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Opioid Initiatives in Carroll CountySeptember 10, 2018Drug Expo (Carroll County)Annual Carroll County Drug Expo hosted by the State’s Attorney Office and partneringwith many other agencies in the county providing community education about services inthe County and how to access them.Don’t Believe the Lie8th Grade assembly on opioid prescription drugs and refusal skills. 2400 studentsMiddle School Program for all 8th graders with a video produced by the SAO withactors from “Fool Proof.” Video shows the consequences of drinking anddrugging through real life scenarios. Great rewind features showing differentoutcomes with good choices. Followed up with role playing to encourage goodrefusal skills with class participation.EIP/ Early InterventionProgramDiversion Program that is offered to early offenders who have a minor non-violentcriminal record and have crimes closely linked to their addictions to illegal drugs (mostoften opiates). One year intense program focuses on substance abuse treatment, testing,and attendance at self-help groups. By closely monitoring participants, criminal justicesystem is able to intervene earlier on than traditional probation violations. Upon aviolation, participants often have more treatment options due to the earlierinterventions. Program can offer additional support for those who struggle to remainabstinent by assisting participants to get into detox services, sober/ recovery homes andother services. The goal is to help participants obtain long term success and sobriety andat the same time minimizing their future risk of overdose. Successful participants obtain achance to have their case dismissed and expunged clearing their record.Emergency Department at Carroll All individuals admitted with overdose or in withdrawal will be issued and OperationHospital - Naloxone Distribution Save a Life- kit with Naloxone included. Bureau of Prevention, Wellness, and Recovery(OD and Withdrawal)gave the hospital doses to provide to the 50-60 per month and families of those at riskfor opioid overdose.Carroll County StatesAttorney’s Office CarrollCounty Health Department,BPWRCarroll County StatesAttorney’s Office! FoolProof/ CCPS/ BPWRCarroll County StatesAttorney’s Office / CCSOCCHD Bureau ofPrevention, Wellnessand Recovery andCarroll Hospital CenterPage 7 of 18

Opioid Initiatives in Carroll CountySeptember 10, 2018Emergency Department at Carroll Hospital has policy to limit prescribing Dilaudid when individuals visit the EmergencyHospitalDepartment. Hospital also has a policy in the ED where patients are given no more than 3days’ worth of an opioid prescription (or enough to get them to their pre-arranged physicianappointment) when leaving the ED. This policy is shared with every patient who enters TheED. The ED has a very conservative policy on dental pain management where dental blocksare offered and only at the discretion of the practitioner will a prescription be offered.Carroll Hospital CenterCHC Complimentary Services: currently piloting a program to offer 'battlefield acupuncture'on a limited basis in the emergency department"Implemented Alternatives To Opioids (ALTO) program utilizing common medications indifferent modalities to treat common pain complaints.Revamped policy for diagnosis and treatment of individuals at risk for alcohol withdrawalEmergency Department at CarrollHospital Center- Screening, Briefintervention, Referral andTreatment (SBIRT)Every individual admitted to the Emergency Department screened with questionsincluded in their electronic health record it is a universal screening.If an individual screens positive are referred for an evaluation for behavioralhealth assessment and to meet with Peer.CCHD Bureau ofPrevention, Wellnessand Recovery andCarroll Hospital CenterFamily Outreach WorkshopsBeginning July 25, 2018 there will be a weekly workshop for Families and Friends affectedby someone’s addiction. Open and Free to all who are interested. Depending on theinterest the group may continue.CCHD Bureau ofPrevention, Wellnessand RecoveryFentanyl CardsCards developed by Behavioral Health Administration to be distributed to anycommunity provider interested to make available to consumers.CCHD Bureau ofPrevention, Wellnessand RecoveryFire and Rescue callsCarroll County Sheriff’s Office will begin tracking fire calls related to Overdose thatthey are called to respond to.First Responder’s DinnerFirst Responders were recognized for their efforts to help combat the effects of addiction.Many have responded repeatedly to the same location for OD response.Carroll County Sheriff’sOffice.CCHD Bureau ofPrevention, Wellnessand RecoveryPage 8 of 18

