CAPE COD REGIONAL GOVERNMENT ASSEMBLY OF DELEGATES APPROVED Journal of Proceedings –October 16, 2013 Speaker BERGSTROM: Good afternoon. Welcome to the Wednesday, October 16th meeting of the Cape Cod Regional Government, Assembly of Delegates. I would like to call this meeting to order. And we will begin with a moment of silence to honor our troops who have died in service to our country and all those serving our country in the Armed Forces. (Moment of silence.) Thank you. We will now stand for the Pledge of Allegiance. (Pledge of Allegiance.) Speaker BERGSTROM: The Clerk will call the roll. Roll Call (87.60%): Richard Anderson (9.15% - Bourne), Cheryl Andrews (1.36% - Provincetown), Ronald Bergstrom (2.84% - Chatham), Leo Cakounes (5.67% - Harwich), Christopher Kanaga (2.73% -Orleans), James Killion (9.58% - Sandwich), Marcia King (6.49% - Mashpee Teresa Martin (2.30% - Eastham), Suzanne McAuliffe (11.02% - Yarmouth), Deborah McCutcheon (0.93% - Truro), Patrick Princi (20.92% - Barnstable), Julia Taylor (14.61% - Falmouth). Absent (12.40%): Ned Hitchcock (1.27% - Wellfleet), John Ohman (6.58% - Dennis),), Anthony Scalese (4.55% - Brewster). Clerk O’CONNELL: Mr. Speaker, we have a quorum with 87.60 percent of the Delegates present; 12.40 percent absent. Committee of the Whole Speaker BERGSTROM: Thank you. In front of you, you have the Calendar of Business. Any additions or corrections to the Calendar? If not, I need a Motion to Approve. Deputy Speaker MARTIN: Motion to Approve. Ms. KING: Second. Speaker BERGSTROM: Okay. Moved and seconded. All those in favor, say “Aye.” “Opposed?” (Motion carried.) Speaker BERGSTROM: You should have also received a copy of the Journal of October 2nd, 2013. Are there any additions or corrections to the Journal? Hearing none. I need a motion. Deputy Speaker MARTIN: Motion to Approve. Ms. MCAULIFFE: Second. Speaker BERGSTROM: Moved and seconded. All those in favor say "Aye." “Opposed?” (Motion carried.) Cape Cod Regional Government – Assembly of Delegates Page 2 APPROVED Journal of Proceedings – October 16, 2013 Communications and Discussion with Human Services Director Beth Albert Speaker BERGSTROM: Okay. We’ll skip number 8 because both Bill is not available and Sheila is out of town and I don’t know where Mary Pat is. Speaker BERGSTROM: So we’ll go right to Communications and Discussion with Human Services Director, Beth Albert, on the work of the Department relative to the issue of substance abuse. Beth. Ms. BETH ALBERT: So thanks for inviting me here today to provide you all a brief update on the department’s work relevant to the issue of substance abuse. Right now, we are investing our resources in two strategic areas. For the past year and a half, we have been working to make existing data around the problem of substance abuse available to towns, community-based groups and organizations. And to that end, we did issue two major reports in the past year compiling that data as well as responded to specific requests by the towns and other organizations for this information if we could get it down to the town level. And so those two reports were about Behavioral Risk Factor Surveillance System. We did a 2008 to 2010. All of these -- both of these reports are online as well as all of the other data and research that the Department does. This particular piece of work aggregated three years of data. It’s the Behavioral Risk Factor Surveillance System Survey is something done by the Massachusetts Department of Public Health. It’s part of a nationwide survey. It looks at not only behavioral indicators but also health indicators like wealth -- health, weight and exercise to alcohol consumption, quality of life, depression. So it’s kind of this big range of factors it looks at. And so we pulled looking at the state data pulled it down to a County level and have issued that report. It was used extensively in the hospitals’ most recent Community Needs Assessment. So we have that available. We can dig into that sometimes in getting information on a town level. So that was one piece of work. And the other piece of -- major piece of work regarding substance abuse was Substance Abuse Treatment Statistics. We issued that in July. And that looks at trends on enrollment to substance abuse treatment facilities for Barnstable County residents into facilities that are regulated by the Mass. Department of Public Health. So what you need to pull out of there is that it’s trends data on admissions, okay, to facilities that are licensed by the Massachusetts Department of Public Health. That’s the information we have available to us. I need to stress that the information in this report should