Comprehensive Opioid, Stimulant, and Substance Use Program

Visit Topic Area: Multisystem Partners

City of Palmer

The Palmer, Alaska, Police Department is leading this project on behalf of the Drug Endangered Children Multidisciplinary Task Force (MDT). The MDT was created to address gaps in the response to drug endangered children and their families living in Alaska’s Matanuska-Susitna Borough, to improve communication among agencies serving these populations, and to create a streamlined approach to providing family-centered, early intervention services to this population, with a goal of reducing both child victimization and repeat interactions between families and MDT member agencies. Grant funds will be used to hire a full-time MDT and drug endangered children (DEC) project coordinator to support MDT member agencies in adhering to newly established protocols, keep agencies on task, and collect, track, and analyze relevant data to determine the MDT’s efficacy in achieving its goals. Activities under this project include (1) real-time data collection and evaluation, which will help the MDT better understand the extent of the issue, the number of families referred to services, and determine the efficacy of the MDT’s efforts and adjust processes as needed; and (2) law enforcement and first responder deflection and diversion, through early identification and referrals of drug endangered children and their families to appropriate services to reduce repeat interactions. Roughly 50 percent of the project’s proposed budget is allocated to these uses, either through direct hires or contracts to hire family advocates to provide services and an evaluator to assist in identifying, collecting, and evaluating relevant data. Priority considerations addressed in this application include advancing racial equity and support for underserved communities (Alaska Native populations). This project serves residents of Alaska’s Matanuska-Susitna Borough and includes a partnership between the Alaska State Troopers, Alaska Youth and Family Network, Chickaloon Village Traditional Council, Knik Tribe, Mat-Su Regional Medical Center, Matanuska Susitna Borough School District, Palmer Police Department, State of Alaska Office of Children’s Services, Southcentral Regional Office, State of Alaska, Attorney General’s Office, Civil Division, State of Alaska Palmer District Attorney’s Office, Set Free Alaska, The Children’s Place (Regional Child Advocacy Center), and Wasilla Police Department.

Alaska

Izard County

This project will serve the Sixteenth Judicial District in northern Arkansas, a rural region comprised of five counties: Izard, Stone, Fulton, Cleburne, and Independence. The mission of this project is to reduce the impact of substance misuse, including overdose deaths, in the area. This will be accomplished by helping more people with substance use disorder (SUD) receive treatment instead of entering the criminal justice system. This project will also help increase community awareness about substance misuse and improve the ability of law enforcement agencies and communities to respond to overdoses. The primary focus for activities will be law enforcement deflection/diversion and access to peer recovery support services, and most of the activities will be conducted by COSSAP investigators and peer recovery support specialists (PRSS). Peers are individuals who have experienced SUD, are in sustained recovery, and have been trained to help others achieve recovery. By expanding access to peer support services, this project will connect more people with SUD to the treatment they desperately need. COSSAP investigators are deputies from the Izard County Sheriff’s office who are also assigned to the existing Drug Task Force for the district. Having designated COSSAP agents on the district task force will ensure that more cases involving substance use can be referred for peer support and that treatment arrangements can be made as quickly as possible. This project will also include outreach and education activities across the district and will improve the accuracy and efficiency of data collection. Allowable activities include: (1) enhancing access to peer recovery support services (35 percent); (2) law enforcement and first responder deflection and diversion (35 percent); (3) embedding PRSS at multiple points of Sequential Intercept Model (10 percent); (4) prevention programs to connect law enforcement agencies with K-12 students (10 percent); (5) drug take-back programs (5 percent); (6) data collection (5 percent).

Johnson County

The Johnson County Opioid Response Effort (JCORE), through the Johnson County Sheriff’s Office, centers on teaming peer specialists with specialty investigators so that behavioral health resources can be implemented during the timeframe when individuals are most receptive to help. This “golden moment” falls immediately after overdose or investigation and possible arrest. By pairing services with investigation, diversion to drug courts, treatment, and other transitional services moves the individual into a more positive path to recovery instead of the traditional method of incarceration only. Utilizing two teams of peer and investigator allows for round the clock coverage without creating stress of continuous coverage on one team which results in burnout. Peer specialists respond to police calls for drug-related incidents and follow the individual through medical care and incarceration as necessary, placing the peer specialist in a position to engage family and friends to elicit support. Peer specialists can use their lived experience to help the individual see the benefits of life change. This approach has proven that individuals are more inclined to assist in investigations and the team approach has reduced stigma among law enforcement. Peer specialists also provide training and distribution of naloxone to the support systems of individuals. Classes and support groups conducted within the jail identifies individuals incarcerated for other charges who are also struggling with substance use disorders. After identification, those individuals can be moved toward treatment options and recovery, resulting in decreased jail population and lowered recidivism. JCORE will utilize participation in drug takeback programs, law enforcement diversion, naloxone for law enforcement, and treatment alternatives to incarceration. The primary use of the funds will center on embedding peer specialists at various points in the Sequential Intercept Model which makes it a labor-intensive program.

Arizona Criminal Justice Commission

The Arizona Criminal Justice Commission (ACJC) is applying for Category 2 in the amount of $6,000,000. The Arizona Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) will advance Arizona’s goal of reducing overdose deaths by providing services to people involved in Arizona’s local justice system. The ACJC will make a total of nine competitive sub-awards to local sites to implement law enforcement diversion programs or virtual peer recovery services. The ACJC will work collaboratively with the nine sites to serve the unique needs of each community, while leveraging the states resources, training experience, and expertise to implement impactful, evidence-based strategies. The ACJC will also build the capacity of the local justice system, including jails and local law enforcement agencies, to implement these programs through robust training and technical assistance, including peer-to-peer learning and cross-site coordination. The project serves the entire state of Arizona, which has a population of 7,421,401. The project includes partnerships with the Arizona Health Care Cost Containment System (the state agency for substance misuse services), the Tucson Police Department, Heritage Health Solutions, and the Arizona Sheriffs Association. Priority considerations addressed in this application include making sub-awards to communities with a high rate of primary treatment admissions for heroin, opioids, and stimulants; high rates of overdose deaths; a lack of accessibility to treatment providers, facilities, and emergency medical services; and providing services to a high poverty area. Applicants will also be asked to demonstrate how their sub-award will further OJP’s priority of building trust between law enforcement and the community.

County of San Luis Obispo

The County of San Luis Obispo's Behavioral Health Department/Drug and Alcohol Services Division, is partnering with Superior Court, Probation and Sheriff Departments for the project. The County of San Luis Obispo is a medium-size jurisdiction in California (pop. 283,159) aims to provide 200 individuals suffering from opiate use and stimulant use disorders with evidence-based therapy and Recovery Residences. The target population is adults that have both opiate and stimulant use disorder, primarily methamphetamine, who are at high-risk for overdose. Project Strategy and Partnerships: San Luis Obispo County is the 11th least affordable housing market in the United States (2017). The enhancement is to provide Recovery Residence stays (Drug and Alcohol-free Living) to all COSSUP participants in San Luis Obispo County who need this level of care for up to 90 days. All Recovery Residences provided funding with this grant will be MAT compliant to serve those with opiate use disorders. In addition, this project will provide for two Behavioral Health Specialist I (Case Managers) to provide intensive case management services to COSSUP participants while in-custody and while in treatment after being released from custody. The Case Manager will provide transportation and an initial supply of hygiene items to provide a warm welcome from custody to outpatient treatment in conjunction with the Recovery Residence. Utilizing Cognitive Behavioral Therapy (CBT) as a brief treatment intervention, this grant proposes to address both mental health and substance use disorders in a coordinated integrated care to provide the bridge from County Jail to community-based treatment. Project Outcomes: When successful, participants in the program will have achieved and sustained a lifestyle of sobriety and recovery, including learning CBT skills to better manage their lives. There will be decreased criminal recidivism, decreased impact on the criminal justice and behavioral health care systems, and re-stabilized lives.

Mendocino County

Mendocino County Behavioral Health and Recovery Services (MCBHRS) is applying for Category 1 funding in the amount of $600,000. The Bridge Program will identify individuals with opioid use disorder (OUD) and other substance use disorders (SUDs) and start them on medication-assisted treatment (MAT) in custody and case manage them to MAT and/or substance use treatment services at clinics and Mendocino County Behavioral Health Substance Use Disorders Treatment (SUDT) sites pre-release. The program will continue to follow these individuals post-release and support them however possible. The program will fund a behavioral health case manager to work full time within the jail and perform comprehensive case management and discharge planning. The project serves rural Mendocino County, which has a population of 86,749. The project includes partnerships between MCBHRS and the SUDT, Mendocino County Sheriff’s Office, Mendocino Community Health Clinics, and Mendocino Coast Clinics. Priority considerations addressed in this application include a high rate of primary treatment admissions for heroin, opioids, and stimulants; high rates of overdose deaths; and a lack of accessibility to treatment providers and facilities.

Arapahoe County Colorado

The Arapahoe County Sheriff's Office services an area with a population of over 500,000. The project will allow the Arapahoe County Sheriff's Office to expand evidence-based substance use treatment and peer recovery support services to individuals in custody and provide critical reentry needs such as transitional housing and peer recovery support services. These services are essential to supporting treatment engagement. The project addresses COSSUP's allowable use of implementing evidence-based substance use disorder treatment related to opioids, stimulants, and other drugs and recovery support services for pre-trial and post-trial populations leaving jail. Deliverables include providing discharge planning for 750 detention center residents over the life of the grant, providing transitional housing for 262 indigent detention residents transitioning from the detention facility to the community over the life of the grant, and providing virtual peer recovery support services to up to 503 individuals as they transition from the detention facility to the community.

Connecticut Department of Mental Health and Addiction Services

The Connecticut Department of Mental Health and Addiction Services (DMHAS) is applying for Category 2 funding in the amount of $5,999,998. The Community and Law Enforcement for Addiction Recovery (CLEAR) Project is a multilateral, community-based opioid overdose response program that will be piloted in six jurisdictions across Connecticut. The CLEAR Project will establish partnerships between community agencies and law enforcement to increase connections to care for people with a substance use disorder (SUD) and create a collaborative response to addiction among community partners. For each jurisdiction, the CLEAR Project will conduct assessments; implement an IPIS/Cordata Integrated System for data tracking and referral management; establish a coordinated safety net of recovery coaches and overdose response teams; support families, including through the identification and referral to services of children impacted by a family member’s SUD; increase access to medication-assisted treatment; and implement a community-based, data-driven dispatch response to surges in overdoses. The goal is to create a replicable model for overdose response that can be scaled in communities across the entire state. Sites were selected based on need, population diversity, and readiness to implement the program. The project serves Bridgeport, Greenwich, Norwalk, Torrington, Winsted, and the State Police Troop B and State Police Troop L service districts; together, the districts represent much of Fairfield and Litchfield counties. The project includes partnerships between DMHAS and the McCall Center for Behavioral Health, Liberation Programs Inc., the Bridgeport Police Department, the Greenwich Police Department, the Norwalk Police Department, the Torrington Police Department, and the Winsted Police Department. The project will engage Dr. Carol Gregory and Dr. Kelly Firesheets as evaluation partners. Priority considerations addressed in this application include a high rates of overdose deaths. The project will also benefit individuals residing in high-poverty areas.

Connecticut

City of Port St. Lucie

The City of Port St. Lucie (PSL) is located on the Southeast Coast of Florida with a population of 217,523 spread over an area of about 120 square miles. PSL has grown by 32.2 percent since 2010, at a rate of about 2.9 percent annually and has a population density of 1,843 people per square mile. This growth has brought with it considerable challenges, which includes the proliferation of drug overdoses. For this project, the Port St. Lucie Police Department (PSLPD) received grant funding for an Overdose Intervention Diversion Detective (OIDD) to expand its efforts to establish an enhanced response to opioid abuse within the city over grant period. The need to have a OIDD to focus on these cases is apparent and the traditional law enforcement response has proven inadequate to effectively address this growing concern in our community. This grant would help fund investigation of overdose cases and provide a critical service to the victims and families by connecting them to the community resources in place to address this issue. The number of overdose cases has had a negative impact on the community and made this detective position a vital necessity to response to overdoses. PSLPD recognizes that enforcement alone will not address this crisis, but by working together with various community partners, PSLPD believes it will increase access to and availability of substance treatment and recovery support along with education and outreach to the community. PSLPD will collect data on a continual basis to measure the effectiveness of the program by tracking the most at risk citizens for overdoses through daily review of overdose incidents reported in the records management system and the Overdose Detection Mapping Application Program (ODMAP). PSLPD also employs the lifesaving use naloxone to reverse the effect of an opioid overdose, which is assigned to every sworn officer.

Orange County

Orange County, Florida, Government Health Services project’s Orange County Post-Overdose Response Team (PORT) will increase access to evidence-based treatment and recovery support for individuals living with an opioid use disorder (OUD). The service area is all of Orange County, with a particular focus on those census tracts with the highest overdose rates, and on individuals who have more than one unintentional overdose requiring emergency response. PORT addresses field-initiated projects that bring together justice, behavioral health, and public health practitioners to implement new or promising practices–which may not yet have a research base–in addressing the impact of opioids, stimulants, and other substances on communities as a whole and individuals at risk of or with justice system involvement. This includes the application of evidence-based strategies from other fields that have not yet been fully examined in the justice context. While there is promising research on the use of a PORT model in multiple settings around the U.S., there is still a need for extensive testing and research. In addition, the focus of this proposal on improved outcomes for people with OUD, while reducing stress on the healthcare and law enforcement infrastructure is not yet a well-examined strategy. The project will target communities that see a disproportionate number of accidental overdose cases, often in areas with higher poverty rates and underserved populations. These communities have traditionally not had equitable access to awareness, prevention, intervention, or treatment. These communities also have disproportionate engagement with the criminal justice system. Targeting individuals with OUD in these communities with the intensive case management approach that PORT provides is a key way to remove barriers to equitable access and better outcomes for individuals and communities.

Georgia Criminal Justice Coordinating Council

The Georgia Criminal Justice Coordinating Council applied for Category 2 statewide area grant funding in the amount of $2,289,701. The Comprehensive Opioid, Stimulant, and Substance Abuse Site-based Program will (1) establish a multi-locality naloxone initiative to include continued training for law enforcement personnel and provide funding to assist with the replenishment of the opioid reversal drug; (2) establish and implement a pre-arrest/post-booking diversion program for youth and adults who have a moderate to high risk of substance abuse within Athens-Clarke County; (3) provide K-12 youth in Athens-Clarke County with increased access to education and treatment; and (4) provide a comprehensive, real-time, information collection database for the City of Savannah to expand the pre-arrest diversion program, which is funded through the FY 2018 Comprehensive Opioid Abuse Site Program (COAP). This project serves serve 23 of Georgia’s 159 counties. The project includes partnerships between Athens-Clarke County Unified Government and City of Savannah.

Idaho Department of Health and Welfare

The Idaho Department of Health and Welfare (DHW) is applying for Category 2 funding in the amount of $3,075,000. The Idaho COSSUP Program will implement projects designed to increase naloxone access, education, and distribution; enhance coordination and expansion of take-back programs; increase access to medication-assisted treatment through provider and public safety education; and evaluate DHW’s naloxone distribution efforts to vulnerable populations. Idaho’s seven local public health districts (PHDs) will serve as project implementation sites to provide naloxone trainings and overdose rescue kits to law enforcement officers, first responders, and vulnerable populations in their regions. The PHDs will also organize and promote permanent drug take-back locations and take-back day events in identified vulnerable counties. The program will fund the statewide naloxone distribution program and the seven PHDs to distribute naloxone to law enforcement officers, first responders, and other organizations interacting directly with individuals at risk of an overdose. To increase accessibility to medication-assisted treatment, DHW will identify vulnerable counties across the state and fund Project ECHO Idaho and a media-marketing vendor to develop and disseminate educational materials to providers. Project ECHO will produce medications for opioid use disorder (MOUD)/substance use disorder (SUD) podcast episodes, conduct outreach, and complete an assessment of current MOUD/SUD educational activities. The project serves the State of Idaho, which has an estimated population of 1,839,106. The project includes partnerships between DHW and the seven Idaho Public Health Districts, Project ECHO Idaho, and the Idaho Division of Behavioral Health. The project will contract with a third-party evaluator to conduct an evaluation of naloxone distribution activities funded under this grant. Priority considerations addressed in this application include a high rate of primary treatment admissions for heroin, opioids, and stimulants; high rates of overdose deaths; and a lack of accessibility to treatment providers and facilities.

