Health officer walks out of talk about treatment resources
The chairman of the Brown County Health Department’s Opioid Crisis Subcommittee and the Brown County Health Officer are working through a difference of opinion on how to handle giving out information about recovery resources.
Dr. Norman Oestrike, the county health officer and head of the health department, walked out of the July 9 Opioid Crisis Subcommittee meeting. Committee chairman Jeff Cambridge was talking about posting the name and contact information for Brandon Drake on the health department’s website.
Drake is an interventionist and treatment navigator who helps guide people into drug treatment programs, and he said he was one of the only people in the area who provide this service. More people need to be trained to do that, he said. Brown County could eventually have its own “Pathways” program, he suggested.
Forming a plan for treatment is essential so that when a person who is addicted to drugs is ready to quit, that plan can be implemented immediately, Drake said. That window of opportunity could be only a few days or an hour, and calling around to find the appropriate resources takes time, especially for a person inexperienced in the treatment network, he said.
Oestrike said it is important to have a person like Drake leading people through the process because of all the hurdles. But he’s concerned about the health department’s role in sharing that information. Dr. Michael Day also raised that concern, about it looking like the health department might be “promoting” a certain individual or service.
“What the health department can’t do is recommend treatment, or diagnose, or refer,” Oestrike said. “… I think that somebody, not the health department, needs to become the Brown County Pathways,” he added.
Cambridge suggested that maybe a disclaimer could be used that says the health department doesn’t promote these resources; it’s merely sharing information. Oestrike said it’s not that simple.
“We cannot tell you to ‘Call Mr. Jones, the contractor for your septic system, because he does the best job.’ … We’re following the law,” Oestrike said.
“You’re saying you want the health department to do these things, which, I’m suggesting to you, are not our role and have never been our role and have resulted in multiple lawsuits. … You said to ‘Call Brandon.’ … I can’t do that.”
Cambridge said that Drake’s program, Monroe County Pathways, was used by Monroe County government and supported by United Way.
“I’ve been here over an hour and I have another appointment,” Oestrike said as he walked out. “I’m not interested in arguing.”
As of July 20, the Brown County Health Department’s “opioid crisis contacts” webpage listed the email address, phone number and website for Centerstone, the website for the state’s Next Level Recovery program, the SAMHSA (Substance Abuse and Mental Health Services Administration) phone number and website. It also had a disclaimer that said: “This list does not endorse any particular organization and is for contact purposes only.”
As of July 20, the Monroe County Health Department’s website said that the Monroe County Pathways program which Drake operates was “currently unavailable.” That health department’s website directs people to two other sites where treatment providers are listed, one operated by the Lutheran Foundation and the other operated by the State of Indiana; and to the Indiana Recovery Alliance to get naloxone, an anti-overdose drug. “We apologize for any inconvenience and hope to have services restored soon,” the Monroe County Health Department website says.
Monroe County’s site also contains a disclaimer that “The inclusion of any links does not necessarily imply a recommendation or endorse the views expressed within them, they are for informational purposes only.”
After Oestrike left, the subcommittee spent the rest of the meeting discussing how to move forward with sharing information about treatment resources with the community. At the June meeting, Cambridge had distributed a seven-page list of treatment options in the counties surrounding Brown, which he had compiled on his own time.
Cambridge, whose nephew died of an overdose last year, said he found it “unconscionable” that the board wouldn’t share information that it had with the community as soon as possible.
Subcommittee member Cathy Rountree, who also is on the health board, suggested taking the issue of how to share information with the public to the full board. That question was not answered at the last health board meeting on July 17 before the board went into a closed executive session.
“I don’t think anyone would be here if we didn’t care,” said Day, a subcommittee member and health board member, at the committee meeting. “… We’re all involved. We’re all concerned. We all have to work together, and sometimes we have to look at the realm of what’s possible rather than the realm of what we’d like to have.”
Naloxone still available through health department
The Brown County Health Department is working to get doses of an anti-overdose drug out into the Brown County community.
The department received a state grant to distribute naloxone earlier this year. Over the course of several months, will be getting about 120 doses of the drug that can reverse an overdose and save a person’s life.
So far, nine doses have been signed over to a local fire department; seven to mental health provider Centerstone; and others to the Brown County probation department and courthouse, said Jennifer Unsworth, nursing supervisor for the health department. The sheriff’s office and Brown County Schools also will receive some, she said.
Individuals also can contact the health department to receive free doses. When a dose is signed over, the recipient gets instructions on how to use it, she said.
So far, not one person has called the health department to ask for naloxone, she told the health board on July 17.
Unsworth said she’s been hanging fliers around the county to tell people how to get it.
“I do appreciate all you have done to get this out in a rapid fashion,” said health board member Jeff Cambridge, who chairs the department’s Opioid Crisis Subcommittee.
Health department looking into wedding barns
The Brown County Health Department is reviewing definitions of “food establishment” over concerns about wedding barns in Brown County.
Jennifer Heller Rugenstein, who inspects food establishments for the county health department, said that the county’s definition of “food establishment” includes places that have a catering kitchen; but because these are barns, they don’t have a lot of the items needed to get a food establishment license. There isn’t a separate, less strict “catering kitchen” license, she said. The food establishment license is the one that restaurants get.
The health department knows of at least five wedding barns in Brown County, and most said that they’re serving food through a caterer. Any catered food that would be served in those wedding barns needs to be prepared in a commercial kitchen, she said.
There are also concerns with the serving of that food, said John Kennard of the health department. Regulations say that food is to be served at 135 degrees, but if that food is coming from a caterer in another county or even within Brown County, he doesn’t know how the could meet that regulation.
The issue is even more complex than food, because if they’re licensed as a food-providing wedding barn, they have to have a commercial septic system, Heller Rugenstein said. Saying that they’re catering everything helps them avoid that issue, she said.
She asked the health board for direction.
Health board President Thomi Elmore said she doesn’t want to put people out of business, but this is a public health issue. The board advised Heller Rugenstein to gather more information from the state and other counties to see how they handle wedding barns and licensing.
Fire-damaged home gets OK for rebuild
The health department has given permission for a Sweetwater Lake resident to rebuild her fire-damaged home despite questions about its septic system.
The septic system at the Muskrat Drive home doesn’t meet code, said Robert Turner of Express Restoration, the company doing the rebuild. He called it a “traditional septic” in the Cordry-Sweetwater lakes area, as it was built on a small lot with no other place to move or expand it. However, the septic has never failed, he said, and only one person lives there.
The health board was brought into the discussion because health department employees weren’t sure if this job could be classified as a “remodel” instead of “new construction.” If it was new construction, the house would need to put in a new septic system, and that would be a problem at this property. If it was a remodel, a new septic wouldn’t be needed.
The first floor and foundation are still standing after a fire at the home on March 10, Turner said. In his work with other counties, it wasn’t new construction as long as new footers weren’t installed, he said.
The board unanimously approved the request so that the rebuild can proceed.
