Abstract
The Public Health and Safety Team (PHAST) Framework and Toolkit were developed by the CDC Foundation in collaboration with the Centers for Disease Control and Prevention to guide local jurisdictions in strengthening coordination among public health, public safety, and other sectors to address the overdose crisis. The PHAST Framework uses guiding principles, strategies, and tools to help improve multisector engagement, data sharing, and coordinated overdose prevention. To assess its utility and inform its refinement, the initial version of the Toolkit was piloted in York County, Pennsylvania. A follow-up assessment was conducted 1 year after the pilot concluded. Application of the PHAST Framework appeared to have contributed to positive and sustained changes to meeting activities, structure, and attendance, supporting the potential utility of PHAST for advancing local-level multisector overdose prevention efforts. This article describes the basic tenets of PHAST, the pilot process, and findings from the 1-year follow-up assessment.
Keywords: multisector, overdose, overdose prevention, public health, public safety partners
The ongoing overdose crisis has led experts to conclude that collaboration between public health and public safety is critical to saving lives.1 Given each sector's expertise, information access, and perspectives2 (Table 1), public health and public safety coordination may present unique opportunities to enhance overdose prevention strategies and bridge knowledge, data, and service gaps that impact local overdose prevention efforts. State and local public health agencies conduct ongoing epidemiological surveillance to understand the extent of the overdose crisis; conduct research to identify effective prevention strategies; implement interventions to reduce overdose deaths and other harms related to drug use; and analyze data to assess the effectiveness of their prevention efforts.3 Public safety officers, including first responders, local law enforcement, and criminal justice authorities, often interact with individuals who have overdosed or are at risk of overdose. They also gather real-time data related to on-scene responses to overdoses and community drug threats.4 As the overdose crisis has evolved, the public safety sector is increasingly being recognized as a potentially valuable intervention point, not for punitive actions against people who use drugs (ie, people at risk of overdose) but for harm reduction and linkage to care.4 However, differences between the 2 sectors may also present challenges.1 Because of the numerous sectors collaborating and intervening with individuals at risk of overdose, the different work, standards, and cultures of the sectors, and the ongoing nature of the public health emergency,5 sustained coordination between public health and public safety may be particularly challenging. The Public Health and Safety Team (PHAST) Framework and Toolkit were developed to help jurisdictions reduce overdose deaths by improving data sharing and coordination among public health, public safety, and other community sectors. Early iterations of the Toolkit were piloted in a total of 10 jurisdictions. This article describes the basic tenets of the Toolkit, the first pilot, and lessons learned from a 1-year follow-up assessment.
TABLE 1. Differences in Public Health and Law Enforcement Investigationsa.
| Characteristics | Public Health | Law Enforcement |
|---|---|---|
| Method of event recognition | Event detected through public health surveillance or calls from clinicians | Event announced by attacker or is evident |
| Challenges to event recognition | Few clinical syndromes that are clearly the result of bioterrorist attack; difficulty distinguishing between disease of natural origin and bioterrorism attack | Large number of hoaxes and noncredible threats not associated with an actual bioterrorist attack; delay in notification of possible event by public health; “copycat” threats or attacks |
| Initial data collection | Hypothesis generation, “shoe-leather epidemiology” | Questioning of witnesses and suspects, follow-up of tips and intelligence information |
| Confirmatory data collection and analysis | Controlled epidemiologic studies | Collection and organization of evidence |
| Data validation | Presentation for scientific peer review | Indictment, arrest, and conviction |
| Goal of investigation | Effective disease prevention and control measures | Prevention and deterrence of future attacks |
aFrom Butler et al.2
PHAST Framework and Toolkit
