- Presentation on Project Outreach

  • Chief Botieri presented that they have 27 towns with signed MOUs to be a part of the outreach program
  • 4 out of the 5 hospitals have a signed agreements as well
  • Follow-up packets are delivered to the home within 12-24 hours of an overdose as this is a crucial time frame for individuals
  • Individuals are on call to respond to all emails that are sent out notifying if an overdose has occurred
  • Plain clothes officers, a clinician and recovery angel are sent out to the home for follow up
  • 90% of the time they are able to locate the individual and no one turns them away
  • There is a monthly meeting in North and South Plymouth County to discuss these efforts
  • 80-85% of individuals do seek treatment as a result of project outreach
    • They have been able to make this happen due to the collaboration that has been developed – this has helped to get a bed that night or the next day
  • Between Plymouth and EB’s Outreach Centers there have been approx. 700 individuals that have come through the door

B. DATA Subcommittee

  • Pam Kelley and Sean Verano presented on the Regional Database for Project Outreach
    • They shared that this is an effort to bring a unified system of overdose incident documentation and systematic follow-up among all law enforcement agencies in Plymouth County
    • This is a unique system with no other county or state utilizing this kind of real-time database to monitor overdoses and follow-up visits
    • They launched the database on April 10th for the initial trial period after going through many phases of development and a county wide training for Chiefs and Data Designees
    • Since then, they have been testing the database to ensure every police department has access and is able to enter data
    • Kelly Research Associates (KRA) entered all OD incidents from the trial period and all police departments have been asked to back fill OD incident data to January 2017
    • Their hope is to also enter 2016 data in the future
    • Along the way KRA is reviewing all new data that is entered and communicated with department designees about missing data or data entry issues
    • This trial process will continue until approx. May 10th 2017 and the database will then be reviewed to ensure that it is user-friendly and if any changes need to be made
    • Next steps for the database include the development of standardized reports will be created to assist in clearly defining the overdose problem across the county as well as the success of the follow-up protocol
    • A unique feature is the alert system which identifies overdoses happening in other towns – there is a “notify other jurisdiction” option which will allow an email to be sent to representatives in that jurisdiction
    • Other features allow you to sort incidences, show which follow-ups have been completed or if they still need to be done
      xii. You can also sort by name which allows for real time conversations to take place
  • Next Steps:
    • The subcommittee discussed that they do not want to publicly notify the community of this tool and outreach system
    • Hospital data is not included in the database, but they have identified that this is a gap and it is there goal for healthcare to have some access in the future
      • They noted that there were 50 overdoses that occurred that they weren’t aware of because they went through the hospital
    • As funding becomes available they hope to populate the data from 2015-2016 so that they can begin to tell their story and the impact they’ve made with outreach and drop-in centers throughout Plymouth County

C. Medical Subcommittee – Presentation of Position Paper

  • Gabby Peruccio presented highlights from the paper in Dr. Muse’s absence
  • The goal is to disseminate the position paper to the healthcare community through the DA & Sheriff as it is a product of the taskforce
  • Through this avenue the group hopes to encourage dialogue to occur amongst the healthcare community in order to begin pushing the dial
  • The objective of the paper is to provide a background on the epidemic and provide recommendations on how the healthcare community can do their part in reversing it
  • Each section of the paper includes an overview of the topic, recommendations and a summary
  • Sections include:
    • Introduction
    • Understanding the Physiology of Addiction and Social Consequences
      •  Brain disease
      • Teenagers and the developing brain
      • Prescribing Practices and Recommendations
      • Pregnancy, Newborns and Drug-Endangered Children
      • Facility Access
        • Detox
        • ATS (Acute Treatment Services
        • CSS (Clinical Stabilization Services)
        • TSS (Transitional Support Services)
        • Section 35
      • Data Collection
        • Why collect data
        • at what level
        • components of collection
      • Public Awareness – effective communication strategies
      • Emergency Department Outreach – recommendations
      • Hospital and Medical Group Outreach – healthcare professionals role
  • The “ASK” of the group included the question: When and how is this paper going to be distributed throughout Plymouth County?
    • The taskforce will have any further feedback submitted by May 12th so that dissemination of the paper can take place as soon as possible
    • The group suggested transforming the document into multiple mediums in addition to distributing it to all healthcare professionals
    • Some members mentioned taking key highlights and utilizing graphic design/social media to disseminate the information in other creative ways
    • They also said to outreach to our already existing partnerships within the hospitals and utilize their expertise to identify which avenues it should be disseminated
    • One member suggested making this a commitment of the hospitals for CME’s – we could utilize the paper as a framework for hosting a forum for this purpose
    • Once the taskforce’s website is up and running, the medical subcommittee will have their own tab and can post it on there as well

D.  Education Subcommittee Report

  • There were a variety of colleges represented at the BSU Substance Abuse Summit
  • A highlight of the Summit were all of the best-practices shared, in particular the SBIRT and Naloxone training
  • Recently, Naloxone has been strategically placed on Quincy College campuses
  • Only administrators have access – students do not
  • On June 22nd 160 Athletic Trainers will take part in a 6 hr training which will be sponsored by the taskforce

E.   Community Coalitions Report

  • Koren Cappiello reported that to date the Champion Plan has serviced 365 unique individuals and has made 528 placements
  • Hillary Dubois presented several initiatives that have been implemented by the Brockton Area Opioid Abuse Prevention Collaborative (BAOAPC)
  • There has been a new partnership developed with Southeastern Technical Institute [Brockton, East Bridgewater, Easton, Foxboro, Mansfield, Norton, Sharon, Stoughton and West Bridgewater]
    • If Only Presentation and Hidden in Plain Sight
    • PhotoVoice began April 25; 10 students, freshman, sophomores and juniors
    • Invited to sit on their drug task force committee
  • There is a Social Host Officer Meeting that takes place every other month – every town now has a pull up banner with the social host law on it
  • Several youth presentations on alcohol, opioids have taken place including:
    • Boys and Girls Club – 3 sessions
    • DARE/Health classes presentations – 8 classes
    • Bridgewater-Raynham Youth Groups – Student Council 2 times
    • Gay Straight Alliance at Brockton High School
    • Brockton High School – PhotoVoice Documentary 900 students reached
    • YMCA Youth Conference presentation on PhotoVoice
    • Pre-Prom Mandatory Event for Juniors and Seniors at East Bridgewater Junior/Senior High School
    • There has been a standing monthly school meeting put in place in the towns of East Bridgewater, Rockland and Whitman Hanson
  • The BAOAPC has conducted several guidance and nurse focus groups to discuss substance use concerns within the school – resource boxes have been created by the BAOAPC and have been delivered to each office
  • Brockton Housing Authority Partnership; Training Resources of America and New Heights Charter
  • The BAOAPC has partnered with BSU to support several initiatives:
    • Substance Use Disorders Summit –
      • Presentations on how we got here
      • Good Samaritan Law
      • Overdose Prevention
      •  Presentation/OD Prevention Training for Social Work Class
  • Rockland Business Leaders Overdose Prevention Training
  •  Whitman Hanson High School Parent Teacher Conferences
  • Outreach to all Funeral Homes in the Collaborative on Safe Guarding their home
  • Regional Meeting held at Bridgewater Pediatrics – truly shows the progress they’ve made
V.  Final Updates
  •  EMS is now providing non-opioid pain relief like, Toradol, to an individual experiencing an emergency as opposed to an opioid like morphine
  • Brewster ambulance has been doing this for a while
VI.  Adjournment