PARTNERSHIP FOR SUCCESS III SUMMARY OF ACTIVITIES FY2016/2017

Transcription

1 Attachment 9 PARTNERSHIP FOR SUCCESS III SUMMARY OF ACTIVITIES FY2016/2017 Lakeshore Regional Entity A summary of activities within the Lakeshore Regional Entity region during FY2017 funded in whole or in part by the Partnership for Success (PFS) III grant serving Mason, Oceana, and Muskegon Counties Report provided by Kori Bissot, KWB Strategies

2 TABLE OF CONTENTS Executive Summary... p. 2 Coalition Development Activities... p. 3 Opioid Prevention Efforts... p. 5 Screening Brief Intervention and Referral (SBIRT)... p. 7 Strengthening Families Program (SFP)... p. 8 Prime for Life (PFL)... p. 10 Community Trials to Reduce High Risk Drinking... p. 11 LRE PFS Metrics Tracking... p. 13 Page 1 of 13

3 EXECUTIVE SUMMARY The Partnership for Success (PFS) III grant is a federal grant received by the Michigan Department of Health and Human Services, Office of Recovery Oriented Systems of Care (OROSC). The PFS project seeks to build healthier communities and increase behavioral health service capacity by strengthening and enhancing community-level infrastructure, linking primary care with effective community coalitions that utilize the Strategic Prevention Framework to address underage drinking among persons age and prescription drug misuse and abuse among persons age Within the LRE region, the counties of Mason, Oceana, and Muskegon were selected by the Michigan Department of Health and Human Services based on selected data indicators to participate in this project. This document will detail the activities of each County during FY17. Coalition Development and Capacity Building: To ensure maximum impact and effective use of PFS resources, PFS efforts are coordinated and driven by county coalitions with the goal of preventing substance abuse and its negative impact in the community. Efforts, funded in whole or in part by PFS, during FY2017 include: Muskegon County: Muskegon County has a well-established coalition, the Coalition for a Drug Free Muskegon. In this community, the primary focus of PFS is to enhance systems and increase screening, brief intervention and referral to services within the healthcare system while sustaining coalition capacity and efficacy. Mason and Oceana Counties: Each county established a coalition and developed a 5-year strategic plan as a result of PFS funding during FY16. During FY17 each county continued building their coalition and worked to formalize procedures, recruit key stakeholders, establish active subcommittees and begin implementation. Interventions and Implementation: During FY17 PFS funds have been used to support the following: Screening Brief Intervention and Referral (SBIRT): SBIRT is an evidence-based practice used to incorporate screening for problematic use of alcohol and illicit drugs through health care settings, followed by a brief intervention by the health care professional and referring the patient to additional services, if appropriate. Prime for Life (PFL): This program uses motivational intervention in a group setting to prevent alcohol and drug problems through early intervention. PFL emphasizes changing participants' perceptions of the risks of drug and alcohol use and related attitudes and beliefs. Instructors use empathy and collaboration to increase participants' motivation to change behavior. Strengthening Families Program (SFP): This program for Parents and Youth works to reduce youth substance use through family skills training. Community Trials to Reduce High-Risk Drinking: Efforts to address underage and young adult alcohol misuse using a collaborative model. This program seek to reduce minor s access to alcohol, improve responsible alcohol retailing, improve visible enforcement, and enhance a community s ability to respond collaboratively to prevent alcohol misuse. Prescription Drug Misuse Prevention: During FY17 each coalition established a workgroup to address the opioid crises. Efforts work to reduce inappropriate over-prescribing of opioid medications, improving community awareness of the risks of prescription opioids, supporting medication disposal to reduce access, improving response to identifying and supporting those experiencing opioid addiction, and enhancing efforts to reduce opioid related overdose deaths. Page 2 of 13