The CDC Foundation, with support from the Bloomberg Opioid Initiative, partnered with the Centers for Disease Control and Prevention (CDC) to develop the PHAST Framework and Toolkit, which offer guiding principles, suggested strategies and activities, action steps (introduced in version 3.0), and tools to support coordinated multisector overdose prevention. The PHAST Framework is modeled after New York City's RxStat initiative, developed in 2012 to reduce deaths associated with prescription opioids.6 RxStat is a public health and public safety initiative that combines principles from the New York Police Department's CompStat7 (a program by which timely, crime-related data are regularly shared and discussed to drive strategic action and accountability) with those of public health epidemiology, surveillance, and injury prevention. Drawing from RxStat's guiding principles and lessons derived from its leaders and participants, the PHAST Framework engages multisector partners—with a particular focus on public health and public safety—to help them advance coordinated strategies to prevent overdose through a structured, data-driven approach. The PHAST Framework relies on 4 guiding principles that are closely modeled after RxStat: (1) a shared commitment to the goal of preventing overdose deaths; (2) recognition of opioid use disorder as a chronic and treatable disease; (3) responsible use of multisector data to inform prevention and response strategies; and (4) continuous improvement of interventions and strategies to reduce overdose deaths. The PHAST Framework provides a structure to help partners develop a shared understanding of the local overdose crisis, optimize jurisdictional capacity to prevent overdoses, and monitor their progress. The first PHAST Toolkit was developed in 2019. The 136-page volume offered general guidance and suggested activities toward achieving 4 objectives: (1) facilitate relationship building and communication among partners; (2) develop a shared understanding of the crisis; (3) identify, develop, and implement policies and practices to enhance response strategies; and (4) track progress (Table 2). The toolkit also included a variety of customizable tools, templates, and other resources to help jurisdictions achieve these objectives. Jurisdictions using the PHAST Toolkit could select, adapt, and implement the strategies and activities most applicable and relevant to their unique needs. The first Toolkit was piloted in a single jurisdiction, reported on here. A second version of the Toolkit was later developed and piloted in 9 jurisdictions. Findings from all of the pilots helped inform the final version, scheduled for release in 2022.
TABLE 2. PHAST Version 1.0 Objectives and Suggested Activitiesa.
| 1. Facilitate relationship building and communication among partners |
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| 2. Develop a shared understanding of the local-level opioid crisis, prevention strategies, and available local resources for reducing opioid overdose deaths |
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| 3. Identify, develop, and implement enhanced response strategies |
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| 4. Track progress toward achieving established outcomes that will ultimately reduce overdose mortality |
|
Abbreviations: CDC, Centers for Disease Control and Prevention; PHAST, Public Health and Safety Team.
aFrom PHAST Toolkit Version 1.0, CDC Foundation; 2019.
Setting
In 2019, the CDC Foundation launched a pilot to assess the utility and implementation of the first version of the PHAST Framework and Toolkit by a high-impact jurisdiction. To recruit an initial pilot site, the CDC Foundation engaged with the Commonwealth of Pennsylvania's Department of Health (PA DOH), which had recently completed a county-level readiness assessment to implement RxStat. The CDC Foundation reviewed the PA DOH report's preliminary findings and worked with its authors to select a pilot site based on the jurisdiction's readiness. Readiness criteria included the following: (1) an identified “leader or champion who heads the county's opioid response efforts”; (2) consistent partner engagement “from both public health and public safety who attend collaborative/task force meetings, communicate with one another outside of these meetings, and value collaboration and data sharing”; (3) demonstrated efforts to advance data sharing among multisector partners; and (4) additional contextual information, such as overdose rates that suggested a “high need” for a coordinated response.8 On the basis of these criteria, York County, Pennsylvania, was selected among jurisdictions “most ready to implement” an RxStat-type model as the first site to pilot the PHAST Framework and Toolkit.
