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Needs Assessment Mendonoma Opioid Response Planning Program Gualala, CA December 2019

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Needs Assessment Mendonoma Opioid Response Planning Program Gualala, CA December 2019 Mendonoma Opioid Response Planning Program Needs Assessment Mendonoma Opioid Response Planning Program Gualala, CA December 2019 Grantee Mendonoma Health Alliance Organization Grant Number G25RH32973 Address 38958 Cypress Way, Gualala, CA 95445 Service Area Northern coastal region of Sonoma County and southern coastal region of Mendocino County. More specifically, 60+ miles of isolated, rugged coastline beginning in Irish Beach down through Timber Cove and parts of Cazadero. South coast of Mendocino County, CA By town and zip code: Irish Beach/Manchester – 95459, Point Arena – 95468, Gualala – 95445, The Sea Ranch – 95497, Stewarts Point – 95480, Timber Cove /Cazadero– 95450 Project Director Name: Micheline White Title: Executive Director Phone number: (707) 412-3176 Email address: [email protected] Consortium Coast Life Support District Members and Stakeholders Mendocino County Public Health Bright Heart Health Mendocino County AIDS Viral Hepatitis Network Contributing Redwood Coast Medical Services Stakeholders Point Arena High School Arena Elementary School South Coast Continuation School RCORP-Planning II – Needs Assessment 1 | P a g e Mendonoma Opioid Response Planning Program Table of Contents Introduction…………………………………………………………………………. 3 Background Information …………………………………………………………… 4 Consortium Partners ……………………………………………………………….. 6 Grant Deliverables ………………………………………………………………..... 8 Vision/Mission/Core Values ……………………………………………………….. 9 Demographic Summary for Target Geographical Area ……………………………. 10 Needs Assessment Methodologies …………………………………………………. 15 Overview of Results & Findings Quantitative Data: Survey Results …………………………………………………. 16 Qualitative Data: Focus Groups – Results & Findings …………………………….. 24 Existing Services …………………………………………………………………… 54 Workforce ………………………………………………………………………….. 55 Priority Setting for Strategic Plan ………………………………………………….. 56 Discussion/Conclusion …………………………………………………………....... 57 RCORP-Planning II – Needs Assessment 2 | P a g e Mendonoma Opioid Response Planning Program Introduction Mendonoma Health Alliance is a non-profit community-based organization that provides direct prevention and wellness services through our Care Transitions Program, care coordination, health screenings, health education sessions and courses, and health resources, such as pill boxes, educational materials, blood pressure cuffs and prescription lock bags, to the community at- large. MHA also acts as the overarching convener for the MHA Rural Health Network. Nestled along a rugged coastline with breathtaking views of the Pacific Ocean, MHA’s unique service area encompasses a diverse group of small communities strung across 60+ miles of the rugged, winding Highway 1 corridor, along the southern coastal region of Mendocino County and northern coastal region of Sonoma County. Roads in and out of this treasured but secluded area are dangerous and sometimes impassable due to weather conditions and downed trees. Our service area is federally designated as “Frontier Area” due to its extreme isolation. From expectant mothers traveling over four hours round-trip for prenatal appointments to aging residents forced to leave their homes to be closer to specialty healthcare resources, no person goes untouched by the challenges of maintaining their health and well-being here. By population, MHA serves about 1,901 residents in Sonoma County between Timber Cove to the south and Sea Ranch to the north, and approximately 3,855 in Mendocino County from Gualala to the south through Manchester/Irish Beach to the north; a total of roughly 5,756 residents. This number fluctuates drastically during peak tourism seasons due to the high volume of part-time residents. It is estimated that part-time residents increase the Mendonoma service area population to more than 10,000. MHA was created in the 2015/2016 Fiscal Year through the work of a Joint Operating Group (JOG), which was launched by our founding partner organizations – Santa Rosa Memorial Hospital (SRMH), Coast Life Support District (CLSD) and Redwood Coast Medical Services (RCMS), with participation by community representatives from different parts of the CLSD/RCMS service area. The JOG engaged in multiple strategic meetings in which community health priorities and partner needs were identified, resulting in four areas of focus, referred to as the MHA Key Initiatives, as seen below: RCORP-Planning II – Needs Assessment 3 | P a g e Mendonoma Opioid Response Planning Program The JOG recognized that each Key Initiative requires support from a variety of resources, such as technology, community buy-in, funding, etc., to be successful. To back the intent and forward