Practice Title: The Power of Partnerships to Address the Opioid Epidemic in Manatee County
Department: Florida Department of Health in Manatee County The Florida Department of Health in Manatee County (DOH-Manatee) is in Bradenton, Florida, along the southwest coast on the Gulf of Mexico. In addition to Bradenton, DOH-Manatee serves 743.1 square miles, including the cities of Palmetto, Anna Maria Island, Bradenton Beach, Holmes Beach, and Lakewood Ranch. The demographics of the population served in Manatee County is as follows: current population is approximately 411,000; seasonal population is 73,000 and annual tourists is approximately 3,180,800. Race: White 86.2%; Black 9.1%; Asian 2.3%. Ethnicity: Hispanic or Latino 16.7%. Gender: male 48.3%; female 51.7%. Median age: 48.7 years. Median household income $56,000. In 2014, Manatee County became the epicenter for the opioid crisis with the highest rate of opioid overdose mortality in the state of Florida. This state of affairs at the time could be attributed to a multitude of reasons, including a lack of public awareness of the risk of prescription opioids and ongoing stigma associated with drug use and opioid use disorder. Manatee County also was and still is challenged by high rates of synthetic opioids, such as fentanyl, in its drug supply. Additionally, treatment options have persistently been limited, awareness of where to seek services is insufficient, and stigmas associated with existing treatment options remain. With funding and technical assistance from National Association of County and City Health Officials (NACCHO) and in collaboration with the Centers for Disease Control and Prevention (CDC), DOH-Manatee was responsible for exploring, planning, and implementing innovative and collaborative approaches to support efforts to combat the opioid crisis within our community with a project, Local Opioid Overdose Prevention and Response (LOOPR) Program that was for the period January 2019 to July 31, 2019. The key goals were to increase the local health department’s (LHD) capacity to reduce fatal and non-fatal opioid overdoses, and to improve the community response to the opioid epidemic. The objectives were to develop and implement a Community Action Plan (CAP) to reduce fatal and non-fatal overdoses and community consequences of the opioid epidemic through prevention, harm reduction, and linkage to care; and monitor and evaluate CAP efforts. DOH-Manatee hosted the CAP meeting on February 14, 2019 with over 60 local, state, national and federal community partners. After discussion and a thorough Strengths, Opportunities, Weakness, and Threat (SWOT) analysis, three themes of prevention, harm reduction, and linkage to care were identified with four strategies to accomplish these themes. The first strategy under prevention included provision of educational classes to medical providers and medical students on opioid prescribing practices; the second and third strategies under the theme of harm reduction included a prescription opioid awareness campaign and provision of a statewide alternatives to opioid (ALTO) toolkit designed by Manatee Memorial Hospital; and, the fourth strategy under the theme of linkage to care included the evaluation of an Opioid-focused Recovery Peer Coach Pilot program. Strategy one outcomes (medical provider and medical student education on opioid prescribing practices) included six classes delivered to a total of 85 health care providers and six classes delivered to a total of 81 medical students. Strategy two outcomes (a prescription opioid awareness campaign) included the provision of a digital and print media campaign via area transit buses, convenience stores and gas stations, Spectrum Cable TV, and local newspaper and movie theater agencies, with a combined reach of over 663,000 impressions/people. Strategy three outcomes (distribution of an ALTO Toolkit) included the actual development of the Toolkit with funding from a local hospital, then distributing the toolkit statewide to hospitals outside of Manatee County. Strategy four outcomes (the evaluation of an Opioid-focused Recovery Peer Coach Pilot program) included better understanding of linkages to care among people with Opioid Use Disorder (OUD), i.e. the receipt of referrals, receipt of resources, and follow up to treatment. The objectives to develop and implement a CAP to reduce fatal and non-fatal overdoses and community consequences of the opioid epidemic through prevention, harm reduction, and linkage to care, and monitor and evaluate CAP efforts were all successfully met. Factors that led to the success of the CAP and to the successful implementation of the four strategies that came from the CAP began with subject matter experts presenting their research at the CAP. This laid the foundation for themes and strategies derived from the SWOT to be expert-driven, based in evidence, and also based in what the Manatee County community was experiencing at the time related to opioid use. Furthermore, over 60 new and existing DOH-Manatee partners attended the CAP which was instrumental in designing as well as implementing the four strategies. For example, the Narcan distribution data shared by partners who attended the CAP shaped the prescription opioid awareness campaign, distribution of ALTO Toolkits, and the educational classes because this data uncovered pockets of inequity in zip codes not previously on our radar. Specific demographics that were affected by the opioid overdose epidemic and may have otherwise fallen through the cracks were targeted by each of these three strategies instead. The substantial public health impact of the CAP as well as the four strategies that were implemented in Manatee County as a result of the CAP is still felt today. To begin with, the CAP spurred the merging of two different Manatee County Task Forces focused on Pain Management and Addiction to merge into one Pain Management and Addictions Task Force, which still meets every month. This Task Force was instrumental in bringing the Infectious Disease Elimination Act (IDEA) aka Syringe Exchange Program (SEP) legislation to the Manatee County Board of Commissioners for approval in December of 2019, after the legislation was passed statewide on July 1, 2019 and left to each county to approve its implementation. The passing of this SEP legislation in Manatee County alone was a step toward addressing and reducing health inequities associated with access to care among people who use drugs who often go without due to their employment, transportation, and insurance statuses. Our DOH-Manatee website can be located at: http://manatee.floridahealth.gov/index.html
Size: Medium (Population of 50,000-499,999 people)
State: Florida
Summary of Practice:
The Power of Partnerships to Address the Opioid Epidemic in Manatee County
Category
Behavioral Health
Description