PRESS RELEASE

December 21, 2017

Contact: Isaac McGinn (mcginni@hra.nyc.gov, o: 929-221-5564 c: 646-946-9667)

 

DE BLASIO ADMINISTRATION, CITY COUNCIL, AND ADVOCATES EXPAND COMPREHENSIVE OVERDOSE PREVENTION PROGRAMMING IN CITY SHELTERS

Administration officials, City Council and homeless advocates collaborate to enhance naloxone training at City shelters, expand training to additional facilities

December 21, 2017—The de Blasio Administration, Council Member Ritchie Torres, and VOCAL-NY, joined by fellow advocates, today announced that the City has expanded overdose prevention programming at City shelters, including enhancing naloxone training.

"The opioid epidemic continues to impact the lives of many New Yorkers, including those experiencing homelessness," said Deputy Mayor for Health and Human Services Dr. Herminia Palacio. "Our Administration is committed to investing in the proper resources and training to ensure that New Yorkers in shelter are equipped to prevent and reverse overdoses, and we will continue to leverage all City resources at our disposal to respond quickly to communities in need, connect New Yorkers to effective treatment, and save lives."

"New Yorkers saved nearly 400 lives with naloxone last year, and the City distributed more kits in the last six months than it did in all of 2016," said Department of Health and Mental Hygiene Commissioner Dr. Mary T. Bassett. "Today's announcement builds on the City's comprehensive plan to turn the opioid epidemic around, including overdose prevention training and naloxone distribution to New Yorkers at risk, making effective treatment for opioid addiction more accessible, conducting community outreach, and reducing stigma about treatment with buprenorphine or methadone."

"The citywide challenge of substance misuse requires citywide solutions, which is why all of our shelters have staff prepared in overdose prevention," said Department of Social Services Commissioner Steven Banks. "Thanks to close collaboration with the City Council and dedicated advocates, we are taking our comprehensive training efforts even further, expanding preparedness programming to additional facilities and offering new training opportunities to clients. As we work together to address substance misuse in our city and country, we remain committed to continuing to empower more New Yorkers to be overdose first responders, ready to save lives."

"Promoting positive health outcomes, harm reduction, and comprehensive overdose preparedness among clients and staff is integral to turning the tide on homelessness and improving quality of life for New Yorkers working to get back on their feet," said Department of Homeless Services Administrator Joslyn Carter. "On behalf of the Department of Homeless Services, I am proud to stand with our colleagues in the City Council and advocate partners to further expand our efforts to prevent and reverse overdoses in City shelters with the shared goal of always saving more lives."

Department of Social Services Commissioner Steven Banks, Department of Homeless Services Medical Director Dr. Fabienne Laraque, Human Resources Administration HIV/AIDS Services Administration Deputy Commissioner Jacqueline Dudley, Council Member Ritchie Torres, VOCAL-NY, and fellow advocates gathered at the Harm Reduction Coalition in Manhattan to commemorate the newly-enacted legislation, which further ensures naloxone administration training is provided to staff at City shelters and to expand naloxone administration training to staff working at HIV/AIDS Services Administration (HASA) facilities that may be at high risk of experiencing an opioid overdose. Codifying DSS policy into City law, the Department of Homeless Services is continuing to implement existing opioid overdose prevention programming and naloxone administration training at city shelters, with a focus on expanding client preparedness and empowering clients to be first responders if they witness an overdose. In addition to DHS shelters, DSS now requires HASA facilities to have a staff member trained in overdose prevention and naloxone administration on duty at all times during the provider's business hours, and has expanded efforts to train clients to HASA facilities, targeting residents that may experience or encounter an overdose. DSS is also developing a comprehensive harm reduction and drug-use prevention plan.

"DHS is committed to helping homeless New Yorkers improve their health by facilitating and increasing access to care," said Department of Homeless Services Medical Director Dr. Fabienne Laraque. "To save lives, DHS now has its own Opioid Overdose Prevention Program, thereby facilitating the expansion of naloxone training and distribution."

"In our city, as in the rest of the nation, the opioid epidemic has become a public health crisis with devastating consequences," said Human Resources Administration HIV/AIDS Services Administration Deputy Commissioner Jacqueline Dudley. "As we continue to explore effective ways to protect our clients' wellbeing and safety we applaud this partnership with our providers, elected officials and the advocacy community that made possible the expansion of naloxone training, which will provide staff in our emergency housing facilities with an effective tool to save lives."

