Allegany County: Minutes from Oct. 26 Heroin/Opioid Strategic Session

ALLEGANY COUNTY HEROIN & OPIOID STRATEGIC SHARPENING SESSION 
October 26, 2017 NOT APPROVED
Committee Members Present: J. Hopkins (Chairman), L. Ballengee, M. Biddle, A. Buchholz, M. Carbone, J. Chaffee, V. Grant, L. Haggstrom, C. Ivers, K. LaForge, K. Monroe, T. O’Grady,W. Penman, B. Riehle, T. Rodgers

Others Present: A. Baird, L. Ballengee, M. Barney, T. Boyde, G. Burstein, C. Crandall, L. Christman, L. Edwards, H. Evans, K. Geffers, L. Hennessy, B. Hetzel, C. Jones, D. Lewis, J. Luckey, C. O’Connor, D. Root, C. Sebastian, J. Tomasi, B. VanHousen, M. Washer, A. Weaver

Media Present: C. Dutton – Cuba Patriot 
Welcome/Introduction:
Chairman Crandall introduced himself to the audience, and on behalf of the Allegany County Board of Legislators, welcomed and thanked everyone for attending. Chairman Crandall stated that we have had this Allegany County Heroin & Opioid Ad Hoc Committee formed and in operation for a while now. A few years ago, we looked at this type of crisis with drugs differently. In a small rural area like ours, we knew there were issues but not to this extent. What we would associate and view as a typical heroin user would have been viewed as “that’s a Rochester, Buffalo, big city problem, and not one here in our small rural area.” Chairman Crandall continued that in talking with our guest Erie County Executive Mark Polancarz, he stated to him that while we’re small and don’t even have a city, what we’ve all been working on is a crisis and epidemic that sees no boundaries and is affecting us negatively all across New York State. Chairman Crandall thanked those that have been involved with the Ad Hoc Committee for their time, effort, and expertise. Chairman Crandall welcomed and thanked Mr. Polancarz and Dr. Burstein for making time to come and visit us in Allegany County.

Heroin & Opioid Ad Hoc Committee Chair Judy Hopkins thanked everyone for coming, stating that we’re honored to have our guests here today to discuss this issue we have going on in our County. Mrs. Hopkins continued that we are here today to learn from experts, take a look at our accomplishments over the last six months, and also to look ahead at our next six months and what we hope to accomplish. Committee Chair Hopkins went to say that the structure of our effort in Allegany County came early in 2016 as the Ad Hoc Committee was appointed out of the Human Services Committee. We gathered experts from all different aspects of the County to come together and start to work on this. From there we contracted with Ardent Solutions because there was so much to do, and so much information to gather. From that relationship with Ardent Solutions, came a report that was compiled on all of our data and recommendations were then given. We’re trying to make an impact, bring awareness and education as well as try to do some advocacy through our County Legislature.

Committee Chair Hopkins introduced Dr. Gale Burstein and provided some background on Dr. Burstein’s career. Dr. Gale Burstein is the Erie County Commissioner of Health and a clinical professor of pediatrics at the State University of New York's School of Medicine and Biomedical Sciences at the University at Buffalo. She holds a B.S. degree in Mathematics and Biology from Union College in Schenectady, NY, received her doctor of medicine (M.D.) degree from State University of New York's (SUNY) School of Medicine and Biomedical Sciences at Buffalo, and gained her Master's in Public Health from Johns Hopkins University School of Public Health, Baltimore, MD, focusing on maternal and child health. In addition, Dr. Burstein is a Fellow of the American Academy of Pediatrics and Society for Adolescent Health and Medicine. Dr. Burstein was appointed the Erie County Commissioner of Health in 2012 where her current focus is on developing strategies to change health care providers' narcotics prescribing practices to prevent opioid addiction in Erie County. She also oversees a groundbreaking program that has significantly increased the availability of naloxone to both first responders and community members that will help in preventing opioid overdose deaths.

Committee Chair Hopkins introduced Erie County Executive Mark Polancarz. Mr. Polancarz has been the Erie County Executive since 2012. In the beginning of 2016, he ordered the creation of the Erie County Opioid Task Force which joined together with local treatment agencies, physicians, first responders, and local experts to prepare a comprehensive plan to address the opioid epidemic. Executive Polancarz served on the joint National Association of Counties League of Cities task force which issued a major report of recommendations which has become a national model. Executive Polancarz is very knowledgeable about this subject, and we are very happy to have him here.

Opioid Addictions Outbreak: A Response to a Public Health Crisis

Dr. Burstein presented a PowerPoint outlining the opioid epidemic and how it’s affecting Erie County. Dr. Burstein stated they do have a larger population so their numbers are larger, but how it affects the County’s population is very similar to them. Dr. Burstein indicated that they are far from solving the problem stating it will take years to get out of it, just like it took years to get to this point. Dr. Burstein discussed responding to the heroin epidemic using a three step approach of Prevent, Reduce, and Reverse. To prevent people from starting heroin they need to reduce prescription opioid painkiller abuse, and identify high-risk individuals early. To reduce heroin addiction, they need to ensure access to Medication-Assisted Treatment (MAT) to treat people addicted to heroin or prescription opioid painkillers using MAT which combines the use of medications with counseling and behavioral therapies. Lastly, to reverse heroin overdoses, they need to the expand the use of naloxone which is a life-saving drug that can reverse the effects of opioid overdose when administered in time.

