Committee Report - PHPS - 4-10-18 — File 205495

Public Health and Public Safety Committee Page 1 of 4 Printed 4/15/2018 April 10, 2018 REPORT OF THE PUBLIC HEALTH AND PUBLIC SAFETY COMMITTEE Attendee Name Title Status Arrived Jesse Clingan Chair Present Stephanie Hirsch Vice Chair Present Matthew McLaughlin Ward One Alderman Present Others present: Doug Kress - HHS, Nancy Bacci - HHS, Judi Walker - SOA, Chief David Fallon - SPD, Patty Contente - SPD, Kathy Betts - CHA, Maryanne Frangules- Massachusetts Organizing for Addiction Recovery, Diane Rose, JoAnn Rivieccio, Peter Forcellese - Legislative Clerk. The meeting took place in the Aldermen’s Chamber and was called to order at 6:33 PM by Chairman Clingan and adjourned at 8:35 PM. Approval of the March 5, 2018 Minutes RESULT: ACCEPTED 205093: That the Director of Health and Human Services report to this Board on the city’s current efforts to address the opiate crisis in terms of treatment, recovery, support and prevention. Chairman Clingan explained that this meeting was called to discuss what has been done in the past, what is being done now and what is being planned, going forward, to deal with the ongoing battle against opioid addiction in the city. Mr. Kress spoke about his department’s efforts and mentioned that HHS is in the process of hiring new Director of Drug Prevention. He emphasized that the problem cannot be dealt with solely on the local level and he went on to speak about the city’s annual Prescription Drug Take Back Day being held on Saturday, April 28th. Unwanted medication may be turned in at the city’s Public Safety Building (at 220 Washington Street) or at the city’s Fire Department (at 6 Newbury Street) from 10:00 AM to 2:00 PM. Mr. Kress noted that these locations would also take medication on any other day of the year, as well. HHS provides Narcan awareness and training and is working with local businesses, asking them to post “Overdose Recognition and Response” flyers in their restrooms. During blood pressure screenings, elder citizens are being asked about any medications they may be taking and are being

Public Health and Public Safety Committee Page 2 of 4 Printed 4/15/2018 provide with a medication list card for their own and their physicians’ reference. High school students are being screened using the CRAFT screening interview form. Relevant data is collected through surveys alternately conducted in middle schools and in the high school. The latest data indicates that there is still a large percentage of students who are not smoking or using drugs and a reduction in stress levels has been seen. The School Department had a part time assessment counselor on staff, but due to his retirement, the position is currently vacant. It was suggested that perhaps revenue that the city will receive from marijuana sales might be used to find that position on a full-time basis. HHS is working with the Somerville Media Center to develop some public service announcements. Ms. Contente explained that the philosophy is to help youths to make healthy choices by providing them with information and giving them the opportunity to ask questions and get factual information. She noted that youths whose parents discuss drugs with them are 50% less likely to use them. She also mentioned that a change in the way drugs are prescribed will help in dealing with addiction. Alderman Hirsch asked if teachers know the criteria for identifying a student who might be at risk for using drugs and Mr. Kress answered that some identifying is being done, but that it depends on the school, adding that the schools are looking at a team approach with teachers. When dealing with youths, the approach can’t be prescriptive. Mr. Kress advised the committee that some of the questions being asked could be better answered by the School Department and/or the School Committee. Chairman Clingan noted that he did invite the Chair of the School Committee to attend, but due to a prior commitment, he was unable to do so. Alderman Hirsch said that she has not received any information from the schools (by way of her children) about what signs to look for that might indicate that a child is at risk or using drugs and she feels strongly that there needs to be more information available to parents and believes that it would be worthwhile to invest in programming to educate parents and help them navigate their way through this time in their children’s lives. The committee was told that it’s important to realize that many youths come from homes where there is drug use and that there is a whole generation that suffers and needs to be included in prevention programs. The consensus of those present at tonight’s meeting was that the schools aren't engaging students at an early enough age. Members were told about a program on prevention that was run at the high school that had very little content devoted to opiate use. There is a small window of opportunity, around grades 4 through 6, when children say they don't want to be like their parents. If this opportunity is not seized and used for prevention, these same children often become addict a few years later. Alderman McLaughlin spoke about many programs that have been implemented to ease this crisis and asked what else can be done? Ms. Rivieccio spoke about an “In Plain Sight” program that teaches parents what to look for in their children’s’ rooms. She noted that parents plan for their children’s future and education, but not about drug prevention. Ms. Betts told the committee that everything needs to be tried. No one agency is responsible for trying to resolve the problem, therefore everyone needs to work together. Ms. Frangules discussed recovery high schools and the important role they play in Massachusetts. Currently, there are 5 such high schools in Massachusetts. Ms. Bacci told members that peer to peer education has proven to be successful and she spoke about an upcoming a day of wellness at the high school where students will assemble a toolbox of skills to use in navigating their way through troubling times. Feedback from this event will be provided to HHS. Chief Fallon commented that sometimes police officers are an addict’s only point of contact in a community, and to that end, his department is investing heavily in training. Follow up calls are performed on all domestic disturbance incidents to investigate whether there might be situations that might lead to or involve drug use. The STEPS program, whereby police officers build relationships

