WECOS April 6, 2018 - Minutes

Meeting Document Type
Minutes

Dr. Wajid Ahmed

Acting Medical Officer of Health; Committee Co-Chair

WECHU

Patrick Brown

Executive Director

Windsor-Essex Community Health Centre

Michael Brennan

Executive Director

AIDS Committee of Windsor

Carissa Chapman

(for Detective Mike Symons)

Ontario Provincial Police

Peter Chevalier

Staff Sergeant

LaSalle Police Service

Sarah Cipkar

Community Development Coordinator Responsible for Neighbourhood Engagement Initiatives

United Way’s Neighbourhood Engagement Strategy

Claudia den Boer

CEO

Canadian Mental Health Association

Bart Dipasquale

Deputy Mayor, Town of Amherstburg

County of Essex

Ramsey D’Souza

Manager, Epidemiology & Evaluation

WECHU

Nicole Dupuis

Director of Health Promotion

WECHU

Lori Feltz

Manager Critical Care & Mental Health

Erie Shores Health Care (via telephone until 9:55 a.m.)

Michelle Graham

Residential Program Manager

St. Leonard’s House/Harm Reduction Network

Dr. Sonja Grbevski

Vice President, Brain & Behaviour Health

Hotel Dieu Grace Healthcare

Patrick Kolowicz

Director, Mental Health and Addictions

Hotel Dieu Grace Healthcare

Bruce Krauter

Chief; Committee Co-Chair

Essex-Windsor EMS

Alison Malott

Peer Representative

 

Dawn Maziak

Director, Sub-Region (Essex)

Erie-St. Clair LHIN (via telephone until 9:55 a.m.)

Gary McNamara

WECHU Board Chair, Mayor, Town of Tecumseh

WECHU

Robert Moroz

Integrated Director, Outpatient & Community Services

Hotel Dieu Grace Healthcare

Eric Nadalin

Manager, Chronic Disease and Injury Prevention

WECHU

Saamir Pasha

Epidemiologist

WECHU

Dan Potvin

(for Staff Sergeant Jason Bellaire)

Windsor Police Service

Sharon Pyke

Superintendent

Greater Essex County District School Board

Gillian Stager

Health Promotion Specialist

WECHU

Rosanne St. Denis

Executive Assistant/Committee Secretary

WECHU

Jeff Theriault

Clinical Practice Manager

Windsor Regional Hospital

Karen Waddell

Executive Director

House of Sophrosyne

       

Regrets:

Tom Bain

Warden

County of Essex

Jason Bellaire

Staff Sergeant

Windsor-Police Service

Steven Bellaire

Principal, Safe Schools

Windsor-Essex Catholic District School Board

Dr. Paul Bradford

Emergency Department Physician

Windsor Regional Hospital

Matt Capel-Cure

Sergeant

Amherstburg Police

Drew Dilkens

Mayor, Corporation of the City of Windsor

Corporation of the City of Windsor

Nichole Fisher

Manager, Clinical Services

WECHU

Dr. Robert McKay

Executive Director

Erie-St. Clair Clinic

Christine Malott

Agent for the Director of Public Prosecutions

Mousseau DeLuca McPherson Prince LLP

Theresa Marentette

Acting CEO, Director of Health Protection and Chief Nursing Officer

WECHU

Edward Marocko

Inspector

Ontario Provincial Police

Pamela Mizuno

Superintendent, Investigations

Windsor Police Service

Rob Modestino

Pharmacist

 

Jelena Payne

Community Development and Health Commissioner and Corporate Leader Social Development

City of Windsor

Debra Renaud

Representative for Families and Friends of Opioid Users

 

Mike Symons

Detective Sergeant

Ontario Provincial Police

Edith St.-Arnaud

Superintendent of Education Responsible for Student Services

CSC Providence (French Catholic School Board)

Guests: (6.1 Community Anti-Stigma Campaign)

Stephanie Bertrand

Peer Representative

AIDS Committee of Windsor

Patrick Firth

Glengarry Neighbourhood Renewal Initiative

AIDS Committee of Windsor

Kim Levergood

Presenter, Women Outreach Worker

AIDS Committee of Windsor

Co-Chairs: Dr. Wajid Ahmed and Bruce Krauter

1.0 Introductions Including New Members
Members were welcomed and thanked for their attendance. Introductions were made around the table.

2.0 Agenda Approval
Approved as presented.

3.0 Review of Minutes

3.1 Minutes of January 26, 2018
Approved with no corrections.

4.0 Standing Agenda Items

4.1 Committee Membership and Attendance/Terms of Reference

  • New members include Inspector Frank Providenti, Windsor Police Service (WPS) replacing Inspector Jim Farrand. Staff Sergeant Jason Bellaire (WPS) is new to the committee replacing Staff Sergeant Jeff Mailloux.
  • The Terms of Reference have been updated and are posted on the health unit website (www.wechu.org) along with WECOS-LC meeting minutes.

