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ST. MARY’S COUNTY
BOARD OF HEALTH
Jan 23, 2018
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AGENDA
Select Health Topics of Concern
Opioid crisis: data update and discussion of local strategies
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Key Updates from Health Department
Accreditation readinessSMCHD Strategic Plan 2018-2019
County Health Improvement Process –Healthy St. Mary’s Partnership
General updates
OPIOID-RELATED
DRUG INTOXICATION DEATHS
IN ST MARY'S COUNTY
Source: Maryland Office of Chief Medical Examiner & Vital Statistics Administration
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RELATIVE CONTRIBUTIONS OF
DIFFERENT OPIOIDS IN
OPIOID- RELATED DEATHS IN SMC
Source: Maryland Office of Chief Medical Examiner & Vital Statistics Administration
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2017 #s are preliminary
OPIOID-RELATED
EMERGENCY DEPT VISITS BY
ST. MARY’S COUNTY RESIDENTS
Source: ESSENCE Maryland Surveillance system
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AGE DISTRIBUTION % OF OPIOID-
RELATED EMERGENCY DEPT VISITS BY
ST. MARY’S COUNTY RESIDENTS
Source: ESSENCE Maryland Surveillance system
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TOTAL OPIOID PRESCRIPTIONS
FILLED IN ST. MARY’S COUNTY
Source: Maryland Prescription Drug Monitoring Program
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AGE DISTRIBUTION OF ST. MARY’S
COUNTY RESIDENTS
WHO FILLED OPIOID PRESCRIPTIONS
Source: Maryland Prescription Drug Monitoring Program
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THE OPIOID EPIDEMIC:
CONTRIBUTING FACTORS
& REMEDIES
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BASELINE
CONTRIBUTING
FACTORS:
• RISK FACTORS FOR DRUG USE
• STIGMA
• BARRIERS TO EARLY DIAGNOSIS AND ADEQUATE
TREATMENT
• BARRIERS TO ONGOING RECOVERY
Increased
prescribing &
illicit supply
Rise in
heroin use
Introduction of
Fentanyl &
Carfentanil
PREVENT
IMPROVE
EXPAND
EXHANCE
new cases of misuse
early identification
and intervention
access to services
data collection, sharing
and analysis
THE OPIOID EPIDEMIC: REMEDIES 10O
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PREVENT NEW CASES OF MISUSE
DECREASE ADVERSE CHILDHOOD EXPERIENCES
Evidence-based home visiting programs for familiesFirst
ENHANCE YOUTH SOCIO-EMOTIONAL DEVELOPMENT, DECISION-
MAKING,
AND MENTAL WELL-BEING
Expand youth mentoring programs, including in faith-based settings, using
evidence-based curriculum
Thoughtful Decision Making dialogue in schools by adolescent clubhouse staff
School-based curriculum that enhances socio-emotional learning
School-based counseling
SMART kids curriculum by MSAP counselors in select schools
THE OPIOID EPIDEMIC: REMEDIES 11O
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PREVENT NEW CASES OF MISUSE
REDUCE INAPPROPRIATE OR UNNECESSARY OPIOID
PRESCRIBING
AND DISPENSING
Continuing professional education and updates for prescribers
Prescription Drug Monitoring Program (PDMP)
REDUCE ILLICIT OPIOID SUPPLY
Enforcement and prosecution
Drug take-back initiatives and education campaigns
THE OPIOID EPIDEMIC: REMEDIES 12O
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PREVENT NEW CASES OF MISUSE
INCREASE KNOWLEDGE ABOUT OPIOID USE/RISKS
Information for patients at hospital
Public education events, forums, and campaigns
School-based curriculum, counseling and programming
Education for EMS, Fire and Law enforcement
THE OPIOID EPIDEMIC: REMEDIES 13O
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IMPROVE EARLY IDENTIFICATION &
INTERVENTION
REDUCE STIGMA AND IMPROVE KNOWLEDGE AND
UNDERSTANDING ABOUT OPIOID ADDITION
Self-stigma: MARS education and presentations, acknowledge individual
stories of treatment and recovery
Structural stigma: trainings and discussion with health care
providers and public safety
Social stigma: anti-stigma communications campaigns and
discussions
INCREASE UTILIZATION OF SBIRT IN HOSPITALS,
SCHOOLS AND HEALTH CARE PRACTICES
THE OPIOID EPIDEMIC: REMEDIES 14O
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PREVENT NEW CASES OF MISUSE
USE PUBLIC SAFETY, HOSPITALS, HEALTH DEPT AND SOCIAL
SERVICES TO BETTER IDENTIFY AND CONNECT INDIVIDUALS
TO TREATMENT AND RECOVERY SERVICES
Substance use assessment/treatment during pre-trial phase
Expand substance use treatment for those with opioid use disorder in detention
center settings
Implement screening protocols and improve skills of hospital team
in motivating persons with opioid use disorder into treatment
Improve ability of DSS and health department staff to encourage persons
who may benefit from treatment
IMPROVE EARLY IDENTIFICATION &
INTERVENTION
THE OPIOID EPIDEMIC: REMEDIES 15O
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EXPAND ACCESS TO SERVICES
IMPROVE ACCESS TO AND QUALITY OF OPIOID ADDICTION
TREATMENT
AND RECOVERY SUPPORT SERVICES IN THE COMMUNITY
Expand local availability and use of Medication Assisted Treatment
Intensive outreach to those experiencing nonfatal opioid
overdose to encourage treatment.