Idaho

Boone County

The Boone County, Illinois, Health Department (BCHD) Community Outreach Advocacy and Recovery (COAR) is a community level program that coordinates interventions to provide behavioral health services in the jail and the community. The COAR program created medication-assisted treatment (MAT) in the local jail and implemented a Navigator model to provide case management services to individuals flowing through the criminal justice intercepts identified in Boone County’s Sequential Intercept Model. The COAR program is requesting funding to build upon current programming. This program proposes the following allowable activities: (1) Evidence Based Substance Use Disorder Treatment, such as medication-assisted treatment; (2) Embedding persons with lived experience at any intercept of the Sequential Intercept Model; and (3) Real-time and enhanced data collection. The COAR program will enhance its current MAT program by adding a second medication option, Buprenorphine, and implement re-entry coordination planning using a quality improvement, weekly Coordination Call with local and jail providers. The Navigator position, who has lived experience, will be enhanced by completing the process to become a Certified Peer Recovery Specialist (CPRS) and will lead the Coordination Calls in the jail and increase peer recovery mentors in the community. This position will also support the criminal justice system through a transition of bond reform. A COAR Strategist will be hired to follow the recommendations of the JusticeCounts project and provide upkeep to the data dashboard, as well as coordinate with partners to gather health equity data. The MAT Jail program (including staff, EHR, transportation and medications) is 22 percent of the budget, the Navigator position (including supervision and mileage) accounts for 41 percent of the budget, and the COAR Strategist salary accounts for 19 percent of the budget.

DuPage County Health Department

The DuPage County Health Department (DCHD) will deliver medication-assisted treatment (MAT) at the DuPage County Jail, implement a data management team to unify disparate data sources related to opioid use in the county; and implement a cross-sector Overdose Fatality Review Team based on the RxStat model. The Illinois Criminal Justice Information Authority will serve as the research partner for this project.

Dubois County

Dubois County is applying for Category 1 funding in the amount of $600,000. The Community Supervision Recovery Continuum will feature law enforcement/first responder diversion, post-booking treatment alternative-to-incarceration programs for individuals at high risk for overdose or substance misuse, and recovery support services, including transitional or recovery housing and peer recovery support services. Dubois County Community Corrections (DCCC) will develop a behavioral health team (BHT) that will be available to respond to behavioral health crises with law enforcement and provide guidance for diversion. DCCC will renovate its 102-bed work release facility to allow for separate housing pods; two pods (one for males and one for females) will be designated as “therapeutic communities,” where a group-based approach to rehabilitation is used to develop pro-social behaviors and work toward recovery. The BHT will augment this programming with individual and group counseling sessions and peer recovery support services. The Dubois County Sheriff’s Department and the Jasper Police Department will participate in Crisis Intervention Team training. The project serves Dubois County, with a population of 42,542. The project includes partnerships with the Dubois County Sheriff’s Office, the Jasper Police Department, and DCCC. Priority considerations addressed in this application include a high rate of primary treatment admissions for heroin, opioids, and stimulants; high rates of overdose deaths; and a lack of accessibility to treatment providers and facilities. The project also provides an opportunity to build trust between law enforcement and the community and will benefit individuals residing in high-poverty areas.

The Health & Hospital Corporation of Marion County

The Health and Hospital Corporation of Marion County (doing business as Eskenazi Health) project is carried out by three agencies—the Substance Use Outreach Services Program (SUOS), the Safe Syringe Access and Support Program (SSAS), and Project POINT—and will encompass a multi-pronged approached to support patients, staff, and community/government partners. These programs will provide community-based prevention services in the form of education and prevention programs and naloxone distribution; community-based intervention in the form of substance use disorder (SUD) treatment and harm reduction activities and support services; and post-intervention support in the form of transitional housing assistance and peer recovery services. The project will focus on the following activities: (1) a drug take-back program (approximately 7 percent of budget); (2) real-time data collection (approximately 11 percent of budget); (3) naloxone distribution (approximately 17 percent of budget); (4) K-12 education and prevention programs (approximately 25 percent of budget); (5) evidence-based substance use disorder treatment related to opioids, stimulants, and other illicit drugs as well as harm reduction activities and recovery support services (approximately 21 percent of budget); (6) transitional or recovery housing and peer recovery support services (approximately 19 percent of budget). This grant-funded initiative is a collaboration between Eskenazi Health and partner agencies, including the Marion County Coroner’s Office and the Indiana Department of Health Laboratory Services Commission, and will impact first responders, substance use disorder providers and patients, and governmental agencies throughout Marion County during the life of the grant and beyond.

County of Reno

The Reno County Health Department will establish Medication Assisted Treatment (MAT) in the jail and implementation funding to support the work of an Overdose Fatality Review Board. Reno County's efforts in partnering to implement overdose mapping, and implementation of harm reduction activities have had positive interactions across our community. These activities have led to a spike alert protocol and messaging for citizens when dangerous substances were entering our community. Messaging, anti-stigma, and education efforts over the past two years have begun to change minds which is evident in the data collected in the 2022 Health Assessment which indicates that 66% of our population support harm reduction efforts and view substance misuse as a disease. Implementing MAT in the Reno County Correctional Facility will provide a harm reduction service to individuals who experience substance use disorder and enter incarceration. MAT is a resource to support jail administrators in providing effective treatment for individuals with opioid use disorder and helping to halt the opioid epidemic in the United States. Jails can be on the front lines of this epidemic, and they also are in a unique position to initiate treatment in a controlled, safe environment. MAT is a cornerstone for best practice for recovery from substance misuse, particularly when coupled with evidence based therapy offered from our partners. This will improve medical and mental health outcomes and reduce relapses and recidivism. Reno County is ready to implement harm reduction efforts that will provide equitable support for all citizens who are ready for recovery. Implementation of an Overdose Fatality Review Board will engage partners such as law enforcement, district attorneys, mental health providers, drug court, not-for-profits, medical partners, and families. The board will review data and activities from individuals who have passed due to an overdose, giving Reno County the opportunity to better understand if there was a missed opportunity to go further upstream and implement prevention methods. Allowing for the development of policies, and services to support individuals and families experiencing substance use disorder. These actions will support prevention efforts, recovery supports, reduce recidivism, and reduce secondary trauma based off the recommendations of this multidisciplinary team.

Kansas

Kansas Department of Health and Environment

The Kansas Department of Health and Environment’s All Hands on DECK (Drug Endangered Children in Kansas) is a project designed to prevent and mitigate adverse childhood experiences, specifically targeting drug endangered children (DEC), those who are found in environments where illegal drugs are manufactured, sold, distributed, used or where there is other significant evidence of illegal drugs. Approximately 140,860 Kansas children are living in environments where their parent or caregiver uses substances, and an estimated 5,155 Kansas infants are born exposed to substances every year. Recent data show Kansas has had increases in drug overdoses and deaths that are higher than the national average. Drug endangered children are much more likely to use substances themselves; have chronic diseases like diabetes, heart disease and obesity; experience mental health issues; and have social problems including financial difficulties and employment challenges. The comprehensive statewide program addresses substance use and misuse, promotes public safety, reduces overdose deaths, and supports access to prevention, harm-reduction, treatment, and recovery services in Kansas communities and multiple systems including the justice system. The goals of this project are to (1) improve identification of and response to drug endangered children in Kansas by providing training, increasing collaboration and multidisciplinary approaches, and implementing a robust subaward component; (2) increase awareness of drug endangered children in Kansas through development of a statewide media campaign, an increase in real-time data collection and dissemination, and integration of DEC awareness into existing initiatives like drug take back days; and 3) build the capacity of project partners to implement a statewide DEC initiative. The project is designed and implemented with an equity frame and will target those who have been underserved and/or adversely affected by inequality. The project divides the state into six regions to ensure geographic equity and will target all four Kansas tribes-- Iowa, Kickapoo, Potawatomi, and Sac and Fox. This project is focused on changing the trajectory for children suffering the negative impacts of living in environments where drugs are present and will develop a model that can be replicated throughout Kansas and across the United States.

Kansas

Purchase District Health Department

The Purchase District Health Department is partnering public health, public safety, and recovery communities to address SUD/OUD epidemic with the purpose of impacting racial and gender equity of recovery service delivery and reducing drug-related harms including overdose and incarceration. The project serves eight counties in far western Kentucky with a population totaling 200,000 people. Project activities fall into four categories: 1) Reducing overdose by (a) distributing naloxone to at-risk individuals and their families and (b) educating young people about fentanyl; 2) Implementing a deflection/pre-arrest diversion program that increases access to substance use and behavioral health treatment; 3) Implementing a warm-handoff to peer support for individuals released from jail; and 4) Providing housing vouchers for individuals in recovery. Expected outcomes include reduced drug-related recidivism, increased utilization of substance use disorder services, and improved coordination of services between public safety, public health, and behavioral health service providers. The intended beneficiaries of the project are individuals with active substance use disorder, individuals in recovery, justice-involved individuals, and families of individuals with substance use disorder. The project includes a rigorous evaluation component and research activities to inform future programming and best practices.

Whitley County Health Department

Whitley County, Kentucky, is one of many Appalachian communities devastated by illicit drugs. Drug overdose mortality in this county far exceeds Kentucky’s rate, the Appalachian region’s rate, and is nearly double the U.S. rate according to the University of Chicago’s NORC Opioid Community Assessment Tool. This project aims to reduce the impact of illicit substances on people and community. Primary activities include: (1) embedding community health workers in local law enforcement agencies; (2) supporting ongoing collaboration between local law enforcement agencies, the local health department, and a local federally qualified health center providing integrated behavioral health services; (3) collecting real-time data; and (4) supporting law enforcement, first responder, and jail diversion opportunities. This project expects outcomes to include a reduction in overdose deaths, a decrease in repeat law enforcement and first responder responses, and increased access to treatment.

Lafourche Parish Sheriff's Office

The Lafourche Parish, Louisiana, Sheriff’s Office (LPSO) will develop and implement a comprehensive opioid prevention effort that promotes civil rights and racial equity in the identification, response, treatment, and support of those impacted by illicit opioids, stimulants, and other drugs in Lafourche Parish, Louisiana. The goal of Project Comprehensive Opioid Prevention Effort (COPE) is to deploy needed service activities and protocols to reduce overdose deaths, promote public safety, and support access to prevention, harm-reduction, treatment, and recovery services, both in the community and the justice system. The Project will function under the direction of a Project COPE Steering Committee, which is a permanent multidisciplinary coordinating body that focus on addressing the issues that arise due to the impacts of illicit opioids, stimulants, and other drugs. It is composed of representatives from the LPSO, court system, Lafourche Parish Coroner’s Office, Parish Government, public and private school systems, Nicholls State University, and prevention, intervention, and treatment agencies. Program activities include law enforcement deflection and diversion, real time data collection, education, and prevention, pre and post booking treatment alternatives to incarceration, evidence-based substance use disorder treatment, and social workers and peer embedment at any intercept of the Sequential Intercept Model. A program-specific priority is in support of Executive Order 13985, Advancing Racial Equity and Support for Underserved Communities through the Federal Government.” In partnership with the Kingdom Impact Global Worship Centre, underserved populations that have been adversely affected by the opioid epidemic will be identified and strategically facilitated under the program.

Terrebonne Parish Consolidated Government

The project supports a community collaboration among the Terrebonne Parish District Attorney's Office Extensive Narcotics Diversion Program (END) and partner public agencies and community organizations to address substance use disorders while reducing unnecessary prosecution and incarceration for felony level drug offenses. The END program seeks to divert non-violent offenders from the traditional court system offering a treatment and recovery resolution instead. The END program is a pre-booking and post-booking treatment alternative to incarceration program. It is a prosecutor led court diversion /intervention program; it utilizes court programming to prioritize and expedite treatment and recovery services for individuals at high risk of overdose; it coordinates evidence-based substance use disorder treatment related to opioids, stimulants and other drugs. Funding will be used to improve and enhance the screening process to increase the number of qualified felony level drug offenses that are offered the opportunity to receive case management referrals and treatment in lieu of conviction and incarceration. The goal is to identify appropriate END participants as early as possible in the process and to increase our capacity to handle the additional participants. By providing expanded case management, treatment referrals and other social services through the program, we can address the substance use and any disorders while pausing the court process in order to allow the participant to address these issues and begin the recovery process. In 2022, the district attorney's office received referrals totaling 625 felony drug offenses. Of these 61 were screened and approved for participation in the END program, being offered the opportunity to participate in supervision and treatment, avoiding trial, conviction and incarceration. Forty-two (42) of these cases, 6.72%, eventually enrolled in the program. The expansion of the program would seek a 20% year over year increase in the number of participants given the opportunity to treatment alternative to traditional case processing. In addition, recent losses in funding and other economic challenges such as COVID-19 and Hurricane IDA have also degraded our ability to offer treatment alternatives to incarceration thru pre-trial diversion programming. BJA support through this award will allow the END program to expand prosecutor screenings to identify all eligible participants, provide dedicated case management, data collection, and increased drug testing to support treatment and recovery as an alternative to incarceration.

Louisiana

Berkshire Regional Planning Commission

The Berkshire County, Massachusetts, project will establish and expand replicable community-centered, field-based interventions to address the full Opioid Use Disorder (OUD) Lifecycle of prevention, harm reduction, treatment and recovery in each of the three regions of Berkshire County. The purpose is to expand access to harm reduction, evidence-based treatment and recovery support services to underserved populations that will advance equity and enhance the research base to be replicable in similar rural areas that face long-standing disparities in access to affordable care. Project activities include 1) extend and expand the Berkshire Post Overdose Program to provide regionally specific medical and behavioral health-centered field outreach to individuals who recently experienced an overdose or are otherwise identified at higher risk for overdose; 2) outreach to and engagement with disadvantaged communities disproportionately affected by substances; 3) supplement existing capacities to address the OUD prevention, harm reduction, treatment and recovery landscape of the area; 4) extend and expand public communications strategies to directly support these efforts while reducing stigma; and 5) provide training to increase the toolkits and supports for first responders, practitioners, providers, families and social networks to reduce the number of community members intercepted by law enforcement and the courts. Expected outcomes include a reduction in fatal overdoses, a decrease in recidivism and intercepts by law enforcement, development of detailed process guides and toolkits that are replicable in similar areas, regular program assessments, and sustainable implementation of community-centered interventions that will empower the communities of Berkshire County to reimagine their futures free from the harms stemming from substance misuse and the related stigma. Subrecipient activities include field medical services, linkage to behavioral health resources, communications strategies to support these services, skill building training for professionals and social networks interacting with those struggling with substance use and contributing to the local and national knowledge base to replicate these activities in other rural areas experiencing similar disparities in the cost of care. The bulk of the funding (46%) will be directed towards field-initiated projects that bring together justice, behavioral health, and public health practitioners. Additional allowable expenses (14%) include embedding peers and experienced community members at intercepts 0 and 1 of the Sequential Intercept Model. Allowable uses also include harm reduction activities and linkage to evidence-based treatment and recovery for those at higher risk of overdose, arrest and/or recidivism; naloxone for law enforcement and first responders; and real-time data collection (2.5%). Less grant funding is needed for these activities as naloxone is provided at no cost, and real-time data collection is provided in-kind from the Northampton Department of Health and Human Services. Remaining project funds cover staff time and resources to implement these strategies (35.6%) and related trainings for first responders, professionals in the field, and families and social networks of those struggling with substance use (2%).

