Provincial Health Services Authority. Correctional Health Services - Update. Dr. Nader Sharifi Andrew MacFarlane. April 11/2018
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1 Provincial Health Services Authority Correctional Health Services - Update Dr. Nader Sharifi Andrew MacFarlane April 11/2018
2 Similar to FNHA, PHSA covers the entire province of BC
3 Correctional Health Services Reason for the Change October 1 st, 2017 Health Services are previously delivered at 10 Correctional Centres by a for profit service provider. Poor health status of the inmate population Reviews, audits, reports calling for change WHO report (2013) BC Coroner s Report (2014) BC Auditor General Report (2015)
4 Provincial Health Service Authority BC Cancer Agency BC Centre for Disease Control BC Women s and Children s Hospital BC Emergency Health Services BC Renal Agency BC Transplant BC Mental Health and Substance Use Services (including Correctional Health Services).
5 BC Mental Health & Substance Use Services An Agency of the Provincial Health Services Authority Burnaby Centre for Mental Health & Addictions Heartwood Centre for Women Forensic Psychiatric Services Correctional Health Services Provincial Specialized Programs (commissioned) Continuum Research & Knowledge Translation & Exchange Provincial Planning & Strategic Networking Academic Teaching/Training MHSU Literacy (BC Partners)
6 Provincial Correctional Centres Lower Mainland Alouette Correctional Centre for Women (ACCW) Ford Mountain Correctional Centre (FMCC) Fraser Regional Correctional Centre (FRCC) North Fraser Pretrial Centre (NFPC) Surrey Pretrial Services Centre (SPSC) Vancouver Island, Interior, Northern Kamloops Regional Correctional Centre (KRCC) Nanaimo Correctional Centre (NCC) Okanagan Correctional Centre (OCC) Prince George Regional Correctional Centres (PGRCC) Vancouver Island Regional Correctional Centre (VIRCC) NCC PGRCC KRCC ACCW FRCC OCC VIRCC SPSC NFPC FMCC
7 CHS Strategic Direction: improve the quality of health care in provincial correctional centres Eliminate barriers to accessing health care for inmates Implement evidence-based clinical guidelines, standards and practices in Correctional Health Improve the continuity of care by improving transitions between correctional facilities and RHAs, primary care and community services Enhance the skills and clinical competencies of all correctional health disciplines Improve reporting and accountability by developing and tracking performance indicators Prepare and implement Accreditation in 2021 Develop strong partnerships with BC Corrections and Ministry of Public Safety & Solicitor General, RHAs, community providers and other stakeholders
8
9
10 Source: Annual Review of Public Health
11
12 Oct deaths 400 >170 OD deaths in Jan and Feb2016 If we continue, > 1,000 in
13 2010
14 2012
15 2014
16 2016
17 BC Coroners Service Death Review Panel: A Review of Illicit Drug Overdoses, March 28, 2018 OD Deaths Jan 1-Dec 31, 2016 Northern, 52 deaths Death rate per 100,000 = 18.5 OD Deaths Jan 1-July 31, 2017 Northern, 31 deaths Death rate per 100,000 = 18.0 Indigenous persons represent 10% of overdose deaths PGRCC 60-80% indigenous population Sixty-six percent had involvement with BC Corrections 10% died within 30 days of release [OD risk 6-8 times higher than general population 1 week post release]
18 BC Coroners Service Death Review Panel: A Review of Illicit Drug Overdoses, March 28, 2018 Recommendations for Correctional Population on Release Take Home Naloxone Access to drug checking services Linkage to addiction services including opioid agonist treatment
19 Current State of Correctional Health Services Response to Opioid Overdose Epidemic Current State at Correctional Health Services Take Home Naloxone Access and Transition Nurses OAT Nurse MHSU Nurse Expanded OAT clinics Currently 30-35% of population on OAT Reduction in wait list to to zero Matrix and Smart Recovery
20 Release date January 2017
21 What does work for opioid addiction: Opioid Agonist Therapy Methadone Buprenorphine/naloxone (Suboxone ) Treatment duration: usually at least 12 months and then a slow taper
22 Full Agonist (i.e. heroin, methadone, morphine) Partial Agonist (i.e. buprenorphine) Antagonist (i.e. naloxone, naltrexone) Full No activation Less activation No activation
23 Partial Agonist (i.e. buprenorphine/naloxon e - Suboxone) Partial activation
24 Full Agonist (i.e. heroin, methadone, morphine) Partial Agonist (i.e. buprenorphine) This relative difference between full activation of the receptor and partial activation of the receptor is called PRECIPITATED WITHDRAWAL Less Full activation
25 Threshold for Respiratory Depression
26 Increase focus on transitions/ continuity of care
27 Our Vision Where we want to go with CHS Engage clients and internal and external supports in the health care system to increase the quality of primary, mental health, and substance use care in custody and enhance the continuity of care upon release. We want to be able to have established discharge plans so that we can do the warm hand-off and insure that our clients make it to their community physician, their pharmacy to pick up their medications, their mental health team, or treatment centre.
28 Questions
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