Hamilton County Public Health (HCPH) serves 45 jurisdictions in Hamilton County, Ohio with a wide range of services and a staff of 132 that include Environmental Health Specialists, plumbers, health educators, physicians, nurses, counselors, epidemiologists and more. Hamilton County is located in southwest Ohio, with a population of 817,473 and contains the city of Cincinnati. The residents are 67.6% white, 26.6% black or African American, 3.6% Hispanic or Latino and 2.9% Asian. The median household income is $57,212. Colerain Township is located in the northwest portion of Hamilton County, has a population of around 60,000 residents and is the largest township by population in Hamilton County.
Like the rest of Hamilton County, Colerain Township has largely impacted by the addiction crisis. In 2019 Colerain Township residents accounted for 219 EMS dispatches for overdoses and 241 emergency department visits for overdoses by residents. In 2019, Colerain residents also accounted for 34 deaths from overdoses. While Colerain Township does have a large population, they lack some of the social service and treatment options that exist in the urban parts of Hamilton County. Colerain Township only has one outpatient addiction treatment facility and no inpatient facilities. Colerain residents also lack direct access to many harm reduction services such as a syringe services program.
In 2015 Colerain Township launched the nations first Quick Response Team (QRT) in response to the increasing number of overdoses. Since that time, Colerain has continued to be proactive in their outreach and partnership development in bringing support and resources to their residents.
In 2020, HCPH approached Colerain Township with an idea for a pilot program to better respond to the public health needs of the addiction crisis and to decrease the number of fatal and non-fatal overdoses among residents. This partnership would place a full time HCPH employee in Colerain Township whose primary goal would be engaging with residents to identify their needs and provide a connection to resources and services. While the focus would be on addiction and recovery support, the staff member would have the ability to provide a wide array of support services and linkage to care.
By embedding a staff person in the Colerain Township administration, they are able to act as an essential resource to all township employees including Fire/EMS, police, code enforcement, maintenance, and others. Navigating resources can be a confusing process for those in need and the front-line employees in Colerain do not always have the expertise to provide referrals and information to residents. The Colerain Community Health Coordinator (CHC) is a bridge between the township residents and the services and supports available in Hamilton County. Providing better access to services and resources allows staff to address the many factors that play a role in a person's ability to seek treatment and maintain their recovery.
This program includes many strategies such as the continuation and enhancement of the Colerain QRT, a community member needs referral system for first responders to send direct referrals to the CHC, engagement with established community service organizations, partnership with Northwest Local School District on a first-time offense diversion program, and outreach to local businesses to provide substance use disorder (SUD) resources and education.
Since the launch of the Colerain CHC program in 2020, Colerain Township has seen a 40.78% decrease in resident emergency department visits for overdoses and a 33.33% decrease in EMS dispatches for overdoses. The referral system for first responders now averages 30 referrals per month. Through the partnership with Northwest Local School District, over 100 individual intervention sessions have been held with students with a first-time drug offense.
The decrease in overdoses bring benefits to the community that reach far beyond the direct lives saved. From a public safety standpoint, Colerain police and EMS can more readily respond to other emergencies in the township with fewer overdose calls coming in. There is also a cost savings associated with fewer EMS runs allowing for funds to be re-allocated as needed. With fewer overdose calls, there are less transports to local emergency departments which also helps to lower the burden on hospitals near Colerain Township.
The success of this program is owed to the partnerships and engagement of township employees and residents. By working with Colerain Township to place this position, HCPH was able to obtain quick buy-in from Colerain Township Fire/EMS and Police as well as other township employees. Colerain is a unique community and residents have a lot of pride for their community. This position has been able to build on the trusting reputation of both Colerain Township and HCPH when engaging with residents, businesses, and community organizations. Teams from different departments of the township have been involved at various stages of the development of this program. By working with these teams to develop the various strategies, HCPH and Colerain were able to build out programs that had more buy-in and were set up for success from the beginning.