movement of the Key Initiatives, the following Supporting Initiatives were developed and adopted: SUPPORTING INITIATIVES In an effort to formalize partnerships within the JOG, grant funds were secured through the Health Resources and Services Administration (HRSA), a department of the Federal Office of Rural Health Policy, for a one-year planning phase to continue developing MHA. Following the one-year planning grant, MHA successfully secured a three-year grant from HRSA in the Rural Health Network Development Program for the 2017-2020 grant period. To ensure sustainability, MHA has expanded partnerships to include both traditional and non-traditional entities and continues to pursue more diverse funding through federal, state, local and foundation opportunities. Other sources of income include contributions from partner organizations and the community. Background Information In early 2018, MHA was approached by Gary Pace, M.D., Public Health Officer for the Mendocino County Public Health Administration, to request support and partnership in helping address the national opioid epidemic on a local level. At the time, Public Health had little presence in the south coast region of the county due to long-time funding shortages. A series of meetings ensued that involved additional county-wide organizations, including the Safe Rx Coalition (a program of Public Health), Mendocino County Aids Viral Hepatitis Network (MCAVHN), and Bright Heart Health. Simultaneously, MHA received a grant from AEGIS Treatments Centers through the Department of Health Care Services to begin working on the development of a local coalition to address opioid and substance use in our community. Motivating MHA and all of the mentioned organizations to take action were baffling statistics showing that Mendocino County had ranked the third-highest in California for opioid overdose RCORP-Planning II – Needs Assessment 4 | P a g e Mendonoma Opioid Response Planning Program deaths in 2017, with 19.3 deaths per 100,000, compared to its neighboring county to the east – Lake County – as the fourth-highest ranking at 17.02 deaths per 100,000.1 Sonoma County, directly to the south, ranked much lower with 5.99 deaths per 100,000, compared to the state average of 5.22 per 100,000. A year prior, one of the smallest communities within the MHA service area, Point Arena, ranked number one in the County for the highest opioid overdose deaths per 100,000, causing MHA to take pause and begin working toward collaborative partnerships that would provide better access to more prevention-based resources, along with analyzing the ability to expand available services. The Mendocino County map below shows Point Arena highlighted in red, representing the highest rate of opioid overdose deaths in the County in 2016. To learn more about opioid misuse in Mendonoma, MHA surveyed 85 students between the ages of 13 to 17 from Point Arena High School. Survey respondents represented 70% of the total student population. Results from the survey were astounding. Respondents reported engaging in opioid misuse – both prescription pills and street opiates, like heroin – at more than four times 1 California Department of Public Health, California Opioid Surveillance Dashboard, https://discovery.cdph.ca.gov/CDIC/ODdash/ RCORP-Planning II – Needs Assessment 5 | P a g e Mendonoma Opioid Response Planning Program higher than the national average. The graph below demonstrates local responses compared to 2016 national data provided by the U.S. Department of Health & Human Services. Point Arena Students reporting opioid use (18/19 90.0% School Year) 84.7% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 15.3% 10.0% 0.0% Yes No According to the U.S. Department of Health & Human Services, in 2016, 3.6% of adolescents ages 12-17 years old reported misusing opioids. Comparatively, Point Arena High School students reported opioid misuse at more than 4 times the national average (15.3%). Recognition of deeper issues began surfacing as MHA received seven referrals between December 2018 and January 2019 to assist clients in seeking treatment for addictions ranging from opioids and alcohol to methamphetamines. Referrals came from primary care providers and the Urgent Care Department at RCMS and community members. In January 2019, MHA pressed forward with CLSD, Mendocino County Public Health, MCAVHN, and Bright Heart Health to form a consortium committed to working together to complete a deeper assessment of needs and a gap analysis of the workforce available to address Opioid Use Disorder (OUD) and Substance Use Disorder (SUD) in Mendonoma. With MHA as the lead applicant, the Mendonoma Opioid Response Consortium was awarded planning funds from HRSA for the 2019/2020 Rural Communities Opioid Response Planning (RCORP) grant. The purpose of the funding is to use data and information gathered through an in-depth
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