Increased recovery supports and outreach in community
INCREASE OVERDOSE EDUCATION AND NALOXONE AVAILABLE
TO INDIVIDUALS AT HIGH RISK OF OVERDOSE, THEIR FAMILIES,
FRIENDS, FIRST RESPONDERS, AND SERVICE PROVIDERS
THE OPIOID EPIDEMIC: REMEDIES 16O
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EXPAND ACCESS TO SERVICES
ENHANCE LAW ENFORCEMENT DIVERSION PROGRAMS,
TREATMENT ALTERNATIVES, AND CRIMINAL JUSTICE
SERVICES TO OFFENDERS WITH OPIOID USE DISORDER TO
CONNECT BETTER WITH TREATMENT SERVICES
INCREASE HARM REDUCTION SERVICES AVAILABLE LOCALLY
Expand HIV and Hepatitis C testing services
Research feasibility and build capacity for harm reduction including syringe exchange services
EXPAND ACCESS TO TREATMENT/RECOVERY SERVICES
FOR INMATES WITH SUBSTANCE USE DISORDERS IN
CORRECTIONAL FACILITIES + TRANSITION TO
OUTPATIENT SERVICES UPON RELEASE
PERSONS TRAINED/EQUIPPED WITH
NALOXONE BY SMCHD
(EXCLUDING DETENTION CENTER)
Source: St. Mary’s County Health Department
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THE OPIOID EPIDEMIC: REMEDIES 18O
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ENHANCE DATA COLLECTION,
SHARING & ANALYSIS
IMPROVE OPIOID UNDERSTANDING AND RESPONSE TO
THE EPIDEMIC BY:
Evaluating epidemiological trends
Establishing a public health surveillance system to monitor indicators of opioid-
related morbidity and mortality for informed rapid and actionable response
Improving prevention program operations and initiatives through
data sharing and analysis projects
Conduct ongoing monitoring and evaluation of response initiatives
to ensure successful implementation and outcomes
SMCHD ACCREDITATION
PROJECTED TIMELINE
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Pre-application
• Accreditation Team Formed 11/2014
• Domains Assigned
• Began documentation gathering 6/2014
Application
• Application fee submitted FY17
• Register with PHAB document collection system in summer 2017
Post-application
• Documentation Submission fall 2017-summer 2018
• Site Visit early 2019
• National accreditation 2019
01 02 03
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• To recruit and develop a highly-skilled and diverse workforce.
• Improve internal communications to support a knowledgeable, efficient and customer-oriented workforce.
• Increase the engagement of team members to support and retain a satisfied workforce.
SECONDARY
1. Professional workforce development
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SMCHD AGENCY STRATEGIC PLAN
3 PRIORITIES WITH 10 GOALS
• Educate and inform all residents about public health services.
• Advocate for and implement public health policies.
• Develop and strengthen community partnerships.
2. Public health outreach and leadership
• Increase health department capacity to address health equity.
• Assess health equity in St. Mary’s County.
• Educate community members about health disparities in the county.
• Reduce health disparities in health care access and quality of health care services.
3. Health equity
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Behavioral Health
Access to Care
Healthy Eating & Active Living
Tobacco-Free Living
HealthyStMarys.com21
HEALTHY ST. MARY’S PARTNERSHIP
COMMUNITY HEALTH PRIORITIES
