SUBSTANCE USE

DISORDER STRATEGIC
PLAN

Butte Community Action Team

December 2022

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Butte Community Action Team (CAT)

Introduction & Background
In 2014 after three youths died by suicide over the span of five weeks, the Community Action
Team (CAT) was formed in Butte-Silver Bow to prevent suicide and has evolved into a
healthy community coalition. The coalition is comprised of local providers, school officials,
public health, government officials, social service agencies, local businesses, law
enforcement, and the faith-based community. The team established a “Healthy and Resilient”
vision for our community that is inclusive of all residents and successfully implemented
multiple evidence-based strategies and interventions over multiple years that resulted in a
decrease in youth suicide attempts.

MISSION: The Butte Community Action Team is dedicated to creating a healthy and
inclusive community through education, referral, and assistance to essential health and
wellness services.

VISION: Through education, relationships, and community connections, the Butte

Community Action Team will build a healthy, resilient, empathetic, and compassionate
community where we all care for one another by taking care of one another.

Currently, substance use is an ongoing concern in Butte-Silver Bow impacting individuals

and families across their lifespan. Overdose deaths attributed to opioid use are rising across
the country, including Butte-Silver Bow. In response to recent, devastating community
losses, Butte-Silver Bow Chief Executive J.P. Gallagher and Butte-Silver Bow Health Officer
Karen Maloughney reconvened CAT to collectively respond to and develop strategies and
systems to prevent, treat, and manage substance use disorders.

A community listening session, facilitated by Chief Executive Gallagher, was held on

September 8, 2022, to explore the challenges and opportunities faced by Butte-Silver Bow in
relation to prevention and treatment of substance use disorder (SUD) and gather feedback
from the community related to addressing the impact of SUD. Using the community
feedback, the CAT steering committee immediately began working on an advertising
campaign aimed at educating the community on the dangers of fentanyl and to start the very
important conversations that need to occur among all residents of Butte-Silver Bow.

The steering committee also identified the need for a strategic approach to addressing SUD
that would not duplicate, but rather compliment, existing efforts across the substance use
disorder spectrum with the goal of reducing drug related morbidity and mortality.

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Epidemiology for Butte-Silver Bow

Overdose mortality data for Butte-Silver Bow for 2016-2018 and 2018-2020 was higher than
the Healthy People 2020 goal of 11.3 per 100,000.

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Strategic Plan Development Process

In collaboration with the CAT steering group, the City-County of Butte-Silver Bow contracted
with the Montana Public Health Institute to facilitate a high-level strategic planning session.
On October 17, 2022, over 20 organizations, agencies, and individuals participated and
identified the priorities and strategies used to develop this plan.

Throughout the process themes emerged:

• Build on pre-COVID efforts and acknowledge the work that has already been done.
• Existing coalitions and structures should be utilized and engaged.
• Prevention efforts need to be sustained.
• Principles of diversity, equity, and inclusion should be woven throughout the actions
and strategies of the plan.
• Law enforcement, emergency services, and child and family services need to be
continually and intentionally engaged in this effort.
• Additional research is needed to understand the data sources and work that is
happening in surrounding counties.
• The focus of the strategic plan should not be limited to fentanyl, but inclusive of
multiple substances, including alcohol.

Due to the urgent nature of the current crisis in our community, the initial focus of the strategic
plan will be on substance use disorder (SUD) in addition to strategies specific to fentanyl. The
framework developed through this plan can be used to expand the focus more broadly to
include other substances, such as alcohol, in the future.

Using the 2020-2023 Montana Substance Use Disorder Task Force Strategic Plan as a
reference, participants were asked to prioritize the focus areas of 1) Partnerships, 2)
Surveillance, 3) Prevention, 4) Treatment, 5) Harm Reduction, and 6) Enforcement based on
two criteria:
1. How important the focus area felt for the response in Butte-Silver Bow.
2. The perceived ability of the community to impact the focus area.

The focus areas selected as priorities include Partnerships, Prevention, Harm Reduction, and
Treatment. Participants expressed a commitment to using data to make decisions and
monitor progress.

During the meeting, participants brainstormed a list of strategies and actions for each of the
priority areas and identified community resources. It was agreed that strategies and actions
should be coordinated and combined, when possible, with other community work focused on
SUD. A list of community resources and existing efforts is included with this plan.

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CAT Steering Group

The CAT steering group will support this project by providing oversight. The project
coordinator will conduct regular check ins with each work group and will gather and provide
quarterly data and program reports for each of the action areas to the steering group. The
steering group will use the information to make informed decisions and update the plan if
needed.