Massachusetts

City of Boston

The Boston Police Department's project aims to 1) increase coordination and collaboration across the Boston Police Department, Suffolk County District Attorney's Office, and North Suffolk Community Services, Inc., in addressing opioid epidemic in a highneeds area of Boston known as Mass and Cass (at the intersection of Melnea Cass Boulevard and Massachusetts Avenue); 2) strengthen the Services Over Sentences (SOS) Program so that it can better serve high-risk, high-need individuals who have been arrested in the area; 3) support Boston Police Department's Street Outreach Unit and City-Wide Bicycle Unit to provide increased outreach and diversion from arrest, as appropriate, to individuals experiencing mental illness and/or substance use disorders in the Mass and Cass area; and 4) conduct process and program evaluations so that the process by which these partnerships are formalized can be better understood and replicated, and to assess the effectiveness of the program in getting high-risk, high-need individuals into treatment and recovery. Project activities include establishing an interagency MOU; hiring two dedicated North Suffolk recovery coaches; hiring a full-time SOS Coordinator through the Suffolk County District Attorney's Office; supporting the Street Outreach Unit and City-Wide Bicycle Unit in their efforts to provide pre-arrest diversion; and partnering with Dr. Melissa Morabito to conduct the evaluations. These are allowable activities, falling under the umbrella of post-booking treatment alternative-to-incarceration programs and law enforcement diversion programs. Expected outcomes include strengthened collaboration across the Boston Police Department, Suffolk County District Attorney's Office and North Suffolk; increased SOS participation and service provision to eligible individuals; reduced criminal sentences for individuals who participate in the SOS Program; decreased recidivism among individuals who participate in the SOS Program; and increased number of individuals diverted from arrest to diversion. Substance-using individuals in the Mass and Cass area who have been recently or previously arrested for a crime (including individuals with outstanding warrants), but have not yet been prosecuted or sentenced, are the intended beneficiaries of the project. Subrecipient activities include the provision of recovery coach services (the cornerstone of the SOS Program) through North Suffolk, high-level project coordination through the Suffolk County District Attorney's Office, and evaluations to be performed by Dr. Morabito.

Massachusetts

City of Holyoke

The Holyoke, Massachusetts, Police Department (HPD) proposes to implement the Expansion of Recovery from Addiction to Substances Efforts II (ERASE-II), which is a multi-component and multi-discipline project designed to significantly improve efforts to curb and eliminate the substantial opiate, stimulant, and substance problem in Holyoke with a goal of a fully sustainable addiction response program in the city. Holyoke is a small, postindustrial city of 38,238 people with elevated levels of concentrated poverty, illicit drug use and abuse, drug trafficking and gang activity. ERASE-II is comprised of a multidisciplinary team, which includes partnerships with community-based service providers Center for Human Development (CHD), the Holyoke Police Department (HPD), Gandara (a community-based behavioral health provider), CERTE (our research and evaluation partner), the court, and the Hampden County Sheriff who oversees the Hampden County Correctional Center in the Holyoke jurisdiction. The purpose of ERASE-II is to implement a multi-component intervention program with project activities that include; (1) support individuals with opioid, stimulant, and other illicit substance issues with interventions to reduce addictions and associated mental health needs, (2) to reduce overdoses and overdose deaths through prevention and intervention strategies, (3) to divert individuals with substance use issues, and (4) to reduce substance-related crime in Holyoke. To meet objectives, we will: implement a team comprised of an Intervention Officer, two Recovery Coaches, and an Outreach Coordinator. The team will: (1) intervene in OD calls, (2) identify engage and recruit ERASE-II clients, (3) provide direct supports and peer-to-peer services to clients, (4) refer and connect ERASE-II clients to evidence based programs, including MAT and Detox programs, (5) divert clients from arrest and divert from incarceration, (6) connect homeless clients with substance addiction to short term housing, (7) conduct extensive outreach and community-based support of clients, (8) provide a walk-in support space for individuals with substance use issues in a central location, (9) provide transitional supports to clients returning from incarceration, (10) improve data management and case management capabilities to better support clients, (11) utilize data to investigate harmful criminal practices (e.g., identification and removal of batches of fentanyl laced drugs), and (12) conduct a research evaluation of the project. All activities will target census tracts that meet the requirements for priority considerations under the High Poverty Area and the Enhanced Public Safety in the Qualified Opportunity Zones which are associated with the majority of drug related activities and arrests and calls relating to drug overdoses.

Massachusetts

City of Holyoke Police Department

The City of Holyoke Police Department (HPD) applied for Category 1c rural/tribal area grant funding in the amount of $597,650. Project ERASE (Expansion of Recovery from Addiction to Substances Efforts) will implement a multicomponent intervention program designed to (1) support individuals with opioid, stimulant, and other illicit substance issues with interventions to reduce addictions and associated mental health needs, (2) reduce overdoses and overdose deaths through prevention and intervention strategies, and (3) reduce substance-related crime in Holyoke. This project serves Behavioral Health Network and Gandara, the Holyoke Police Department, Hampden County Sheriff, Holyoke Probation, and research partners. The project includes partnerships between the House of Corrections to provide detox treatment options and develop a law enforcement liaison between HPD, the courts, and probation personnel. Priority considerations addressed in this application include a high-poverty area and enhanced public safety in Qualified Opportunity Zones.

City of Newburyport

Newburyport Police Department (NPD) in Massachusetts, one of the founding departments of the Essex County Outreach Program, proposes to expand the outreach program to encompass all of Essex County. The Essex County Outreach Program is a series of stigma-free entry points to treatment on demand. The program supports nonarrest or early diversion program models that reach people before they enter the criminal justice system. The program supports multiple law enforcement entry points to treatment, including self-referrals to the stations. Cross-sector collaboration and partnerships are key to the program’s success which is supported by clinicians, social workers, recovery coaches, and trained volunteers.

City of Newburyport

The City of Newburyport, Massachusetts, leads the Essex County Outreach (ECO) program. The primary focus of the project is law enforcement and first responder deflection and diversion programming (98 percent of the budget), followed by real-time data collection (two percent of the budget). This project serves the area of Essex County, which has a population of 785,205. ECO is a police-directed post-overdose outreach model and serves to make treatment more accessible for those struggling with substance use disorder (SUD) and their families. The key components of this program are informed by a recent Sequential Intercept Mapping Model (SIM) process that ECO completed, as well as lessons learned from the first four ECO program years. The ECO COSSAP grant prioritizes the following strategies that have emerged as gaps in resources: (1) program coordination/administrative support; (2) funding for police overtime for post-overdose follow-up visits; (3) clinical/child advocacy services; (4) housing and transportation resources to support clients in early stages of recovery; (5) addiction and recovery training for police officers; and (6) expansion of access to harm reduction supplies/kits. This project includes partnerships between the 34 police departments in Essex County, the Essex County Sheriff’s Department, and all local treatment providers and community service providers. ECO is administered by the Newburyport Police Department along with the Essex County Chief’s Association. The research partner for this project will maintain the Critical Incident Management System (CIMS) software which records real-time data on all overdoses that occur in Essex County. CIMS also manages and documents incident follow-up outreach visits to determine the success at connecting individuals with treatment services, shares information across communities using a county-wide incident notification system and provides real-time reporting tools.

Commonwealth of Massachusetts, Sheriff's Department Hampden

The Commonwealth of Massachusetts Sheriff’s Department Hampden applied for a Category 1b suburban area grant in the amount of $900,000. Hampden County Sheriff’s Department’s All Inclusive Support Service Program will reduce opioid-related overdoses and related fatalities. The program will take a multipronged approach to (1) enhance a database in Hampden County that will allow for the collection, analysis, and dissemination of comprehensive, real-time overdose information, and (2) implement a law enforcement, first responder-driven multidisciplinary overdose prevention, response, and diversion referral model known as the Rapid Response and Connection Program. This project serves Hampden County, Massachusetts, which has a population of 470,406. The project includes partnerships between the Hampden County Sheriff’s Department, Office of the District Attorney, Baystate Medical Center, Trinity Health Mercy Medical Center, local law enforcement entities, and other established community partners. Priority considerations addressed in project include the disproportionate impact from substance use on a rural, high-poverty census tract and public safety impact in Qualified Opportunity Zones.

Department of Public Safety

The Commonwealth of Massachusetts is implementing the Diversion to Care (DivCare) project; a responsive and adaptive approach to reduce exposure to the criminal justice system and alleviate racial inequity by strengthening regional implementation of interventions along the Sequential Intercept Model (SIM) grounded in community input and participation in project design, implementation, and evaluation (Priority 1A). The goals of DivCare are to improve statewide coordination and increase access to harm reduction, addiction treatment, and recovery services in 6 overdose burdened communities through reduced justice system involvement. Project activities will include: (1) statewide coordination to maximize existing resources, improve data surveillance systems, and better coordinate responses to events such as seizures and clinic closures; (2) incorporation of communities experiencing racial and ethnic inequities in project design, implementation, and evaluation; (3) implementation of interventions that reduce exposure to the criminal justice system and focus on racial inequities; (4) integration of peers and people with lived experience in intervention activities; and (5) expanded utilization of evidence-based harm reduction, addiction treatment, and recovery support resources across the intercept points. Site selection factors will include readiness, capacity, need, and geography. Expected outcomes include: improved realtime data collection and data sharing agreements at the state and local level; expansion of culturally specific interventions advised by a community feedback process; integration of people with lived experience into the intersecting criminal justice and addiction care continuum; strengthened regional coordination of community-based harm reduction, treatment, and recovery services across the intercept points. Local jurisdictions and their community residents who are at risk of both criminal justice involvement and harms from the use of opioids, stimulants, and other substances are the intended beneficiaries of the project. Subrecipient activities will include creation of data-sharing agreements between partners, using SIM map workshops to identify intercept points in need of strengthening, integration of culturally specific advisory groups including peers with lived experience to approve intervention activities, and enhanced utilization of evidence-based harm reduction, addiction treatment, and recovery support services across the intercept points focused on racial inequities. This project will be aided by training and technical assistance plan using nationally renowned experts in addiction, criminal justice, and SIM mapping. The only active BJA-COSSAP grant award at the state jurisdiction level, the EOTC managed Project NORTH (awarded FY20), will end 9/30/23.

Massachusetts

Lowell, City of

The City of Lowell, Massachusetts, Police Department (LPD) project will expand and enhance the City of Lowell's existing Community Opioid Outreach Program (CO-OP). The CO-OP was implemented in 2016 to try to connect persons in Lowell, who recently overdosed, to services. The partners include LPD, Lowell Fire Department, Lowell Health Department, Pridestar Trinity EMS, and Lowell House Addiction Treatment and Recovery, Inc. The purpose of the project is to meet the growing needs of those with substance use disorder (SUD) in the City of Lowell. Project activities will include adding a Recovery Housing Specialist and bilingual Outreach Recovery Specialist to the CO-OP team. These positions will be essential to addressing the needs of homeless individuals with SUD and better serving individuals with SUD who speak English as a second language. The LPD is also proposing to provide financial assistance for transitional and recovery housing with recovery support services to individuals that qualify. Additionally, the department will continue to support the Lowell Health Department's Youth Outreach Specialist. This individual will assist youth and their families impacted by substance use and work closely with the Recovery Housing Specialist to secure housing for homeless young adults (18-26) with SUD. The LPD is also proposing to partner with the University of Massachusetts Lowell to conduct an evaluation of the project to understand the effect the program has on the opioid epidemic in the City of Lowell and the lives of those struggling with SUD and housing. Expected outcomes include securing transitional or recovery housing for 36 homeless individuals with SUD, increasing the number of individuals that access recovery services (i.e. youth and individuals that speak a different language), and increasing the number of individuals with SUD that make forward progress on stages of change. The project will address the following allowable activities: expand law enforcement and first responder deflection program (80%) and provide transitional or recovery housing and peer recovery support services (6%). 14% of the budget will also be dedicated to program evaluation. A breakdown of the budget is below. Additionally, please note that the LPD was awarded the BJA FY 19 Comprehensive Opioid Abuse Site-based Program in the amount of $900,000 (2019-AR-BX-K005). This grant will end in September 2023.

Massachusetts

Massachusetts Supreme Judicial Court

The Franklin County Sheriff's Office, in collaboration with the Opioid Task Force of Franklin County, the North Quabbin Region, and other partners, will expand services provided by the Community Opportunity, Network, Navigation, Exploration, and Connection Team (CONNECT) project. Serving 30 rural communities across nearly 1,000 square miles, CONNECT became the first team serving 86,773 residents to respond to fatal and non-fatal overdoses in July 2021 in the only federally designated rural county in Massachusetts. CONNECT was created to address consistently high levels of fatal overdoses in a region marked by persistent poverty, further exacerbated by the COVID-19 pandemic, which drove up opioid-related fatalities by 45.5% between 2020 and 2021. Despite the presence of CONNECT, gaps remain. Lack of law enforcement and first responder capacity, budget cuts, and staff turnover have emerged as issues. The distribution of naloxone to our law enforcement and first responders remains a priority as many municipalities cannot afford it due to high costs. Advancing racial equity in our work has also emerged as a priority, as data reveal people of color are disproportionately impacted by opioid overdoses in Massachusetts. Rural isolation and lack of access to services remain a concern, where limited transportation routes and Internet connectivity prevent individuals from accessing SUD treatment services and peer recovery coaching supports in community settings, preventing their entry into the mental health and criminal justice systems. To address these challenges, CONNECT will: 1) implement a set of new strategies at Intercept Zero that would include the creation of a CONNECT Mobile Outreach Program to visit residents in their communities, including targeting priority populations (e.g., trade workers), create self and at-risk referral pathways to leverage CONNECT services to prevent opioid overdoses from occurring, provide grief support visits, and create an opioid fatality review team; 2) embed peer recovery coaches in community, court, and emergency room settings; 3) continue to provide naloxone to law enforcement and first responders; 4) support CONNECT Cultural Humility Initiative to ensure the diversity, equity, inclusion, and justice principles are part of our community outreach; and 5) expand real-time data collection with our Critical Management System for CONNECT's new services. Led by research scientists Pamela Kelley and Dr. Sean Varano, Kelley Research Associates will act as CONNECT's Research Partner to assess its effectiveness.

Massachusetts

Northampton, City of

The Northampton Department of Health and Human Services (DHHS) Drug Addiction Recovery Team (DART) Enhanced Model will provide deflection interventions at sequential intercepts zero and multiple communities in Hampshire and Hampden counties in Western Massachusetts and will provide regional data collection and synthesis for the region, including an additional ten communities in Berkshire County. DHHS played a leadership role throughout the opioid crisis in Western Massachusetts and is committed to continuing to strengthen that work. The project will build upon DHHS's current multi-sector, cross-county foundation of police departments, recovery centers, behavioral health and treatment providers, and hospitals. The specific aim of the enhanced model is to improve engagement with communities that have been historically underserved, marginalized and adversely affected by inequality. The DART model consists of teams of first responders, community responders, and harm reductionists who offer free support to people who use drugs, and their families, after an opioid overdose or other high risk substance use. DHHS will collaborate with local recovery centers to hire community responders, with the goal of more effectively reaching nonwhite and homeless individuals with SUD, as well as persons with co-occurring SUD and mental health disorders. Moreover, DHHS will shift its model to ensure that more post-overdose responses are conducted by a non-police DART member whenever possible to increase engagement with persons from historically marginalized groups. Secondly, DHHS plans to conduct outreach activities in communities in the catchment area that are most impacted by environmental harms and risks (known as environmental justice communities), as people living in these overburdened communities may be more at risk for drug use and overdose. The goal of these activities is to reduce SUD stigma and increase deflection of individuals with SUD and cooccurring disorders prior to police intervention. Thirdly, DART will continue to support partnering police departments in obtaining an ongoing supply of Naloxone and will expand distribution to individuals likely to reverse an overdose in the community. Lastly, DART will continue its focus on real-time data collection and analysis and utilize the UMass Center for Program Evaluation to support evaluation of program efficacy and quality assurance. DART aims to divert individuals with SUD and co-occurring disorders from involvement with the criminal justice system and reduce the high rates of opioid overdose deaths in the region, specifically among historically marginalized groups.

