SAFE INJECTION FACILITIES SAFE INJECTION FACILITIES TASK FORCE TASK FORCE RECOMMENDATIONS RECOMMENDATIONS HCPC Presentation 2-26-2018 HCPC Presentation 2-26-2018 Laura Thomas (TF Laura Thomas (TF Member), Mike Discepola Member), Mike Discepola (TF TF Member), Member), Paul Harkin Paul Harkin **Special thank you to Eilleen Loughran & DPH staff for support & the use of the slides adapted for this presentation.
Gener General Fr Fram amework: ork: San San Fr Francisc ancisco Sa Safer Inje Injectio ction Ser Services ices Ta Task Fo Forc rce The Task Force developed 17 total recommendations that support the creation of safe injection services in San Francisco, and address the need for legal analysis, program planning and management, delivery model, location considerations, community engagement and education, and identifying special populations. February 26, 2018 HCPC 2
HI HIV Comm Communi unity ty Pl Planni anning ng Council Council Mo Motion on **Ap **Approved by by St Steerin eering Commi mmittee 2/15/ 15/18 18** ** • The HCPC full membership endorses the Safe Injection Services (SIS) Task Force’s recommendations for operating safe injection services in San Francisco. • The HCPC supports Assembly Bill 186 • The HCPC supports the implementation of safe injection services February 26, 2018 HCPC 3
INJECTION DRUG USE IN SF INJECTION DRUG USE IN SF Estimated 22,500 people who inject drugs in SF SF has continued to see overdoses from heroin, methamphetamine, and fentanyl poisoning People who inject drugs are at-risk for • unhealthy substance use • acquisition and transmission of HIV and hepatitis C • serious physical and mental health conditions • premature death February 26, 2018 HCPC 4
OVERDOSES IN SF OVERDOSES IN SF 160 160 SF has continued to see overdoses from heroin, methamphetamine, and 200 200 TO fentanyl poisoning Overdose deaths from RANGE OF OVERDOSE DEATHS IN opioids and stimulants in SF SF PER YEAR SINCE 2006 have been fairly stable February 26, 2018 HCPC 5
HARM REDUCTION HARM REDUCTION Public health philosophy Examples in San Promotes methods of reducing Francisco the physical, social, emotional, and economic harms associated with harmful Syringe Access & Disposal Naloxone behaviors that impact Medication-Assisted individuals and their Treatment (e.g. community methadone, Free of judgment and directly buprenorphine) involve clients in setting their Sobering Center own health goals February 26, 2018 HCPC 6
SAFE INJECTION SERVICES SAFE INJECTION SERVICES Professionally supervised facilities where drug users can inject pre-obtained drugs in safer conditions Service models: • Integrated • Specialized • Mobile 7 February 26, 2018 HCPC
SAFE INJECTION ROOM - MONTREAL
SAFE INJECTION ROOM - VANCOUVER
SAFE INJECTION ROOM - AUSTRALIA
TASK FORCE OVERVIEW TASK FORCE OVERVIEW BOARD OF SUPERVISORS RESOLUTION #123-17 Introduced by Supervisor London Breed (passed April 2017) Urged SFDPH to convene a safe injection services (SIS) task force Task Force Purpose: • to investigate: the potential opportunities and obstacles associated with safe injection services; the community need for such services; and the feasibility of opening and operating such services. February 26, 2018 HCPC 11 k l d
TASK FORCE COMPONENTS TASK FORCE COMPONENTS TASK FORCE APRIL 2017 – SEPTEMBER MEETINGS COMMUNITY 2017 ISSUE BRIEF SURVEY … 15 TASK FORCE MEMBERS SURVEY WITH PUBLIC … 3 TASK FORCE MEETINGS PEOPLE IN … 3 SURVEYS BUSINESS & ONLINE NEIGHBORHOOD SURVEY OF … FOCUS GROUPS 2 FOCUS GROUPS February 26, 2018 HCPC 12
KEY TASK FORCE RECOMMENDATIONS KEY TASK FORCE RECOMMENDATIONS Support creation of safe injection services in San Francisco “You don’t want to see me use drugs. I don’t want you to see me use drugs. SIF will meet both our needs.” –Seven 13 February 26, 2018 HCPC