Dr. Burstein discussed the many successes they have had since starting this task force, indicating their most notable program to come out of it is their 24-hour Addiction Hotline. It has received over 3,000 calls since it began in August 2016. The number for this hotline is 716-831- 7007. Dr. Burstein discussed new projects they are working on, stressing the importance of Buprenorphine and the training and administering of it. They are hoping to have emergency departments trained and certified to administered this drug in the next six months.

Overview and Discussion of “A Prescription for Action”

Erie County Executive Marc Polancarz presented a PowerPoint regarding “A Prescription for Action” to combat this epidemic that is sweeping our country. Executive Polancarz stated this is his eighth presentation across New York State, and the one thing he has learned is that there is no one location that can be considered ground zero. In 2016, Erie County experienced 301 deaths, and he anticipates this year they will show a larger number. Executive Polancarz stressed to the audience that the data we are seeing is not accurate in terms of overdose related deaths, adding there are probably many happening that are going unreported.

Executive Polancarz discussed that our local governments have to set the tone for taking a stance against this epidemic. Executive Polancarz commended Allegany County for taking charge as not every county is doing what we are because they don’t think they have a problem. Executive Polancarz continued that some elected officials don’t want to admit they have a problem, indicating that it’s an epidemic across the country, and if you aren’t admitting you have a problem, you are doing a disservice to your community.

Executive Polancarz discussed focusing on prevention and education, stating if we don’t, then we just have a revolving door policy. Executive Polancarz discussed expanding treatment and the many benefits that could come from making intranasal naloxone widely available as well as increasing the availability of medication assisted treatments. Executive Polancarz indicated there is a lot of criticism for the use of naloxone because it just allows the abuser to get their high, be saved, and then turn around and do it again; however, he views naloxone as the equivalent of a tourniquet saving people from bleeding out, and without the use of naloxone, our death totals would be extremely high.

Executive Polancarz discussed recommendations to public safety and enforcement, indicating that alternatives to incarceration matters because we don’t want them in the system; we want them in treatment. We need to arrest the dealer, and get the drugs off the street, but the user needs to be placed into treatment, not just arrested for overdosing. Executive Polancarz provided an example of a normal citizen obtaining a back injury and subsequently becoming addicted to pain medications and committing a petty crime to get a drug. Should they really be placed into a penitentiary when what they really need is treatment and help.
The meeting was opened up for questions and answers and discussion was had regarding data, criminalizing the act of overdose, the use of ODMAP, as well as President Trump’s declaration and how it will trickle down to the smaller counties.

Ardent Solutions Presentation

Committee Chair Hopkins introduced Ardent Solutions Associate Director Helen Evans who will present on Ardent and the County’s contract with them. Ms. Evans presented a PowerPoint that highlighted what the Heroin & Opioid Ad Hoc Committee has accomplished over these last six months as well as what they hope to achieve in the future. Ms. Evans stated Allegany County’s data is not going to be as rich as we need it to be, adding that it’s one of those pieces we’ve talked about for a long time. Executive Polancarz stated that our numbers are not accurate, in fact, everyone’s are probably inaccurate, adding he knows this because they have a better handle on what is being reported, and one of the biggest complaints that came in was the data.

Ms. Evans discussed the successes of the Heroin & Opioid Ad Hoc Committee as follows:

-           Partnering with PPAC and Allegany County Sheriff’s Office to assist in the expansion of the Prescription Drug Take-Back & Disposal Program. They successfully increased disposal sites from seven to eight with the purchase of a Jones Memorial Hospital Medical Practice Drop Box location. 
-           Increased awareness with Allegany County Rx Drop Box locations via a magnet
-           Implemented the Homebound Rx Pick-Up Program
-           Voices of Allegany County Documentary
-           Special group presentations and trainings
-           Quarterly Chronic Pain Self-Management Workshops
-           Collaborating with the Allegany County Suicide Prevention Coalition Incorporate JustTellOne.org
-           Recognized for efforts at the WNED Press Conference
-           Continued efforts for successful passing of the Tobacco 21 legislation

Dr. Burstein stated that it appears we have made a lot of progress in a short period of time, adding that we’re all in this together, and it is a journey. It took years to get here, and it’s going to take years to recover from it, and sharing ideas, resources, and medication based treatment is how we’re going to get out of it. Executive Polancarz thanked the County, and stated that it is quite apparent that we have a plan in place; however, there is always more to be done, and they are here to help. Heroin & Opioid Ad Hoc Committee member Terrence Rogers acknowledged Ms. Evans and all of her hard work, stating she has a used a tremendous amount of her personal times and deserves to be acknowledged for it. Ms. Evans stated is has truly been a pleasure to work with everyone.

Next Meeting: 
The next regular meeting will be Thursday, November 9, 2017, at 1:00 p.m. in the Legislative Chambers.
Respectfully submitted,
Meghan Washer, Secretary to Clerk of the Board Allegany County Board of Legislators