The jurisdiction and collaborative
Among Pennsylvania's 67 counties, York County is a mid-sized jurisdiction with rural, suburban, and urban communities, with easy transportation access to Philadelphia, Baltimore, and New York City. In 2014, York County had the sixth highest rate of drug overdose deaths in Pennsylvania, with an estimated 27 overdose deaths per 100 000 population.9 Between 2014 and 2018, York County remained in the top 40% of overdose death rates in Pennsylvania.10,11 The York Opioid Collaborative (YOC), a 501(c)(3) organization, was established in 2014 by key community public health and public safety leaders. The YOC works to reduce overdose deaths and minimize the opioid overdose epidemic impact by coordinating prevention, rescue, and treatment and recovery efforts between public health, public safety, and community partners.12 The YOC received state-funded technical assistance from the University of Pittsburgh School of Pharmacy Program Evaluation and Research Unit (Pitt PERU) to develop the YOC's meeting construct and initial Three-Year Strategic Plan (2018-2021). The strategic plan identified 4 priorities that appeared to align with the PHAST Framework: (1) increase efforts to prevent or delay the onset of substance use disorders (SUDs); (2) increase efforts to promote the health and safety of persons at risk for overdose; (3) eliminate barriers to increase access and use of SUD programs; and (4) ensure that all individuals have the opportunity for successful recovery. The YOC is led by an executive director and is governed by a 16-member board of directors that meets monthly; it includes public health and public safety leaders across public, private, and nonprofit sectors. Prepilot, community-wide YOC meetings were convened monthly and included discussions, data summaries, and workgroup sessions.
PHAST pilot
The PHAST pilot took place from September 2019 through February 2020. During the 6-month pilot, YOC leaders and partners completed several Toolkit tasks and activities to promote multisector collaboration and coordination in their efforts to address the local opioid overdose crisis. As part of the pilot requirements, the YOC were contractually obligated to hold 6 monthly meetings and participate in postpilot interviews. Adoption of any specific guidance provided in the Toolkit was encouraged, but optional. The YOC was provided funding, tools, resources, and technical assistance to support their multisector data-driven overdose prevention and response efforts. Six meetings were convened during the pilot. CDC Foundation staff facilitated an introductory meeting where they introduced the Framework and Toolkit and led attendees through a brainstorming exercise to identify strengths, weaknesses, opportunities, and threats (ie, barriers) related to (1) partner engagement, (2) YOC organization, and (3) overdose-related data. Subsequent meetings were led by the YOC executive director, who also served as the PHAST coordinator and helped form a leadership team modeled after the PHAST Framework. The PHAST leadership team included public health and public safety leaders representing the city's health department and county's district attorney's office, an “adjunct” data analyst (a local college professor), and the PHAST coordinator.
Methods
At the conclusion of the pilot, CDC Foundation staff interviewed 7 pilot participants, including the members of the leadership team, to better understand participants' perceptions of (1) the Toolkit's utility and (2) strengths and weaknesses related to their multisector data sharing and coordination. The CDC Foundation drafted and shared a postpilot summary that identified key findings and suggested strategies to help strengthen multisector data sharing and coordination efforts identified through participant interviews and direct observations of monthly meetings. One year after completion of the pilot, the CDC Foundation reengaged the YOC for a follow-up assessment to examine progress and activities since the pilot concluded and the extent to which the PHAST Framework or suggested strategies offered by the CDC Foundation had been implemented, sustained, or improved. The follow-up assessment was informed by a review of minutes from YOC PHAST meetings held since the pilot concluded (from April 2020 to April 2021); observation of YOC PHAST meetings held during the assessment period (from May to August 2021); and interviews with 8 YOC PHAST partners. The findings presented from the pilot period and the 1-year follow-up assessment were informed by observations and participant interviews.
Findings and Lessons Learned
Table 3 lists the CDC Foundation's suggested PHAST strategies to help improve partner engagement and multisector data and information sharing identified at the conclusion of the pilot. For each suggestion, findings from the 1-year follow-up assessment are listed alongside corresponding PHAST Toolkit elements intended to support strategy implementation.
