Special Projects Fund

Grantee Name

Essex County Public Health

Funding Area

Special Projects Fund

Publication Date

August 2021

Grant Amount

$125,000

Grant Date:

May 2016- April 2018

The opioid epidemic has been called the worst drug crisis in American history; death rates rival those of AIDS during the 1990s, and overdoses from heroin and other opioids kill more than 27,000 people a year.

New York has not been spared—in 12 upstate New York counties alone, the number of heroin overdoses jumped 417% from 2009 to 2013. In response to this emerging crisis, Essex County Public Health (ECPH) established the Essex County Heroin and Opioid (ECHO) Prevention Coalition, a multiagency collaboration to prevent and reduce heroin and opiate use and addiction. A top priority for the coalition was to launch a Screening, Brief Intervention, and Referral to Treatment (SBIRT) program in Essex County. An evidence-based, effective approach to combat substance use disorders, SBIRT can reduce health care costs, decrease severity of drug and alcohol use, and reduce risk of trauma. In 2016, NYSHealth awarded ECPH a grant to introduce and implement SBIRT into Essex County.

Outcomes and Lessons Learned

  • Launched SBIRT at Elizabethtown Community Hospital and the Essex County Health Department Maternal Child Health Program.
  • Launched a campaign to raise awareness of opioid use in Essex County, establishing a social media presence, website materials, and community forums.
  • Hired a coordinator to provide assistance in implementing SBIRT and increase awareness and education of opioid and heroin use. The coordinator worked closely with the ECHO Prevention Coalition in creating a referral resource list to connect emergency departments, safety-net providers, and public health centers using SBIRT with treatment options for high-risk patients.

ECPH was successful in increasing the number of provider organizations adopting SBIRT policies, but it fell short of its goal of enlisting one of its target systems, Hudson Headwaters Health Network (HHHN). The main reason for this was the size of the organization—HHHN is one of the largest providers in the region, with 21 community health centers providing primary care to residents living in the 7,200 square miles of the Adirondack North Country and Glens Falls region. The adoption of an SBIRT policy would have required buy-in from, as well as training for, each of these sites. ECPH underestimated the amount time and resources needed to recruit HHHN by the end of the grant. This project was a grantmaking lesson learned for NYSHealth in working with health systems in rural areas of the State. In the future, NYSHealth will work more closely with grantees to take stock of the major barriers to scaling this type of program and set appropriate goals.

Apart from this NYSHealth grant, ECPH also worked with Albany’s Chief of Police to explore the possibility of piloting a Law Enforcement Assisted Diversion (LEAD) program in the North Country. ECPH has since worked toward incorporating a LEAD program in Essex County. LEAD is currently being developed and piloted by the Sheriff’s office in Essex County.

An important takeaway from this grant was the role that limited resources play in rural health projects. Like many of New York State’s rural regions, the North Country’s infrastructure and limited resources continue to pose major access barriers to health services. The opioid crises highlighted the challenges that rural public health departments face, especially as they pertained to the demand for SBIRT training and technical assistance. In recognition of ECPH’s limitations, and to ensure the program’s sustainability, the ECHO Prevention Coalition relocated the SBIRT training program to St. Joseph’s Rehabilitation Center, a coalition member with more readily available resources. In 2018, NYSHealth gave a grant to St. Joseph’s Rehabilitation Center to further expand SBIRT to health care providers throughout the North Country.

Co-Funding and Additional Funds Leveraged: None