SYRINGE SERVICE PROGRAM Policies, Procedures, and Operating Plan Draft – August 2019 Grand Forks Public Health 151 S 4th St #301, Grand Forks, ND 58201 www.grandforksgov.com/publichealth Public Health Table of Contents 1 North Dakota SSP Application Entity Overview 2 Agency Information 2 Current Services Delivered 2 Populations to be Served 2 Governing Bodies 2 Primary Contacts 2 Medical Supervision 2 Community Support 4 Public Hearing Documents 6 Financial Sustainability Statement 7 Determination of Need 8 Policies and Procedures Plans 9 Eligibility Criteria for Participants 9 Location 9 Hours 9 Transaction Model 9 Enrollment Process 10 Ongoing Assessment 11 Sharps and Medical Waste Disposal 11 Medical and Other Supportive Services 12 Staff Training 15 Staff Safety 16 Evaluation Plan 16 Short Term Objectives 16 Long Term Objectives 16 References 17 Appendix A: Published Public Hearing Notices 18 Appendix B: Budget 19 Appendix C: Intake Form 20 Appendix D: Ongoing Services Log 21 Appendix E: Sharps Disposal Procedures 22 Appendix F: Referral Procedures 23 Appendix G: Referral Documentation 27 Appendix H: Safety Plan 28 Public Draft – August 2019 1 North Dakota SSP Application Entity Overview Agency Information: Grand Forks Public Health is a local health department that serves Grand Forks County and the City of Grand Forks. The department provides a full spectrum of public health services, with a broad focus on disease prevention, health promotion, access to care, and preparedness. The vision of Grand Forks Public Health is “Healthy people, healthy environment, healthy community.” The mission is to promote healthy environments and lifestyles, prevent disease, build community resilience through preparedness, and assure access to health services. The core values are integrity, collaboration, client focused, social justice, advocacy, science- based, and respectful. All values are held to high esteem when developing and supporting programs and services. Services Delivered at Grand Forks Public Health: Naloxone distribution and peer support for people who use Overdose training drugs (PWUD) Withdrawal Management Center Immunizations Linkage to treatment centers, medical Ryan White HIV Case Management assisted treatment (MAT), primary care Program Populations to be Served: Our program is built with the intention of providing services to people who use drugs or are at risk for HIV, HCV, or other infections transmitted by risky behavior and are at least eighteen years old. Governing Bodies: Grand Forks Public Heath is overseen by the Grand Forks Board of Health. Grand Forks Public Health is a department of the City of Grand Forks and has a collaborative agreement to provide public health services with Grand Forks County. Grand Forks Public Health is located in the Grand Forks County Office Building which is owned by Grand Forks County and is managed by the Grand Forks County Commission. Primary Contacts: Michael Dulitz, MPH, NRP Debbie Swanson, MS, RN Opioid Response Project Coordinator Director [email protected] [email protected] (701)787-8129 (701)787-8101 Medical Supervision: Joel Walz, MD, family medicine physician and Grand Forks Health Officer, will act as medical supervisor of the Grand Forks Syringe Service Program. Public Draft – August 2019 2 Community Support Engagement: After an informational presentation, the initial approval to move forward with establishing a plan and budget for a Grand Forks Public Health Syringe Service Program (SSP) was granted from the Grand Forks Board of Health on May 2, 2019. The Grand Forks Public Health Syringe Service Program was presented to the Northeast Human Service Center Community Partners at the second quarter meeting on June 10, 2019. The Community Partners are a group of agencies throughout the community who interface with clients of the Northeast Human Service Center. No objections were raised during or after the meeting, and positive feedback was received from some agency representatives. From this meeting, we were able to identify potential partners to refer participants to for particular services. On June 19, 2019, Grand Forks Public Health met with Mayor Michael R. Brown and Police Department Chief Mark Nelson. Chief Nelson expressed full support on behalf of the Grand Forks Police department. Mayor Brown gave his support to move forward with the program after discussing the scope of the impact of substance use on our community. He voiced that he was happy to hear that we were creating a system that will support individuals with substance use disorder in the Grand Forks area to better the community as a whole. Ashlee Nelson, Grand Forks Public Health Opioid Response Intern, had the opportunity to go on two ride-a-longs with Corporal Justin O’Neill of the Grand Forks Police Department. Corporal O’Neill is the mental health liaison for GFPD which allows him to develop a unique and positive relationship with members of the Grand Forks community that may use substances. In early August, Grand Forks Public Health provided informational briefings to the Grand Forks City Council