TABLE 3. PHAST Strategies Identified During Pilot Period, 1-Year Follow-up Assessment Findings, and Relevant PHAST Version 3.0 Toolkit Features and Elementsa.
| Suggested Strategies | 1-Year Follow-up Assessment Findings | PHAST Version 3.0 Toolkit Features and Elements to Support Implementation |
|---|---|---|
| Leadership strategies that may support participant engagement | ||
| 1. Consistent attendance and active engagement from both public health and public safety leaders at all PHAST meetings | Public health and public safety leads consistently attended PHAST meetings. |
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| Weekly meetings were held with public health and public safety leads and the YOC PHAST program coordinator. | ||
| 2. A repeated call to action from leadership to emphasize the urgency and severity of the overdose epidemic during PHAST meetings | The purpose of PHAST and guiding principles were routinely reviewed at the beginning of each PHAST meeting. | |
| Structural changes that may support participant engagement | ||
| 1. Include a statement of need for multisector collaboration in the mission statement and/or strategic plan | A new organizational structure was adopted; mission statement was developed for the YOC PHAST. |
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| 2. Communicate participation expectations to all critical partners | Multisector partners or their delegates regularly attended PHAST meetings. | |
| 3. Ensure all YOC PHAST participants understand the purpose, utility, and benefits of the PHAST Framework and Toolkit | Monthly meetings included an overview of PHAST and its purpose. |
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| New partners were sent a link to the PHAST Toolkit and asked to complete a DSA. |
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| Full review of the Toolkit is left to individuals. |
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| 4. Schedule meetings to maximize participant engagement | Meetings were held on a set, predictable schedule for 1.5 h each. |
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| 5. Develop meeting agendas that are action-oriented | Meeting agendas were well defined and included discussion of action items. Action items were recorded at the end of each meeting. Each action item included the key task, person responsible, and the due date. |
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| Activities that may support data sharing and use | ||
| 1. Develop and deploy a logic model to show how various activities will help partners achieve their shared goal of reducing overdose deaths | Not implemented |
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| 2. Develop a sustainable plan for PHAST data analytic capacity | Continued to leverage on individual partners for data analysis capacity. |
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| A sustainable plan to increase data analytic capacity has not been developed. | ||
| 3. Schedule partner presentations | Partners regularly shared updates during round-robin discussions. Guest presentations were incorporated into some meetings. |
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| 4. Leverage DSAs in alignment with local statutes to overcome data sharing challenges | All partners signed a DSA upon joining PHAST. |
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| Facilitation strategies that may support data sharing and use | ||
| 1. Encourage partners to openly discuss challenges and capacity limitations | Partners appeared willing to discuss agency-specific challenges. |
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| 2. Encourage partners to engage in active problem-solving and data-driven discussions, by asking questions, including question prompts provided in the Toolkit | Problem solving was primarily driven by individual partners raising concerns. The program coordinator regularly asks questions of partners during data discussions and partner updates. Specific question prompts provided in the Toolkit were minimally used. | |
Abbreviations: DSA, Data Sharing Agreement; MOU, Memorandum of Understanding; PHAST, Public Health and Safety Team; YOC, York Opioid Collaborative.
aAdapted from the CDC Foundation's PHAST Toolkit Pilot One-year Evaluation Report, August 2021.
bPHAST Critical Elements are components that are considered to be important to have in place when initially forming a multisector team or applying the PHAST Framework to an existing work group. The Toolkit encourages teams to assess the extent to which these elements are in place before starting a PHAST.
cPHAST Guiding Principles are beliefs and behaviors that ground the work of a PHAST and help align collective action and foster collaboration. The Toolkit encourages teams to routinely revisit these guiding principles during monthly meetings.
dPHAST Action Steps are specific, concrete, and sequential “actions” jurisdictions can implement to help achieve each PHAST objective. There are several action steps for each objective. The Toolkit encourages teams to review and complete action steps that support the team's objectives. The Toolkit also provides suggested strategies and activities to help teams complete each action step.
eStrategies expanded upon or added into version 3.0 of the PHAST Toolkit.
