© FSG| TYSA Progress Assessment UPDATED: FEBRUARY 5, 2015.

© FSG |

TYSA Progress AssessmentUPDATED: FEBRUARY 5, 2015

© FSG | 2

Table of contents

Topic Slide number

Reflections from TYSA coalition members 3

Current substance abuse landscape on Staten Island 4 - 8

Outcomes across workgroup focus areas 9 - 26

Enhanced resources for Staten Island 27 - 33

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In the words of coalition members:What has TYSA accomplished?

“This is the only collaboration I’ve worked with that makes a difference. It has saved lives.”

“In over 30 years of working across New York, I’ve never seen this kind of collaboration”

“We’ve dropped our judgments”

“TYSA validated the issue. It made it not just one person’s problem, but everybody’s problem”

“I hear hope when I’m talking to parents and grandparents on Staten Island, I don’t hear despair - and that is because

of TYSA”

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Current substance abuse landscape on Staten Island

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Story of Impact: Narcan

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Overdose deaths decreased dramatically on Staten Island as collective efforts increased

2010 2011 2012 20130

2

4

6

8

10

12

Staten Island

Bronx

Brooklyn

Manhattan

Queens

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Overdose rates from prescription pills, by borough of residence

From 2010-2014, the medication naloxone (Narcan) has saved over 400 lives in NYC*

Community awareness and education in Staten Island helps

people identify overdose situations*Data for 2013 are preliminary and subject to changeSource of graph: NYC Department of Health and Mental Hygiene, Epi Data tables: “Unintentional Drug Poisoning (Overdose) Deaths Involving Opioids in New York City, 2010-2013” Original data from NYC Office of the Chief Medical Examiner and NYC DOHMH Bureau of Vital Statistics*Source: Staten Island advance, “Despite some decline, Staten Island still leads city in overdoses”

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Population-level changes: Substance use

Status in 2009 Most recent (2013) 2020 Goal*

20.7%

14.2% 14.0%


37.3%

28.5%32.0%

Drinking in the last 30 days Binge drinking

Data refers to youth in 9th -12th grades drawn from NYC DOHMH. “NYC Youth Risk Behavior Survey.” 2009. Note: opioid data tracked by Borough of school *2020 goals for Staten Island youth match the reported 2009 rates for NYC on averageNote: originally, TYSA was tracking “lifetime use” of opiates; this has changed to “yearly use” to match current YRBS data

Opioid pill use in the last year (See note on indicator)

Youth-reported drinking has followed state and national trends

of overall decreases

The percentage of youth using opioid pills has increased slightlyStatus in 2011 Most recent (2013) 2020 Goal*

8.1%8.2%

TBD

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52.7

37.845

Status in 2009 Most recent (2013)

2020 Goal*

25.3% 24.8%20.0%

Population-level changes: Healthy Choices

Data refers to youth in 9th -12th grades drawn from NYC DOHMH. “NYC Youth Risk Behavior Survey.” 2009 and 2013*2020 goals for Staten Island youth match the reported 2009 rates for NYC on average* Silive repot, “Pregnancy, abortion rates for Staten Island teens lowest in NYC” from statistics of Department of Health and Mental Hygiene

Staten Island has the lowest teen pregnancy rates in the entire city*

Use of alcohol or drugs beforesexual encounter

Teen pregnancies (per 1,000 teens)

The data here shows that teens use substances before taking part in risky behaviors such as sexual

activity

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Outcomes across workgroup focus areas

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TYSA’s progress is occurring across the levels of influence and types of outcomes

Professional Practice

Community Infrastructure

Awareness/ Knowledge/

Belief

Behavior

Policy


10

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TYSA can measure impact across levels of influence and types of outcomes

Parents, schools, and the community adopt attitudes and behaviors that support healthy

youth attitudes towards substance abuse

Social Norms

Policy and Advocacy

Creating systems level change to impact norms, supply and

continuum of care

Substances are only available in settings that support appropriate

use

Retail and Marketplace Availability

Continuum of CarePrevention and treatment

organizations provide a high quality, integrated continuum of care for

youth

Working Group Strategies Impact

Changes in Systems

Alcohol Rx Drugs


Actions of professionals who influence youth behavior in various settings (healthcare, schools, pharmacies, justice system, police)

Community Infrastructure

Local environment and assets (liquor stores, treatment centers, substance abuse resources)

Policy

Policy context that surrounds substance abuse (I-STOP, liquor licenses)

