Incident Action Plan Community Overdose Action Team (COAT)

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Incident Action Plan (COAT) Operational Period: December 1, 2017 to December 31, 2017 Our goals are to stabilize the number of people dying from drug overdoses; then reduce the number of fatal overdoses.

BACKBONE SUPPORT APPROVAL The following individuals have approved the Incident Action Plan (IAP) for this operational period on December 5, 2017. Name Barbara Marsh Jodi Long Brian Johns Tim Kernan Vanessa Carter Rob Streck Joe Spitler Larry Sexton Janine Howard Jeff Jordan Organization Public Health - Dayton & Alcohol Drug Addiction and Mental Health Services Dayton Police Department Greater Dayton Area Hospital Association Common Pleas Court Sheriff s Office Criminal Justice Council Jefferson Township Fire/EMS Public Health - Dayton & Office of Emergency Management IAP Prepared by: Larry L. Cleek, Planning Chief Date/Time: December 4, 2017 2

Situational Status Report (COAT) 1. Situation to date The COAT now begins year two of its existence. Per the Coroner s Office, there have been 559 accidental overdose deaths from January through November 30, 2017. There has been a decline in the number of monthly deaths since May 2017. On October 26, 2017, U.S. Health and Human Services Acting Secretary determined that the opioid crisis is a public health emergency which will reallocate funding and change policy to address the crisis. The emergency is in effect for 90 days and can be renewed for an undetermined period time. Drug Enforcement Agency launched the 360 Degree Strategy in Dayton. The Power of You, was held on October 16, 2017 at Wright State University Nutter Center. ADAMHS expanded access with Nova Behavioral Health and Samaritan Behavioral Health to do court-ordered assessments inside the Jail. ADAMHS was awarded a SAMSA grant to expand Naloxone support for first responder organizations in Montgomery, Preble and Darke counties. Monthly Media Briefings are scheduled with the Joint Information Center. 2. Actions to date Steering Committee o Last meeting held October 24. o Will meet quarterly. o Provided feedback to the Backbone Support and Operations Branches. Backbone Support o Last meeting held November 7. o Provided feedback on the Operations Branches. Operations Section o Met on November 27. o Branch leads provided a verbal update on progress to date, actions and shared information among members. o Discussed the need to annotate completed actions for Branches. 3

Operations Branches o Education and Information Branch met November 13. o Harm Reduction Branch met November 6. o Treatment and Recovery Branch met November 9. o Collateral Response Branch met November 21. o Criminal Justice Services Branch met November 10. o Prescription Opioid Branch met November 24. o Prevention Branch met November 28. Planning Section o Generated the current IAP. o Attended Operations Branches meeting. Joint Information Center (JIC) o Completed monthly COAT Media Briefing on November 2. 3. Actions to be completed a. Backbone Support o Next meeting is January 2. o Approval of IAP. b. Operations Section o Operations met with all Branches on November 27. o Gather all accomplishments and progress from Branch co-leads. o Offer technical assistance to each of the Branches. c. Planning Section o Gather information for next IAP. o Attend Backbone Support meeting to update on draft IAP. o Attend next Operations Branches meeting. d. Data Unit o Continue to meet as needed and provide data upon request. o Generate drug overdose and death data on a monthly basis. e. Joint Information Center o Working with upcoming requests from media both locally and nationally. o Monthly COAT Media Briefing the first Thursday of each month. 4. Issue(s) 4

On-going Progress Completed Actions During Operational Period Completed Actions Branch Date Completed Recovery Community Organizations (RCO) established and have been visited by architects, distribution of funds will begin soon for facility upgrades. Expanded Booking Project where ADAMHS providers follow-up with individuals quickly, providing services within the Jail (MCJ). Treatment and Recovery Criminal Justice Nov 2017 Jul 2017 Determined alignment of Samaritan Behavioral Health Services with NaphCare services to increase inmate access to diagnostic/connect to treatment need in the jail. Two SBIRT Trainings were completed for Kettering and Premier hospital employees Criminal Justice Prescription Opioid Jul 2017 December 2017 5