Partner attendance improved
At the start of the pilot, meeting attendance by public safety leadership and other key partners was inconsistent and participation among law enforcement and behavioral health partners was limited. Many partners identified scheduling conflicts, limited staff capacity, and competing priorities as barriers to consistent engagement. During the pilot, outreach to local police chiefs and behavioral health programs by the PHAST coordinator and the public health and public safety leads resulted in new partner engagement. From the first to the last pilot meeting, the number of attendees more than tripled from 4 to 13 and included representatives from treatment and recovery programs, criminal justice agencies, local police departments, health care, and the local fire department. At the 1-year follow-up, the number of meeting attendees remained high, ranging from 13 to 17 participants from across affiliations and sectors (Table 4). Meeting attendance records showed increased membership among treatment and recovery providers and more consistent attendance among the leadership team and chiefs from 3 high priority local police departments. Participants attributed increased attendance to a variety of factors directly or peripherally related to PHAST. Attendance among public safety partners was attributed to encouragement from PHAST public safety leaders, an increased focus among law enforcement on the connection between drug trafficking and overdose risk, and the adoption of a new data analytic software tool to track drug-related police encounters, including overdose events in the county. Interview participants noted that partners representing recovery and mental health were more actively engaged since the initial pilot and throughout the follow-up period. For example, one recovery service organization regularly attended PHAST meetings and shared data updates related to SUD treatment referrals, treatment resource capacity, and accounts of increased isolation among people in recovery during the COVID-19 pandemic. At follow-up, emergency medical service (EMS) and fire first responders continued to have minimal engagement with PHAST, which partners attributed to county-level reorganizations and EMS staffing challenges. PHAST members reported intending to reengage with EMS once their reorganization is complete.
TABLE 4. YOC PHAST Member Engagement by Affiliation and Sector at 1-Year Follow-upa.
| Public Safety Partners | Public Health Partners | Other Partners |
|---|---|---|
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|
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Abbreviations: PHAST, Public Health and Safety Team; YOC, York Opioid Collaborative.
aFrom YOC PHAST Meeting Minutes, April 2020-April 2021.
Changes to existing organizational structures and meetings were implemented
At community-wide meetings that predated the pilot, few law enforcement partners were in attendance, due to their perception that insufficient action resulted from these meetings. In addition, according to interview participants, some partners expressed a reluctance to speak openly about drug use in the community in the presence of any law enforcement attendees, thus stymying discussion. To address these challenges, YOC leadership instituted 2 distinct entities in its organizational structure by the end of the pilot: (1) YOC Prevention Coalition (community-wide, largely focused on outreach and community education), and (2) YOC PHAST, with an Overdose Fatality Review Team (OFRT) as a subset of PHAST (Figure). (Although planning for an OFRT began during the pilot, implementation took place during the follow-up period, in June 2021.) Each entity focused on advancing separate, yet related, YOC goals. PHAST and OFRT, each acting as a its own workgroup, focused on examining agency data and identifying opportunities to refine and implement agency-led policies and programs, while monthly YOC public meetings continued to focus on community education. At the 1-year follow-up, participants reported that the new organizational structure, which had been maintained, resulted in more focused meetings limited to public health and safety leaders with action-oriented authority and responsibilities. In addition, PHAST meetings continued to follow a consistent structure that was first established during the pilot, beginning with a basic data presentation by the coordinator and ending with general updates from partners. PHAST meetings were regularly scheduled, meeting minutes were recorded, and agendas included action items that identified the task, person accountable, and due dates, as well as presentations and discussion topics. To reinforce PHAST concepts among new partners or alternates, the PHAST coordinator would send a brief explanation of the PHAST Framework, a Memorandum of Understanding, a Data Sharing Agreement, and the link to the PHAST Toolkit to new partners before they attended meetings. Every meeting during the follow-up period began with a slide listing the guiding principles of the PHAST Framework and the shared common “North Star” (or goal) of reducing overdoses and overdose fatalities.
