Minutes- December 2015

I.  Welcome from DA Tim Cruz
  • Design of the Plymouth County Model
    • DA acknowledged the uniqueness of the group from a county-wide perspective – we are so diverse – rural, urban, suburban areas coming together
    • Ed Jacoubs made a suggestion to the layout of the taskforce
      • Area coalitions could be shifted from the public safety sub-committee to the data collection sub-committee
      • The DA’s Office works with the coalitions on a frequent basis and are already meeting monthly with each of the area coalitions
  • The group agreed and the DA suggested that we shouldn’t duplicate the work if it is already taking place
  • Since all of the members under public safety have now been moved from Public Safety to Data Collection, who should represent Public Safety with Chief Botieri?
    • The Chief suggested looking into the fire departments and chiefs, Brewster ambulance, etc.
  • There were no other suggestions for making changes to the layout of the taskforce
II.  Subcommittee Reports

A.  Education Sub-Committee

  • The committee has created a timeline for bringing on other members to attend their meetings and they plan to have conversations with both groups of members beforehand
    • K-12 Educators (February)
    • Higher Ed Institutions (March)
  • There have been 15-20 participants on their committee so far, but they would like to build the model out at the institution so that they can be prepared and have a structure
  • They acknowledged that working with K-12 educators is different from the higher ed institutions because they already have connections and experience there
  • They’ve been doing research to see if other schools already have curriculum in place – some curriculum is outdated and there aren’t many indicators that the K-12 model is effective
  • There are many 1 time per year models and K-12 educators are saying that we need a much more comprehensive model – all providers in a child’s life need to be prepared to address opioid prevention
  • Sean Verano notified the group that Brockton has a revised curriculum that has been implemented in grades 6-12 with the addition of prescription education
    • BSU has reviewed their model
  • BSU is working with faculty to improve their own curriculum because they are producing future educators who will need this type of education
  • Questions were raised in regards to proven models for specific age ranges, benchmarking, working with diverse communities
  • BSU mentioned they brought in two experts to their last meeting to educate the group on the overall topic so that they can begin bringing it into the learning community at the college
    • There were good discussions that came after the meeting with their legal council
  • The group questioned whether the Department of Education has created any curriculum, but nothing has been done yet – it seems as though DPH is focused on this
  • The education sub-committee might need to partner with data collection sub-committee because of the outcome measures
  • Institutions are limited in resources, so we want to be successful and have concrete outcomes
  • The Youth Risk Behavior Survey was mentioned which is done on an annual basis
    • Schools are reluctant to share YRBS data to the community, but it needs to be seen as what is the community going to do about the problem and that is why were are at the table to all take a piece
  • BSU is looking at parent organizations, continual of ed, wrap around services, etc.
    • Reaching out to secular type places to compare to more pubic type curriculum

B.  Medical Sub-Committee

  •  Dr. Muse and Peter Holden are working to make changes on the hospital level
    • Nurses will be presenting new material to patients receiving narcotics – Brockton is now doing this and it is encouraged that other local hospitals bring this information back to present to their patients
    • The Section 12 and Section 35 legislation was discussed
      • Everyone with a “problem” is simply going to the ER
      • More beds being taken up with people who don’t want to be there
  • ER doctors treating long term care, withdrawals – this is taking away from other patients seeking help as well
  • Patients using drugs will frequently say they will go to treatment voluntarily so that their Section 12 or 35 is taken away and then they walk out and most likely don’t seek help
  • Dr. Muse noted that the proposal in principle is correct, but practicality is not
  • There are far too many pain meds being distributed for acute care – meds are given out after the problem is fixed which is only causing more problems for the patient
  • Dr. Muse suggested doctors write prescriptions for 1-2 days and if meds are prescribed for more than 3 days’ worth, they will have to call to check up on their patient
  • The Sheriff noted that the medical community needs to know that they have the opportunity to craft this problem and the solution
  • BSU said they will need to reach over to the medical committee as well – educators, physical education teachers need to be exposed to the work that Dr. Muse is doing with SportSmart, parents and families
  • The DA suggested Dr. Muse speak with the Governor to provide suggestions for legislation
  • Muse noted that he has been with three different DA’s to hear his suggestions
  • There is a bill before the house committee that states that police, fire, medics will need to make sure an individual who has overdosed and has been given narcan will need to go to the hospital after to be monitored because they will have been put into withdrawal
  • The committee noted the work that Peter Holden is doing behind the scenes to try and change procedures within the hospital – he will update the taskforce next meeting
  • Muse noted that we need facilities that aren’t managed by a hospital so that they are not seen as detox facilities – “spin dry”
    • Facilities that are close to hospitals for secondary care, but treatment in the ER is not sufficient
  • Sheriff provided an overview of the Section 35 unit in Plymouth
    • Patients first go to the Massachusetts Alcohol and Substance Abuse Center and then the ones that are most likely to succeed are typically sent over to the unit – this does not include voluntary users seeking treatment
    • Sheriff noted that we should be able to do this in every other corrections facility – the numbers are going down and the infrastructure is there
  • The DA noted that we need to get other hospitals on board to provide data to get a truer read on the problem
    • Its more than doubled by the end of December since last year – even with all of the attention on it, that’s why this group is more important than ever
  • Treatment is short
  • Chief Botieri mentioned the importance of the Drug Courts
    • Plymouth is doing section 35’s, but it is short term
    • Drug Court provides split sentences

C.  Data Collection Sub-Committee

  •  The committee noted that they will be where they want to be by next meeting
    • They are working with schools, hospitals, Brewster, emergency rooms to gather data – they need more local hospitals to get on board
    • Pat Nevins presented on a recent grant that the DA’s Office just applied for to support the taskforce through an EOPPS JAG grant focusing on the opioid issue
      • Law enforcement nexus
      • The goals of the grant would be to enhance the capacity of the county to address opioid abuse, reduce the opioid demand, reduce the opioid supply, and to utilize existing treatment services
    • Sean Verano noted the importance of involvement from law enforcement in the recovery process – a more proactive approach
      • Looking at hospice and nursing homes – recovery as a part of close out
      • The police are at the forefront and could focus on this under non committed time – they can be a resource at the community level
  • Chief Botieri noted that there can be issues when recovering drugs from households – documentation and liability that comes into place – sign off and accountability could help to fix this problem

D.  Public Safety Subcommittee

  • Chief Botieri brought up a 3 day old initiative that started in Plymouth which provides intervention for users who’ve overdosed and are vulnerable within that 12-24 hour window
    • A police officer and counselor go out to an individual’s home to check in and provide support within that time frame
    • He will report back to see how well they are doing within a month
III.  Adjournment