Monika Salvage 5/12/22 Auburn City Council Meeting

Project Director
Web: cayugacounty.us/healingcayuga
Social: @healingcayuga
YouTube: Playlist on Cayuga County Channel
HEALing Communities Study
• Helping to End Addiction Long-term
• Goal to reduce opioid overdose deaths by 40%
• 67 communities in 4 states participate
• Evidence-based interventions
• Local steering committee & implementation team

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 Community-Driven Approach

• Local steering committee

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 Local Steering Committee
• Bill Berry, Chair, Harriet Tubman Center for • Ashley Moench, Executive Director, Nick’s
Justice and Peace Ride 4 Friends
• Jerimy Blowers, Associate Professor, Cayuga • JoLynn Mulholland, Program Coordinator,
Community College STOP ACT
• Bryan Bush, Certified Recovery Peer Advocate, • Travis Poole, Fire Fighter, Auburn Fire
Confidential Help for Alcohol & Drugs Department
• Carol Colvin, Resource Coordinator, Auburn • Dorothy Radcliff, Program Director, Grace
City Problem Solving Courts House Chemical Dependency Program
• Elane Daly, Cayuga County Legislator • Courtney Seamans, Emergency Room Nurse
• Caroline Dixon, Interim Director, Confidential
Manager, Auburn Community Hospital
Help for Alcohol & Drugs • Brian Schenck, Cayuga County Sheriff
• Adam Duckett, Cayuga County Coroner • James Slayton, Chief of Police, Auburn Police
• Monica Hastings, Mental Health Social Worker,
Department
Cayuga County Jail • Lauren Walsh, Director of Community
• Shelyagh Kennedy, Psychiatric Nurse
Services, Cayuga County Mental Health
Practitioner, Cayuga County Mental Health Clinic

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Multiple Public Health Crises - Nationally

• COVID-19 pandemic
o 2 years and no end in sight
• Opioid crisis
o 100,000+ died from a drug overdose in 2020 (+29%
from 2019, CDC)
o Emergency room visits for opioid overdoses up in
2020 (+29% from 2019, JAMA)
• Mental health crisis
o Isolation, increased substance use, suicides (CDC)

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Multiple Public Health Crises - Locally
• In 2020, Cayuga County lost almost as many people to
overdoses (23) as to COVID-19 (27).
o Data suggests that our interventions in 2020 prevented
additional overdose deaths.
• Suicides have increased from 5 to 13 since 2019.
• All overdose fatalities in the last 6 months were female.

The US government has seized enough fentanyl this year to give every American a
lethal dose

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Gaps in Cayuga County before HEALing
• Data collection
o Identifying countywide trends across the system
• Narcan distribution
o Keeping people alive
• Post-overdose outreach
o Identifying & connecting with high-risk individuals for overdose
• Accessibility of services
o Same-day access to medications for opioid use disorder
• Linkage to services
o Referrals & follow-up support
• Countywide coordination of opioid/substance use response
o Providing a countywide response plan & engaging partners

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 Overdose Trends in Cayuga County
2019 2020 2021
• 179 overdoses • 208 overdoses • 278 overdoses
• 15 ODs/month • 17 ODs/month • 23 ODs/month
• 25% suspected opioids • 30% opioids • 35% opioids
• 9 fatal • 23 fatal • 18 fatal
(4 outside of
Auburn)

YTD 4/2022
• 74 overdoses
• 16% opioids
• 3 fatal

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2020/2021: 22% Decrease in Fatal Overdoses

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Overdoses – County
Jan 2020 – Mar 2022
(540)

78% of all overdoses

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Overdose Hotspots in Auburn
(78% of Total Overdoses)

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95% of Fatal Overdose Fatalities
in 2021 Involved Opioids

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Gaps in Cayuga County before HEALing
• Data collection
o Identifying countywide trends across the system
• Narcan distribution
o Keeping people alive
• Post-overdose outreach
o Identifying & connecting with high-risk individuals for overdose
• Accessibility of services
o Same-day access to medications for opioid use disorder
• Linkage to services
o Referrals & follow-up support
• Countywide coordination of opioid/substance use response
o Providing a countywide response plan & engaging partners

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The only thing you can’t recover
from is death
• Keeping people alive, another chance to get help
• Naloxone (Narcan) saves lives
o Nasal spray can reverse opioid overdoses (heroin,
fentanyl, prescription opioids)
o Does not induce high, can’t be diverted/misused
o Can be administered by anyone w/ short training
o Narcan is provided at no cost by NYS DOH
o HEALing funding for shipping/event materials