"The opioid crisis that confronts us is the deadliest public health emergency in New York City, and every effort must be made to stop it," said Council Member Ritchie Torres. "All New Yorkers can learn how to save a life on a moment’s notice - not just doctors and emergency responders. The newly enacted law, which expands naloxone training to more shelter residents, shelter employees and providers, has the potential to save hundreds of lives and help fight against overdose incidents and the opioid crisis."

"Naloxone is most effective at preventing overdose deaths when it's in the hands of people who need it most. By equipping our city's shelter staff and residents with Naloxone, we will reverse the rising rates of homeless New Yorkers dying of overdose every year," said VOCAL-NY Co-Executive Director Alyssa Aguilera. "Thank you to Council Member Ritchie Torres, the NYC City Council, and the de Blasio Administration for valuing the lives of drug users and investing in proven public health interventions that will save lives."

"When I go to facilitate groups at Kingsboro Men's Shelter, I always bring my naloxone. As a former resident of Kingsboro, I know the importance of training residents to recognize an overdose and value their role as those most likely to respond to an overdose," said William Robertson, VOCAL-NY Community Leader and Harlem United Recovery Coach. "I look forward to seeing DHS' and HASA's plans to train residents and to, hopefully, playing an active role in seeing them through."

Opioid misuse continues to be a national and citywide challenge. In FY16, there were 1,374 overdose deaths citywide. During that same period, the deaths of 61 homeless individuals citywide were drug related, surpassing cardiac arrest to become the leading cause of death amongst homeless New Yorkers, with 25 of those 61 deaths occurring in City shelters. Those fatalities fall into two categories:

1. "Acute poisonings" also known as overdoses: wherein individuals die specifically as a result of the use of a substance; potentially preventable with naloxone
2. "Chronic use" fatalities: wherein individuals may have suffered from other bodily health complications due to chronic substance use, like liver cirrhosis due to hepatitis B or C acquired through injection drug use; not preventable with naloxone.

Of the 25 deaths tied to substance use in shelter, 20 of those deaths were considered acute poisonings, also known as overdoses, that could potentially have been prevented with naloxone.

BACKGROUND ON OVERDOSE PREVENTION IN CITY SHELTERS

Following Mayor de Blasio's 90-day review of homeless services, to address this citywide challenge head-on, in September 2016, DHS required staff from all shelters participate in comprehensive naloxone trainings to ensure shelters across the city are equipped to administer the life-saving drug. All current shelter providers have been trained and all shelters now have staff equipped to administer naloxone, including frontline staff, security staff, and social service staff at traditional shelters for both adults and families, as well as staff, including outreach teams, at dedicated facilities for street homeless individuals, like Safe Havens and drop-in centers. Additionally, every single naloxone use in shelter is reported to DHS management and reviewed by the DHS Medical Office.

In 2016, DHS staff administered naloxone 112 times, with 97 overdoses reversed and lives saved as a result. As a result of expanded naloxone preparedness, shelters have seen increased reporting as well as rapid response, with the number of overdoses reversed due to naloxone administration significantly increasing in 2017. From January to November 2017, there have been over 200 naloxone uses in shelters citywide and 181 overdose reversals—an 87 percent increase, in overdose reversals compared to 2016. DHS remains squarely focused on standardizing overdose awareness and prevention knowledge across the entire shelter system citywide, holding comprehensive trainings through the end of last year, with additional trainings continuing throughout this calendar year, and ongoing still, as new facilities are brought online and shelters may get new staff.

From September 2016 to November 2017, DHS offered trainings to ensure they are equipped to administer naloxone, with DHS and trained shelter staff training over 1,700 staff members and over 400 clients—and counting—to administer the life-saving drug.

Additionally, DHS partners with NYU Medical School to offer naloxone training opportunities to homeless New Yorkers residing at the 30th Street Men's Shelter. Under this Administration, since 2014, more than 400 clients have been trained through this initiative, including nearly 120clients trained this calendar year alone.

To further expand naloxone preparedness, DHS, with support from the Health Department, has instituted a train-the-trainer-model to share skills and best practices in overdose prevention across shelters citywide. Since November 2016, staff previously trained in naloxone administration have trained an additional 695 staff and 153 clients under this model. To date, DHS distributed nearly 3,000 naloxone kits.

"There are heroes all around us—people ready and willing to help others in their time of need," said Chair of the Committee on General Welfare Council Member Stephen Levin. "But we need to make sure those willing to help are equipped with the appropriate tools and training they need to save lives. That's why this approach is so important. The opioid epidemic affects the entire community, so it will take a community-based approach to address this public health crisis. Together, with this law and other innovative city initiatives, we can turn the tide."

