WECOS April 6, 2018 - Minutes

Regrets:

Guests: (6.1 Community Anti-Stigma Campaign)

Co-Chairs: Dr. Wajid Ahmed and Bruce Krauter

1.0 Introductions Including New Members
Members were welcomed and thanked for their attendance. Introductions were made around the table.

2.0 Agenda Approval
Approved as presented.

3.0 Review of Minutes

3.1 Minutes of January 26, 2018
Approved with no corrections.

4.0 Standing Agenda Items

4.1 Committee Membership and Attendance/Terms of Reference

• New members include Inspector Frank Providenti, Windsor Police Service (WPS) replacing Inspector Jim Farrand. Staff Sergeant Jason Bellaire (WPS) is new to the committee replacing Staff Sergeant Jeff Mailloux.
• The Terms of Reference have been updated and are posted on the health unit website (www.wechu.org) along with WECOS-LC meeting minutes.

4.2 Roundtable Update/Opioid-Related Information Sharing with Community Partners

• Peer Representative A. Malott will be initiating a large youth group.
• She discussed an incident at the U.S. border involving the confiscation of Naloxone. She was alarmed that officials she spoke to were unfamiliar with the Naloxone.
• The review on residential services report at Hotel Dieu Healthcare should be coming out soon.
• An update on behalf of the Windsor Regional Hospital Emergency Department was provided.
• St. Leonards House offers a support group for mothers, wives, etc. associated with males who have been incarcerated.
• The Canadian Mental Health Association (CMHA) is trying to define its role in addiction to be able to do more on mental health related to addictions. They are reviewing the program and looking at capacity and what they can do to support the withdrawal aspect.
• K. Waddell cautioned that the committee needs to be mindful of its name, that there are other substances being discussed besides opioids. She encouraged everyone to keep this in the forefront that the work the committee is doing is really about addictions. The group would not want to send the wrong message to the community that opioids is the only drug of concern. Dr. Ahmed agreed that now with the creation of the opioid strategy and pillar working groups, it should get us to the point that we are able to focus on other drugs, not just opioids.
• At the recent Harm Reduction Conference in Chatham, the AIDS Committee of Windsor was one of the presenting partners along with CMHA and the Chatham-Kent AIDS Committee of Windsor. The US surgeon general, Dr. Jerome Adams issued a national advisory recommending all U.S. residents carry naloxone.
• M. Brennan of the AIDS Committee of Windsor updated on distribution of kits and training.
• Windsor-Essex CHC has been busy working on the Overdose Prevention Site (OPS) and Supervised Injection Site (SIS) applications. The OPS location has been secured next to the Street Health location at 711 Pelissier, Unit 1. Dr. Ahmed is hopeful that this group will have an opportunity to provide letters of support.
• J. Payne has been leading the working group re: the needle disposal kiosks, looking at what type, style, and location, for their purchase.
• E. Nadalin and G. Stager (WECHU) have been busy coordinating working group activities while R. D’Souza and S. Pasha have been working on the opioid monitoring and surveillance piece.
• S. Cipkar reported that most of her work has been on the anti-stigma campaign.
• Despite changes in WPS committee representation (see 4.1), police services have been participating in the Enforcement and Justice working groups.

5.0 Business Arising

5.1 Monitoring and Response System

• S. Pasha presented a PowerPoint to the committee. It provided background on information currently being shared as part of overdose monitoring efforts. He highlighted the intended goals of the proposed overdose early detection system, provided descriptions of the methods that would be used in collecting data, defined cases, identified aberrations and classified alerts based on severity. He also described the different action pathways public health is proposing based on the alert type and the expected response from community partners. An alert classification system is part of a proposed monitoring and response strategy that would need to be discussed by WECOS-LC.
• The Health Unit receives a weekly update on suspect opioid overdoses in Emergency Departments. The proposed plan is to communicate increasing overdose events in the community to provide early direction for local response.
• The hope is that everyone can come forward to tell us the data that is needed and what data they can offer that will help define what the monitoring and surveillance system will look like.
• WECHU’s main data sources are from the Ministry of Health & Long-Term Care (MOHLTC), but it is very limited as far as detail and not timely, and ACES which provides real-time data from emergency departments. SPC is used by the WECHU leadership team. It allows for identification on the severity of opioid overdoses and cases monthly.

Next steps proposed for the early detection system to move forward;

1. Identify key contacts within WECOS-LC to share alerts and receive updates. Who do we send a message to first and how will this be determined?
2. Initiate opioid overdose hotline for first-responders to notify Health Unit after hours.
3. Subscribe for EMCT to obtain monthly naloxone distribution from the MOHLTC in Windsor-Essex County.
4. Formalize timely access to data collected by partners (i.e. EMS, Hospital lab, Police seizures).
5. Conduct additional studies with shared data.