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 1,808 Narcan Kits Distributed in 2 Years
2019 2020 2021
• 136 kits • 620 kits • 1,004 kits
• 12 trained/month • 69 trained/month • 84 trained/month
• Before HEALing • 9 months • Added red boxes
• Online/mail service, in public settings,
in-person, jail leave-behind by
AFD

YTD 4/2022
• 184 kits
• 46 trained/month

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Weedsport

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Cato
Auburn HS
BOCES

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QR Codes on Narcan
Boxes

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 Narcan kits & resource bags
go to housing development residents
in overdose hotspots

Thank You
Auburn JV Lacrosse Team
for helping to stuff bags!
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2020/2021: Bystanders Saved 76 Lives w/ Narcan

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Gaps in Cayuga County before HEALing
• Data collection
o Identifying countywide trends across the system
• Narcan distribution
o Keeping people alive
• Post-overdose outreach
o Identifying & connecting with high-risk individuals for overdose
• Accessibility of services
o Same-day access to medications for opioid use disorder
• Linkage to services
o Referrals & follow-up support
• Countywide coordination of opioid/substance use response
o Providing a countywide response plan & engaging partners

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 Post-Overdose Outreach
• Post-overdose outreach transitioned from
HEALing team member to Nick’s Ride
• HEALing funding for additional peer
• Mobile Crisis expansion allows for on-the-scene
assistance after an overdose
• HEALing funding for start-up costs
• Opened it up to substance use calls and to the public
directly

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Mobile Crisis Expansion to SUD/Public

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 Overdose Task Force
• HEALing PM facilitates meetings to discuss high-risk
cases for overdose and death
• In 2021 and YTD, 32 individuals overdosed in Auburn
two or more times and are alive.
• Repeated post-overdose follow-up conducted by
HEALing team member
• 12 couldn't be reached at the given address or are transient
• 10 have been contacted, not receptive to help, some are
connected to Nick’s Ride; 2 are in Jail
• 8 have been linked to MH clinic, Grace House, out-of-
county Supportive Living, or Inpatient

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Gaps in Cayuga County before HEALing
• Data collection
o Identifying countywide trends across the system
• Narcan distribution
o Keeping people alive
• Post-overdose outreach
o Identifying & connecting with high-risk individuals for overdose
• Accessibility of services
o Same-day access to medications for opioid use disorder (MOUD)
• Linkage to services
o Referrals & follow-up support
• Countywide coordination of opioid/substance use response
o Providing a countywide response plan & engaging partners

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Medications for Opioid Use Disorder (MOUD)
is not substituting one drug for another

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 Same-Day MOUD Initiations
• Small window of opportunity when people are
ready to seek help
• Local providers mostly not able to fill this need
• HEALing funds for contracted on-call prescriber
o Contract runs out in June
• HEALing funds to pay for first script
• HEALing funds to train peers
• Clients are linked to local providers for ongoing
care – good retention rate at MH Clinic – started
integrating mental health/substance use services

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2020/2021: 89 Individuals Started
MOUD Treatment the Same Day
with compassion & care

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What if it was your
child? How many
phone calls should it
take to get care and
how quickly should it
be available?
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 Stigma
Campaign

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Local Testimonials

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 HEALing Impact
• Implementation period and funding is ending
• Many strategies have been integrated and are self-sustaining
after initial start-up funds

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Gaps in Cayuga County before HEALing
• Data collection
o Identifying countywide trends across the system
• Narcan distribution
o Keeping people alive
• Post-overdose outreach
o Identifying & connecting with high-risk individuals for overdose
• Accessibility of services
o Same-day access to medications for opioid use disorder
• Linkage to services
o Referrals & follow-up support
• Countywide coordination of opioid/substance use response
o Providing a countywide response plan & engaging partners

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 Countywide Vision & Coordination
• Dedicated team built a countywide framework
• Project Director, Epidemiologist, Community
Outreach & Partner Engagement Coordinators
• Formulated Opioid Response Action Plan with 13
evidence-based, measurable strategies
• Planned with and supported partner agencies
during implementation
• Collected and analyzed data/trends and tracked/
reported on outcomes
• Implemented Public Information Campaigns

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 Looking Ahead:
Comprehensive Substance Use Response
• In 2021, 1/3 of all overdoses were suspected to be opioid-
related
• Address 2/3 of other substances, poly-substance use
• In 2021, 83% of fatal overdoses involved multiple substances
• Include robust prevention activities for different substances
• Continue to compile, analyze, and provide countywide data
trends to agencies to inform their programs and strategies
• Continue to facilitate cross-agency collaboration, service gap
elimination, community outreach that aligns with county vision

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Monika Salvage, Project Director
Email: msalvage@cayugacounty.us
Web: cayugacounty.us/healingcayuga
Social: @healingcayuga