4.2 Roundtable Update/Opioid-Related Information Sharing with Community Partners

  • Peer Representative A. Malott will be initiating a large youth group.
  • She discussed an incident at the U.S. border involving the confiscation of Naloxone. She was alarmed that officials she spoke to were unfamiliar with the Naloxone.
  • The review on residential services report at Hotel Dieu Healthcare should be coming out soon.
  • An update on behalf of the Windsor Regional Hospital Emergency Department was provided.
  • St. Leonards House offers a support group for mothers, wives, etc. associated with males who have been incarcerated.
  • The Canadian Mental Health Association (CMHA) is trying to define its role in addiction to be able to do more on mental health related to addictions. They are reviewing the program and looking at capacity and what they can do to support the withdrawal aspect.
  • K. Waddell cautioned that the committee needs to be mindful of its name, that there are other substances being discussed besides opioids. She encouraged everyone to keep this in the forefront that the work the committee is doing is really about addictions. The group would not want to send the wrong message to the community that opioids is the only drug of concern. Dr. Ahmed agreed that now with the creation of the opioid strategy and pillar working groups, it should get us to the point that we are able to focus on other drugs, not just opioids.
  • At the recent Harm Reduction Conference in Chatham, the AIDS Committee of Windsor was one of the presenting partners along with CMHA and the Chatham-Kent AIDS Committee of Windsor. The US surgeon general, Dr. Jerome Adams issued a national advisory recommending all U.S. residents carry naloxone.
  • M. Brennan of the AIDS Committee of Windsor updated on distribution of kits and training.
  • Windsor-Essex CHC has been busy working on the Overdose Prevention Site (OPS) and Supervised Injection Site (SIS) applications. The OPS location has been secured next to the Street Health location at 711 Pelissier, Unit 1. Dr. Ahmed is hopeful that this group will have an opportunity to provide letters of support.
  • J. Payne has been leading the working group re: the needle disposal kiosks, looking at what type, style, and location, for their purchase.
  • E. Nadalin and G. Stager (WECHU) have been busy coordinating working group activities while R. D’Souza and S. Pasha have been working on the opioid monitoring and surveillance piece.
  • S. Cipkar reported that most of her work has been on the anti-stigma campaign.
  • Despite changes in WPS committee representation (see 4.1), police services have been participating in the Enforcement and Justice working groups.

5.0 Business Arising

5.1 Monitoring and Response System

  • S. Pasha presented a PowerPoint to the committee. It provided background on information currently being shared as part of overdose monitoring efforts. He highlighted the intended goals of the proposed overdose early detection system, provided descriptions of the methods that would be used in collecting data, defined cases, identified aberrations and classified alerts based on severity. He also described the different action pathways public health is proposing based on the alert type and the expected response from community partners. An alert classification system is part of a proposed monitoring and response strategy that would need to be discussed by WECOS-LC.
  • The Health Unit receives a weekly update on suspect opioid overdoses in Emergency Departments. The proposed plan is to communicate increasing overdose events in the community to provide early direction for local response.
  • The hope is that everyone can come forward to tell us the data that is needed and what data they can offer that will help define what the monitoring and surveillance system will look like.
  • WECHU’s main data sources are from the Ministry of Health & Long-Term Care (MOHLTC), but it is very limited as far as detail and not timely, and ACES which provides real-time data from emergency departments. SPC is used by the WECHU leadership team. It allows for identification on the severity of opioid overdoses and cases monthly.

Next steps proposed for the early detection system to move forward;

  1. Identify key contacts within WECOS-LC to share alerts and receive updates. Who do we send a message to first and how will this be determined?
  2. Initiate opioid overdose hotline for first-responders to notify Health Unit after hours.
  3. Subscribe for EMCT to obtain monthly naloxone distribution from the MOHLTC in Windsor-Essex County.
  4. Formalize timely access to data collected by partners (i.e. EMS, Hospital lab, Police seizures).
  5. Conduct additional studies with shared data.
  • WECHU is hoping to look for participants to work with its epidemiology team to figure out the method for data transfer and getting real time data. The Health Unit would like to acquire information about all data systems to be able to get some actionable items. Dr. Ahmed asked everyone to consider and respond.
  • Surveillance is one piece of the system. The Health Unit needs to get enough information from all relevant partners to create a complete picture about what is happening in the community around substances. This will assist in driving planning.
  • J. Thereault, M. Brennan, B. Krauter, and police services expressed an interest in participating in the group.
  • Ideally, the Health Unit’s vision is to have a live data system available to community providers minus confidential information, with some additional information that can be shared with partners that would be relevant to them.
    A system for sending alerts will also need to be determined.
  • Dr. Ahmed will work to set up a meeting with those who have expressed interest in participating in a committee to develop the system.