Opioid Initiatives in Carroll CountySeptember 10, 2018Good Samaritan LawOffered at various locations throughout the county through host sites including Access Carroll.Grief After Substance Abuse Loss Supportive Group Therapy offered at Carroll Hospice. Group offers support and advice oneffective strategies in managing the complex emotions involved with the death of a loved onefrom an overdose or addiction in grief support group. During the sessions members canshare their experiences, participate in educational discussions and received comfort in awarm and welcoming environment. No registration is required.CCHD Bureau ofPrevention, Wellnessand Recovery/ State’sAttorneyCarroll Hospice CenterHandle with Care InitiativeCarroll County Public Schools will be notified of students who might be witness to aDomestic Violence situation, Death or Overdose. So that the school might respond withsupport and handle with care. drugs/alcohol/a family history, refusal skills, angermanagement, how to bond positively withHeroin Kill’s RemakeCollaborating with the SAO for a remake of the Heroin Kills educational awareness videoCarroll County State'sthat is a two day lesson in the eighth grade curriculum in CCPS. The working title is “Heroin Attorney's Office and CarrollStill KillsCounty Health Department/Bureau of Prevention,Wellness and RecoveryCarroll County State’sAttorney Office andCarroll County PublicSchools.Page 9 of 18

Opioid Initiatives in Carroll CountySeptember 10, 2018Health Professional/Prescriber Created and delivered in 2016 to educate and prevent opioid addiction. Three trainingsOpioid Educationtargeted to health professionals that educated on, “The Path. Prescription drugs toHeroin” one additional training is pending.Carroll Hospital has targeted our community physician practices for increased educationand prescribing policies.HOPE ProjectHeroin, Opioid, Prevention,EducationA series of community education programs facilitated in partnership with the libraries, faithcommunity, and a local awareness organization to bring HOPE throughout the countyCCHD Bureau ofPrevention, Wellnessand Recovery ,DrugEnforcement Agencyand Carroll HospitalCenterCCHD Bureau ofPrevention, Wellnessand Recovery/Community agenciesIntegrated Health Care at Access Offers clients full access to medical, dental, and behavioral health service’s through anCarrollintegrated health care team at one location, and is in direct partnership with CarrollHospital and the Carroll County Health Department to ensure clients receive timely,appropriate, and affordable care.Access Carroll/ CCHDBureau of Prevention,Wellness and RecoveryLaw EnforcementLaw Enforcement staff are trained in a week long training to assist individuals in crisisCrisis Intervention Teams (CIT)CCHD Bureau ofPrevention, Wellnessand Recovery and LocalLaw EnforcementLaw EnforcementAll Law Enforcement staff that are interested attend the Mental Health First AideMental Health First Aide (MHFA) training specific to Law Enforcement.CCHD Bureau ofPrevention, Wellnessand Recovery and LocalLaw EnforcementPage 10 of 18

Opioid Initiatives in Carroll CountySeptember 10, 2018Law Enforcement- NaloxoneAll of the Carroll County Sheriff’s Office, Carroll County Detention Center, WestminsterPolice Department, Taneytown Police Department, Sykesville Police Department, MtAiry and Hampstead Department staff carry Naloxone to respond to individuals in need.Pending Hampstead training.CCHD Bureau ofPrevention, Wellnessand Recovery and LocalLaw EnforcementSecurity staff at McDaniel and Carroll Community College are trained as well.Lion’s Club Speaker SeriesMonthly speaking engagements at various Lions International clubs including presentingat the Regional Lions International Convention. Speaking partners include On Our Own,Carroll Hospital, Recovery Peers, Sober Homes, CHES, and Law Enforcement, arranged bythe Prevention Office.CCHD Bureau ofPrevention, Wellnessand RecoveryLocal Overdose Fatality ReviewTeam –LOFRTMultidisciplinary agencies attend. Meetings are held every other month to review localOverdose Deaths and look for intercept points that activities could be implemented toimpact the rise in Overdoses.CCHD Bureau ofPrevention, Wellnessand Recovery withother agencies thatattendMajor Offender UnitTargeting the major drug offenders in Carroll County and working collaborative withother jurisdictions to get as much evidence as possible to strengthen the prosecution’scase for court.Carroll County StatesAttorney Office andother local/state lawenforcement agencies.MOI/Major Overdose InitiativeNew program targeting multiple overdose victims. Through charting and tracking we haveplaced these individuals in 3 categories: on Parole/Probation, pending court date/ trialand no criminal justice involvement. SAO takes a head on approach and aggressivelymeet with them to steer them toward entering into treatment.Carroll County StatesAttorney’s OfficePage 11 of 18