"No one who is addicted need die from this disease, yet sadly far too many do. Knowing that New York's homeless population is among the most vulnerable to opioid addiction and overdose, BRC, one of New York City's leading homeless services providers, has had great success with our strategy of training all our staff in opioid overdose prevention," said Bowery Residents' Committee President and CEO Muzzy Rosenblatt. "We are excited about the new initiative from the de Blasio Administration to help those who are vulnerable and in need, and are grateful to the de Blasio Administration for their ongoing attention to the life and death struggle of those whom we serve who are living with the challenge of addiction."

"At Project Renewal, we provide naloxone training to all our employees, including those at our seven shelters and six supportive housing developments across the city," said Project Renewal President and CEO Mitchell Netburn. "Having seen our staff use naloxone to save dozens of clients’ lives, we are heartened that the City is expanding overdose prevention programming at its shelters, including more training for clients so they are empowered to save the lives of their peers in need. We applaud the de Blasio Administration and the City Council for taking this important step in the fight to end the opioid epidemic."

"The opioid epidemic is a national scourge and the most far reaching ever experienced. CUCS applauds the City’s leadership in supporting preventive and educational initiatives that will save lives," said Center for Urban Community Services President and CEO Tony Hannigan.

"The homeless and unstably-housed population in NYC is particularly at risk due to the disproportionately high incidence of substance use disorder and mental illness," said Care for the Homeless Chief Medical Officer Regina Olasin. "This opioid overdose training initiative is an essential life-saving program for this vulnerable population."

"BOOM!Health praises Ritchie Torres and the City Council for the passage of this important bill. All New Yorkers deserve access to life saving medication and response, regardless of housing status," said BOOM!Health Interim President and CEO Nunzio Signorella. "As we work to combat rising overdose rates, we cannot leave any community untrained or unequipped to respond to an opioid overdose and having DHS/HASA staff and residents prepared to effectively respond to an overdose is a crucial step toward protecting those at highest risk."

"More opiates on the streets means more risk for our patients but now naloxone availability at shelters make saving lives possible," said Dr. Jeffrey Bouchard-Burns, NYU Langone Family Health Centers Department of Community Medicine.

ADDRESSING ROOT CAUSES OF SUBSTANCE MISUSE

To address the root causes of substance misuse and further supplement citywide opioid prevention efforts and naloxone training, under the leadership of DHS Medical Director Dr. Fabienne Laraque, DHS is also developing an overall harm reduction and substance use disorder management strategic plan for City shelters.

To ensure City shelters are safe and secure environments, as a part of the Mayor’s 90-day review of homeless services, the NYPD conducted a comprehensive review of security in shelter facilities and began training all DHS security personnel in March 2016—and in January of this year, DHS formalized its partnership with the NYPD, implementing an NYPD management team to oversee and enhance security at DHS facilities, with the goal of improving quality of life for the homeless New Yorkers residing in shelter while they stabilize their lives, as well as staff. As part of this partnership, the NYPD continues to improve security measures citywide, including standardizing and professionalizing staff training, deployment, and access control, with security personnel receiving enhanced training, including naloxone administration training to prevent as many opioid-related deaths in shelter as possible and to prevent contraband, including illegal substances, from entering City shelters.

New Yorkers can purchase naloxone without a prescription at over 700 pharmacies throughout the city including all major chain pharmacies (Walgreens, Duane Reade, Rite Aid, and CVS). At least one form of naloxone is covered by most insurance plans, including Medicaid. Naloxone is also available for free from registered Opioid Overdose Prevention Programs. The Health Department offers regular naloxone trainings, which teach New Yorkers to recognize the signs of an overdose and respond by calling 911 and administering naloxone. The trainings are free, and all participants are offered a free naloxone kit.

###

About the Department of Homeless Services (DHS):

The Department of Homeless Services works to prevent homelessness before it occurs, address street homelessness, and assist New Yorkers in transitioning from shelter and street homelessness to permanent housing. DHS collaborates with non-profit partners to provide temporary shelter and services that homeless New Yorkers need to achieve and maintain housing permanency. In April 2016, Mayor de Blasio announced a major restructuring of homeless services in New York City by creating an integrated and streamlined management structure for DHS and the Human Resources Administration (HRA) under the Commissioner of the Department of Social Services. In February 2017, the Mayor announced his comprehensive plan to turn the tide on homelessness, neighborhood by neighborhood. The plan’s guiding principle is community and people first, and giving homeless New Yorkers, who come from every community across the five boroughs, the opportunity to be sheltered closer to their support networks and anchors of life, including schools, jobs, family, houses of worship, and communities they called home in order to more quickly stabilize their lives. Learn more about how DHS is turning the tide on homelessness, neighborhood by neighborhood, at nyc.gov/tide.