4 COALITION DEVELOPMENT ACTIVITIES As part of PFS efforts the Mason and Oceana Counties established coalitions and developed 5-year strategic plans during FY2016. Since then the coalitions have continued to grow and are using the Strategic Prevention Framework (SPF) to enhance community level infrastructure through linkages with primary care and to address underage drinking and prescription drug misuse and abuse among youth and young adults. Muskegon County has a well-established coalition, The Coalition for a Drug Free Muskegon. Muskegon s focus for PFS is to ensure screening, brief intervention and referral to services within the healthcare system; ensure that early intervention and family skills programming is available in the community to receive referrals; and to reduce underage drinking and youth and young adult misuse of prescription drugs. A summary of efforts funded, in whole or in part, by PFS during FY2017 include the following: Mason County: During FY2016, Mason County engaged 31 active members on their full coalition with additional participants serving on subcommittees and another 81 stakeholders receiving continual information about the group and supporting the coalition as necessary. Participants represent law enforcement, education, the courts, media, youth-serving organizations, behavioral health, healthcare, businesses, and faith-based organizations. Efforts to enhance the coalition include: Recruitment and Engagement: The coalition worked to raise awareness of the coalition and recruit members. Coalition leadership participated in other local collaborative groups to forge connections, presented at community events, conducted outreach to parents at parent-teacher conferences. Needs Assessment: Additional data collection was done to fill data gaps from strategic planning. This included the alcohol workgroup developing and implementing an additional survey with high school students and parents. In addition, the group coordinated with the Medical Examiner and local healthcare providers to update statistics for opiate overdose deaths and reversals in the county. The coalition also worked with local schools to schedule a survey day for the MIPHY implementation to ensure collection of MIPHY data in Subcommittees: Mason established 5 active subcommittees, including the Executive Committee and a workgroup for each goal area of the strategic plan including alcohol, synthetic drugs, marijuana and opioids. Each subcommittee elected a chair to facilitate the group and developed a three-month plan to guide their workgroup s efforts. Muskegon County: The coalition concluded long term strategic planning for the 3 rd time with sessions on June 22 nd, July 20 th, and August 17 th at the Folkert Community Hub and a final session during the coalitions September General meeting on September 6 th. Led by Kori Bissot, the strategic prevention framework (SPF) process developed problem statements, identified intervening variables and explored strategies that were presented to the active work teams for further dissemination. The coalition also revised their mission statement during this planning process resulting in the mission, To reduce substance use disorder in Muskegon County through education, prevention and treatment. Page 3 of 13

5 Data reviewed during planning include the following: Michigan Profile for Healthy Youth, Muskegon County 2008 thru State and national comparisons provided by the Michigan Youth Risk Behavior Survey, 2015 Core Survey of College Students, Muskegon County, 2014 Lakeshore Regional Entity Treatment Episode Data, Muskegon County Residents FY2016 Muskegon County Behavior Risk Factor Survey, county averages Office of the Medical Examiner, Muskegon County, Annual Report 2015 Michigan State Police/Office of Highway Safety Planning, Traffic Crash Statistics Michigan State Police Uniform Crime Statistics Prenatal drug use from MI Vital Statistics and Mercy Healthcare System admissions Michigan Automated Prescription System (MAPS) Hackley Community Care, Rapid Assessment for Adolescent Prevention Services (RAAPS), 2016 Adverse Childhood Experiences, Muskegon County Study, 2016 Focus groups with teens throughout Muskegon County Stakeholder interviews with mental health providers, substance use disorder treatment providers, and law enforcement professionals. Review of this data resulted in prioritization of problem statements for opioid related overdose deaths, teen and young adult alcohol use, maternal smoking, teen and young adult vaping, and teen marijuana use. Once priority problems were established the coalition reviewed the data to determine local conditions contributing to selected problems, and developed targeted strategies for local conditions. The active work teams reviewed their plans, made minor revisions and the coalition is scheduled to vote for final approval at the Executive Committee and general meetings in December Oceana County: Oceana County engaged 17 active members on the full coalition and established an Executive Committee to provide guidance for coalition development with four key stakeholder members. Other subcommittees met throughout the year to work on initiatives of the Strategic Plan including the Alcohol and Marijuana workgroup, Opioid workgroup and a Keep Out work team. Recruitment and Engagement: The coalition worked to raise awareness of the group and recruit members by participating in other local collaborative groups, presenting at community events, and conducting outreach to parents at parent-teacher conferences. Press releases promoting the coalition resulted in two additional members. Personal recruitment meetings were also conducted as appropriate. Needs Assessment: Additional participant data was collected for the Survey of Attitudes about Alcohol and Other Drugs to better understand substance abuse rates and related attitudes. Due to a small sample size Oceana County in 2016 the coalition re-opened the survey and expanded age range to ages 18-45, collecting data from 185 Oceana County residents. Branding: The Executive Committee worked with marketing professionals to create a brand identify for the coalition including a logo, G-mail account and FaceBook page. Page 4 of 13