FIGURE.
YOC Postpilot Organizational Structurea
Abbreviations: ORFT, Overdose Fatality Review Team; PHAST, Public Health and Safety Team; YOC, York Opioid Collaborative.
aFrom CDC Foundation PHAST Toolkit One-Year Evaluation Report, August 2021.
Data and information sharing practices improved, while systems-level solutions proved more challenging
At each meeting during the pilot, county-level data on overdose deaths, naloxone administrations, and treatment referral outcomes were compiled and shared in the form of monthly data reports. During the pilot, outreach to a regional EMS entity resulted in a new data source being added and shared to provide a more complete picture of first responder encounters with overdose events, though overdose encounters from other first responders were still inaccessible (and efforts were underway to obtain additional overdose encounter data). Although data were shared at every meeting, they were typically presented as “point in time” and were seldom accompanied by sufficient context or framing to help partners identify trends or patterns. In addition, while these near real-time data were useful, PHAST members expressed a need for data integration to better understand the effectiveness of their prevention efforts. This stated need led to discussions about identifiable data sharing restrictions and related statutes that prevented data sharing across sectors. At the 1-year follow-up, additional data points had been included in monthly data reports, including those resulting from York County's investment in a new law enforcement data collection and analysis software platform that was planned prior to the PHAST pilot, drug seizure data obtained data from the High Intensity Drug Trafficking Areas (HIDTA) program,13 and data shared by behavioral health partners. Monthly data reports also included additional context, detail, and time trends to allow for more meaningful interpretation and discussion. Each PHAST meeting agenda included time for a round-robin discussion when partners discussed topical issues, needs, and resource availability and asked questions of one another for greater situational awareness. Partner and guest presentations, which had begun toward the end of the pilot period with a presentation on a law enforcement diversion project and another by a peer recovery organization, continued to occur. These included presentations from the Pennsylvania Prescription Drug Monitoring Program and the Pennsylvania Opioid Command Center, a state-level multiagency group established in 2018 to reduce fatal overdoses. A guest presentation provided by a certified recovery specialist prompted a discussion about stigma and compassion fatigue among first responders, and the meeting participants began discussing possible ways to address these challenges. In general, observers noted that opportunity for discussion and cross-sector learning was enhanced by the new meeting structure and improved meeting facilitation. Another activity to inform situational awareness and data-informed prevention strategies emerged with York County's launch of a local OFRT in June 2021, following a lengthy planning process that began during the pilot period. A comprehensive overdose fatality review (OFR) process shares the same guiding principles and processes as the PHAST Framework,14 by which fatal overdose cases are examined in concert with population-level data to derive practical recommendations to prevent similar overdose deaths. In York County, the OFRT comprises key partner agencies, including PHAST members, from the city bureau of health, coroner's office, county probation, county prison, and the district attorney's office, among others, who have the critical data needed to inform each individual case review. Additional partners, such as the local or state police, may also be asked to join a specific case review if they had information relevant to the individual case. OFRT partners meet bimonthly and operate under strictly defined participation and confidentiality rules and insights. Recommendations that arise from OFRs are reported to the YOC PHAST. The OFRT has identified challenges, formed recommendations for providing resources and training, shared these recommendations with the YOC PHAST, and assigned responsible parties within a defined timeline. The OFR findings are intended to help inform YOC PHAST action items. Despite the noted improvements, participants cited data sharing and analysis capacity limitations as ongoing challenges at the 1-year follow-up. Many PHAST members said that without a dedicated county department charged with aggregating and analyzing data across all county agencies, complete situational awareness was limited.
New Toolkit features may encourage greater use
The CDC Foundation and CDC developed and leveraged additional tools and templates based on participant feedback provided during the pilot, including more specific tools to facilitate highly structured meetings and guided discussions. In addition, YOC PHAST members offered 2 overarching observations about the piloted Toolkit and suggested some revisions. First, the lengthy Toolkit was difficult for time-constrained partners to fully explore; abbreviated “quick-start guides” were suggested, both in the case of an existing collaborative and for jurisdictions wishing to establish a new one. Members also suggested the development of a user-friendly online learning module with easy-access tools.