ACTION REQUIRED
Representatives to contact Dr. Ahmed or R. St. Denis about their ability to provide data and whether he/she would like to be a part of the committee to look at developing the surveillance and monitoring system.

5.2 Pillar Working Groups-Project Charters and Updates

  • There were 13 project charters developed within the four pillar working groups.
  • The charters do not have an end date, however they do need to be finalized and approved by the Chairs of the working groups.
  • The Chairs of the working groups are as follows:

     

    • 1—HARM REDUCTION WORKING GROUP
      Chairs: Michael Brennan (ACW) & Rita Taillefer (WECHC)
    • 2—TREATMENT AND RECOVERY WORKING GROUP
      Chairs: Patrick Kolowicz (HDGH) & Doris Stillman (House of Sophrosyne)
    • 3—PREVENTION AND EDUCATION WORKING GROUP
      Chairs: Claudia den Boer (CMHA) & Nicole Dupuis (WECHU)
    • 4—ENFORCEMENT AND JUSTICE WORKING GROUP
      Chairs: Al Gibson (Lasalle Police Service) & Jason Bellaire (Windsor Police Service)

Next Steps for the Working Groups

  • Further refinement of charters, activities, and indicators
  • Finalize 2018 annual plan created
  • Continue meetings of working groups (minimum 6/year)
  • Provide ongoing support to project leads
  • Provide quarterly progress updates to the Leadership Committee

Gaps identified in Windsor-Essex treatment/harm reduction services were raised as follows:

  • A huge gap in services for youth, especially the under 16 age group. There are issues with the 12-13 year olds that are not mainstream that need to be addressed. Programs should be geared to younger clients so that they can easier relate to people near their ages.
  • There should be something to bridge the time while clients are waiting for recovery services. With a waiting list of 9 months at the House of Sophrosyne, for example, clients need to be kept engaged.
  • All the entry pieces re: law enforcement need to be figured out.
  • There needs to be more services offered around treatment. Residential treatment should not be the only option. Some individuals going into residential treatment would be better suited for weekend or other non-residential services. As well, more programs for moms and their children are needed. Single parents who do not have support systems have to put their children in care to receive treatment. The House of Sophrosyne in their new facility allows moms to come in with their children.
  • We would like people to begin anywhere in the system. The gap is that people get an assessment and then what.
  • There was a query about the difference between an Overdose Prevention Site (OPS) and a Supervised Injection Site (SIS). An OPS was described as a small component of a SIS. People can bring their own product to take at a supervised injection site. A SIS provides a place to inject a drug without overdosing as there is someone there to monitor/save lives in the case of overdose. An OPS can address an immediate need in the community as it does not require support personnel like a SIS or community consultation in order to open.
  • Dr. Ahmed made the point that as the working groups continue their work, there should be some progress. All the agencies collaborating are working for the same cause and trying to leverage each other to serve the common goal. The Pillar working groups in conjunction with the WECOS-LC are now in a position to take on the actionable items and make them a reality.

6.0 New Business

6.1 Presentation: Community Anti-Stigma Campaign (10:25 a.m. – 10:45 a.m.)

  • Kim Levergood provided a PowerPoint presentation on the AIDS Committee of Windsor & Community Renewal Strategy Project: Label Me Person.
  • She discussed two initiatives, the anti-stigma community campaign and the public awareness campaign.
  • K. Levergood would like to launch the anti-stigma campaign in May to run throughout the summer. She would like to come back to WECOS-LC in January to discuss the community evaluation/lessons learned.
  • The anti-stigma campaign falls under a charter of the WECOS-LC Prevention & Education working group.
  • Dr. Ahmed encouraged WECOS-LC representatives to register for the pilot workshops and to participate in the panels. He will leave it for the leadership team to connect with K. Levergood.
  • S. Cipkar thanked K. Levergood et al. for their work on the project. She also encouraged WECOS-LC to attend the pilot workshops.
  • As information becomes available it will be shared with the WECOS-LC.
  • It is important for WECOS-LC to be out in the community showing its support.
  • The Prevention and Education Chair will take the oversight role for this project.

7.0 Next Steps

  • See Next Steps in 5.1 and 5.2.
  • Representatives to contact Dr. Ahmed or R. St. Denis about their ability to provide data and whether he/she would like to be a part of the committee to look at developing the surveillance and monitoring system.

8.0 Next Meetings

  • Friday, June 22, 2018, 10 a.m. to noon (Health Unit Main Boardroom)
  • Friday, September 21, 2018, 1 p.m. to 3 p.m. (Health Unit Main Boardroom)

9.0 Adjournment: 10:47 a.m.