Massachusetts

Town of Seekonk

The Seekonk Police Department is applying for Category 1 funding in the amount of $798,156. The Bristol County Outreach Opioid Intervention/Mental Health Program is a law enforcement-led post-overdose outreach collaboration among eight towns in Bristol County that will facilitate access to treatment for individuals struggling with substance use disorder, as well as support for their families and friends. The program includes hiring a project coordinator/clinician and a recovery specialist to support the eight-town coalition of police departments in their efforts to provide post overdose/referral recovery support services to individuals experiencing non-fatal overdoses and those determined to be at risk for overdose. Outreach teams will conduct post-overdose home visits within 72 hours of an overdose to offer access to treatment. Outreach will also include distribution of harm reduction tool kits including naloxone. All eight towns currently use countywide overdose/referral tracking software called the Critical Incident Management System (CIMS), which tracks all fatal and non-fatal overdoses, shares data among law enforcement agencies, and documents post-overdose follow-up. The project serves the towns of Dighton, Easton, Fairhaven, Mansfield, Rehoboth, Seekonk, and Somerset in Bristol County, which have an aggregate population of 136,738. The project includes partnerships between the municipal police departments in Dighton, Easton, Fairhaven, Mansfield, Rehoboth, Seekonk, and Somerset. The project will engage Kelley Research Associates as a research partner. Priority considerations addressed in this application include a high rate of primary treatment admissions for heroin, opioids, and stimulants; high rates of overdose deaths; and a lack of accessibility to treatment providers and facilities.

St. Mary's County

The St. Mary’s County Health Department (SMCHD) is applying for a Category 1 award in the amount of $899,963. The St. Mary’s County Day Reporting Center project will provide community-based services and treatment to offenders under parole/probation in St. Mary’s County, Maryland. The offenders will live at home and report to the center on a daily basis. While at the center, the offenders receive various services including substance misuse counseling, anger management, moral reconation therapy, parenting skills, relapse prevention, mental health coordination, job skills, case management, educational classes, life skills, after-care planning, and touch-ups. This project serves a population of roughly 113,510 individuals in St. Mary's County. The project includes partnerships between SMCHD and St. Mary's County Detention and Rehabilitation Center (SMCDRC).

Cumberland, County of

The purpose of the Pathways for ME: Person-Centered Recovery and Reentry project is to reduce fatal overdose deaths and recidivism and enhance public safety in Cumberland County, Maine. The Cumberland County Public Health Department project will implement activities under the following allowable uses: embed peers in the jail and community to assist people with SUD and justice involvement; implement pre-booking and post-booking treatment alternatives to incarceration program; housing navigation and support for transitional or recovery housing; and coordinated efforts among police departments to expand the use of diversion. To meet the goal of the project, the primary activities are to: facilitate and sustain a coordinated network of organizations that provide reentry support and case management; expand the network to include Police Community Liaisons; screen people for Substance Use Disorder (SUD) and co-occurring disorders in the jail; provide reentry supports as people with SUD leave the jail; and increase peer recovery support in the jail and upon release. The activities will be focused on people who have an SUD and are in the county jail at least seven days. Given the complexity of needs among the target population and a host of barriers for people as they leave jail, the project relies on several strategic partnerships (and subawards) across a range of organizations and services that, together, create a tailored and coordinated system of care. Those organizations include: Cumberland County Jail, Maine Pretrial Services, Co-occurring Collaborative Serving Maine, Amistad, and Portland Recovery Community Center. Other partners include SUD treatment providers and Police Departments across the county. The expected outcomes of the project are: 1) A coordinated network of organizations that meets at least 2 times per month to coordinate care, eliminate barriers, and provide reentry services to people with SUD as they leave the county jail. 2) Annual screening of 1000 people for SUD and co-occurring disorders and offering materials on treatment and recovery support for all who screen positive. 3) All people who leave the jail receive naloxone. 4) Annually, 100 people in the jail receive reentry support, including navigation for the continuity of Medications for Opioid Use Disorder and safe housing as well as linkages to peer recovery support. 5)Annually, 100 people in the community receive reentry support, peer recovery support and community service navigation immediately after release from jail. John Snow, Inc will collect data and conduct the evaluation for the project.

Maine

City of Detroit

Over the past decade, more than 2,000 Detroiters have been lost to fatal drug overdose, and over 7,000 Detroiter's have experienced an opioid-involved emergency since the onset of the COVID-19 pandemic. Illicit drug poisonings cost an estimated $193 billion annually in the United States and nearly $1 billion annually in Detroit alone; this includes costs in healthcare, treatment programs, traffic crashes, foster care, and criminal justice economic burdens. The actual cost to the community can be assumed to be higher when accounting for indirect costs (e.g. lost wages, reduced productivity, and child drug endangerment), and the intangible societal costs of the drug crisis, such as grief, fear, and social scarring, are immeasurable. The pandemic also exacerbated housing inequities particularly among precariously housed and homeless Black and Brown young adults under the age of 34. The Detroit HOME (Housing, Overdose prevention, Managed care, and Empowerment) Project will galvanize the resources of the City of Detroit Housing and Revitalization Department, 36th District Court Specialty Court, Changing Lives And Staying Sober, and a network of public health, recovery support, and treatment providers, to combat the drug and housing crisis in Detroit. The aim of the project is to prevent fatal drug poisonings, ensure pathways to permanent housing, and nurture holistic wellness opportunities to sustain recovery among Specialty Court participants. The Detroit HOME Project seeks to engage 500 participants and stakeholders in direct wraparound care, training, education, and strategy development as part of its mission to advance behavioral health equity and diversion to care strategies.

Ottawa County Community Mental Health

Ottawa County's Community Mental Health project will reduce the impact of opioids, stimulants and other substances for justice involved individuals in Ottawa County, Michigan, by increasing access to comprehensive treatment, case management and recovery support services. Community Mental Health of Ottawa County received a FY 2020 COSSAP grant. Accomplishments in implementation include 97 individuals receiving assessments for substance use or co-occurring disorders in six months, which led to 77 referrals for substance use or co-occurring treatment services. Program implementation has identified a strong need for an additional case manager for timely treatment and referral coordination. Expansion of services through this grant application include (1) coordinated case management comprising 57% of the overall budget; (2) pre-booking or post-booking treatment alternative-to-incarceration; (3) individual, group and doubling MAT treatment; (4) peer recovery support services; and (5) transitional housing comprising of 6% of the overall budget. Expected outcomes include a reduction in substance use dependency, an increase in stabilization as individuals re-enter the community and improved multi-agency collaboration.

Saint Louis County

The County of St. Louis applied for Category 1b suburban area grant funding in the amount of $897,607. The St. Louis County FY 2020 COSSAP Initiative will expand access to evidence- based treatment (including medication-assisted treatment and recovery services in jail), expand peer recovery support services and access to treatment for rural residents, and provide coordination to support comprehensive responses to substance abuse. This project serves St. Louis County with a population of approximately 200,540. The project includes partnerships between the St. Louis County Jail, Recovery Alliance Duluth, Human Development Center, and Duluth Family Medicine Clinic. Priority considerations addressed in this application include providing services to Qualified Opportunity Zones, addressing communities that are primarily rural and/or localities facing persistent poverty, and serving a region that has been disproportionately impacted by substance abuse. Grant funds support a nurse who delivers medication assisted treatment in the St. Louis County Jail, a community health care worker at Duluth Family Medicine, jail-based and community-based peer recovery support services (from Recovery Alliance Duluth and the Human Development Center), and a project coordinator (from Recovery Alliance Duluth). All of these individuals work together to improve outcomes for individuals with substance use disorders involved in the criminal justice system.

Mississippi State Department of Health

The Mississippi State Department of Health (MSDH) project is titled Mississippi COSSAP Advanced Response Enhancement System (MCARES), will enhance real-time response to illicit substance use and misuse; reduce overdose fatalities; promote rapid response; and support access to prevention, treatment, and recovery. MCARES is a statewide project that will mitigate the effects of opioids, stimulants, and other substances by delivering initiatives that collectively identify, respond to, treat, and support those locally impacted at the community level while ameliorating racial and health inequities. This three-pronged approach of demand reduction, harm reduction, and supply reduction ensures a holistic initiative, one that while directed at the state level, simultaneously enlists and enhances local capabilities to sustain these efforts beyond the project’s timeframe. Attention will be focused on counties or county clusters within the state that have a documented record of elevated vulnerability to the impacts of opioids, stimulants, and other illicit drugs. MCARES will select six community-based organizations within six of the nine Mississippi public safety districts to direct the community-based response, prioritizing areas of high need through a data-driven process in which multiple years of fatal and nonfatal overdose death rates will be carefully analyzed along with other indicators to create community risk profiles. MCARES goals include: (1) comprehensive, real-time, regional information collection, analysis, and dissemination that promote the use of data for both efficient and effective planning and response to overdoses and emerging drug trends (35 percent of total budget); (2) expansion of naloxone distribution for first responders and direct distribution to end users (e.g., individuals experiencing a drug overdose) (10 percent of total budget); and (3) evidence-based substance use disorder treatment related to opioids, stimulants, and other illicit drugs, including medication-assisted treatment (MAT) and harm reduction activities (20 percent of total budget). To attain these goals, MCARES will implement activities to achieve the following outcomes: (1) development and implementation of a state-level overdose spike response framework to guide transportable response units in rapid local response efforts; (2) transportable response units to provide a concerted, collaborative rapid response to communities experiencing a drug overdose spike, based on real-time surveillance data received by MSDH; (3) expanded naloxone access to individuals suffering from a nonfatal overdose; and increased MOUD for under-insured and uninsured Mississippians.

Mississippi

City of Billings

The City of Billings applied for Category 1b grant funding in the amount of $900,000. The Billings Peer Support Diversion Program (Billings PSDP) will develop a peer support-driven prebooking diversion program that provides support for individuals at high risk of overdose or chronic substance abuse. The program will use trained and certified peer support specialists, working independently and embedded with law enforcement to engage in street outreach with the chronically homeless through mobile behavioral health crisis response. The primary objective of the project is to use evidence-based strategies to divert high-risk individuals from incarceration into treatment and social support services. The project will also overcome local barriers related to length of treatment for methamphetamine recovery and limited recovery housing options in the community. This project serves individuals who have been arrested and chronically homeless individuals with opioid or stimulant use disorders in all of Yellowstone County, with a focus on downtown Billings, where this population is concentrated. The project includes partnerships among the City of Billings, Billings Police Department, Downtown Billings Association, and Rimrock, Montana’s largest mental health and substance abuse treatment provider. Priority considerations addressed in this application include a Qualified Opportunity Zone.

Lenoir County

The County of Lenoir applied for Category 1b grant funding for the amount of $288,713. The purpose of the project is to improve capacity of the district’s Family Accountability and Recovery Court (FARC) to serve families involved in the family court system due to substance dependence. Project objectives include providing more seamless and comprehensive treatment, as well as recovery services to parents with substance use disorders through increased staff capacity, enhanced training and professional development, and expanding treatment and complementary services. The project also aims at addressing systemic barriers faced by parents with substance use disorders through family transitional housing and expanded transportation assistance, as well as improving FARC performance through evaluation and performance management. This project serves North Carolina’s 8th Judicial District (Lenoir, Wayne, and Green counties). The total population of the district is 201,483. The project includes partnerships between Lenoir County, the 8th Judicial District FARC program, Hope Restorations Inc., Kinston Community Health Center, and the National Center for State Courts. Priority considerations addressed in this application include rural challenges, high and persistent poverty, and improved safety in Qualified Opportunity Zones.

Lincoln County

Lincoln County, North Carolina, is a mix of urban and rural communities. There were 143 cases of documented overdose/substance misuse in 2019 compared to 380 in 2021–over a 100 percent increase. In all age ranges, overdose/substance misuse increased since 2019. Lincoln County lacks critical infrastructure to support enhanced needs of individuals with substance use disorder and county leadership is prepared to make the necessary changes to align Lincoln County with the priority areas outlined by the state government in North Carolina. Currently, there is no deflection or diversion work happening in Lincoln County, so the Lincoln County Health Department is using grant funds to create a community paramedicine-led Post Overdose Response Team (PORT), the first deflection and diversion program of its kind for first responders in the county. The full budget will be used to build and implement the program including hiring staff, buying supplies, acquiring a robust data tracking system among other expenses that might arise. The PORT would serve individuals with substance use disorder to mitigate injury and death. The PORT program will consist of a certified community paramedic, a certified peer recovery support specialist, and a licensed clinical social worker. The team will connect with eligible individuals and their family members to provide peer support services, linkages to appropriate care, education on the disease of addiction, harm reduction services, safety education, parenting education, and education on any co-occurring health care needs, and training to those who suffer from a substance use disorder and their loved ones. The goals for this program include: (1) reduce reoccurring use of emergency services or hospital emergency departments; (2) connect people with services for acute or long-term needs; and (3) assist individuals in recovery, sobriety, and daily life skills.

Pitt County

The Pitt County, North Carolina, Sheriff's Office proposes to expand the evidence-based substance use disorder (SUD) treatment programs that operate within the Pitt County Detention Center. The Sheriff's Heroin Addiction Recovery Program (SHARP) and the Women's Empowerment and Recovery (WEAR) program are designed to combat substance use disorder and overdose deaths in Pitt County. These programs include general education development/high school equivalency services, cognitive behavioral therapy, moral recognition therapy, peer support services, access to a social worker, licensed substance abuse counselors, peer support services, and Medicated Assisted Treatment. The proposed expansion would fund three more years of programmatic staff, offer ride-sharing services to newly released low-income detainee’s for SUD’s related treatment and recovery needs, provide a residential treatment housing option to low-income individuals with substance use disorder, contract with a local university for programmatic development and evaluation, and connect law enforcement with more local K-12 students. The plan is use 7 percent of the budget to provide 2,100 total rides, 700 per project year, to treatment and recovery support services by partnering with the specialized non-profit organization, Danny’s Ride. Funds will also be used to hire a case manager who will track participants, create discharge plans, and aid participants with discharge needs. Thirty-five percent of the budget will go towards the salaries and benefits of the SHARP/WEAR Programs Coordinator and the Social Worker. The Pitt County Sheriff’s Office will partner with East Carolina University (ECU) for programmatic evaluation/analysis, data collection, SHARP/WEAR curriculum development, and family life education classes for detainees (20 percent of the budget). The Principal Investigator for the project will be Dr. Mallette, CFLE, and her team of human service graduate students. This COSSAP project will also dedicate 4 percent of the funds to expand the reach of evidence-based D.A.R.E. programming in Pitt County. D.A.R.E is an education and prevention program that connects law enforcement agencies to K-12 students. The curriculum has been reinvented to include components such as opioid and OTC/Rx drug abuse, vaping prevention, depression awareness, coping mechanisms, bullying, and communication skills.