Conclusions and Implications
The YOC PHAST pilot and 1-year follow-up assessment shed light on both the potential usefulness and challenges of sustained public health and public safety coordination to address the overdose crisis. The overdose crisis is unique in that its severity, evolution, and duration5 have demanded a sustained focus among a large number of public health and public safety entities. As this pilot demonstrated, the public safety sector within a mid-sized county can include multiple EMS companies, fire departments, police departments, and criminal justice agencies, each with its own standards, culture, and approach to the overdose crisis, as well as distinct data systems. By also including public health, behavioral health, and the health care system, the size and complexity of cross-sector partnerships can become considerable. Of note, observations from the pilot and follow-up assessment were limited to YOC PHAST monthly meetings. Therefore, it is possible that additional overdose prevention strategies, interventions, and data collection initiatives were ongoing but are not reflected in these findings. Although the early version of the PHAST Toolkit piloted in York County offered general guidance and suggested activities to achieving its objectives, the Toolkit did not provide concrete or detailed suggestions for how each individual strategy or activity may be applied or implemented. These findings have led to the development of concrete “action steps” and detailed checklists in the final version of the Toolkit. Nonetheless, the 1-year follow-up assessment findings indicated that the PHAST Framework's guiding principles and many of the Toolkit strategies were applied, implemented, and sustained and appeared to have contributed to positive and sustained changes to meeting structure, to partner attendance, and to more data-driven, action-oriented meetings, thus supporting their relevance for advancing local-level multisector overdose prevention efforts. Although these improvements cannot be directly or solely attributed to use of the PHAST Framework and Toolkit, sustained activities, combined with participant feedback, support the Framework's potential utility. The pilot also highlighted the challenges and complexities of multisector coordination focused on the overdose crisis. In York County, though several partners had preexisting relationships and were committed to addressing the local overdose crisis, their participation in PHAST throughout the pilot and follow-up period ebbed and flowed because of competing demands, limited capacities, and resource restraints. For these reasons, organizational consistency and structure, supported by active and engaged leadership may be key elements to help support sustainability. In addition, the pilot demonstrated that coordinating, analyzing, and interpreting disparate data sources within and across sectors to provide a complete picture of the local overdose crisis may involve significant resource and time investments. The YOC PHAST leveraged multiple sources to advance data sharing and develop a shared understanding of the overdose crisis, including timely data from PHAST partners; the executive director's efforts to compile, develop, and share data reports; data analysis assistance from University of Pittsburgh's School of Pharmacy; the establishment of a local-level OFRT to leverage and share case-level data and findings with PHAST; and the launch of a new data management system to house overdose-related data. In conclusion, the pilot and follow-up findings suggest that technical assistance resources, such as the PHAST Toolkit and Framework, which provide guiding principles, strategies, and structure, can be useful to jurisdictions as they work to improve and sustain cross-sector coordination to address the overdose crisis. The final version of the PHAST Toolkit, an accompanying Web site, and several supplemental tools and resources are anticipated to available in 2022.
Footnotes
Financial support for the development of the PHAST Framework and Toolkit and for the York County PHAST pilot was provided by the Bloomberg Opioid Initiative through the CDC Foundation with a grant from Bloomberg Philanthropies. This work was supported by the Bloomberg Opioid Initiative.
The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention, the CDC Foundation, or the York Opioid Collaborative.
The authors declare no conflicts of interest.
Contributor Information
S. Sarisa Roe, Email: qdn5@cdc.gov.
Roseann Cordelli, Email: roseann@cordelliconsultingstrategies.com.
Brittany Shutz, Email: bshutz@yorkopioidcollaborative.org.
Stephanie Rubel, Email: fvw4@cdc.gov.
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