Public Health and Public Safety Committee Page 3 of 4 Printed 4/15/2018 with 5th grade classes and follow those youths through high school, has been very successful. Chief Fallon said that even though drug fatalities are down, lives have still been lost lives in our communities. Alderman Hirsch inquired about any follow up with the schools in cases where a student’s parent over-doses, etc., and Chief Fallon thinks that a system could be put in place. On the treatment side of this topic, jurisdictional issues were mentioned as adding to the problem of providing proper treatment. There aren't enough resources available, especially with regard to after- care. Housing and financial issues also add to the treatment problem since it’s difficult to be placed into a program if the patient doesn’t have a residence. Inconsistency among sober homes, which are independently operated, is also a contributing factor to ineffective treatment and efforts are underway to set standards and to monitor sober homes. Recovery homes are licensed by the state. Opioid addiction is extremely difficult to overcome but intensive programs are very effective for recovery. It’s important to remember there are individuals who find themselves in trouble with drugs due to real circumstances. The committee was told that Somerville needs a detox facility and that statewide, the waiting time to get into a recovery homes is 2 months. City agencies call the same facilities that are available to the public and information may be found at the Substance Abuse Helpline website, <https://helplinema.org/> The Cambridge Health Alliance (CHA) has a full-time recovery coach on staff. CHA has applied for a $250,000 grant that would allow them to expand their treatment hours and continual care. It’s been said that getting off drugs is sometimes the easy part while staying off them is more difficult. People need support to learn how to live off drugs and it’s ok to ask for help along the way. Drop in centers would be helpful in providing a place for this to occur. New Day is a program geared to helping pregnant women who are dealing with addiction and the committee was told that the stigma of addiction keeps some pregnant women from entering a program. At New Day, women may stay at the facility until their child reaches age one, providing them with the time needed to heal the brain during recovery and to provide them with the support to grow emotionally. Alderman McLaughlin spoke about drug courts, i.e., a court meant for offenders whose crimes are related to addiction, and Chief Fallon will help to facilitate a meeting with the appropriate contact person to continue this conversation. Through the use of drug courts, addicts form strong relationship with their probation officers and the courts, leading to some remarkable results. Chief Fallon said that connecting an addict to the resources available in the community is more beneficial than locking someone up for 18 hours. The situation is always evolving and there is a role that the police can play. Alderman Hirsch asked what the committee could do to help and suggested that perhaps funds from the proposed Real Estate Transfer Fee could be used to combat drug addiction. Mr. Kress noted that there is no one solution to the problem and trying to prioritize programs would take some time. He did, however, say that it’s important to begin working with children as early as possible. Among the suggestions offered to the committee were to have Narcan and social workers available at public libraries, continued public engagement, helping to get indigents off the streets, talk to the city’s state delegation about a drug court, provide more communication about the services available, ensure that 311 has relevant information available, educate parents through an “In Plain Sight” event, establish drop-in centers where available recovery coaches may volunteer to help those who are reaching out, expand the partnership with CHA for a supported work training recovery model program and push to have revenue from marijuana sales used for drug treatment. Mr. Kress noted that the city expects to receive approximately $50,000 in revenue from the first 6 months of marijuana operations.

Public Health and Public Safety Committee Page 4 of 4 Printed 4/15/2018 Alderman McLaughlin asked that a representative from the School Department be invited to address the committee on this topic at a future meeting. Alderman McLaughlin’s motion that the Clerk Magistrate from the Somerville District Court be invited to appear before the Committee on Public Health and Public Safety to speak about drug courts, was approved. Handouts: • CRAFT Form (with 205093 • Flyers (with 205093)