• WECHU is hoping to look for participants to work with its epidemiology team to figure out the method for data transfer and getting real time data. The Health Unit would like to acquire information about all data systems to be able to get some actionable items. Dr. Ahmed asked everyone to consider and respond.
• Surveillance is one piece of the system. The Health Unit needs to get enough information from all relevant partners to create a complete picture about what is happening in the community around substances. This will assist in driving planning.
• J. Thereault, M. Brennan, B. Krauter, and police services expressed an interest in participating in the group.
• Ideally, the Health Unit’s vision is to have a live data system available to community providers minus confidential information, with some additional information that can be shared with partners that would be relevant to them.
  A system for sending alerts will also need to be determined.
• Dr. Ahmed will work to set up a meeting with those who have expressed interest in participating in a committee to develop the system.

ACTION REQUIRED
Representatives to contact Dr. Ahmed or R. St. Denis about their ability to provide data and whether he/she would like to be a part of the committee to look at developing the surveillance and monitoring system.

5.2 Pillar Working Groups-Project Charters and Updates

• There were 13 project charters developed within the four pillar working groups.
• The charters do not have an end date, however they do need to be finalized and approved by the Chairs of the working groups.
• The Chairs of the working groups are as follows:

   

  • 1—HARM REDUCTION WORKING GROUP
    Chairs: Michael Brennan (ACW) & Rita Taillefer (WECHC)
  • 2—TREATMENT AND RECOVERY WORKING GROUP
    Chairs: Patrick Kolowicz (HDGH) & Doris Stillman (House of Sophrosyne)
  • 3—PREVENTION AND EDUCATION WORKING GROUP
    Chairs: Claudia den Boer (CMHA) & Nicole Dupuis (WECHU)
  • 4—ENFORCEMENT AND JUSTICE WORKING GROUP
    Chairs: Al Gibson (Lasalle Police Service) & Jason Bellaire (Windsor Police Service)

Next Steps for the Working Groups

• Further refinement of charters, activities, and indicators
• Finalize 2018 annual plan created
• Continue meetings of working groups (minimum 6/year)
• Provide ongoing support to project leads
• Provide quarterly progress updates to the Leadership Committee

Gaps identified in Windsor-Essex treatment/harm reduction services were raised as follows:

• A huge gap in services for youth, especially the under 16 age group. There are issues with the 12-13 year olds that are not mainstream that need to be addressed. Programs should be geared to younger clients so that they can easier relate to people near their ages.
• There should be something to bridge the time while clients are waiting for recovery services. With a waiting list of 9 months at the House of Sophrosyne, for example, clients need to be kept engaged.
• All the entry pieces re: law enforcement need to be figured out.
• There needs to be more services offered around treatment. Residential treatment should not be the only option. Some individuals going into residential treatment would be better suited for weekend or other non-residential services. As well, more programs for moms and their children are needed. Single parents who do not have support systems have to put their children in care to receive treatment. The House of Sophrosyne in their new facility allows moms to come in with their children.
• We would like people to begin anywhere in the system. The gap is that people get an assessment and then what.

• There was a query about the difference between an Overdose Prevention Site (OPS) and a Supervised Injection Site (SIS). An OPS was described as a small component of a SIS. People can bring their own product to take at a supervised injection site. A SIS provides a place to inject a drug without overdosing as there is someone there to monitor/save lives in the case of overdose. An OPS can address an immediate need in the community as it does not require support personnel like a SIS or community consultation in order to open.
• Dr. Ahmed made the point that as the working groups continue their work, there should be some progress. All the agencies collaborating are working for the same cause and trying to leverage each other to serve the common goal. The Pillar working groups in conjunction with the WECOS-LC are now in a position to take on the actionable items and make them a reality.

6.0 New Business

6.1 Presentation: Community Anti-Stigma Campaign (10:25 a.m. – 10:45 a.m.)

• Kim Levergood provided a PowerPoint presentation on the AIDS Committee of Windsor & Community Renewal Strategy Project: Label Me Person.
• She discussed two initiatives, the anti-stigma community campaign and the public awareness campaign.
• K. Levergood would like to launch the anti-stigma campaign in May to run throughout the summer. She would like to come back to WECOS-LC in January to discuss the community evaluation/lessons learned.
• The anti-stigma campaign falls under a charter of the WECOS-LC Prevention & Education working group.
• Dr. Ahmed encouraged WECOS-LC representatives to register for the pilot workshops and to participate in the panels. He will leave it for the leadership team to connect with K. Levergood.
• S. Cipkar thanked K. Levergood et al. for their work on the project. She also encouraged WECOS-LC to attend the pilot workshops.
• As information becomes available it will be shared with the WECOS-LC.
• It is important for WECOS-LC to be out in the community showing its support.
• The Prevention and Education Chair will take the oversight role for this project.

7.0 Next Steps

• See Next Steps in 5.1 and 5.2.
• Representatives to contact Dr. Ahmed or R. St. Denis about their ability to provide data and whether he/she would like to be a part of the committee to look at developing the surveillance and monitoring system.

8.0 Next Meetings

• Friday, June 22, 2018, 10 a.m. to noon (Health Unit Main Boardroom)
• Friday, September 21, 2018, 1 p.m. to 3 p.m. (Health Unit Main Boardroom)

9.0 Adjournment: 10:47 a.m.