6 OPIOID PREVENTION ACTIVITIES Local efforts funded in whole or in part during FY17 to prevent opioid abuse and overdoses include the following: Mason County: The Mason County Opioid Task Force met for the first time in April 2017 and has worked to collect additional data, recruited physicians and pharmacists to become involved and to gather their input on how the coalition can support them and to request feedback on task force efforts. With 10 active members, the group is working to reduce stigma of addiction and encourage people in the community to seek treatment. The workgroup continues efforts to engage community members, healthcare professionals, the courts, and local law enforcement in collaborating to address the opioid problem. Highlights include: Media: The coalition worked in partnership with the Oceana coalition to engage local media, the Mason County News, to run a series of articles about the local opioid issue and to promote coalition events and activities to address the opioid issue. Data Collection: Worked with local Medical Examiner to improve tracking and reporting of opioid related overdose deaths and healthcare and law enforcement to track overdose responses. Disposal: An additional medication disposal unit was purchased and installed at the Scottville Police Department in Mason county. Lock Boxes: Efforts to distribute medication lock boxes are underway. Procedures were developed, and staff trained at 5 participating facilities. Distribution will begin early in FY18. Muskegon County: During FY17 the Coalition for a Drug Free Muskegon s Muskegon Area Medication Disposal Project (MAMDP) committee continued efforts to reduce inappropriate access to prescription medications. Efforts work to increase community awareness of the importance of properly monitoring and disposing of medications; providing disposal locations throughout the county; and hosting highly visible take -back events. The MAMDP hosted successful take back events in October and in April in support of the national Drug Enforcement Agency s National Take Back Day. Since this event first began in 2010, Muskegon has collected 29,000+ pounds of medications. In addition, Muskegon County established an opioid task force mid FY2016. Healthwest, the local community mental health, provides staffing to chair the taskforce and administrative support for the group. To date the coalition has garnered 25 members and a goal has been incorporated into the new long-term strategic plan to reduce opioid related overdose deaths in Muskegon County. During FY17 Opioid Task Force efforts include the following: Annual Opiate Summit: In June 2017, the Opioid Task Force hosted the 1sts Annual Opiate Summit with more than 300 participants. A nine-member panel shared their insights on the opioid epidemic and specific measures and initiatives taking place in Muskegon County to combat the epidemic. Panelists included: Steve Alsum, executive director, Red Project Page 5 of 13

7 Pamela Beane, MSW, director of access and correctional services, HealthWest Scott Brown, BSM, certified recovery coach trainer, Recovery Resources of West Michigan Louis Churchwell, clinical supervisor and family counselor, Muskegon County Family Court Huda Fadel, MPH, Ph.D., consulting manager, Social Mission Department, Blue Cross Blue Shield of Michigan Andy Fias, section commander, West Michigan Enforcement Team, Michigan State Police Nate Johnson, re-entry director, 70 x 7 Rica Paulsen, RN, complex care manager, Trinity Health Stephanie VanDerKooi, MPH, CPS-M, interim substance abuse prevention and treatment director, Lakeshore Regional Entity During the summit panelists discussed the following: Medication Assisted Treatment information and local availability Paths to opioid addiction and ease of progression Coalition efforts, highlighting the Opioid Task Force, and how to become involved The Red Project efforts, including what naloxone is, local availability, and training opportunities Peer Recovery Coaches and their importance in supporting recovery from opioids Advocacy for Responsible Prescribing Practices: Dr. Katrina Olsen with Affinia Health Group, has become a local champion for improving prescribing practices within the Mercy Health system after reviewing data on the committee showing that 1.5 opioid prescriptions are written in the county for each resident. She successfully advocated for adoption of the Center for Disease Control s newly released opioid best-practice prescribing practices throughout all of Mercy Health. She also sent a communication to each physician in the Mercy Health Physician Practices (1800 physicians) highlighting their personal rate of opioid prescriptions per consumer and encouraging them to reduce their rate. Oceana County: The Oceana County Opioid Task Force met for the first time in March 2017 and has worked in partnership with the Mason coalition to engage local media to develop and run a three-part newspaper series to highlight the scope of the local opioid problem. This first article worked to engage law enforcement and the court system to share what they are experiencing. Subsequent articles are highlighting an upcoming event hosted by the coalition to engage community members around this issue. The coalition is also partnering with Families Against Narcotics (FAN) to provide a presentation and explore the feasibility of beginning a FAN chapter to serve both Mason and Oceana Counties. Page 6 of 13