North Carolina

Public Health Authority of Cabarrus County

The Public Health Authority of Cabarrus County is applying for Category 1 funding in the amount of $900,000. Through the Providing Medication Assisted Treatment (MAT) and Recovery Support Services to Individuals with Opioid Use Disorder (OUD) project, Cabarrus Health Alliance (CHA), the local health department for Cabarrus and Rowan counties, will provide MAT to 50 uninsured individuals with OUD residing in the counties. The program will combine pharmacotherapy (via buprenorphine-naloxone), behavioral health treatment, voluntary access, recovery support services, and low-barrier access for participation. CHA will receive referrals for detainees post-release from the Cabarrus County Detention Center (CCDC) and recruit other MAT patients through its internal syringe access program and MAT program for pregnant women with OUD. The program will expand local capacity for care beyond pregnant women with OUD to adults with OUD; increase the number of individuals with OUD receiving MAT in combination with behavioral health services; and decrease opioid overdoses among participants of the MAT program. The project serves Cabarrus and Rowan counties, with a total population of 358,541. Parts of both counties are U.S. Human Resources and Services Administration-designated Medically Underserved Areas and Health Professional Shortage Areas in primary, dental, and mental health care and are also designated as High-Poverty Areas. The project includes partnerships with CCDC, the Stepping Up Initiative, and Atrium Health Addiction Services. Priority considerations addressed in this application include disproportionate impact by the misuse of opioids, protecting the public from crime and evolving threats, and benefiting individuals residing in high-poverty areas or persistent-poverty counties.

Transylvania County

Transylvania County, through its Community Awareness Recovery Effort (C.A.R.E.) Coalition, is applying for Category 1 funding in the amount of $599,767. The Creating Access to Therapeutic, Reentry, and Recovery Support Services in Transylvania County Detention Center program will create access to trauma-informed behavioral health services and peer support specialist-informed recovery and reentry services for detainees residing in the detention center. This goal will be achieved by hiring and training a behavioral health therapist and a care coordinator to support the needs of detainees across the continuum of their detention, from booking/intake to release. The project will also support expansion of Transylvania County’s substance use disorder response efforts to include trauma-informed care (TIC) approaches and evidence-based interventions specifically targeted at persons involved with the criminal justice system; distribution of naloxone to detainees upon release; completion of a strategic plan for advocacy for medication-assisted treatment (MAT) bridge prescription; and TIC training for detention, law enforcement, and probation officers. The project serves Transylvania County, which has a largely rural population of 34,385. The project includes partnerships with the Transylvania Opioid Response Team, the Transylvania County Sheriff’s Office, and Transylvania Public Health. The project will engage the University of Western Carolina as a research partner. Priority considerations addressed in this application include a high rate of primary treatment admissions for heroin, opioids, and stimulants; high rates of overdose deaths; and a lack of accessibility to treatment providers and facilities.

Wake County

The Wake County Sheriff’s Office (WCSO) will develop an Opioid Abuse Management Program, which aims to reduce the high rate of opioid overdoses and opioid fatalities in Wake County. The Opioid Abuse Management program will be overseen by a Program Coordinator who will implement and oversee the progress of the program. Funding through the program will ensure that all deputies are equipped with naloxone to administer and reverse the effects of an overdose. The program will also provide handheld narcotics analyzers and necessary accessories, which will enable deputies to quickly identify suspected controlled substances in emergency situations. Tablets will also be funded through the program and will be provided to deputies responding to substance abuse calls. These tablets will provide a direct connection to Alliance Health Access and Information Line, where deputies will receive immediate virtual assistance from a social services professional. Tablets will also be used in the Detox Unit by project staff for reporting and data management, as well as by residents housed in the Detox Unit to assist with job applications, substance abuse treatment programs, and telehealth visits. WCSO recognizes that our duty of care must not stop upon a resident’s release and therefore will implement collaborative partnerships with behavioral health clinics and treatment providers to expand our comprehensive efforts to respond to, treat, and support those impacted by illicit opioids, stimulants, and other drugs of abuse once released from our care. WCSO will procure a software company to develop and implement a Substance Abuse Disorder Management Platform that will track treatment during incarceration and upon release. This software will connect the WCSO with outside healthcare professionals to better understand patterns and to share crucial information.

Atlantic City (Inc)

Atlantic City is applying for Category 1 funding in the amount of $600,000. The Atlantic City COSSAP program will focus on promoting public safety and supporting access to recovery services, strengthening data collection and sharing, aligning and maximizing resources, and preventing substance use. It will implement a comprehensive plan to reduce the risk of overdose death and enhance treatment and recovery engagement through recommendations made by the city’s overdose fatality review team, bringing together stakeholders with different perspectives and different data sets to improve public health and clinical practices. Strategies include enhanced outreach to overdose survivors and their families and enhanced targeting of high-frequency cases. Goals of the project include reducing the impact of opioids, stimulants, and other substances on individuals and communities, reducing the number of overdose fatalities, and mitigating the impacts on crime victims by supporting comprehensive, collaborative initiatives, in part by enhancing the proactive use of prescription drug monitoring programs to support clinical decision making and preventing the misuse and diversion of controlled substances. The project serves Atlantic City, which has a population of 37,999. The project includes partnerships with the city’s Director of Public Health, the Jewish Family Services Department, Southern Jersey Family Medical Center, AtlantiCare Regional Medical Center Behavioral Health, the Atlantic City Police Department, the Atlantic City Municipal Court, and emergency medical services. Priority considerations addressed in this application include a high rate of primary treatment admissions for heroin, opioids, and stimulants; high rates of overdose deaths; and a lack of accessibility to treatment providers and facilities.

Burlington County

Burlington County is applying for Category 1 funding in the amount of $900,000. The Burlington County COSSAP Program will expand law enforcement and other first responder deflection and diversion programs; embed social services within law enforcement in order to rapidly respond to drug overdoses where children are impacted; incorporate comprehensive, real-time, regional information collection, analysis, and dissemination; include naloxone training and distribution; and utilize evidence-based treatment, including medication-assisted treatment (MAT), as well as recovery support services including transitional or recovery housing and peer recovery support services. The project will support the 24/7 Operations program, a naloxone plus/Quick Response Team model that delivers services to people who use drugs through a “warm hand-off” from police to trained peer recovery specialists, expanding this service to reach the Burlington County Jail population; expansion of the Straight to Treatment program, a self-referral pathway in which people facing addiction can walk into police stations at designated times and get assessed, referred, and transported to treatment; and expansion of Hope One, a mobile access unit that offers critical support for persons and their families struggling with addiction, with the goals of preventing drug overdoses and deaths and providing linkages to treatment and recovery support services, in collaboration with the county sheriff’s office, the Department of Human Services, Volunteers of America, the New Jersey Transit Police, and community organizations. It will also support law enforcement-initiated training for motel/hotel owners on the distribution of Narcan, as well as the distribution of Narcan doses to replenish county and local law enforcement supplies, as needed. The county will also develop improved systems for collecting and analyzing data to improve internal operations and decision making while contributing to the state and national body of best practices on responding to the opioid crisis. The project serves Burlington County, which has a population of 446,596. The project includes partnerships with the county’s Department of Corrections, the Sheriff’s Department, the Department of Human Services, the County Prosecutor, and several treatment providers. The project will engage the Senator Walter Rand Institute for Public Affairs at Rutgers University as an evaluation partner. Priority considerations addressed in this application include a high rate of primary treatment admissions for heroin, opioids, and stimulants; high rates of overdose deaths; and a lack of accessibility to treatment providers and facilities.

New Jersey

New Jersey State Parole Board

The New Jersey State Parole Board (NJSPB) is applying for a Category 2 award in the amount of $3,278,813. The FY 2021 COSSAP-New Jersey State Parole Board project will provide peer recovery-based services to individuals with substance use disorder who are under parole supervision, as well as expand Rutgers University’s current Intensive Recovery Treatment Support (IRTS) program and create a team of providers specifically dedicated to the needs of individuals under NJSPB supervision. The target population to be served under this grant will be a minimum of 110 adult offenders released from New Jersey state correctional facilities to parole supervision residing in any one of New Jersey’s 21 counties. Medium-to-high-risk offenders will be identified prior to their release from prison and will be referred, when released on parole, to receive IRTS services with the aid of a Peer Health Navigator. The project includes a partnership with Rutgers University Behavioral Health Care. Priority considerations addressed in this application include protecting the public from crime and evolving threats, building trust between law enforcement and the community, and serving individuals residing in high-poverty areas.

Pueblo of Pojoaque

The Pueblo of Pojoaque, a federally recognized American Indian Tribe, is in north-central New Mexico and is one of the six Northern Tewa-speaking Rio Grande Pueblos. The Pueblo is in the Pojoaque Valley, 15 miles north of Santa Fe and 10 miles south of Rio Arriba County, and situated along interstate US 84/285, a major highway with more than 25,000 commuters per day. This level of traffic and the Pueblo’s proximity to Rio Arriba County, a county that has historically had one of the highest rates of drug-related deaths, makes the community vulnerable to the sale and distribution of illicit substances. The project will provide services to individuals and families of the Pueblo of Pojoaque, the Hispanic communities in Pojoaque Valley, and the tribal communities of San Idefonso, Nambe, Santa Clara, Tesuque, and Ohkay Owingeh. The purpose of the program is to (1) enhance evidence-based harm reduction efforts within the Pueblo of Pojoaque; (2) expand access to recovery support services for individuals with substance use problems; and (3) support evidence-based culturally centered prevention efforts to reduce youth substance use. The long-term program goals are to prevent substance use among youth and reduce the impact of substance abuse on individuals and the community. The project will focus on three specific allowable activities described in the solicitation: (1) naloxone education and distribution for law enforcement and first responders; education and prevention programs to connect law enforcement agencies with K-12 students; and evidence-based substance use disorder treatment related to opioids, stimulants, and other illicit drugs, as well as harm reduction activities and recovery support services. Within each activity and trainings offered, the program will give priority to American Indian Tribal members to promote racial equity and remove any barriers to access. The program will design a culturally responsive program that represents the Pueblo and fills existing gaps created by colonization and the forced removal of traditional ways.

New Mexico

Rio Arriba County

Rio Arriba County, through Rio Arriba Health & Human Services (RAHHS), is applying for Category 1 funding in the amount of $582,810. The project will enable RAHHS to expand its Law Enforcement Assisted Diversion (LEAD) Program, resulting in enhanced coverage during peak off-business hours and an expanded intake network in order to maximize the number of beneficiaries of the program. While referrals from law enforcement will be prioritized, referrals will also be accepted pre-arrest from community providers, as will self-referrals. RAHHS will also work with the New Mexico Behavioral Health Services Division (BHSD) to develop a reimbursement model for care that is consistent with LEAD, provides the actual services needed by LEAD clientele, and can be scaled to the 32 other counties in New Mexico. The project will assign one certified peer support worker case manager to district court to serve and redirect LEAD clients back to LEAD who disappear into the corrections system in other counties and will expand prevention efforts by assigning a half-time clinician to provide dialectical behavioral therapy to at-risk youth in the Española and Chama School Districts. Deliverables include the referral of 80 individuals by law enforcement for pre-arrest diversion to treatment. The project serves Rio Arriba County, which has an estimated population of 38,921. The project includes partnerships with BHSD, the Rio Arriba County Sheriff’s Office, the Española Police Department, the New Mexico State Police, Adult Probation, the District Attorney’s Office, the Public Defender’s Office, the First Judicial District Court, the Rio Arriba Community Health Council, the Northern New Mexico Rural Health Network, and the Opiate Use Reduction (OUR) Network. The project will engage Dr. Anne Hayes Egan of New Ventures Consulting as an evaluation partner. Priority considerations addressed in this application include a high rate of primary treatment admissions for heroin, opioids, and stimulants; high rates of overdose deaths; and a lack of accessibility to treatment providers and facilities.

New Mexico

City of Henderson

This initiative is a post-overdose outreach effort engaging overdose survivors and their social networks (e.g., family, friends, and acquaintances) to create positive outcomes. The overarching objective is to implement a strategy that addresses priority needs within the region/local by increasing public safety through a community-based endeavor designed to reduce or eliminate citizen harm and free law enforcement to perform their criminal justice duties effectively. The approach also includes helping individuals in substance use or mental health involved crises avoid unnecessary arrests, unintended injurious force by police officers, and involuntary commitments to the hospital. The plan incorporates engaging stakeholders to develop and create safe and supportive responses. These responses may consist of connecting individuals and their social networks with support services, appropriate health care, education on the disease of addiction, harm reduction services, safety education, parenting education, education on any co-occurring health care needs and training and treatment for those who suffer from a substance use disorder, and services for those coping with death or serious injury. The collaborative will consist of those with a stake in the community's well-being, including treatment professionals, grief counselors, social services, peer support entities, and government community resources. The engagement goal of the initiative is to follow up within 24-72 hours or as requested by the contacting authority. This time frame is crucial for potential behavior change in participants; letting them know care is available, increasing the likelihood for positive outcomes. The principal goals are 1) prevent fatal overdoses by connecting survivors with harm reduction resources, evidence-based treatment for substance use disorder and recovery supports; 2) engage people at high risk for overdose who are not otherwise receiving services or practicing overdose prevention, including optimizing engagement and minimizing criminal-legal consequences for the overdose survivor or others present; and 3) engage and assist those in need of post traumatic services.

Nevada

Nevada Office of the Attorney General

The Nevada Office of the Attorney General (NOAG) is applying for Category 2 funding in the amount of $5,751,772. The project involves enhancing existing or implementing new drug deflection/diversion programs undertaken by Mobile Outreach Safety Teams (MOST) or Forensic Assessment Services Triage Teams (FASTT), increasing provision of naloxone, and conducting drug take-back days to address drug/mental health crisis situations. MOST is a jail and hospital diversion program whereby public safety personnel and behavioral health clinicians collaborate to address the behavioral health needs of people involved in or at risk of involvement in the criminal justice system. FASTT provides assessment and case management for individuals who are screened as moderate to high risk using the Ohio Risk Assessment System and those with mental health and co-occurring disorders. The project serves seven sites from Nevada’s 16 counties and one independent city: Carson City, Churchill, Douglas, Lincoln, Lyon, Nye, and Storey. The subaward sites consist of three designated rural areas, three designated frontier areas, and the smallest urban area in Nevada. The project includes partnerships between the NOAG and the Nevada Department of Health and Human Services and community coalitions. The project will engage the University of Nevada, Reno (UNR’s) program evaluation team as an evaluation partner. Priority considerations addressed in this application include high rates of overdose deaths and a lack of accessibility to treatment providers and facilities.

Southern Nevada Health District

The Southern Nevada Health District (SNHD) serves Clark County, Nevada which reports a population of 2,338,127 individuals. This COSSUP project will be carried out by two main agencies: Southern Nevada Health District and the Las Vegas Metropolitan Police Department (LVMPD), in an effort to further integrate and expand current multijurisdictional partnerships in Clark County, Nevada, to end fatal drug overdose. These agencies will create a field-initiated linkage to care team that responds to overdoses using a public health framework, called Southern Nevada Post-Overdose Response Team Supports (SPORTS). In addition, the project will enable the expansion of law enforcement diversion services and increase training on the importance and use of naloxone for law enforcement and other first responders and increase naloxone availability for their use and distribution. Expected outcomes include an increase in access to linkage to care and diversion services and decrease in fatal drug overdose. The project will also involve a research partnership with the University of Nevada Las Vegas (UNLV) School of Public Health to assess the effectiveness of the model and implementation to achieve stated outcomes. The two sub-awardees on the project are LVMPD and UNLV. The initiative will also further current funded partnership activities of the Southern Nevada Opioid Advisory Council. The grant beneficiaries include first responders, people and families that experience overdose, governmental agencies, substance use disorder treatment agencies, and recovery community organizations throughout Clark County, Nevada, during the life of the grant and beyond.