Opioid Initiatives in Carroll CountySeptember 10, 2018CCHD Bureau of Prevention,Wellness and RecoveryMcDaniel CollegeAlcohol Education class for students who receive an alcohol citation. Curriculum is twohours and interactive. BPWR annual guest speaker in Dr. Paul Mazeroff’s ‘Drugs and theMind’ class. BPWR guest speaker in ‘Human Behavior in Environment’ class.Mobile Crisis and Stabilizationtwo shiftMobile Crisis with two teams covering from 9 am to 12 midnight started in Carroll County May1 with a Law Enforcement Roll out and will be rolling out the services to Local Providers August1, 2018. Mobile Crisis staff to respond to the overdose or any behavioral health incident in thecommunity where additional supports are needed. A division effort to eliminate a visit to theEmergency Department.CCHD Bureau ofPrevention, Wellnessand RecoveryNational Night Out- Annual Event National Night Out is held in neighborhoods throughout Carroll County, and across theMultiple agencies inthe County.nation. Neighborhoods are asked to join forces with thousands of communitiesnationwide for the event. National Night Out is sponsored by the National Associationof Town Watch (NATW) and cosponsored by the various law enforcement agencies andorganizations nationwide.Not In CarrollFacebook page is a community social media and information forum.Not In Carroll- Agency ForumAnnual Carroll County agencies gather to discuss the initiatives in Carroll County used to fightthe opioid epidemic. Leader of agencies present to the public and others the methodsand initiatives used to prevent, treat and referrals.Operation Marquee HeroinEncourages local businesses to post the Good Samaritan Law messages onbusiness marquees during the summer months.CCHD Bureau ofPrevention, Wellnessand RecoveryCarroll CountyCommissioner StephenWantz and invited localagenciesCCHD Bureau ofPrevention, Wellnessand RecoveryPage 12 of 18

Opioid Initiatives in Carroll CountySeptember 10, 2018Operation Save a Life (OSAL)Naloxone trainingCommunity based trainings that are provided to individuals or agencies on the provision ofNaloxone. Includes uses of Family and Peers Support trainers to the high Risk populations.Trainings are held monthly at Access Carroll and in the community where requested.CCHD Bureau ofPrevention, Wellnessand Recovery/ AccessCarrollBureau of Prevention, Wellness and Recovery has trained the Carroll County Public Librarystaff, Nursing and Environmental Health staff at Carroll County Health Department, CarrollCounty Youth Services Bureau, Boston Inn, Public schools) nurses and administrators, localshelter staff, Penguin Random House, Potomac Case Management, Carroll County State’sAttorney Office, Carroll County Drug Court Team, Carroll County Parole and Probation, CourtBailiff’s, Carroll County Department of Social Services, Dr. Freiji Office staff, McDaniel CollegeSocial Work Students. Carroll Community College Nursing students, Carroll County Vo Techstudents if interested (no Medication) , Local Recovery Support meetings,Operation Stall HeroinPlaces opioid prevention and Good Samaritan Law posted in employee and public restrooms.CCHD Bureau ofPrevention, Wellnessand RecoveryOpioid Misuse PreventionCoalition- Every other MonthThis group is recognized at the County Overdose Intervention Team and is comprised ofmultidisciplinary agencies. The group discusses current trends, new programming or areasto focus our efforts.CCHD Bureau ofPrevention, Wellnessand Recovery and localagenciesOverdose Response PeerCCHD is receiving OD reports from CCSO. In conjunction with the SAO a peer is making coldcalls to those individuals as well as anyone listed on the report at a witness. To assist themwith getting connected to services in the community and providing Naloxone training.Overdose Survivor GroupA Certified Peer is providing a Overdose Survivor Support Group is to offer peer to peersupport in a treatment setting to individuals who have survived an overdose. Peer topeer support is beneficial in a safe environment without fear of judgment and withothers who have similar experience. This includes discussing triggers, consequences andrelapse prevention.CCHD Bureau ofPrevention, Wellnessand Recovery andCarroll County State’sAttorney Office.CCHD Bureau ofPrevention, Wellnessand RecoveryPage 13 of 18