8 SCREENING BRIEF INTERVENTION AND REFERRAL (SBIRT) Screening Brief Intervention and Referral (SBIRT) is an evidence-based practice used to identify, reduce and prevent problematic use, abuse and dependence on alcohol and illicit drugs through a process of screening in healthcare settings using standardized tools, a brief intervention by the health care professional for patients engaging in risky substance use behaviors; and referring the patient to additional services, including referrals to Prime for Life and Strengthening Families Programs as appropriate. Local efforts funded in whole or in part during FY17 include the following: Mason and Oceana Counties: Mason and Oceana Counties have begun to work with local healthcare providers to assess current screening and referral practices and determine opportunities for enhancement. It has been identified that Mercy Health conducts their own assessment tool and the coalition will work to support Mercy Health in ensuring appropriate referrals in response to screening results. Northwest Michigan Health Services does not currently use a screening tool and the coalition plans to support them in integrating the SBIRT tool into their practice and establishing referral procedures. They have also researched effective models for implementing SBIRT in a local community and have identified SBIRT Colorado Peer Assistance Services as a resource to assist their communities in developing a plan for comprehensively implementing SBIRT in their community healthcare systems. This resource provides technical assistance to support local communities in setting up an effective SBIRT model. It is anticipated that during FY18 the coalition will begin local training, systemdevelopment and implementation of SBIRT. Muskegon County: Efforts to embed SBIRT throughout Mercy Health continues with efforts to overcome barriers. One challenge during FY17 is that the emergency rooms began implementation of a rapid triage program at the same time as SBIRT and the rapid triage took precedence which limited full implementation of SBIRT. Because of this referrals to treatment continue to be low. To address these issues Muskegon County is working to embed peer support specialists within the emergency room (ER) to improve follow-through and referral to services based on screening results. To support this effort Mercy Life Counseling successfully applied for a grant through the Lakeshore Regional Entity (LRE). Informational Technology enhancements to support effective implementation continue to be identified and addressed. For example, it was found that nurses in the ER were skipping the SBIRT assessment questions, but the IT system did not flag the information as missing in the electronic health record. The State Innovation Model (SIM) initiative incorporates the necessary components to support SBIRT from an IT perspective and create the necessary systems to ensure the screening questions are asked and the follow up is automated. The coalition has established representation on the SIM data meeting to ensure the agenda addresses necessary SBIRT issues moving forward. Mercy Health continues to explore doing SBIRT within primary care and pediatric offices. A local physician, Dr. Sprague, has begun actively advocating within the system to encourage expansion. In addition, the Rapid Assessment for Adolescent Preventive Services (RAAPS) continues to be implemented in Muskegon County at Hackley Community Care with all youth served between ages 12 and 18. The assessment results in a brief printout that continues to be used within their system to identify services within the clinic that may be beneficial to the teen and to encourage participation. Page 7 of 13

