The partnership between ACHD and Shuman Juvenile Detention Center led to a more comprehensive understanding of partner roles and challenges associated with responding to the public health threats presented by the opioid epidemic.
To support community level efforts to address the vulnerability of juvenile justice facilities during public health emergencies, the Allegheny County Health Department and the Shuman Juvenile Detention Center in Allegheny County, Pennsylvania, engaged with twelve other partners to improve, implement, and disseminate a comprehensive emergency operation plan to strengthen facility preparedness.
The United States is experiencing a growing opioid epidemic. In 2016, the CDC identified 26 states, including Pennsylvania, as being most vulnerable to new HIV or viral hepatitis infections due to unsafe injection drug use. Allegheny County, located in western Pennsylvania, is one of the counties most affected by the opioid epidemic, experiencing 564 overdose deaths in 2019. That same year, 1,739 confirmed and probable cases of chronic HCV and 12 acute cases of HCV were reported among Allegheny County residents. Similar to trends seen across Pennsylvania and elsewhere, a bimodal age distribution of HCV cases in Allegheny County has emerged. The increase in cases k in the younger age groups is associated with an increase in injection drug use. Shuman Juvenile Detention Center, located in Allegheny County, has reported increasing numbers of youth with substance use disorders. Although Shuman has an existing emergency operations plan (EOP) and offers health services for detained juveniles, enhanced and updated protocols were needed to address the specific and growing public health threats presented by the opioid epidemic.
Juvenile justice residential facilities are charged with the responsibility of providing youth with safe, secure environments and must adequately prepare for and respond to potential overdoses and infectious disease outbreaks among juvenile detainees. The Allegheny County Health Department (ACHD) has partnered with several county agencies to provide information, education, and resources to reduce and prevent overdoses as well as infectious disease outbreaks in their community. The ACHD recognized that a coordinated EOP among the county’s juvenile justice residential facility, the health department, and other relevant emergency personnel was necessary to adequately prepare for, respond to, and recover from the public health threats presented by the opioid epidemic to juvenile detainees.
Partners met at the ACHD in May 2019 to share their experiences working with the current Shuman EOP. NACCHO staff facilitated discussion to identify where updates were needed and prioritize next steps. An interdisciplinary planning team, representing 13 partner agencies ranging from nonprofit organizations to city and county government offices, defined communication pathways and established hazard priority areas. The team participated in monthly planning calls, facilitated by NACCHO. Hazard vulnerability groups were created for each identified priority area. These groups met outside of the regular monthly calls to develop specific hazard plans. Five hazard plans were developed and discussed during monthly calls: infectious disease, overdose prevention and response, evacuation, security active threat, and medical active threat. Using an EOP and functional annex from a local school district, Shuman staff took the lead in updating their EOP. Subsequently, Allegheny County Emergency Services developed a tabletop exercise. This weather -related exercise was designed to test various components of the EOP. However, the exercise was not completed due to the closing of the Shuman Juvenile Detention Center.
Infectious disease preparedness planning at the juvenile justice residential facility in Allegheny County had not previously been assessed. The ACHD identified a need for a multidisciplinary emergency preparedness planning team to assist Shuman Juvenile Detention Center with the review, refinement, and implementation of infectious disease policies and procedures.
The partnership between ACHD and Shuman Juvenile Detention Center led to a more comprehensive understanding of partner roles and challenges associated with responding to the public health threats presented by the opioid epidemic. In addition to refining policies and procedures relating to drug use, such as screening for infectious diseases like HCV, the relationships built throughout the course of the project led to a more robust response to the challenges of the COVID-19 pandemic. Defining communication pathways, recognizing the variety of tools and resources available to each agency, and understanding unique challenges allowed for a rapid and coordinated response during an infectious disease pandemic.