Changes in Individual Youth and Family

Alcohol Rx Drugs

Awareness/ Knowledge/ Belief

Youth and family awareness, knowledge, and beliefs about substance abuse

Behavior

Child and family behaviors that prevent substance abuse

Population Outcomes

Decrease Alcohol Use

Decrease Rx Drug Use

Make Healthy Choices

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Social Norms



Social Norms

Policy and Advocacy


continuum of care


use




youth

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Social Norms Accomplishments (1 of 2)

13

Raised visibility and awareness of issues:

• Hosted an event with Chris Herren in partnership with the District Attorney, The Staten Island Foundation and Borough Hall for ~1,000 students

• Ran media campaigns on the Staten Island Ferry, working with TYMCA

• Partnership for Drug Free did co-branded TV radio and print ads with TYSA tagline

• Collaborated with Sundog Theatre Company and Illuminart Productions on educational plays

• Participated in panels at Staten Island Health and Wellness Expo for 3 years, average 100 people attending

Directly engaged with youth to better understand their perspectives and help them become part of the solution:

• Created and actively support TYSA Youth Council

• Hosted Youth Connect Summit (2014)

• Recruited 15 youth to attend the Community Anti-Drug Coalition of America (CADCA) National Youth Leadership Institute (NYLI)– as a result, several youth to go to national train-the-trainer conference with paid scholarships

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Social Norms Accomplishments (2 of 2)

Worked to expand youth prevention education services on Staten Island:

• NYPD has agreed to partner for in-school prevention education, piloting in 5th grade

• Working with Borough Hall-convened substance abuse advisory council that is geomapping existing programs on Staten Island and identifying gaps

Launched Staten Island Parents You Matter education workshops and materials:

• Hosted 5 events to train 169 community members as trainers

• Ran 24 parent workshops and trained 985 parents throughout Staten Island

• Shared parent education materials via websites and workshops

Collected data to better understand youth and adult attitudes and behaviors:

• Worked with partners to conduct Metis survey of adults on attitudes towards underage drinking and drug use, results released in 2012

• Supported Youth Development Survey run by OASAS, results to be released in 2015

• Supported Youth Risk Behavior Survey planning for Staten Island

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Continuum of Care



Social Norms

Policy and Advocacy


continuum of care


use




youth

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Continuum of Care Accomplishments

16

Expanded tools to identify and refer more youth to treatment:

• Identified CRAFT tool for adolescent screening (2012)

• Working to offer SBIRT training to NYC Administration for Children’s Services

• Worked with RUMCSI to offer SBIRT training to pediatric residents at RUMCSI

• Worked with NYC Departments of Probation to explore screening models

• Worked with Staten Island Physicians Practice Group to adopt SBIRT

• Participated in planning for NYPD Youth F.I.R.S.T (Family Intervention Response Support Team) rapid response pilot to intervene with families of youth suspected of having a substance issue and connect them to providers, including making connections to treatment providers and offering training via OASAS

Expanded awareness of existing treatment resources on Staten Island to allow more youth to access them:

• Created first ever Staten Island treatment guide

• Distributed 75,000 brochures via the DOHMH physician trainings and detailings

• Provided treatment brochures on website and at parent workshops

Enhanced existing resources through coordination:

• Created referral grid for professionals to use in coordinating services

• Created regular communications opportunities that allow providers to work and learn together

• Working to support new Salvation Army drop-in center and offer services

• Worked with SICASA on treatment initiatives

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More Staten Island youth are seeking treatment than in the past for their opiate use

Non-Crisis treatment admissions for opioid analgesic misuse, by borough of residence

“During our continuum of care meetings, we constantly talk about how to do our work better as treatment providers; for one, now there are treatment

brochures for the first time that we have spread all around the island. It’s easier for parents and kids to know about where to go for care”

Tota

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f ad

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Data from NYC Mayor’s Task Force on Prescription Painkiller Abuse,“RxStat: Opioid Analgesic Use and Misuse in New York City” original data sourced from: NYS Office of Alcoholism and Substance Abuse Services Treatment Data

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Citywide, more youth enter treatment with opioid as their primary drug vs. other substances

Number of opioid analgesic non-crisis treatment admissions in NYC, by age group

“Given the high amounts of pill abuse in our community’s kids, there is an enormous need for youth-specific recovery services. There

aren’t enough safe places for recovery on the Island to make sure that our kids don’t fall into the same patterns again after treatment.”