GOALS The following goals listed below have been established and approved by the Backbone Support. These goals are in place for the duration of this collective impact approach. 1. Stabilize the number of people dying from drug overdoses. 2. Reduce the number of fatal overdoses. OBJECTIVES The following objectives listed below have been established by the Backbone Support. These objectives are in place to address concerns during this operational period. Objective #1 - Align goals, objectives and activities of existing coalitions and organizations working to address the opioid epidemic and determine gaps. Objective #2 - Improve multi-agency communications through exchange of COATrelated information and situational awareness data. Objective #3 - Expand and focus public information efforts. Objective #4 - Coordinate and improve opioid prevention and education activities. Objective #5 - Improve methods for response, intervention, treatment and recovery efforts. 6

Current Actions 1. Prescription Opioid Branch 1. Researching Accent Health Project, possible Opioid Treatment & Prevention Videos for doctor s offices and Pharmacy waiting areas. 2. Continue to work with WSU to incorporate SBIRT training/experience into Medical Resident program. 3. Working with Prevention Branch exploring how to get Generation Rx into doctor s offices. 3. Introduced a program getting pharmacy interns into the hospitals to talk with patients upon being released. 4. In the process of working with Accent Health to start airing messages in. 5. Change Opiate/Drugs drop zone locations to local Fire Station/EMS (vs. Police Station) as option for community members. May 2017 Nov 2017 Mar 2017 Nov 2017 May 2017 Nov 2017 May 2017 Nov 2017 May 2017 Nov 2017 Jul 2017 Nov 2017 2. Illegal Opioid Supply Control Branch 1. Complete 8 town-hall meetings on opioid crisis and will continue in the coming months. 1. Dayton Police Department and Ohio State Highway Patrol is holding monthly directed patrols to target guns and narcotics. 2. The HERO Operations has had several initiatives that have taken place in the last month. The cases are currently under investigation. 3. Drug Free Coalition Law Enforcement Committee will continue to hold community blitzes. July 2017 Nov 2017 Jan 2017 Dec 2017 Jan 2017 Dec 2017 June 2017 Dec 2017 7

3. Treatment and Recovery Branch 1. Finalize draft version of GAP service recommendation. Nov 2017 Dec 2017 2. Continue data mining in hospital systems concerning clients who need skilled nursing care. 3. Conduct the first training for Recovery Community Organizations (RCO) members on Kernels for Life Prevention Strategies. 4. Continue to work with RCO Organizations to identify appropriate prevention programming. 5. Provide information collected on specific youth programming by local providers. Sept 2017 Dec 2017 Nov 2017 Dec 2017 Nov 2017 Dec 2017 Nov 2017 Dec 2017 4. Prevention Branch # Current Actions 1. Identify more locations and partnerships to run the alternatives to pain management campaign. Aug 2017 Jun 2018 2. Administer a survey to obtain data about the general population s perspectives on prescription pill use, storage, and disposal. GOAL: Obtain 600 completed surveys. As of 11/01/17 a total of 288 surveys have been completed. Mar 2017 Jun 2018 3. Create a survey marketing campaign to obtain a total of 600 survey responses. Currently need 412 surveys. 4. Identify local festivals/events to attend to pass out survey. Goal: gather 150 completed paper surveys. 5. Contact local blood drives, plasma donation sites, medical service providers, and patient waiting rooms to set up a time to complete surveys with individuals. Goal: gather 150 completed paper surveys. Aug 2017 Jan 2018 Aug 2017 Jun 2018 Aug 2017 Jun 2018 8