City of New York

The New York City Office of the Chief Medical Examiner (OCME) is applying for Category 1 funding in the amount of $1,194,050. The project will enable OCME’s Drug Intelligence and Intervention Group (DIIG) to expand three initiatives: the suspected potential overdose tracking (SPOT) system, which is designed to inform key stakeholders of rapidly evolving overdose trends across New York City; the recently restructured New York City Overdose Fatality Review (OFR), by implementing a data management and evaluation system that incorporates an investigation of the social determinants of health associated with overdose deaths to ensure that OFR recommendations and outcomes are tracked systematically; and an OCME-based service referral program for next of kin of overdose decedents, by conducting a needs assessment and pilot program to better understand and meet the complex needs of next-of-kin. The goals of the project are to share overdose and drug use data and information quickly and effectively, examine the social determinants of health and structural inequalities that lead to high rates of overdose in high poverty areas of the city, and expand grief and trauma support for families of overdose victims, as well as linkages to care for high-risk individuals and social networks. The project serves New York City (population 8.3 million), with a focus on Bronx County, which has a population of 1.4 million. The project includes partnerships with the New York State Department of Health’s Office of Drug User Health Post Overdose Response Team (PORT), New York City’s Correctional Health Services, the New York City Police Department, the New York State Office of Addiction Services and Supports, the New York State Bureau of Narcotics Enforcement, New York City’s Department of Health and Mental Hygiene, and the district attorney offices of Manhattan, Queens, Staten Island, and the Bronx. The project will engage Health Research Inc. (HRI) as an evaluator. Priority considerations addressed in this application include an opportunity to benefit individuals residing in high-poverty areas and areas impacted by high rates of overdose deaths.

New York

Rockland County, NY

The County of Rockland, New York, applied for Category 1b suburban area grant funding in the amount of $899,964. The Law Enforcement Assisted Diversion (LEAD) program will start with a pilot with the largest law enforcement agency in Rockland County and then roll out to other police agencies. The goal is to improve public safety, reduce the number of low-level substance-using offenders from entering the criminal justice system, address issues of disproportionality, and strengthen the relationships between prosecution, law enforcement, and the community. This project serves Rockland County, New York. The project includes partnerships between the District Attorney’s Office, Town of Clarkstown Police Department (for the pilot), all local law enforcement agencies in Rockland County, the Rockland Council on Alcoholism and other Drug Dependence, and the Samaritan Daytop Village. Priority considerations addressed in this application include high-poverty areas and Qualified Opportunity Zones.

The City of Ithaca

The City of Ithaca applied for Category 1b suburban area grant funding in the amount of $900,000. The Ithaca LEAD Program (ILP) will reduce repeated arrests and incarceration for people whose unlawful conduct stems from unmet behavioral health needs in the city of Ithaca and adjacent towns in Tompkins County, New York. ILP will reduce racial disparities in criminal justice involvement for the region’s African-American population, reduce unnecessary arrests and prosecutions imposed on the justice system, improve officer efficiency, maximize the value of the city’s community-based service array, and improve outcomes for this complex population. In the era of COVID-19, these changes are especially critical. Across the nation, officers are confronting new challenges in interacting with people on the street; jails are striving to reduce incarceration so as to mitigate COVID-19 risks; and judges, attorneys, and court staff are seeking to reduce congestion in courtrooms. This project serves the city of Ithaca, New York. The project includes partnerships with Tompkins County District Attorney and Legislature, Community Leadership Team DCI, Ithaca Police Department, Tompkins County Sheriff, REACH Medical, Greater Ithaca Activities Center, and the LEAD National Support Bureau. Priority considerations addressed in this application include Qualified Opportunity Zones, as well as challenges faced by rural communities and high-poverty areas.

Ulster County

Ulster County is applying for Category 1b suburban area grant funding in the amount of $900,000. The High-Risk Mitigation Team (HRMT) will increase ORACLE’s capacity to respond to overdose scenes by providing crisis intervention training (CIT) to officers throughout Ulster County. The project will develop the HRMT to work directly with ORACLE, providing certified peer advocate services (CRPA) and intensive case management within the city of Kingston, New York. The project will also develop an initial alert system for first responders in Kingston to alert the ORACLE team of overdose when it happens. This project serves Ulster County, a community of approximately 177,573 people. The project includes partnerships between the Ulster County Department of Health and Mental Health, Ulster County Sheriff’s Office, and ORACLE team. Priority considerations addressed in this application include a high rate of primary treatment admissions for heroin or other opioids and a high rate of overdose deaths.

Ulster County

The Ulster County Sheriff’s Office will; (1) expand a law enforcement diversion co-response team previously funded by the Bureau of Justice Assistance modeled after LEAD, PAARI, QRT, and traditional care management to provide peer services within the rural areas of the county; (2) provided peer care management services in the Ulster County Jail to provide MAT programing support, as well as pre/post re-entry services to assist the coordination of re-entry for individuals with SUD, linking individuals with community-based treatment and recovery supports which increase access to behavioral health care, and following up with individuals for up to post release; and (3) provide naloxone vending machines in public spaces at the jail and in the community as a harm reduction measure for close networks of individuals experiencing opioid use disorder to gain easy and equitable access. The project includes collaboration between Ulster County Department of Mental Health, the Ulster County Sheriff’s Office, and Opioid Response as County Law Enforcement's High Risk Mitigation Team. This expansion project aims to increase collaboration between law enforcement and the community with the following goals: (1) reduce opioid fatalities in the rural region of the county by 40 percent in three years; (2) decrease opioid fatalities among incarcerated individuals upon re-entry by 40 percent over the course of three years; (3) increase naloxone distribution to the families and networks of individuals experiencing opioid use disorder by 100 percent within three years. The goal of all proposed programs is to enhance relationships between law enforcement and black, indigenous, and people of color communities struggling with substance use disorder by ensuring that all outreach and practices are trauma informed and sensitive to the historical and systemic racism.

Unified Court System of New York State

The New York State Unified Court System (UCS) is applying for Category 2 funding in the amount of $5,783,403. The New York Rural Opioid Court Initiative will implement opioid courts (OICs)—pre-plea court programs that expedite treatment and recovery services for offenders at high risk for overdose—in eight USDA-designated rural counties in New York State (Sullivan, Greene, Delaware, Genesee, Cortland, Columbia, Chenango, and Lewis). The project provides the infrastructure, planning, and evaluation of evidence-based treatment interventions, supervision, and recovery supportive services to successfully divert defendants with substance use disorder at risk of overdose. The OICs’ development will be supported locally by engaging in Sequential Intercept Model mapping in each jurisdiction and by the establishment of an OIC Center of Excellence, which will provide guidance to the selected counties in applying best practices to address the issues of polysubstance use disorders, mental health, and trauma. The project will also improve court supervision and access to treatment and peers through teleservices and will engage with drug testing laboratories to enhance testing for complex synthetic drugs to target effective supervision, treatment, and supportive services. The goal of the project is to stabilize defendants while an appropriate disposition of their case is determined so that participants may connect with treatment and other services that produce behavior change. The project serves Sullivan, Greene, Delaware, Genesee, Cortland, Columbia, Chenango, and Wyoming counties in New York State, with a combined population of 408,060. The project includes partnerships with the New York Office of Addiction Services and Supports and Policy Research Associates. The project will engage NPC Research as an evaluation partner. Priority considerations addressed in this application include a high rate of primary treatment admissions for heroin, opioids, and stimulants; high rates of overdose deaths; and a lack of accessibility to treatment providers and facilities.

New York

City of Columbus

The City of Columbus Department of Public Safety project implements The Rapid Response Emergency Addiction Crisis Team (RREACT) program. The purpose is to expand comprehensive, multi-disciplinary first responder led outreach with the goal of stabilizing the household and reducing barriers and increasing access to drug and/or behavioral treatment for the individuals with substance use disorder. RREACT program activities include connecting overdose survivors with evidence-based harm reduction services and licensed treatment programs; addressing healthcare disparities and increase access to overdose prevention, treatment, and recovery resources for minority groups; connecting families with trauma specialists to rapidly respond to the needs of children impacted by drug overdose; implementing drug take-back campaigns in partnership with the DEA and local community organizations; expanding access to peer recovery and case management services for individuals with substance use disorder and justice involvement and their families; developing and implementing harm reduction and drug prevention campaigns for K-12 students within the vulnerable communities. Expected outcomes include: the development of culturally appropriate protocol for SUD/OUD EMS outreach protocols, harm reduction and case management protocols and drug prevention campaigns for at-risk youth; increased provision of evidence-based treatment for individuals with substance use disorder; decreased rate of opioid misuse and drug overdose death rate, including prescription and illicit opioid overdose death rates; increased access to critical child and kinship supports for kids and other caregivers in the home impacted by opioid use. RREACT program will serve individuals who experienced a non-fatal overdose and their households residing in Franklin County in the city of Columbus. RREACT actively partners with local treatment providers, public health departments, justice agencies and Franklin County's Family and Children First Council to achieve desired project outcomes. Mighty Crow, Inc. serves as the evaluator for the project.

Ohio

County of Hamilton

Hamilton County Public Health (HCPH)'s project will improve its response to overdose deaths and have more real time data as it relates to next of kin interviews and identify and support innovative community overdose prevention strategies as identified by the Overdose Fatality Review (OFR) Team. HCPH will expand the OFR and next-of-kin interviewing to increase access to qualitative data and create space for implementation of OFR recommendations. The primary activities that will be implemented include 1) Interview friends and family of deceased individuals; 2) Interview friends and family of individuals who currently have an SUD and may have suffered a nonfatal overdose; 3) Partner with Hamilton County Heroin Task Force to serve as liaison between HCPH, QRT, and local law enforcement; 4) Partner with an academic evaluator (Ohio University) to evaluate the project; 5) Develop a dashboard that showcases OFR activities and recommendations; 6) Develop a tool to determine which recommendations are suggested for funding; 7) Outreach to hospitals and funeral homes; 8) Lead OFR meetings. This project will serve Hamilton County residents. Expected project outcomes include increasing the number of next of kin interviews by 50%, obtaining a baseline number of interviews of loved ones who know someone in active addiction and implementing and providing funding for two OFR recommendations per project year.

Cuyahoga County

The Alcohol, Drug Addiction, and Mental Health Services Board of Cuyahoga County (ADAMHS) is in the Northern District of Ohio (NDOH). Cuyahoga is the NDOH’s most populous county with 1.2 million residents in 58 municipalities. Since 2018, ADAMHS has partnered in surveillance and outreach with law enforcement, public/private health, and social welfare agencies to improve the effects of the opioid epidemic, but stark challenges remain. The county suffered 675 overdose deaths in 2021, one of the highest rates per 100,000 population in the country, with similar numbers expected in 2022. The purpose of this effort is to identify, respond to, and support those affected by illicit drugs, reduce overdose deaths, and mitigate impacts on individuals in the criminal justice system. ADAMHS will (1) expand comprehensive information gathering, analysis, and dissemination of fatal and nonfatal overdose incidents that promote the use of real-time data collection for planning and response and emerging drug trends (65 percent); and (2) conduct a peer recovery support services pilot (29 percent), with an evaluation of the latter (6 percent). This work involves the follow subrecipients: the Begun Center for Violence Prevention Research and Education, Cuyahoga County Board of Health, and Thrive Peer Recovery Services. The three objectives are to: (1) expand the Cuyahoga County Multi-Jurisdictional Overdose Surveillance Program to gain more information and develop clearer insight for better informed planning and response, especially across underserved communities; (2) enhance and diversify the data subcommittee of the U.S. Attorney’s Office NDOH Heroin and Opioid Task Force by increasing participation of more culturally specific, faith-based, and citizen action organizations; and (3) pilot a peer recovery support services program to bridge in-custody and community-based services for many non-Hispanic Black and Hispanic persons. Overdose Surveillance Program deliverables are an expanded overdose data dashboard, quarterly written drug trend and overdose hotspot alerts, annual reports of overdose trends, and quarterly reports of synthesized law enforcement decedent data provided to the county Overdose Fatality Review, including infographics, data briefs, and manuscripts submitted for peer review, and a medical examiner coded-data final report. Data subcommittee deliverables are bi-monthly meetings, a more diverse membership roster, and bi-monthly data subcommittee oral presentations by regional, state and national peers.

Ohio

Cuyahoga, County of

The Cuyahoga County Medical Examiner's Office (CCMEO) is implementing the Cuyahoga County Overdose Fatality Review Counteractive Initiative (CCOFRCI). The purpose of this effort is to enhance Cuyahoga County's Overdose Fatality Review (OFR) to promote cross-system coordination within the criminal justice and behavioral health systems for the identification and implementation of preventable risk factors and missed opportunities for intervention in order to reduce overdose deaths in Cuyahoga County, particularly for those historically marginalized, underserved, and adversely affected by inequality in Cuyahoga County, Ohio (metropolitan Cleveland). The OFR is a 20+ member, multidisciplinary body established in 2013 that shares identified cross-agency data to conduct intensive case reviews of exemplar overdose deaths, to identify systems gaps, and create recommendations, all with the purpose of learning from fatal overdose deaths and working towards decreasing deaths. This process and access to cross-agency information is uniquely distinctive to OFRs. The OFR is under the purview of the CCMEO and co-led by The Cuyahoga County Board of Health. Project activities include enhancing the OFR, with the addition of desk reviews and increasing the number of reviews from 18 to 54. Subrecipient activities include (1) 54 Next-of-Kin interviews conducted by the Alcohol, Drug Addiction and Mental Health Services Board; (2) The University of Kentucky Institute for Pharmaceutical Outcomes and Policy will pilot and develop a Natural Language Processing (NLP) plug-in for the COSSAP OFR Data System (COSSAP DS) for use by all OFRs who utilize this data system; and (3) The Case Western Reserve University (CWRU) Begun Center for Violence Prevention Research and Education will conduct survey and focus group/interviews with OFR stakeholders to evaluate the utility of OFR recommendations and apply risk terrain modeling to findings from the OFR to inform a county-wide educational outreach program in Year Three. Expected outcomes include: (1) increasing the pool of OFR cases to substantiate findings from previous reviews; (2) oversampling of populations of interest to understand variability of characteristics not captured due to the limited sample (Priority 1A); (3) implementation of a county-wide community outreach education campaign to share emerging overdose trends and promote public health strategies to reduce overdoses; and (4) create a resource guide that describes the OFR model of Cuyahoga County and its application of the COSSAP DS that can benefit and assist other OFRs.

Ohio

Montgomery, County of

Public Health - Dayton and Montgomery County (PHDMC) is one of 113 local governmental health departments in Montgomery County, Ohio and serves an estimated population of 537,309 residents. PHDMC has provided drug epidemic surveillance since 2010 and co-leads a community-wide effort to respond to the drug crisis, the Community Overdose Action Team (COAT). The COAT members are supportive and invested in the implementation of the Continued Linkage to Hope Project. The purpose of the Continued Linkage to Hope Project is to enhance data sharing among partners, advance data collection and analysis, and expand the current Certified Peer Recovery Support (CPRS) services into the criminal justice and hospital systems by filling a gap in the continuum of care for those who are in active addiction. The Continued Linkage to Hope Project will address the allowable uses of funding by: (1) Further enhancing and expanding a comprehensive real-time data system to include regional information, collection, analysis, and dissemination. PHDMC will continue to work with its data partners to integrate hospital and criminal justice data systems into a care coordination platform that will be available to the CPR's to assist in response to those in active addiction. (2) Enhancing and expanding the current Overdose Fatality Review efforts by integrating qualitative data collection to contextualize overdose trends as well as barriers to care following fatal and nonfatal overdoses. The data has been and will continue to be used to develop program and policy recommendations and improve coordination and collaboration between agencies and community conditions to prevent future overdose deaths. (3) Prototyping a risk stratification system to prioritize and respond to drug overdose survivors by utilizing a machine-learning algorithm to identify the largest risk factors of addicted individuals. PHDMC and other county behavioral health providers will use the scores to determine the level of risk of future overdose or death. (4) Expanding law enforcement and court-based interventions to expedite treatment and recovery services for individuals who are at high risk of a drug overdose by utilizing CPRS services. The Continued Linkage to Hope Project will enhance and expand a system of care that increases engagement for those in active addiction by embedding CPRS's into the municipal courts. CPRS's will provide the much-needed support and direct connection to additional resources that will decrease future criminal justice involvement and increase individuals' likelihood of moving towards recovery.

