August 23, 2022 Minutes

Weld Regional Opioid Council Meeting

Weld County Department of Public Health and Environment, Room 103
1555 North 17th Avenue, Greeley CO 80631
August 23, 2022 @ 9:30 am to 11:30 am

Council Members in Attendance:  David Angelo – Firestone Police Department; Joel Smith – Nunn Police Department; Eric Aakko – Weld County Department of Public Health and Environment; Rick Brandt – Windsor and Evans Police Department; Matt Turner – Weld County Sheriff’s Office; Kim Emil – Town of Windsor Government; Mike Zeller – Greeley Police Department; Scott James – Board of County Commissioners; Scott Moser – Town of Eaton; Jamie Ulrich – Weld County Department of Human Services

Non-Council Members in Attendance:  Tanya Geiser – Weld County Department of Public Health and Environment; Holly Smith – Weld County Department of Public Health and Environment; Gene O’Hara – Weld County Department of Public Health and Environment; Chris Cross – Fort Lupton City Government; Matthew Elbe – Weld County Sheriff’s Office; Caitlin Perry – Weld County Government; Allyce Torres – North Range Behavioral Health; Jenny Wallace – North Range Behavioral Health; Mickey Pirraglia – Weld County Government; Lesley Brooks – North Colorado Health Alliance; Richard Zeigler; Rafael Gutierrez; Melissa Wiley