and Grand Forks County Commission regarding the proposed program. Both entities were given a short description of the need in Grand Forks and the services that will be offered. From there, a roll out plan was detailed, including a plan for a community meeting and follow up with the Council and Commission in September 2019 for a concurrence vote. Grand Forks Public Health did a number of media interviews regarding the syringe service program immediately before, and after the informational briefings with the City Council and County Commission. Date Organization Type Title 8/5/19 KNOX Radio Radio GF Syringe Program 8/5/19 Prairie Public Broadcasting Radio News segment – title not available 8/6/19 KNOX Radio Radio Grand Forks Syringe Program 8/7/19 Valley News Live Television News segment – title not available Northwood residents advocate for bridge 8/7/19 Grand Forks Herald Newspaper replacement (County Commission Public Draft – August 2019 4 Meeting Summary) Grand Forks Considers Syringe Service 8/8/19 iNewz.tv Online Program Grand Forks Public Health seeks input on 8/10/19 Grand Forks Herald Newspaper proposed syringe exchange program Grand Forks Public Health seeks input on 8/10/19 WDAY TV Television proposed syringe exchange program Dramatic spike in Hep. C cases reported 8/12/19 Valley News Live Television in Grand Forks County On August 7, 2019, Grand Forks Public Health met with Grand Forks County Police Chief Mark Nelson, Grand Forks County Sheriff Andrew Schneider, University of North Dakota Police Chief Eric Plummer, and States Attorney Haley Wamstad to discuss the proposed program. Public Draft – August 2019 5 Public Hearing Documents The public hearing will be held on Wednesday August 14, 2019, in the third floor lobby of the County Office Building in Grand Forks. The meeting is scheduled for 6:00PM-7:00PM which includes a presentation about the program and the services that will be offered as well as time for questions from the community members. This meeting is meant to be informational and educational to all who attend. The operation manual will be available for review at this meeting. Grand Forks Public Health is also interested in gaining feedback from community members so that the program can best serve the intended population with an overall benefit to the community as a whole. The published notice for this meeting can be found in Appendix A. It was sent for release through the department’s news release listserv which includes print, digital, radio and television media outlets. Public Draft – August 2019 6 Financial Sustainability Statement The Grand Forks Syringe Service Program (SSP) will not use state or federal funds to purchase injecting equipment. Operation: The SSP will operate utilizing federal opioid funding made available to communities through the State Opioid Response Grant. The State Opioid Response Grant will run through September 2020, but continuation of funding is expected in the future. These funds will be used for the operation of the program, including staff time, office supplies, training and education, and sharps disposal supplies. In the event that federal opioid funds are unavailable, efforts will be made to secure other federal funding, and if needed, private funding to assist with sustaining operations. Supplies: No federal or state funds will be used to purchase injecting equipment or supplies. Grand Forks Public Health will seek funding from individuals and private organizations to purchase injecting equipment. A $5,000 grant has been secured to cover injecting equipment for the first year. The program will purchase supplies through a group purchasing program from the North American Syringe Exchange Network (NASEN) which allows for the purchase of supplies at a considerable discount. Donations: The SSP will offer services to clients regardless of their ability to pay. A suggested donation of $10 per visit will be requested which will be used to offset the cost of injecting equipment. Monetary donations will also be accepted from individuals and organizations. Donations of injecting equipment will be accepted from individuals and healthcare organizations if the supplies are in the original, unopened, sealed, and tamper-evident packaging. A budget for operation and supplies for the first year can be found in Appendix B. Public Draft – August 2019 7 Determination of Need Since 2017, Grand Forks Public Health had a significant role in the community’s response to the opioid crisis through their Opioid Statewide Targeted Response grant activities. The department’s opioid response is focused on prevention and treatment of opioid use disorder. The department’s prevention efforts have focused on increasing naloxone availability, along with appropriate training, to various organizations throughout the community as well as providing naloxone directly to individuals at risk for overdose. Through the Opioid Statewide Targeted Response Grant, the department has also provided funding to a variety of community organizations to increase access to evidence-based treatment for opioid use disorder.