Data from NYC Mayor’s Task Force on Prescription Painkiller Abuse,“RxStat: Opioid Analgesic Use and Misuse in New York City” original data sourced from: NYS Office of Alcoholism and Substance Abuse Services Treatment Data

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Social Norms

Policy and Advocacy


continuum of care


use




youth

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Story of Impact: Prescription painkillers

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Until 2011, the rate of opiate prescriptions filled in Staten Island was higher than any other borough

Rate of residents who filled an opioid analgesic prescription (per 1,000 residents)

Median day supply of Rx pills, by borough

2009 2010 2011

20

25 25

1214 1515 15 15

8 810

12 1315

2009 2010 2011

130 132 131

89 94 99

65 68 74

98 102 106

71 75 79

Staten Island

Bronx

Brooklyn

Manhattan

Queens

New York City Department of Health and Mental Hygiene, Epi Data Tables: “Patterns of Opioid Analgesic Prescriptions for New York City Residents” original source: Prescription Monitoring Program; analysis by NYC DOHMH Bureau of Alcohol and Drug Prevention, Care and Treatment

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Prescription rates are decreasing for the first time in five years

5% drop in total Rx filled

• Hydrocodone prescriptions dropped 23%, from 71,877 to 55,651

• Oxycodone prescriptions dropped from 141,430 to 134,011

2012-2013

Rate of high-dose opioid analgesic prescriptions filled, by borough of residence

New York City Department of Health and Mental Hygiene, Epi Data Brief: “Patterns of Opioid Analgesic Prescriptions for New York City Residents” 2013

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Retail and Marketplace Availability Accomplishments- Prescription Drug Focus

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Advocated for policies to limit misuse of prescription drugs:

• Promoted passage of I-STOP legislation

Trained prescribers in practices that reduce availability of pills in community:

• Hosted 2013 Opioid Summit in partnership with Department of Health and Mental Hygiene and the Staten Island Borough President's Office, which addressed prescribing strategies that providers can use to ease the epidemic

• Worked with DOHMH to bring prescribing practice trainings to the 2 hospitals on Staten Island

‒ As a result of ongoing dialogue with hospitals on their role, hospitals changed policy to limit ER opioid prescriptions to a 3 day supply

• Worked with DOHMH to bring detailing for approx. 900 community physicians and other prescribers

• Hosted training for pharmacists in partnership with St. John’s and Touro Colleges

Created more opportunities for Staten Island residents to dispose of prescription drugs:

• Encouraged expansion of drug take back days and promoted them in community, working with NYPD, hospitals, and others:

‒ 2012: 190 lbs collected



• NYPD set up continuous disposal sites at its four precincts on Staten Island as part of a pilot project

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Retail and Marketplace Availability Accomplishments- Alcohol Focus

In process of exploring alcohol use on Staten Island college campuses

• Exploring connections between alcohol and other unhealthy behaviors impacting women, due to grants from City Council and Soroptimists

Raised awareness of alcohol issues on Staten Island and NYC

• Shared statistics via social media during Alcohol Awareness month

• Support Teen Council in doing a social media scan and alcohol advertising scan to inform their understanding of the influences that youth face

• Spoke at Alcohol and Prom Season Forum

• Participated in citywide forums around alcohol abuse

Worked to limit advertising and sale of alcohol to minors

• Hosted a free responsible beverage service train-the-trainer event for Staten Island residents

• Partnered with the Forest Avenue BID and provided resources to store owners on how to prevent sales to minors

• Worked with NYPD and state liquor authority to do compliance checks

• Working across the city to remove alcohol advertising on MTA as part of BAAFT (Building Alcohol Free Transit), along with NY Alcohol Policy Alliance, Unidos, Bronx Health Reach, Throggs Neck Community Action Partnership

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Policy and Advocacy



Social Norms

Policy and Advocacy


continuum of care


use




youth

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Policy and Advocacy Accomplishments

Promoted policies that support TYSA goals at local and state levels:

• Supported passage of I-STOP legislation, in partnership with Senator Lanza and Assemblyman Cusick

• Exploring social host ordinances

• Promoted a bill that reduced barriers to accessing treatment, sponsored by Assemblyman Cusick, passed in 2014

• Supported a change in New York State naloxone policy that allows possession of naloxone by a non-prescriber, in addition to training on naloxone use without a licensed health care professional on site, passed in 2014

Regularly met with local and state policymakers to discuss issues impacting Staten Island:

• 2012, 2013:Hosted legislative briefing for staff and elected officials

• 2013: Met with Community Boards to brief on potential ways they can support the overall goals

• 2014: TYSA met with legislators in Albany as part of an “advocacy day”

• 2014: Partnering with the JCC, hosted the statewide hearings on drugs and alcohol with over 400 individuals

• 2014: Met with state legislators and Drug Free Communities program officers to discuss progress