9 STRENGTHENING FAMILIES PROGRAM (SFP) This program for Parents and Youth ages works to reduce youth substance use through family skills training. The program includes seven two-hour sessions in which parents and youth meet separately for instruction during the first hour and together for family activities during the second hour. Sessions work to support parents in understanding the risk factors for substance use, to improve parentchild bonding, and to monitor compliance with parental guidelines and setting appropriate consequences and managing anger and family conflict. Children receive instruction on resisting peer influences to use substances. Local efforts funded in whole or in part during FY17 include the following: Mason and Oceana Counties: Training was provided by the LRE for both Mason and Oceana Counties on the 14-week version of Strengthening Families Program. Mason county staff have also received training on the 7-week program and plan to begin offering the program in the 1 st quarter of FY2018 for which 2 referrals have already been received. Oceana County staff will receive training on the 7-week program early in FY18. Muskegon: SFP is provided in Muskegon County by Pathways, a program of Arbor Circle, and funded in part through PFS funds. During FY 2017, efforts continued to build partnerships throughout Muskegon County, to raise awareness of the program, and establish effective referral procedures from community partners. They established relationships with the Great Start Collaborative, Father s Matter Committee, Case Manager s meeting, Youth Homeless Committee, Growing Goods, Good for Youth, and HealthWest (the local CMH). Promotional efforts included digital billboards, a FaceBook ad campaign, and advertising on local buses. They also passed out post cards to promote the Talksooner website where parenting class opportunities are highlighted, including Strengthening Families Program. The campaign achieved 199,290 impressions for the Be a Parent campaign and a total of 1,440 clicks to the webpage. Thirty-two referrals were received including continuing referrals from Mercy Health, the Department of Human Services, schools, hospitals, physician s offices and counseling practices throughout Muskegon. During FY2017, five series of the program were provided serving 27 youth and 18 parents/caregivers. Youth Outcomes: Youth participating in the program reported the following improvements as a group based on the mean scores using a retrospective survey tool designed to capture relationship with parents, resistance skills, stress management, family communication, and rule following. Overall scores show an improvement on 14 out of 15 measures. Highlights from individual questions include: Improvement Indicator 36% I listen to my parent(s)/caregiver(s)' point of view. 24% My parent(s)/caregiver(s) and I can sit down together to work on a problem without yelling or getting mad. Page 8 of 13

10 24% I am able to tell when my parent(s)/caregiver(s) are stressed out or having a problem. 13% I feel truly loved and respected by my parent(s)/caregiver(s). 12% I know what my parents/caregivers think I should do about drugs and alcohol. Parents/ Caregiver Outcomes: Parents and caregivers participating in the program reported the following improvement as a group based on the mean scores using a retrospective survey tool designed to capture communication, setting rules and following through with consequences, nurturing and support, and school involvement. Overall scores show an improvement on all 20 measures. Highlights from individual questions include: Improvement 93% 69% Indicator I wait to deal with problems with my child until I have cooled down. Find ways to keep my child involved in family work activities, like chores. 53% Let my youth know the reason for the rules we have. 44% 37% 35% 35% Help my youth understand what the family and house rules are. Give compliments and rewards when my child does chores a home or learns to follow rules. Work together with my youth to solve problems that come up at home. Let my youth know what the consequences are for breaking rules. 35% Listen to my youth when he or she is upset. 33% Try to see things from my youth's point of view. 31% Talk with my child about ways to resist peer pressure. Page 9 of 13

11 PRIME FOR LIFE (PFL) This evidence-based program uses motivational intervention in group settings to prevent alcohol and drug problems or provide early intervention. Depending on the needs of the participants the program can range from 4.5 to 20 hours in duration. PFL emphasizes changing participants' perceptions of the risks of drug and alcohol use and related attitudes and beliefs. Instructors use empathy and collaboration (methods consistent with motivational interviewing) to increase participants' motivation to change behavior to protect what they value most in life. Participants assess their level of progression toward addiction and develop a detailed plan for reducing risky behavior. Mason and Oceana Counties: Both Mason and Oceana Counties enhanced capacity to deliver Prime 4 Life programming during FY17. Staff were trained, and referral forms were developed and distributed to community partner organizations including schools, local Department of Human Services, and law enforcement and probation officers. Mason County provided one P4L session serving one individual using a one-onone approach. Additional programming is planned during FY18 and the community continues working to improve referrals from the courts and parole system. Muskegon County: Nine series of PFL were provided by Public Health Muskegon County in Muskegon County during FY2017 over 75 sessions and serving a total of 68 individuals. The program was provided to adults in the process of transitioning from jail to home, youth at the Juvenile Transition center, and middle and high school students In the Fresh Start program which serves 14- to 18-year-olds who are enrolled in Muskegon Public Schools and have involvement with the court system. Overall, 41% of PFL participants demonstrated an improvement at post-test. Of the eleven youth participating in the Universal Syllabus, more than one-fourth (27.3%) demonstrated an improvement at post-test with an average of eight sessions attended. Of the twelve youth participating in the eight hour syllabus 25% demonstrated an improvement at post-test with an average of eight sessions attended. Of the nine adults participating in the adult eight-our syllabus 78% demonstrated improvement at post-test with an average of five sessions attended. As the program is newly up and running, the community continues to work to improve referral structures and relationships. Currently all participants were referred by the court system. Page 10 of 13

