1. Narcotics Strategy and OTN DRAFT

2. Current State of Addictions Addictions-funded HSPs in 12-13 –five in total –partnered with two outside Central West –up from four in 11-12 Landscape in 10-11 –two HSPs –1,331 service recipients –case management, assessment and treatment, withdrawal management Higher than provincial average use of cocaine

3. Current State of Addictions

4. Concurrent Disorders* 25 cross-sector member organizations of the Concurrent Disorders Network wide adoption and implementation of GAIN Short Screener 1,640 completed by spring 2012 456 clients endorsed high mental health and substance use in past year 219 in past month

5. Osler Repeat Visit Study Conducted client chart audits Covered records from Q3 and Q4 10-11 Substance use repeat visitor profile: male, mid 30’s, alcohol

6. Dual Diagnosis Snapshot Four providers identified 54 complex cases in 2011 records Addictions, developmental disability, trauma, mental illness 28% of clients had a concurrent disorder

7. Dual Diagnosis Snapshot 92 of 149 visits attributed to six individuals 40 clients had average inpatient stay of 93 days Half the clients lacked treatment direction

8. Narcotics Strategy Narcotics Safety and Awareness Act (2011) Strategy driven by an MOHLTC Expert Panel Proper use, prescribing and dispensing of prescription narcotics and other controlled substance medications Ensure that people who need them continue to have access Reduce the misuse, addiction, unlawful activities and deaths related to these medications

9. Local Narcotics Strategy OTN units allocated in 11-12 as per approved Central West LHIN plan $1M funded in 12-13 as per MOHLTC directive Pregnant/parenting women and individuals with opioid addictions Provincial framework

10. Local Narcotics Strategy Service Delivery partners include: –Canadian Mental Health Assoc./Peel –Family Transition Place –Jean Tweed* –Peel Addiction Assessment & Referral Centre* –Punjabi Community Health Services –William Osler Health System

11. Local Narcotics Strategy Community Treatment –pregnant/parenting women, individuals –targeted populations include South Asian residents and youth –community workers and limited nursing Case Management – MMT –priority is pregnant/parenting women Community Development

12. Local Narcotics Strategy Clinical Coordinator –collective efficacy to provincial framework and functional centres as defined –cross-sector service partnerships –development of Addiction Services Strategy OTN Facilitator –multi-site support including for scheduling, procedures development, training, troubleshooting Work Group

13. Meeting Needs with OTN Improve access by rural, suburban, and urban residents to services Build on existing eight community mental health and addiction service providers Neutralize the travel distance between residents and services and between services Create addiction and mental health “service locations” across the LHIN

14. Meeting Needs with OTN Enhance capacity to respond where clients present e.g. emergency departments, shelters Better connect health resources to addiction and mental health services Facilitate cross-LHIN boundary service delivery e.g. consultations, sessionals

15. OTN Sites See handout –sites overview including unit type –mapped to show geographic coverage –indicates type of organization Health Mental health Addictions MH&A

16. AgencyResources BCHC*prepared to assign an RN or RPN to the role of T-med Coordinator, health informatics and IT support CMHA/Peel1 FTE T-med Nurse, 1.0 T-med Admin., 1 FTE I.T. DAFHTdeploying staff to support moving forward, ongoing clinical training Hope Acresled by the Program Director and Nurse/Intake Worker and supported by onsite IT person, additional support from Toronto SHIPimplementation supported through I.T./I.M. supported by 2 FTEs WOHS*1.0 RN FTE for Brampton Civic, Etobicoke General and WMC sites, T- med Dept., I.T. OTN Resources for Strategy *Phase 2

17. Unit Installation Status Site by Provider and Location Installed Projected “Live” Date Comments from OTN CircuitEquip. Bramalea CHC – BramptonnnEarly September Bramalea CHC – MaltonnnEarly September CMHA Peel – CaledonynLate April Dufferin Area FHTnnLate August Hope Acres Addictions & Rehabilitation CentrennMid June Jean Tweed^ Peel Addiction Assessment and Referral CentreyyMid April Pine River Institute*nnEarly September Rexdale CHC^ Supportive Housing In Peel – Dufferin County SitennEarly August Supportive Housing In Peel – Main OfficennEarly August Supportive Housing In Peel – Wilkinson sitennEarly August William Osler Health System – BramptonexistingnLate April William Osler Health System – EtobicokeexistingnLate April William Osler Health System – WM CentreexistingnLate April

18. Issues Identified Installing the OTN units Building the team (incl. role clarification) Establishing e-management –OTN scheduling system –communication –coordination –common language Training (certification) and Uptake (incl. barriers) Integration of OTN to clinical practices Promotion Modelling use of OTN Priorities for Access

19. Next Steps Determine an approach to connect work of LHIN TH/TM Committee and Narcotics Work Group TH/TM Committee to share work to date and plans with Work Group Work Group developing an implementation plan and related work plan

20. Contacts Christine Devoy, CMHA/Peel devoyc@cmhapeel.ca Wendy Ross, WOHS wendy.ross@williamoslerhs.ca Suzanne Robinson, Central West LHIN suzanne.robinson@lhins.on.ca