The steering group includes representatives from the following:

• People with Lived Experience
• Local Government/Public Health
• Local School Districts
• Medical Providers
• Community Based Organizations
• SUD/OUD Treatment Providers
• Local Non-Profit Organizations
• Local Businesses
• Southwest Montana SUD/OUD Coalition

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Strategic Plan

Overall Reduce Drug Morbidity and Mortality Across all

Goal Populations in Butte-Silver Bow

• Partnerships
Focus • Prevention
Areas • Harm Reduction
• Treatment

• Decrease mortality due to all drug overdoses

Baseline – 18.8 per 100,000 (2018-2020)
Overall • Decrease hospitalizations due to drug overdoses
Metrics Baseline – 159.1 per 100,000 (2018-2020)
• Decrease emergency department visits due to drug
overdoses
Baseline – 312.5 per 100,000 (2018-2020)

Criteria for Strategies Included in this Plan

Evidence
based & Sustainable Realistic & Comprehensive Multidisciplinary Trauma Empower at
data Achievable informed risk groups
driven

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Partnerships
FOCUS AREA 1
Metrics Regularly Convene CAT Steering Group
Target - 4 meetings per year

Regularly Convene CAT Work Groups

Target – 10 meetings per year

Key Area for Action 1.1 Cross Sector Collaboration

Strategies & Leads

1.1.1 Support cross sector collaboration between SUD stakeholders community wide,
including people representing at-risk groups.
Lead - CAT Steering Group

1.1.2 Combine applicable activities with the Southwest Montana SUD/OUD coalition
Lead – Alexis Tobin and George Mulcaire-Jones, SW MT SUD/OUD

Key Area for Action 1.2 SUD Partner Resources

Strategies & Leads

1.2.1 Conduct a crosswalk of programs and services provided within organizations and
agencies with possible mapping of services.
Lead –

1.2.2 Develop a community wide information system for treatment, recovery, and support
services that is inclusive to all.
Lead – Jamie Vanderlinden, SW MT OUD/SUD RCORP Grant (ref. coalition workplan
Objective 2.1)

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Prevention
FOCUS AREA 2

Metrics Decrease Youth Illegal Substance Use, ages 14-17

Baseline - Lifetime pain prescription misuse 11.5%, 2021

Decrease Adult Illegal Substance Use, ages 18+

Baseline – Need data for baseline

Key Area for Action 2.1 Local Prevention Infrastructure

Strategies & Leads

2.1.1 Support local prevention efforts to implement evidence-based programs.

Lead – Tami Martin, Butte Cares

Key Area for Action 2.2 Adverse Childhood Experiences (ACEs) and
Resiliency
Strategies & Leads

2.2.1 Support the work of local coalitions focused on early childhood and ACEs
Lead – Shelby Whelan, Butte 4-C’s, Zero to Five Collaborative

Key Area for Action 2.3 Awareness and Stigma Reduction

Strategies & Leads

2.3.1 Increase public understanding and awareness of SUD

Lead – CAT Steering Group, One Pill Can Kill/fentanyl campaign and website.

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Lead – TBD, Provide education for youth (focused on emotional awareness),

educators, parents, and community.

2.3.2 Work to decrease stigma

Lead – Kacie Bartholomew, SW MT OUD/SUD RCORP Grant (ref. coalition workplan
Objective 1.1), Develop and launch anti-stigma campaign for pregnant and parenting
persons including evidence-based prevention, treatment, and recovery strategies and
resources.

Harm Reduction
FOCUS AREA 3
Metrics Increase Access to Syringe Services Programs
Baseline – 1 Day Per Week, 2022

Increase the Number of People Receiving MAT

Baseline – Need data for baseline

Key Area for Action 3.1 Support and Expand Local Syringe Services
Programs (SSP)
Strategies & Leads

3.1.1 Provide community education about harm reduction strategies

Lead – Butte-Silver Bow Health Department (BSBHD)

3.1.2 Implementation of overdose SPIKE plan/team.

Lead - BSBHD

3.1.3 Co-locate SSP with Medication-Assisted Treatment (MAT)

Lead - BSBHD & Southwest Montana Community Health Center (SWMTCHC)

Key Area for Action 3.2 Increase Access to Naloxone

Strategies & Leads

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3.2.1 Encourage co-prescribing of naloxone with opioids.

Lead – TBD

3.2.2 Encourage initiation of MAT in people who receive naloxone.

Lead – TBD
3.2.3 Help community members and stakeholders obtain naloxone.
Lead – Kacie Bartholomew, SW MT OUD/SUD RCORP Grant (ref. coalition workplan
Objective 1.2)

Key Area for Action 3.3 Support Low or No Barrier Housing

Strategies & Leads

3.3.1 Support local evidence-based models for no/low barrier housing

Lead – Action, Inc., Housing First model through Continuum of Care and Emergency
Solutions grants
Lead – Butte Rescue Mission

Treatment & Recovery

FOCUS AREA 4
Metrics Increase Annual Admissions to Substance Use Treatment
Baseline – Need data for baseline