6. Partner with local universities during health fairs and other community events to distribute paper surveys. Example: Health fairs, Outreach Wednesday on Central State Dayton Campus. Goal: gather 150 completed surveys. 7. Promote information on the prevention of opioid abuse to athletic directors. Aug 2017 Jun 2018 Sep 2017 Jun 2018 8. Promote information on the prevention of opioid abuse to athletic directors. # Planned Actions 1. 2. 3. 4. 5. 6. 7. 8. Develop a public awareness campaign promoting patients advocating for their own health and wellness through an open dialogue with their prescribers. Collaborate with local drug stores and pharmacies to make disposal sites more accessible. Develop a flyer to hand out with every prescription listing all disposal locations. Develop a poster/banner to display disposal site locations. List disposal sites in utility bills, mail orders, and newsletters. Determine the feasibility of working with local pharmacies to get disposal sites listed on the back of each bag/receipt. Determine the feasibility of working with local pharmacies to add a link to disposal site locations in text messages sent out when a prescription is ready. Determine the feasibility of working with pharmacies to add information on disposal sites during automated messages. Aug 2017 Mar 2018 9

5. Harm Reduction Branch 1. Weekly Project DAWN Narcan presentations on Wednesday from 12:00 1:00 p.m. at Elizabeth Place. May 2017 Nov 2017 2. Narcan Education and Distribution intervention of the Nov 2016 Dec 2017 Syringe Services Program has distributed 1,295 Narcan kits. Of the 1,295 kits, 540 kits were re-fills. 3. Continue to distribute Project DAWN kits. Jan 2017 Nov 2017 4. Project DAWN is in the process of setting dates to start weekly Narcan presentations for Project CURE patients. 5. Develop a Survival Tips Card for Drug Overdoses, Abscesses, and other topics. 6. Advertisement of the syringe services program through social media. # Planned Actions 1. Advertisement of the syringe services program through social media. Aug 2017 Nov 2017 Jun 2017 Nov 2017 Jun 2017 Nov 2017 Aug 2017 Dec 2017 2. Purchasing a mobile unit for. June2017 Dec 2017 3. Develop a survival tips card for drug overdoses, abscesses, and other topics. Jun 2017 Dec 2017 6. Education and Information Branch 1. Identify gaps and needs within the community around education/information for addiction. 2. Continue to connect the programming, training, education / information events of the DEA 360 program. Mar 2017 Dec 2017 Sept 2017 Dec 2017 3. Aggregate all events into monthly calendar concerning opioid epidemic. 4. Vet panel requests for education/information on opioid epidemic. Mar 2017 Dec 2017 Jul 2017 Dec 2017 10

5. Continue to work with other branches as requested to incorporate education/information. Sept 2017 Dec 2017 7. Collateral Response Branch 1. Working on efforts to finish protection for K9 officers. 2. Working on improving protection efforts for all first responders. Aug 2017 Dec 2017 Aug 2017 Dec 2017 8. Criminal Justice Services Branch 1. Working with Key Vision TV for generating 3-5- minute video clips for Jail population. 2. Reviewing NaphCare contract to determine jail capability to prescribe Medication Assisted Treatment within Jail. 3. Dayton Adult Probation is examining the possibility of piloting use of URICA Screening Tool to screen probationers. 4. Increase Post Release Protective Factors working with Harm Reduction Branch. 5. ODJFS working on universal county Release of Information without violating HIPAA rules. 6. Investigating the possibility of business agreements to best share information among agencies. 7. Proposals requesting the city to fund two detox beds and vehicle to share between Dayton Fire and Police, and fund a grant writer. # Planned Actions 1. Cooper Complex Charlie Facility 96 beds open to all suggestions and options for potential use. May 2017 Dec 2017 May 2017 Dec 2017 Mar 2017 Dec 2017 Mar 2017 Dec 2017 Aug 2017 Jan 2018 Jul 2017 Jan 2018 Sep 2017 Dec 2017 Oct 2017 Jan 2018 11

The following documents are available upon request: COAT Data Unit Available Data Glossary of Program Definitions Organizational Chart Communications List The documents listed above can be requested from Larry Cleek (Planning Chief) at 225-4483 or Tracy Clare (Operations Chief) at 225-5713. The progress report is now its own stand-alone document and will be generated on a quarterly basis. 12