Ohio

Ohio Office of Criminal Justice Services

The Ohio Office of Criminal Justice Services (OCJS), a division of the Ohio Department of Public Safety, project will support a combination of local initiatives and statewide programs and resources to reduce the impact of opioid, stimulant, and substance use on Ohio's individuals and communities. This project focuses on two primary efforts: 1) increase connectivity to treatment and supportive services through community partnerships that develop, expand, or enhance Ohio's footprint of deflection, specifically the Naloxone Plus (i.e., QRT) model, Ohio's predominant deflection pathway; and 2) build multi-sector collaboration that allows local deflection teams as well as communities that do not have deflection teams to more effectively and accurately identify people who are at risk and provide comprehensive support. Funding will be used to support a framework for providing consistent support and training to aid the efforts of local deflection programs, such that deflection programs become an indispensable and sustainable part of their community. Specifically, OCJS will provide project-based funding to support six to eight sites in Ohio to develop, expand, or proactively enhance local Quick Response Teams, identified through a grant application process designed to promote more equitable opportunity for communities to participate. OCJS will also fund a statewide law enforcement initiative, BRIDGE, to proactively alert healthcare professionals of the potential for overdoses in the wake of a large drug seizure. In addition, BRIDGE saturation events will combine local law enforcement efforts with outreach provided by QRTs and/or prevention, treatment, and recovery services. Process and outcome evaluations will be woven throughout these local and state initiatives. The Substance Use Deflection Center of Excellence will promote the latest in research and best practices by offering training, technical assistance, and resources to support deflection in Ohio. The Center will expand membership of their long-standing Collaboration Board to serve as the multidisciplinary coordinating body to increase cooperation and collaboration across all sectors.

Ohio

City of Jay

The City of Jay accepted funding for a Category 1 award in the amount of $600,000. The Delaware County COSSAP program continues to develop comprehensive, locally driven responses to opioids, stimulants, and other substances of misuse by expanding access to treatment and recovery support services. The program employs a recovery services coordinator who supports the existing efforts of law enforcement case managers and the drug court supervisor. Meanwhile, the Project Coordinator seeks out additional strategic partnerships in efforts to reduce stigma and entice treatment seeking behaviors in place of law enforcement involvement. Project also focuses on substance use prevention in the local school districts by increasing community/parent/youth awareness of emerging drug trends. Local and national speakers are utilized for presentations and/or trainings, regarding evidence-based prevention curriculum. A COSSAP Advisory Council has been formed to serve as a formal cross-agency collaboration assembled for strategic planning and communication across the county. The program is working to facilitate comprehensive, real-time, regional information collection, analysis, and dissemination by ensuring that law enforcement agencies throughout the county have an officer trained to utilize ODMAP. This addresses the need for quality data collection, which is currently a challenge to obtain because of a lack of resources within this rural community. Project serves all of Delaware County, Oklahoma, which has a population of 42,433. The project includes partnerships between the Ottawa/Delaware County Drug Court Program, the Delaware County Health Department, the Delaware County Sheriff’s Department, Jay Police Department, Cherokee Nation Behavioral Health Prevention Programs, Delaware County Community Partnerships, Grand MH, Grove Police Department, Community Health Centers of NE Oklahoma and the Northeastern Oklahoma Regional Alliance. This project will engage CARE Consulting Group, led by Principal Investigator Dr. Jeremy Goldbach, as the evaluation partner. Priority considerations addressed in this application include Delaware County being an area with a high rate of primary treatment admissions for heroin, opioids, and stimulants and a lack of accessibility to treatment providers, facilities, and emergency medical services. In addition, Delaware County contains several census tracts that are high-poverty areas.

Oklahoma

South Western Oklahoma Development Authority

South Western Oklahoma Development Authority is applying for a Category 1 award in the amount of $467,365. The Western Oklahoma Opioid Prevention Consortium will develop, implement, or expand comprehensive programs in response to illicit opioids, stimulants, or other substances of misuse. This project’s objectives and methods will include developing education and prevention programs to connect law enforcement agencies with students in 6th through 9th grades in the public school system by using the "keepin’ it REAL" curriculum, an effective, multicultural middle school drug prevention program derived from evidence-based research; providing naloxone to law enforcement and other first responders each year, which will help with the opioid overdose death rate; establishing drug take-back programs to safely dispose of unused controlled substances that are found in the home and used by hospitals and long-term care facilities; distributing in-home medication lockboxes to the public to help reduce accidental overdose and to help prevent someone stealing one’s prescriptions. This project serves five counties which are designated as rural challenges, persistent poverty counties, or qualified opportunity zones by the Office of Justice Programs and U.S. Census information: Caddo, Harmon, Jackson, Kiowa, and Tillman Counties. The total population size of the five counties is 73,314. The project includes partnerships between law enforcement agencies and the Western Oklahoma Opioid Prevention Consortium in each of the five counties. This project will engage a researcher selected by the Bureau of Justice Assistance who may conduct a site-specific or cross-site evaluation in future years as the research partner for this project. The project will also consult with research partners at Southwestern Oklahoma State University and other partner agencies. Priority considerations addressed in this application include lack of accessibility to treatment providers and facilities and to emergency medical services.

Oklahoma

Clackamas County, Health Housing and Human Services

Clackamas County applied for grant funding in the amount of $900,000 under Category 1B for the Law Enforcement Assisted Diversion (LEAD) Plus project. This project serves the 424,747 residents of Clackamas County, which consists of urban, suburban, and rural areas spanning 1,879 square miles (larger than the state of Rhode Island). The goals of LEAD Plus were to continue and enhance Clackamas County’s LEAD program and to support aligned system work. Clackamas County has achieved the first of these goals by securing sustainable funding for LEAD. The LEAD program in Clackamas County offers support for individuals experiencing unmet needs associated with homelessness, mental health, and substance use. Through outreach, intensive case management, and system navigation, it aims to reduce involvement in the criminal justice system. LEAD is now administered by a different division within Clackamas County, operating without grant funding. The Children, Family, & Community Connections Division is continuing to implement LEAD Plus through efforts to coordinate substance use and overdose prevention initiatives in the county, increase the capacity of the local public safety system to address systemic issues that will reduce disparities, and implement efficient strategies for data collection. Key partners included in this project include the Clackamas County District Attorney’s Office, Clackamas County Sheriff’s Office, Milwaukie Police Department, Clackamas County’s Health, Housing and Human Services Department, and local behavioral health, housing, and substance use prevention and treatment professionals.

Multnomah County

The Multnomah County, Oregon, Sheriff’s Office (MCSO) will expand and enhance Multnomah County’s Supported Recovery Program, implementing modifications needed to effectively respond to changes in the county’s criminal justice system resulting from the pandemic and Oregon’s recent decision to decriminalized the possession of certain drugs or quantities. Once implemented, the project, which serves individuals throughout the county jail system, will ensure overall effectiveness, improve access for marginalized populations, and ensure smooth transitions to community supports for individuals with substance use disorder being discharged from jail. Primary activities and associated outcomes include: (1) design and offer education and harm reduction programs within the jail to improve transition planning and long-term recovery upon reentry; (2) expand treatment options, including MAT, to include services for opioids, stimulants and other illicit drugs found in the community and begin services within the jail to improve transition planning and long-term recovery upon reentry; (3) ensure effective use of peer support specialists to improve seamless transition to community-based treatment settings; and (4) address known disparities by redesigning treatment and group processes and actively outreach underserved communities. The project will serve individuals with substance use disorders within the Multnomah County jails, with most services offered within the jail and transitional services offered by peer support specialists in the community. Subrecipients include the Multnomah County Health Department’s Corrections Health. Grant funds will also support an external evaluator from program design and evaluation services. Allowable uses to be addressed by this project include: (1) evidence-based substance use disorder treatment, including MAT, for addictions to opioids, stimulants, and other illicit drugs as well as harm reduction activities and recovery support services (approximately 30 percent of the budget); (2) transitional or recovery housing and peer recovery support services (approximately 30 percent of the budget); (3) embedding social workers, peers, and/or persons with lived experience at any intercept of the Sequential Intercept Model (approximately 5 percent of the budget).

Oregon

Multnomah, County of

The Multnomah County project will expand and enhance the continuum of support for justice-involved individuals with opioid and other substance use disorders (SUD). The project bolsters the care continuum between the jail and post-release settings, aimed at increasing the likelihood of Medication Assisted Treatment (MAT) (also known as Medication Supported Recovery or MSR) initiation and maintenance between jail and community settings. This project will increase overall effectiveness of support service provision and sustainability for justice-involved individuals experiencing SUD, improve access for marginalized populations to SUD supports, and ensure smooth transitions to community supports for individuals with SUD being discharged from jail. Primary activities and associated outcomes include: (1) Work with Multnomah County Sheriff's Office and Corrections Health to increase ability to administer MSR more efficiently to clients in custody. (2) Provide access to low-barrier MSR at MCHD's Harm Reduction Clinic (HRC), co-located with syringe services in the community. (3) Provide additional social worker/case manager support at SSP sites and the HRC. (4) Promote education and prevention activities at SSP sites and the HRC. (5) Strengthen multidisciplinary oversight and coordination. (6) Work with the BJA evaluation team to create an evaluation plan (including process, impact, output measures, as appropriate).

Bucks County

Bucks County, Pennsylvania, through its Division of Human Services (including the Bucks County Behavioral Health/Developmental Program and the Children and Youth Social Services Agency, along with the Bucks County Drug and Alcohol Commission), is partnering with the courts, law enforcement, and the IJIS Institute, on this project. Bucks County will develop Project Connect, an intensive, home-based program designed for parents experiencing challenges related to substance use disorder (SUD), mental health problems, and parenting. It is strength-based and trauma-informed and its implementation approach is developed using standardized implementation strategies. This service will decrease recidivism, prevent relapse, and maintain families and/or reunite families in a safe and permanent manner. The project centers on the impact of SUD on child welfare, the child welfare court system, the law enforcement community, and the foster care system, which is providing services to parents with SUD, including parents leaving incarceration or preventing incarceration, and/or parents after receiving non-community-based, residential drug and alcohol treatment, with children in foster care or relative care. This proposal will enable Bucks County to contract with by Children’s Friend, Inc., the Rhode Island agency that created Project Connect, to provide training to the Bucks County staff and a provider. As part of the training package, implementation assistance is included in the form of technical support. The formal support varies depending on the needs of the provider and the community. The goals of this project include: (1) decreased substance use; (2) reduced probability of relapse/reoccurrence; (3) lower rates of re-incarceration; and (4) improved family functioning and safety.

City of Erie

The City of Erie is applying for a Category 1 award in the amount of $459,576. The Probation Transition Response Project will strengthen methods that local law enforcement can use to develop and expand comprehensive, locally driven responses to opioids, stimulants, and other substances of misuse and address an identified gap in services and/or invention activity for probationers with opioid use risks. The gap analysis is derived from data collected over the last two years while implementing other strategies for high-risk substance use disorder (SUD) probationers. The Erie Police Department (EPD) will create a COSSAP Diversion and Investigation Unit that will help identify at-risk individuals or low-level offenders for diversion and referral programs. The goal is to help these individuals enter into support programs, be connected with resources, and avoid the possibility of negative outcomes such as incarceration or escalation of involvement in illicit substance use. EPD will also form a Survivor Follow-Up Team of two officers who will focus on individuals who have survived an opioid or illicit drug overdose. These interactions can accomplish several goals, including building trust with law enforcement, conveying the very serious nature of illicit drugs, and reinforcing that supports are available. The project's strategy will expand current law enforcement mentorship programs with Erie Public School students. The Erie Police Athletic League (PAL) has demonstrated the value and impact of the cop-kid relationship in the city after relaunching in 2015. Through this COSSAP site-based initiative, Erie PAL will further expand positive activities with officers and youth. All of these new law enforcement endeavors will leverage and complement existing resources for Erie residents impacted by opioids and substance misuse. This project serves the jurisdiction within the City of Erie boundaries, with an estimated population of 95,508, but it should be noted that the population protected by the Erie Police Department within the jurisdiction goes beyond the residents living within the city. The project includes partnerships between the Erie Police Department, Mercyhurst University Civic Institute, and the many agencies, providers, and resources available in the City of Erie for individuals and their families. Priority considerations addressed in this application include that the project will benefit individuals residing in high-poverty areas or persistent-poverty counties.

Pennsylvania

Pennsylvania Department of Corrections

The Pennsylvania Department of Corrections will focus on persons reentering the community from Pennsylvania Department of Corrections facilities who are high-frequency utilizers of services across systems (e.g., justice, health care, social services). Project efforts will focus on improving data sharing across relevant entities in the Commonwealth, with formation of a stakeholder team to advise on naloxone distribution, data sharing systems, and administrative protocols. BetaGov/Litmus at New York University (NYU) will serve as the research partner for the proposed project.

Greenville County

The Greenville County Sheriff’s Office (GCSO), located in Northwest South Carolina, project involves implementing and delivering a law enforcement led diversion to treatment initiative in Greenville County, which has a population of 516,126. The project will develop a comprehensive local response to the county’s substance abuse problem through synthesizing grant resources with existing practices and personnel to support planned activities per allowable use of funds to: (1) enhance existing police assisted addiction and recovery initiative (PAARI) program with law enforcement and first responder deflection and diversion (30 percent of budget); (2) collaborate with the coroner's office and research partner on a data dashboard and real-time overdose tracking program (5 percent); (3) provide naloxone for law enforcement and first responders (11 percent); (4) support school-based prevention and parental education programs to connect law enforcement with K-12 students (8 percent); (5) deliver evidence-based substance use disorder treatment including medication-assisted treatment (MAT), counseling, and connections with certified peer support specialists (15 percent); and (6) embed a case manager into GCSO to divert individuals with substance use disorders as early as possible in the Sequential Intercept Model (16 percent). To aid in implementing this plan, recovery community stakeholders from the county, including law enforcement agencies, community behavioral and mental health services, addiction services, state representatives, and hospital and emergency services will be included on the multidisciplinary Substance Abuse and Recovery Coordinating Council (SARCC) to participate in ongoing meetings with the project team and serve as a permanent standing body with the mission of increasing cooperation and collaboration to sustain substance abuse and recovery efforts. The project addresses issues related to racial equity and the removal of barriers to access and opportunity for communities that have been historically underserved, marginalized, and adversely affected by inequality through providing enhanced implicit bias training for law enforcement and treatment services targeted to underserved minority communities. Additionally, the includes a strong research-practitioner partnership with the Center for Justice and Social Research at Clemson University to provide a scientific mixed methods program evaluation to provide empirical feedback for program improvement and dissemination of process and outcome findings to the law enforcement, and research communities.