12 COMMUNITY TRIALS TO REDUCE HIGH-RISK DRINKING This program uses a community mobilization model to reduce underage and high-risk drinking through reduced youth access, responsible beverage service, and increased perceptions of risk for binge drinking and driving after drinking alcohol. Mason County: The Alcohol Workgroup has 7 members and met 3 times during FY2017 to develop a workplan. Implementation efforts are expected to begin in FY2018. Muskegon County: Muskegon continues to implement this program through Muskegon Alcohol Liability Initiative (ALI), a subcommittee of the Coalition for a Drug Free Muskegon. Efforts include strategies to reduce sales of alcohol to minors, over-serving at bars and restaurants, and working to increase awareness of the risks of underage drinking, binge drinking, and of driving while intoxicated. The following efforts were supported in part by the PFS grant during FY17: Party Patrol: As noted in FY16 a tip line was established through a partnership with the Lakeshore Chamber of Commerce s Silent Observer program to serve as the tip-line for reporting underage drinking parties so that law enforcement could intervene. Law enforcement continue to utilize the agreements for a multi-jurisdictional response to ensure safe and effective responses to parties with underage drinking. Awareness of enforcement efforts were promoted through a multi-tiered campaign including billboards, FacetheBook, fliers, posters, and sidewalk graphics. High School Age Public Awareness Campaign: The Coalition for a Drug Free Muskegon continued their public awareness campaign with multiple billboards, fliers, banners and public service announcements for area high school sports events and sports fan materials for distribution at area games to raise awareness about the risks of underage drinking and to support and highlight teens making responsible choices. All schools were sent materials and each participated to varying degrees. A poster competition was conducted with 9 schools participating in the contest. Page 11 of 13

13 College Age Efforts: Multi-jurisdictional efforts were conducted to educate students with media messages throughout the campus as well as an on-line presence. Muskegon ALI, Muskegon Community College and Baker College held several events during National Collegiate Alcohol Awareness Week. In addition to several alcohol prevention social media messages were distributed and local law enforcement provided several opportunities for simulated drunk driving with live driving experiences at MCC in October Alcohol Retailers: Educational information was provided to 104 local alcohol retailers followed by compliance checks with each retailer to ensure they would not sell to minors. A total of 104 compliance checks were conducted during FY17 with only 6 retailers willing to sell to the underage decoy resulting in a compliance rate of 94%. Oceana County: Social Hosting Campaign: The campaign to raise awareness of the legal consequences for providing alcohol to a minor was promoted through distribution of coasters at 10 local bars and restaurants. The coalition also partnered with the local sheriff s department to promote messaging on their electronic message boards. KeepOut Project: The Keep Out work team garnered resources to put together a simulation teen bedroom room to give parents an opportunity to see the ways that teens can hide alcohol or other drugs or paraphernalia. The committee set up the room at the Oceana County Fair and over 150 parents participated in the event. Parents provided feedback that they were shocked and surprised at what they learned. They encouraged coalition members to reach out to more parents and provide additional opportunities for parents to participate in the experience. Page 12 of 13

14 Lakeshore Regional Entity, Partnership For Success Metrics Tracking Indicators Source: MIPHY Youth Survey MASON MUSKEGON OCEANA % recent alcohol use, HS % 18.6% 17.0% 15.9% % ever drank alcohol, HS % 42.3% 43.5% 37.3% % alcohol use before age 13, HS % 11.3% 14.4% 11.6% % report it would be easy to get alcohol, HS % 55.8% 65.1% 55.0% % report binge drinking as lowrisk, HS % 31.6% 31.2% 26.4% % report Rx misuse as low-risk, HS % 25.8% 18.4% 18.7% % family has not discussed alcohol or drug expectations w/ them, HS % 22.8% 21.1% 22.1% Indicators MASON MUSKEGON OCEANA # Opioid overdose deaths* Opioid prescriptions rate per 100 residents Alcohol-related traffic crashes Drug-related traffic crashes Michigan Death Certificates, Division for Vital Records and Health Statistics, MDHHS via Michigan Substance Use Data Repository 2 Michigan Automated Prescription Service via Michigan Substance Use Data Repository 3 Michigan Office of Highway Safety Planning via Michigan Substance Use Data Repository Page 13 of 13