POTENTIAL BENEFITS OF SIS FOR SAN POTENTIAL BENEFITS OF SIS FOR SAN FRANCISCO FRANCISCO ANNUALLY ANNUALLY $3.5 $3.5 110 110 1 415 415 3.3 3.3 19 19 M PWID LIFE SAVED HOSPITAL HIV CASES HEP C ENTERING EVERY 4 STAYS CASES TREATMENT NET SAVINGS YEARS *Source: Irwin, A., Jozaghi, E., Bluthenthal, R. N., & Kral, A. H. (2017). A Cost-Benefit Analysis of a Potential Supervised Injection Facility in San Francisco, California, USA. Journal of Drug Issues, 47(2), 164-184. February 26, 2018 HCPC 14
KEY TASK FORCE RECOMMENDATIONS KEY TASK FORCE RECOMMENDATIONS PROGRAM PLANNING PROGRAM PLANNING Plan for legal and real estate barriers legal and real estate barriers Conduct need need and planning assessments assessments Clear program goals Clear program goals, metrics, and program improvement processes “By not being subjected to the these images in public areas, this will help in reducing any triggers I sometimes feel.” – Anonymous, in early recovery February 26, 2018 HCPC 15
KEY TASK FORCE RECOMMENDATIONS KEY TASK FORCE RECOMMENDATIONS MODEL MODEL Integrated model Integrated model with on-site services and linkages to other services, including peer staff peer staff “These sites would make a huge difference for people in recovery or that want to be in recovery.” –Courtney February 26, 2018 HCPC 16
KEY TASK FORCE RECOMMENDATIONS KEY TASK FORCE RECOMMENDATIONS LOCATION LOCATION Multiple sites Multiple sites throughout San Francisco where drug where drug use most often occur use occurs Locate where existing servi where existing services are delivered es are delivered to people who inject drugs “I use drugs. I’ve also reversed over 20 overdoses. If we had a SIF, you could save more lives than I could.” – Frank February 26, 2018 HCPC 17
KEY TASK FORCE RECOMMENDATIONS KEY TASK FORCE RECOMMENDATIONS COMMUNITY ENGAGEMENT & EDUCATION COMMUNITY ENGAGEMENT & EDUCATION Strong community engagement Strong community engagement with: Residents, business owners, and neighborhood groups Law enforcement, probation, and parole agencies City agencies and community organizations “I don’t want to use drugs in public, especially in front of children.” – Kyle February 26, 2018 HCPC 18
TASK FORCE RECOMMENDATIONS TASK FORCE RECOMMENDATIONS SPECIAL POPULATIONS SPECIAL POPULATIONS Identify populations at populations at greater risk greater risk for health disparities, barriers to services, and/or risk for experiencing violence related to drug use “I don’t want to die of an overdose alone.” –Johnny February 26, 2018 HCPC 19
NEXT STEPS NEXT STEPS LEGAL ANALYSIS ADVOCATE FOR AB 186 INVESTIGATE POTENTIAL PARTNERSHIPS AND SERVICE SITES DEVELOP WORK PLAN February 26, 2018 HCPC 20
AB AB 186 186 – S – Safer Sub Substance nce Use Use Ser Services ices This bill allows local governments the discretion to authorize public health and medical intervention programs intended to reduce death, disability, or injury due to the use of controlled substances. According to the California Department of Public Health, drug overdose is a leading cause of accidental death in California. AB 186 would allow, pursuant to a vote of local government, exemptions for employee, staff, volunteers, and clients of health facilities intended to reduce drug overdose death and injury from charges related to possession of a controlled substance and drug paraphernalia, visiting a place where a controlled substance is present, or maintaining a place where controlled substances are used. February 26, 2018 HCPC AB Fact Sheet – Office of Assemblymember Susan Eggmann, 21 13 th Assembly District
HCPC HCPC Mo Motion on • The HCPC full membership endorses the Safe Injection Services (SIS) Task Force’s recommendations for operating safe injection services in San Francisco. • The HCPC supports Assembly Bill 186 • The HCPC supports the implementation of safe injection services. February 26, 2018 HCPC 22
QUESTIONS? QUESTIONS? *Special thank you SF DPH & Eileen Loghran for support and the use of the slides adapted for this presentation.
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