Minutes

1. Elect Replacement Chair; Eric Aakko, WCDPHE
   • Mark Lawley has retired from the Weld County Department of Public Health and Environment (WCDPHE) and is no longer on the council. Gene O’Hara has stepped in as the interim Executive Director of the WCDPHE.
   • Commissioner Scott James nominated Eric Aakko as the Council Chair. Kim Emil seconded the nomination. Eric was unanimously voted in as the new voting representative for the WCDPHE and was elected as the Council Chair.
2. Review and Adoption of Bylaws; Bruce Barker, Weld County Attorney
   • Only discussion was that there was no mention of a representative for the Juridical District included in the bylaws. Per the MOU, there should be a voting member from the Judicial District. Council currently does not have this member and will reach out to get one. Caitlin added the Judicial District as a voting member and sent out updated bylaws to the council. Council approved bylaws.
3. North Range Behavioral Health; Jenny Wallace, North Range
   • The staffing shortage is real. Between January and June there were 32 open positions for substance use continuum. Vacant positions go into all the problems that people complain about with the behavioral health systems. Issues with capacity, wait times, etc. All of that happens because there are not enough people to do the work. Good people end up working so hard and getting burnt out that they leave. Need staff to build up all the ideas of programs we would like to see in the community. Would like to talk/brainstorm of how to attract people to Weld County and retain good people. 
   • Expanded detox services
     • Have a social model detox. Provide support for people going through withdrawal and connect them with services after the fact. Act as a point of entry for many people coming into the system.
     • Instead of creating something brand new, would like to enhance what is already there. Medically enhancing the detox would allow for medical clearances. The trouble now with current staff is there must be a clearance given for more complicated situations, done by an outside staff person because there are none on staff to make those determinations. Folks in addiction are clogging up ERs. Want to be sure to clear that out for others that need those services. Enhancement would also allow for more complicated withdrawal symptoms and provide a higher level of care. Would consider hiring own staff or contracting out. Have amazing partnerships with medical community.
     • If we can use all our resources, we can make this money go a long way and help out a lot of people.
4. Discussion of Potential Funding Areas; Eric Aakko, WCDPHE
   • Determine where the greatest need for Weld County is at this point (prevention and education, treatment, harm reduction, criminal justice, recovery).
   • Staffing seems to be a big piece. None of the other areas can happen without staff. Possibility of using dollars for recruitment, finding ways to retain staff, and supporting internships (supporting individuals getting the training they need to seek their licensure/degree).
   • Training that can happen (nontraditional ways). How might we create structures that a person could get on the job training to become a peer or certified counselor.
   • Health Department does not have a substance use disorder educator. This person could help coordinate and integrate with partners, the council, and exploring other grant opportunities.
   • Windsor is interested in enhancing the co-responder program. Found that has been very effective. Also considering a device that allows first responders to identify a drug. This device would be housed somewhere in Weld County but would be available to all entities in Weld County to use. Would be a great safety tool for first responders.
   • Setting aside a portion of funds for smaller municipalities to submit applications for things they think they might need that the council can then discuss and distribute funds.
   • Next steps
     • Consider funding option ideas and what those cost. At the next meeting the council can then start discussing to split the funding for different areas.
5. Colorado Opioid Synergy--Larimer & Weld (CO-SLAW); Leslie Brooks, MD, NCHA
   • Matt Turner motioned to remove the topic of Medication Assisted Treatment (MAT) in jails from Leslie's presentation and focus solely on CO-SLAW.
   • Program overview
     • Dr. Lesley Brooks serves as the Assistant Medical Director for the North Colorado Health Alliance (NCHA). Worked for Sunrise for almost 10 years and have been doing a variety of things in the medical space and in the public health space to talk about substance use and mental health.
     • About 7 years the Northern Colorado Opioid Prevention Workgroup was formed which was a collaboration between many members of Larimer and Weld to figure out how to address the challenge in the community.
     • That group is now over 100 people and more than 50 different entities between Weld and Larimer communities – both public health departments, both community mental health centers, both federally qualified health centers, and a variety of advocacy organizations working in these spaces. Law enforcement on both sides as well are involved.
     • That group is now called NOCO CARES – Northern Colorado Collaborative for Addiction Response Service.
     • The group has a 7-member steering committee, which both Jenny Wallace and Dr. Brooks serve on, to help direct those efforts.
     • From this group came CO-SLAW – Colorado Opioid Synergy Larimer and Weld.
     • Collectively agreed to pursue a SAMHSA grant to support the advancement of MAT between the two regions. That grant supports the CO-SLAW team.
     • CO-SLAW is a network of treatment providers (9 clinics between the two counties) and a team of community-based care coordinators. The grant funds a team of 5 individuals – 1 program director and 4 care coordinators (2 care coordinators devoted to Larimer and 2 devoted to Weld). Through a variety of other funding sources, that team has been increased to about 15ish, with team spilt about half and half between Larimer and Weld. Their job is to run around our two counties supporting people on medication assisted treatment (already on it, to get to it, etc.)
     • Community based care coordination team can be agnostic to payer source. The team can leave and go wherever they need to provide support to the people that need it.
     • One of the other programs under CO-SLAW is the MAT program. The group wanted to be sure they were able to provide resources to the emergency departments and incarcerated individuals. Have great relationships with UCHealth and Banner.
     • CO-SLAW is also a 24/7 staffed 1-800 number. Emergency Departments, case managers, nurses, doctors, etc. can call for clinical guidance (dosage) as well as where the patient will be going when they leave the emergency department.
     • Group sought several grants for programming for Overdose Awareness Day and have done that for the last 3-4 years. Activities happening in the communities to raise awareness around substance use disorder.
     • Support folks coming out of the jail in both counties. Jail Based Behavior Services (JBBS) are happening in both county jails. Through those services people can get help/resources with navigation outside an incarcerated setting.
     • One of the requirements of the SAMHSA grant is to have evaluation. Group has worked with the Butler Institute (out of the University of Denver) to do a robust evaluation. Have done this for 3 years. Got one three-year grant from SAMHSA as well as a second five-year grant. Currently in the first year of the five-year grant. Will send out the report of the evaluations. Have robust data to show that through this programming people are more employed, more housed, and use less illicit substances.
     • Team has been incredibly busy. Have served around 500 people through the metric of a questionnaire. The team serves far more, however, than the people that complete the questionnaire. The team has probably served well over 800-1000 people in the last 4 years.
     • Getting into south county and out east presents challenges for the team. Growing the team would allow team to serve more of the county.
     • Part of the success of these programs is peers. Have 5 peers that serve both counties. That is an area of growth and need. Still learning what it means to pay people for their lived experience. Continued funding will be needed after the SAMHSA grant runs out in 4 years.
   • Medication Assisted Treatment (MAT) in jails (removed from agenda)
6. Selection of Next Meeting; Group Consensus
   • Group decided next meeting will be Tuesday, August 30th at 9:00AM.
7. Adjourn