not be interpreted as prevalence as far as it doesn’t tell you about how much use is going on. It simply looks at how many people are being admitted to these facilities. I would be happy to have staff come back at a later time and really dig into this. That’s not what I have prepared for today. Really, I just wanted to let you know that in the past year and a half as far as the County’s -- our departments’ resources have really been acting as to supplements of the other work that’s been going on in the community by providing this research and data that can be used by other organizations working in the area of substance abuse by the hospital and by the towns. And I actually prepared just kind of a quick little cheat sheet. I’m not sure if you’re interested in that on some of the data that we found? Deputy Speaker MARTIN: Yes. Ms. MCAULIFFE: Yes. Cape Cod Regional Government – Assembly of Delegates Page 3 APPROVED Journal of Proceedings – October 16, 2013 Ms. BETH ALBERT: You can pass it down. I just kind of pulled out what I thought was kind of the -- because it gets really deep into it and I didn’t want to do that. So, I’ll just give you a minute to pass that around. Speaker BERGSTROM: Just a quick question. Ms. BETH ALBERT: Yes. Speaker BERGSTROM: Does the data you collected, did that give us an opportunity to judge year by year the increase in incidents of, let’s say, admissions? Ms. BETH ALBERT: We can look at trends for admissions, yes. And there’s other data that’s collected that gives you kind of some insight into correlations between incidents, but I just want to caution you that it’s very different what we’re talking about as far as admissions. It’s strongly associated with substance abuse prevalence but it’s not the same thing. We also, and I say this in my notes, we’re a County who has the great resource in Gosnold, which is one of the lead treatment providers in the state here. So you always have to wonder sometimes proximity may not be leading to some of those. But, regardless, what we do know and what I’ve given you is just some selected data. If you’re more interested, we really have all of it in these reports, is on admission rates in Barnstable County. So inpatient admissions by County residents, so this is anybody who’s a County resident regardless of where they have inpatient admissions in the state. So Barnstable County is one of the higher rates of treatment admissions contrasted to the rest of the state. And, again, whereas treatment admission rates are strongly associated with substance abuse prevalence, we do have to be somewhat cautious in making the assumption that County residents -- because County residents do have access to Gosnold. As far as enrollment, the cluster of you know when you look at the age range, it’s the age range 20 to 29-year-olds that represent almost 38 percent of admissions. So that is kind of the cluster, that age range. And this surprises people but treatment admission where alcohol is listed as the primary substance remains the largest portion of admissions. So alcohol is the largest portion of admissions if someone’s going into treatment. And that comprised 46 -- in fiscal year ’11, that comprised 46 percent of the admissions. Treatment admissions over time because again we did this from 2007 to 2011 because we want to look at the trends, how things are going. So treatment admissions for other opiates and how that’s defined because all this is based on coding, how they code things when people come in to a facility, is all narcotics other than heroin. So for other opiates as a primary substance at the time of admission that has increased significantly over time and in fiscal year comprised almost 30 percent of admissions. And just some other indicators that we’ve looked at around substance abuse show higher rates for Barnstable County contrasted to the state, in particular looking at emergency room visits and ED data including opioids, which I can never say. So in a nutshell, that’s kind of the facts that we have pulled out that kind of give you the background around admissions data. And then we also have the Behavioral Risk Factor Survey. So our role primarily up to this point, we do have seats in our Health and Human Service Advisory Council. We’re involved in substance abuse and a lot of different ways, but not in a prime kind of convening role. And over the past six months or eight months, I’ve been approached by several members of our Health and Human Service Advisory Council and elected officials looking for the department to really take a stronger role, a more leadership role as far as organizing a Countywide something around substance abuse.