• 2014: Supported Senate Task Force Forum with TYSA, YMCA, Camelot, CHASI, NYPD and the hospitals as panelists

• Participate in NY State Environmental Policy Prevention Taskforce

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Enhanced resources for Staten Island

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TYSA has made significant progress in bringing and aligning resources to the common agenda

Resources include funding, data, services, staff, and information

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TYSA’s partnerships and influence bring and align resources to the common agenda

TYSA Common Agenda

TYSA backbone

and strategies

3. Resources are obtained for the community that support TYSA common agenda

2. Partners align their resources to TYSA activities and common agenda

Partners

1. New resources are obtained for TYSA backbone and strategies

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1. New resources directly for TYSA’s role in the common agenda

Who What

U.S. Dept. of HHS, Substance Abuse and Mental Health Services Administration

• Drug Free Communities Grant total of $500,000. $125,000 per year for 5 years

The Staten Island Foundation

• METIS study: total $40,000• Backbone funding: total $400,000 over 3 years• Alliance membership in Partnership for Drug-Free America:

total of $30,000 for up to 10 years

The Rotary Foundation • Grant total of $1,000 for TYSA Youth Council

City Council • Grant total of $2000 for alcohol forum with colleges

Soroptimist • Grant total of $530 for alcohol forum with colleges

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2. Partners align their resources to TYSA activities

Who What

YMCA Counseling Center and the Staten Island Mental Health Society

• Worked together to apply for OASAS prevention funding for their individual organizations’ programs, ensuring to align their proposal to the TYSA common agenda, and earmarking a portion of their grant dollars to support TYSA work directly

NYPD • Will begin training and assigning officers to teach prevention lessons in schools

• Sponsored sites for pill take back days• Began Narcan training in police academy• Equipped officers with Narcan

NYC Dept of Health and Mental Hygiene

• Donated Narcan kits for the Staten Island Health and Wellness Expo• Printed and distributed Staten Island treatment brochures• Trained 1,000 Staten Island physicians, nurse practitioners, physician

assistants (Jun-Aug 2013) in prescribing practices• Produced a public service announcement campaign that is currently

airing featuring a Staten Island mother who tragically lost her child to an overdose

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2. continued

Who What

Staten Island Ferry • Donated space for 3 ad campaigns on alcohol and prescription drugs (“Mind Your Meds”)

Staten Island Advance

• Donated space for TYSA ads• Committed to consistently covering the stories and science behind

youth substance abuse issues on Staten Island, publishing ~40 related articles in 2014 alone (all with mentions of TYSA)

CTV • Donated airtime to run TYSA public service announcements

Prevention Resource Center, an OASAS partner

• Paid for 6 people to attend train-the-trainer event on detecting fake IDs

OASAS • Re-launches Youth Development Survey in Staten Island

Community Health Action New York- Staten Island

• Led Narcan training at the Staten Island Health and Wellness Expo

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3. Resources are obtained for the community that support TYSA common agenda Who What

OASAS • Increase in total OASAS funding for Staten IslandFY 2014-2015: Staten Island received less than $1,000,000FY 2015-2016: Staten Island receiving $1,180,000

• Recent law requires OASAS to create a public awareness and education campaign on prescription painkiller abuse, which includes a website with information about signs of abuse and PSAs

Mayor’s Task Force on Prescription Painkiller Abuse

• Produced RxStat, a data set that includes emergency room visits to city hospitals for opioid overdoses, Fire Department and Emergency Medical Services calls for overdoses, deaths from opioids, prescription data from the state, and information from the Drug Enforcement Administration and the Manhattan District Attorney’s Office

District Attorney and NYPD

• NYPD received grant of $50,000 grant secured by District Attorney Daniel Donovan to equip all Staten Island officers to carry Naloxone

State Attorney General Eric Schneiderman and MTA

• The Metropolitan Transportation Authority officers patrolling the Staten Island Railway are given $40,000 to carry the anti-overdose medication naloxone through State Attorney General Eric Schneiderman’s "Community Overdose Prevention" program, which uses criminal and civil forfeiture money to equip police officers with the anti-overdose spray, and train them how to use it

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3. continued

Who What

Bayley Seton Hospital Alcohol Crisis Center

• Richmond University Medical Center, Staten Island worked with OASAS to create a new 15-bed crisis center for alcohol detox operated by Project Hospitality

Camelot Counseling

• Doubled its capacity from 35 to 70 beds dedicated to recovery

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© FSG| TYSA Progress Assessment UPDATED: FEBRUARY 5, 2015.

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