Opioid Initiatives in Carroll CountySeptember 10, 2018Carroll County States Attorney Office will be working with local schools to present a bedroomscene to parents of locations that drugs and alcohol might be hidden. Parent’s will search thebedroom to attempt to locate the items and then when they have completed the student’swill then go to the room and identify other locations where items were hidden and missed bythe parents. This should help identify areas that parent’s often do not think about whensearching children s rooms.Carroll County State’sAttorney Office andCarroll County PublicSchools.Peer Support Specialist (certified Carroll Hospital Center will be hiring peers for the ER and other units in the near future.BPWR previously had a Certified peer specialist assigned to hospital four days per week dayand uncertified) assigned totime hours to assist with interventions and engagement of individuals with behavioralspecial assignmentshealth diagnoses when referred. Does follow up contacts after discharge. The project wassuccessful and the hospital has decided to continue with Peers working at CHC.CCHD Bureau ofPrevention, Wellnessand RecoveryParent Bedroom EducationOver Dose Response Peer assigned to follow up on overdoses identified offeringadditional peer support, connection to resources (treatment services, self-help meetings,medical services, housing, etc.) and naloxone training.Pharmacy Opioid EducationToolkitsTool Kits were created and delivered in 2016 to educate and prevent opioid addiction.Carroll Hospital Center met with all hospital practices and provided updated informationabout the Prescription Drug Monitoring program and Opioid prescribing new regulations.CCHD Bureau ofPrevention, Wellnessand Recovery, CarrollHospital Center andAccess CarrollPrescription Drug DisposalProgram encourages the community to dispose of unused medications at one of ninecurrent county locationsCCHD Bureau ofPrevention, Wellnessand Recovery, localLaw Enforcement andNew Windsor FireDepartmentProvider CouncilLocal Behavioral Health agencies attend. Meetings are held monthly second Thursday ofthe month.CCHD Bureau ofPrevention, Wellnessand RecoveryPage 14 of 18

Opioid Initiatives in Carroll CountySeptember 10, 2018Provider OutreachThe Life bridge Clinically integrated network is working on prescribing g MDH, CCHD has partnered with the Carroll Hospital Center toensure proper educational opportunities, resources and support for provideraccountability in the use of CRISP for the PDMP.Public Service’s Announcement’s PSA’s have been played on cable television through local cable station channel 19,Comcast and Online. Also promoted through Social Media.CCHD Bureau ofPrevention, Wellnessand RecoveryTopics: Downward Spiral, Heroin, Faces of Addiction, Proper Disposal, UnintentionalDrug Dealer, Transition from Prescription to Heroin.ReEntry Service’s from CCDCRisky BusinessSBIRTInmates will be trained in Naloxone upon release and connected to service’s upon releaseand have community contact with individuals linking them to services. They will also beprovided education related to Medication Assisted Treatment (Buprenorphine, Vivitrol andMethadone)This includes those with persistent mental illnesses as identified by the Maryland CommunityCriminal Justice Treatment Program.Annual event hosting over 400 individuals from various agencies to provide them with newinformation and open discussions about various topics.Access Carroll Integrated Healthcare has fully integrated Screening, Brief Intervention,Referral & Treatment, (SBIRT) into all service lines including Medical, Dental and BehavioralHealth. State and Federal researchers have been extremely interested in the Dental lineand Access Carroll has been featured on the Federal SBIRT.CCHD Bureau ofPrevention, Wellnessand RecoveryCCHD Bureau of Prevention,Wellness and RecoveryAccess Carroll /CCHD/Dr. KimJohnston Primary CareDr. Kim Johnston’s Primary Care Practice has begun training on SBIRT as part of the MDHSBIRT grant. CCHD Local Behavioral Health Authority will be working closely with theMosaic Consulting Group, Dr. Johnston’s Practice and MDH to ensure appropriate resourceavailability.Page 15 of 18

Opioid Initiatives in Carroll CountySeptember 10, 2018Senior OutreachCommunity Education targeted to the older Adult Population.Topics include: Proper Disposal and Opioid EducationSources of StrengthProgram provided to Middle School first school first school to be involved is West MiddleSchool.Special OPTSOpiate Prevention & TeenSupportCCHD Bureau ofPrevention, Wellnessand RecoveryCarroll County PublicSchools and CCHD Bureau ofPrevention, Wellnessand RecoveryCarroll County StatesHigh School opioid prevention program to all the juniors and seniors in our county. A videoproduced by our office is played in the beginning along with an opening skit from “Fool Proof. Attorney’s Office/ Fool Proof/CCPSThis program also presented stories of opioid/heroin use and recovery from persons close inage to the high school students. This is a “raw truth program” from local youth and theirstories of addiction and recovery. The program concluded with announcing the winnerof the art contest for the winner of the prevention poster.The Partnership for a HealthierSubstance Abuse and Behavioral The Partnership for a Healthier Carroll County coordinates this effort along with keyHealth Resources Directory for community members and organizations. The extensive 100 page bound directory identifies Carroll County, Carr

Psychology: Substance Abuse and Mental Health Issues: The Heroin Epidemic As time permits, students in HI and H2 also play jeopardy which includes a 'Life Skills' component Health Education 9-12 Carroll County Public Schools in conjunction with Carroll County Health Department, BPWR staff