Increase the Number of Treatment Providers in CONNECT

Referral System
Baseline – 1 Agency, 2022

Key Area for Action 4.1 Linkage and Access to Treatment

Strategies & Leads

4.1.1 Expand the CONNECT Referral System to treatment and recovery systems

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Lead – BSBHD

4.1.2 Assess regional telehealth offerings including counseling and MAT

Lead – Jamie Vanderlinden, SW MT OUD/SUD RCORP Grant (ref. coalition workplan
Objective 2.2)

4.1.3 Provide training for primary care providers on Screening, Brief Intervention, and
Referral to Treatment (SBIRT) and MAT service business operations.
Lead – Jamie Vanderlinden, SW MT OUD/SUD RCORP Grant (ref. coalition workplan
Objective 2.2)

Key Area for Action 4.2 Crisis Response

Strategies & Leads

4.2.1 Explore Crisis Now model for community crisis response

Lead – Strategic Alliance Coalition

4.2.2 Increase the number of families receiving peer-support

Lead – Bill Deavel and Nikki Russell, SW MT OUD/SUD RCORP Grant (ref. coalition
workplan Objective 3.2)

Key Area for Action 4.3 Develop Recovery Community

Strategies & Leads

4.3.1 Recruit new partners and resources to be included in recovery, navigation, and
outreach
Lead - Bill Deavel and Nikki Russell, SW MT OUD/SUD RCORP Grant (ref. coalition
workplan Objective 3.2)

4.3.2 Increase the number of families receiving peer-support

Lead - Bill Deavel and Nikki Russell, SW MT OUD/SUD RCORP Grant (ref. coalition
workplan Objective 3.2)

4.3.3 Incorporate recovery-oriented services and supports into anti-sigma campaign

Lead - Bill Deavel and Nikki Russell, SW MT OUD/SUD RCORP Grant (ref. coalition
workplan Objective 3.1)

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Timeline

2023
Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov
2022 2023

1. Leads, Workgroups & Activities

• Finalize strategy leads

• Form workgroups
• Workgroups develop
activities and metrics
• Implement activities

• Workgroup meetings*

• Workgroup reports due

• Steering group meetings

2. Identify data points and coordinate data collection

• Identify local data sources

• Create data sharing MOUs

• Gather qualitative data

3. Fentanyl Advertising campaign** – ad materials finalized in November 2022

• Digital marketing campaign

• Website finalized

• Radio ads

• Billboard(s)

• Short film created

• Other media

4. Funding & Sustainability

Explore available funding

Develop sustainability
plans

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Community Resources

Action, Inc.:
Housing First model through Continuum of Care and Emergency Solutions grants,
Coordinated Entry, FUSE/WRAP Program

Alpenglow Clinic:
Chemical Dependency and mental health

Behavioral Health Local Advisory Council

Butte 4-C’s:
Zero to Five Collaborative, Children’s Mental Health Committee

Butte Cares:
Communities that Care

Butte Catholic Schools

Butte Rescue Mission

Butte School District #1:

PAX Good Behavior Game, Signs of Suicide, Zones of Regulations, Check and
Connect, Check-In Check-Out, Second Step, Kindergarten Home Visits

Butte-Silver Bow County Government:

Jail Diversion Program, Crisis Response grant, DUI Court, Drug Court, Veteran’s
Court

Butte-Silver Bow Health Department:

Syringe Services Program, SPIKE Team Project, CONNECT Referral System

Butte SPIRIT Home:

Transitional housing for addiction recovery

Community, Counseling, and Correctional Services:

SMART Program

Faith Based Community

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Mariah’s Challenge

Montana Chemical Dependency Center:

In-patient treatment, Detox Center

Montana’s Peer Support Network:

Recovery oriented behavioral health services

Montana Tech

People with Lived Experience

St. James Hospital / Intermountain Healthcare

SW MT Community Health Center:

Healthcare for the Homeless, FUSE/WRAP Program, MOUD Treatment, Behavioral
Health Services

SW MT Opioid and Substance Use Disorder Community Coalition:

RCORP Grant

Western MT Mental Health:

Community based mental health services

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References

Page 3: 2020 Community Health Needs Assessment, State of MT, Department of Public
Health and Human Services, Vital Statistics

Page 4: 2020-2023 Montana Substance Use Disorder Task Force Strategic Plan, State of
MT, Department of Public Health and Human Services,
https://dphhs.mt.gov/assets/publichealth/EMSTS/opioids/MontanaSubstanceUseDisordersTa
skForceStrategicPlan.pdf

Page 6: Baseline data for overall plan metrics, State of MT, Department of Public Health and
Human Services, Vital Statistics

Page 8: Baseline data for Prevention metrics, 2021 Montana Office of Public Instruction,
Youth Risk Behavior Survey, 2021,

Page 9: Baseline data for Harm Reduction metrics, Butte-Silver Bow Health Department
Syringe Services Program,

Page 10: Baseline data for Treatment & Recovery metrics, Butte-Silver Bow Health
Department CONNECT Referral System,

Page 16: Final BSB SUD Strategic Planning Notes & Community Assets Brainstorm
Montana Public Health Institute

Butte Community Action Team