HomeMy WebLinkAboutInteragency Agreement - Winnebago County Overdose Fatality Review TeamInteragency Agreement
Winnebago County Overdose Fatality Review Team
As of the current date, January 15, 2025, the following agencies* have been invited to engage in
this cooperative agreement:
Addiction Medical Solutions of Wisconsin
Apricity
Ascension
Aurora Medical Center of Oshkosh
City of Menasha Health Department
City of Menasha Police Department
City of Oshkosh Fire Department
City of Oshkosh Police Department
Community Church
Fox Crossing Police Department
Fox Valley PRISM Team/Unity Recovery
Services
Gold Cross Ambulance Service
Hometown Pharmacy
Lake Winnebago Area Metropolitan
Enforcement Group
Medical College of Wisconsin
Neenah Police Department
Northeast Wisconsin Mental Health
Connection
Nova Counseling Services
Omro Police Department
Oshkosh Area School District
Partnership Community Health Center
Solutions Recovery, Inc.
ThedaCare
ThedaCare Behavioral Health
United States Attorney's Office
University of Wisconsin Oshkosh Police
Department
Village of Winneconne Police Department
Winnebago County Coroner's Office
Winnebago County Health Department
Winnebago County Human Services
Department
Winnebago County Human Services
Department, Behavioral Health
Winnebago County Human Services
Department, Child Welfare
Winnebago County Office of District
Attorney
Winnebago County Safe Streets Committee
Winnebago County Sheriff's Office
Winnebago County Sheriffs Office — Jail
Wisconsin Department of Corrections
WHEREAS, the parties are vested with the authority to promote and protect the public health and
safety and to provide services which will improve the well-being of individuals and their families.
WHEREAS, the parties agree that they are mutually served by the establishment of multi -agency,
multi -professional overdose fatality reviews, and the outcomes of the reviews will be the
identification of preventable overdose deaths and recommendations for interventions and
prevention strategies.
WHEREAS, the objectives of an overdose fatality review team are agreed to be:
1. Accurate identification and uniform reporting of the cause, manner, and relevant
circumstances of every overdose death with special emphasis on those features that relate to
potential preventability.
2. Improved communication and coordination of agency responses to overdose deaths in the
investigation and delivery of services.
3. Design and implementation of cooperative, standardized guidelines for the investigation of
certain categories of overdose death.
4. Identification of needed changes in legislation, policy and practices, and expanded efforts in
behavior health and safety to prevent overdose deaths.
04.21.2022
WHEREAS, the parties agree that all members signing this agreement are essential to an effective
review. *
WHEREAS, the parties agree that the review process requires case specific sharing of records,
and that confidentiality is inherent in many of the involved reports so that there will be clear
measures taken to protect confidentiality, and no case review will occur without all present
abiding by the confidentiality agreement.
NOW THEREFORE, it is agreed that all team members and others present at a review will sign a
confidentiality agreement which prohibits any unauthorized dissemination of information beyond
the purpose of the review process. The review team will not create any files with case specific
identifying data. Case identification will only be utilized to enlist inter -agency cooperation in the
investigation, delivery of services, and development of prevention initiatives. It is further
understood that there may be an individual case which requires that a particular agency be asked
to take the lead in' addressing a systemic or quality of care issue based on the agency's clear
connection with the issue at hand. It is further understood that a participating agency may use
information obtained at the review in accordance with the mandated responsibilities of that
agency. It is also understood that team review data may be entered into the Centers for Disease
Control and Prevention National Violent Death Reporting System and submitted to the Wisconsin
Department of Justice/Wisconsin Department of Health Services Overdose Fatality Review
REDCap, where it will be maintained for the purpose of establishing a state central registry for
overdose death data. The registry will include standardized data from overdose fatality review
teams throughout Wisconsin.
By signing this document, each party of the Winnebago County Overdose Fatality Review Team,
agrees they have read, understood, and agreed to the aforementioned terms and conditions.
Signature:�� Date:
Print Name: (� 1.-� ,_ ;�i i� l 0 1.
r
Title:
Agency Name:
* Winnebago County Health Department, as facilitator of the Overdose Fatality Review process, will
maintain a copy of this signed agreement form and a current list of all parties who have signed the
agreement.
04.21.2022