South Carolina

Bradley County

Bradley County is applying for a Category 1 award in the amount of $891,575. The Bradley County Prevention Coalition will implement a comprehensive plan to reduce the risk of overdose death and enhance treatment and recovery service engagement among the criminal justice-involved individuals in the community. This plan was developed as a result of the identification of top-priority needs and prevention solutions for Bradley County and includes three main areas of focus: a comprehensive Resource Hub, a Quick Response Team (QRT), and the expansion of appropriate, substance use-informed training for officers and other personnel. In a first-of-its-kind Resource Hub initiative, the goals of engaging and improving the quality of life of individuals with or at risk of a substance use disorder, promoting public wellbeing, and reducing overdose deaths are met with a focus on utilization of comprehensive, appropriate, and integrated community-based services. The Resource Hub will be a center of representation for partnering community agencies, law enforcement, court personnel and legal counsel, recovery treatment providers, and other community professionals. The Resource Hub will serve the community by including representation and direct access to all of the community’s frontline recovery support services. The development of a QRT will serve the community through assisting victims of drug and human trafficking for the first 24 to 72 hours after their identification of such, a very critical recovery service. The QRT will bridge the gap between first responders and victim service providers. The expansion of trainings for law enforcement will help to better prepare officers in the community to best respond to the population of individuals experiencing the impact of substance use disorder (particularly opioids), to include not only adults who are impacted but children and youth as well. This project primarily serve Bradley County, although ultimately all resources will be available to the benefit of the entire 10th Judicial District, which is comprised of Bradley County, Polk County, Meigs County, and McMinn County. The 10th Judicial District has a population of approximately 225,000 people, with approximately 110,000 of those being residents of Bradley County. The project includes partnerships between the Bradley Prevention Coalition, the Bradley County Sheriff's Office, the City of Cleveland Police Department, Cordata, Willowbend Farms Inc, Parkridge Valley Cleveland Outpatient Center, the Caring Place/United Way Housing Coalition, and 10th Judicial District Treatment Courts.

Tennessee

Knox, County of

Knox County is implementing a probation-focused case management program (Intensive Case Management Program). The program's purpose is to provide an evidence-based response to the use and misuse of opioids, stimulants, and other substances by expanding access to treatment and recovery support services for probationers supervised through the Knox County Probation Department. The project will provide intensive case management services and substance use treatment for individuals on probation who have a substance use disorder and are at risk for overdose. The project will also increase access to recovery support services for individuals on probation, which will be partially accomplished through a subrecipient agreement with the Metro Drug Coalition. Expected outcomes include reducing risk of overdose death and enhancing evidence-based treatment and recovery service engagement for those on supervised probation.

City of Houston Health Department

The Houston Health Department (HHD) serves the city of Houston with a 2.3 million population. This project includes partnership with Houston Police Department (HPD) and The Center for Recovery and Wellness Resources (CRWR). This project, Collaboration Houston: Addressing Substance Use and Misuse (CHASM), expands upon COSSAP funded surveillance and alert system to inform outreach, education and mobilization. CHASM will implement a locally driven, comprehensive response to address substance use and misuse by: (1) Providing targeted substance use awareness activities in partnership with law enforcement for with K-12 students and curriculum-based education with justice involved individuals, parents/caregivers and older adults. (2) Integrating data from the current opioid surveillance system to improve community awareness, program messaging, and mobilization of stakeholder response. (3) Delivering evidence-based substance use treatment and recovery support services. Houston/Harris County continues to experience a rise in opioid misuse and overdose. In 2020, Harris County was the highest Texas county for the number of accidental poisoning deaths involving opioids. This area continues to experience increased rates of illicit drug use from 6.6 per 100,000 in 2010 to 9.1 in 2020. During this same period, death rates from substance use increased from 9.2 to 17.7, greater than Texas rate. Most drugs being used in Houston, including heroin and opioids, are now being cut with fentanyl further complicating this epidemic in Houston. Deaths involving fentanyl skyrocketed by 341% from 2019-2021. Houston is known as one of the most racially/ethnically diverse large metropolitan areas in the country, with over 145 languages spoken. However, Houston has an overrepresentation of underserved communities of color. In these neighborhoods, populations are of greater risk and require specific interventions, including youth and justice involved individuals. CHASM partners with law enforcement and recovery experts providing specific strategies for these communities and populations that are more likely to be impacted by opioid overdose, stimulants and other substance use. Awareness activities, curriculum-based education and substance use treatment will be augmented with real-time surveillance data. Public access to web-based data will include a warning system to gauge opioid overdoses, deaths and substance use trends in Houston. CHASM promotes public safety and supports access to recovery services. CHASM responds to contextual changes in the opioid epidemic through multi-sector collaboration and strategic, evidence-based interventions for individuals, groups and communities with higher vulnerability.

Texas

Dallas County Hospital District

Dallas County Health District dba Parkland Health is devoted to serving the health care needs of its surrounding communities. Parkland Health has more than 165 outpatient specialty and sub-specialty clinics on its main campus, operates an extensive mobile health van program to care for the underserved and homeless in Dallas County, and serves as the medical provider for the Dallas County Jail through its Correctional Health Department. The Correctional Health Department has provided health care services at the Dallas County Jail and Juvenile Justice Centers since 2006. The Correctional Health Department endeavors to offer evidence-based medication-assisted treatment to adults and juveniles who present upon intake with substance use disorder. The program’s goals are to provide MAT service with counseling and rehabilitative groups, advance racial equity, support evidence-based prevention for youth substance use and assist all patients with social determinants of care during their transition back to the community. The project will provide evidence-based substance use disorder treatment, following the Medication Assistance Treatment program. The project will also collaborate with the courts and probation services to facilitate the release and provide resources in the community to support the individual after release. Using the Sequential Intercept Model, MAT-trained Social workers and peer-lived mentors will partner with service providers for assistance with supportive services such as transitional housing, health insurance, healthcare home placement, pharmacy assistance, career planning and placement, and the identification of a peer with lived experienced for discharge. Peer mentors will receive training via webinars from the National Reentry Resource Group and the Substance Abuse and Mental Health Services Administration (SAMHSA) Resource Center. Expected outcomes will demonstrate a need for the program, show racial inequities as it relates to the background of patients participating, and show a decrease in recidivism. This data should drive processes and contribute to supportive funding. Activities under the grant include: evidence-based substance use disorder treatment related to opioids, stimulants, and other illicit drugs, such as MAT, as well as harm reduction activities and recovery support services (34 percent) and embedding social workers, peers, and/or persons with lived experience at any intercept of the Sequential Intercept Model (33 percent).

Texas

City of Harrisonburg

The City of Harrisonburg is applying for a Category 1 award in the amount of $600,000. The Harrisonburg Fire Department-Community Paramedic Program will implement a community paramedicine program in the City of Harrisonburg. In the past decade, emergency medical services (EMS) and fire departments have been called upon to create programs that offer care options for high-risk patient populations—such as those with substance use disorder—to reduce the burden these individuals have on community systems. Community paramedicine is a concept of prehospital care designed to use paramedics to help bridge the gap between access to primary care services and the needs of the community. The extension of acute and primary care providers and mental health (including substance use dependence) resources are made available by specially trained paramedics. The goals of this COSSAP-funded program are to increase connectivity to substance use disorder and co-occurring substance and mental health disorder treatment in the community; reduce the strain people with substance use disorders and co-occurring substance and mental health disorders have on the health care system; decrease recidivism rates linked to substance use and mental health disorders; create a roadmap to inform stakeholders and city/county leadership on the appropriate formation of the Marcus Alert System in their community; and begin determining the long-term financial sustainability of such outreach programs. This project serves the County of Rockingham, Virginia (population 81,244). The project includes partnerships between the Harrisonburg Fire Department, the Harrisonburg Police Department, the Middle River Regional Jail, the Rockingham County Sheriff’s Office, Sentara Healthcare, the Harrisonburg Rockingham Community Services Board, the Healthy Community Health Center, the Harrisonburg-Rockingham Crisis Intervention Team, Strength In Peers, the James Madison University School of Nursing, and Cordata Healthcare Innovations. Priority considerations addressed in this application include serving individuals residing in high-poverty areas.

Virginia

City of Olympia

The City of Olympia, Washington, faces a multifaceted crisis of factors related to homelessness, the opioid epidemic, lack of available mental health services, and challenges within the legal system to provide holistic solutions that address the needs of people engaging in low-level criminal activity. By investing in intentional collaboration between local government, social services providers, and research professionals. The City of Olympia believes these challenges can be addressed in a compassionate, evidenced-based way to help reduce the strain on emergency management and create opportunities for success among people impacted by behavioral health issues and criminal justice involvement. There are two primary activities of the project: training for city-employed first responders, and support for case management, peer support, and mental health services for community members. The training topics outlined in this proposal support the continuing education of crisis workers, firefighters, and paramedics during times of crisis, along with tools and resources to cope with the immense secondary trauma they experience that often leads to high burnout. The expansion of capacity in both hours of operation and caseload of a diversion program operated by Catholic Community Services of Western Washington, and the creation of an adult mental health program within the same agency, will provide meaningful solutions to the long-term needs of the community. By utilizing a coordinated approach, the city seeks to improve direct referral pathways from highly competent and well-resourced first responders to appropriate resources for relationship-based support, creating a compassionate and effective response to a community-wide struggle. Throughout the course of the project, a comprehensive process and outcome evaluation will be conducted by a highly-qualified research team at Washington State University. The project partners anticipate outcomes that include measurable increases in perceived and demonstrated skills for first responders, increased client contacts within the diversion program, the existence and operation of a community-based mental health program providing individual and group therapy, peer services, and psychiatric medication management, and decreased dispatch call volume for behavioral health incidents.

Washington

City of Seattle

The Seattle, Washington, Police Department is testing a program that provides transitional housing and other services to reentering justice-involved women with substance use disorder (SUD) histories who will be returning to Seattle and adjacent locations within King County after transitioning from prison to the community. Using a case-management approach to address women’s multiple service and treatment needs will improve reintegration and is expected to lead to better outcomes for program participants. Allowable activities include: law enforcement deflection and diversion (15 percent); use of real-time data (20 percent); evidence-based SUD treatment related to opioids, stimulants; other illicit drugs MAT, harm-reduction activities, and recovery-support services (30 percent); and transitional or recovery housing and peer recovery-support services (35 percent). Despite previous and ongoing efforts to address the drug-use epidemic, relatively little has been done to specifically address the needs of justice-involved women with SUD histories who are returning to the communities after a period of incarceration. To target justice-involved women with SUD histories, the project aims to align with and enhance existing efforts by: (1) increasing the knowledge and sensitivity of law-enforcement officers to identify and interact with justice-involved women with SUD histories in the community; (2) establishing methods and measures for improving needs and service assessment of justice-involved women with SUD histories before release to the community and regularly across a 12-month period to capture changes in needs regarding social services and SUD treatment; (3) providing housing for reentering women, working with Washington Department of Corrections on a stable housing location with associated program and education options; and (4) coordinating programming and SUD treatment for reentering women including facilitating connections to MAT and other treatment services in the community. Partnering with the Washington Department of Corrections to provide housing, programming and other services, this project will help to fill the gaps in knowledge about this population’s needs and a team of New York University researchers will evaluate the process and document the outcomes.

Washington

King County

The project will develop comprehensive, locally driven responses to the use of opioids, stimulants, and other substances through the implementation of an overdose fatality review (OFR) process in King County, Washington. The funds will support the creation of an OFR as a community-based rapid response network to foster evidence-based strategies for treatment and prevention of overdose. King County Medical Examiner’s Office (KCMEO), the applicant and intended beneficiary of funds, will partner with the Overdose Prevention team of Public Health – Seattle and King County, law enforcement, and community groups to establish and conduct OFR. Primary activities include: (1) design and establish an OFR process supported by existing real-time fatal drug overdose surveillance conducted by KCMEO; (2) utilize OFR to recommend evidence-based responses to drug overdoses and emerging drug trends; and (3) translate recommendations into action plans for effective community-based interventions. The project will address the following allowable uses: (1) real-time data collection to inform OFR (75.5 percent of the budget); (2) naloxone for law enforcement and first responders (3.5 percent of the budget); and (3) embedding persons with lived experiences into the Sequential Intercept Model (21 percent of the budget). Funding will be allocated to personnel and test kits for in-house testing of drug evidence and decedent blood and naloxone for distribution to law enforcement and first responders. Expected outcomes include: (1) hire and onboard project staff; (2) design and establish an OFR committee; (3) produce quarterly recommendations from OFR, once established; (4) provide up to 500 naloxone kits for law enforcement and first responders annually; (5) provide educational resources for law enforcement and community groups; (6) embed law enforcement community outreach and Community Liaisons into the Sequential Intercept Model; and (7) establish a Quality Improvement and Oversight Committee to conduct continuous quality improvement for the project.

Washington

Lummi Indian Business Council

The purpose of the Lummi Indian Business Council project is to increase the availability of care and reduce barriers to those suffering from addiction and mental health issues and to create protective factors for Lummi and Tribal Youth in Washington. The primary activities of this program will be to use the Sequential Intercept Model (SIM) to help those dealing with their substance use disorder and mental health issues to help them address their illnesses. Lummi will also enhance its relationship with the Lummi Nation Police Department (LNPD) and Lummi Court System in this process. Currently, the Lummi Nation provides Narcan and Kloxxado to various community and business programs and departments, including LNPD, for overdose reverses. Lummi Nation has Drug Court and Family Court programs that prioritize and expedite treatment and recovery services and uses a variety of medication-assisted treatment evidence-based practices at their Opiate Treatment Program providing mono-buprenorphine, buprenorphine/naloxone, naltrexone, and Sublocade. It also features various harm reduction activities including transitional housing, recovery support services, needle-exchange and motivational interviewing. Lummi Nation will enhance these services and use the SIM and embed a Mental Health Counselor and Peer Counselor/Recovery Coach in Intercept 1 (law enforcement) to help those dealing with addiction or mental health issues. It will also create an education and prevention program that focuses on connecting law enforcement with K-12 students. It will not only use evidence-based practices, but also culturally based practices to ensure that protective factors are created to help children and youth be able to withstand the pressures to use drugs. Expected outcomes are to increase referrals and enrollment to mental and substance use health services through our law enforcement agency and decrease need for incarceration and increase educational and prevention services in schools to decrease alcohol and drug use in youth and school age children.

Washington

City of Madison

The City of Madison Police Department proposes to enhance its pre-arrest diversion program with additional pathways to treatment that include self-referral, active outreach, naloxone plus (Quick Response Team), and officer prevention and intervention. Grant funds will be used to hire an addiction resource team comprised of an addiction resource officer, community paramedic, and certified peer specialist, as well as an assessment clinician for referred clients, program evaluator, and project coordinator. Additional funds will be used to purchase naloxone for community distribution. The project services residents of Madison and Dane County. Project partners include Public Health Madison and Dane County, Dane County Department of Human Services, Madison Fire Department, and the University of Wisconsin Population Health Institute (UW PHI). The project will engage Janae Goodrich of the UW PHI as the research partner.

City of West Allis

The City of West Allis Fire Department (WAFD) is applying for Category 1 funding in the amount of $900,000. The Mobile Integrated Health MAT Access Advocate Program (MAAP) will expand the range and capability of the West Allis Fire Department’s Mobile Integrated Health (MIH) team to facilitate MIH and medication-assisted treatment (MAT) services to every Milwaukee County municipality, as well as support the development of training materials to allow for application of sustainable MIH practices across the entire county. WAFD’s MIH team pairs a community paramedic and a certified peer recovery support specialist who provide targeted outreach and facilitate new enrollments or reengagements to MAT services, reaching the opioid use disorder (OUD) population via either real-time, 24/7 response to overdose emergencies or visitation to patients referred to the program from local and regional partners. MAAP will connect with each participating municipality’s local framework to establish a referral process and connect the local effort to broader regional efforts. A local hospital will provide MAT (including buprenorphine induction), mental health screening with counseling, and warm handoffs to primary care and community MAT clinics. MAPP will educate police, fire, and health departments in all Milwaukee County suburbs on how they can adopt the West Allis OUD outreach practices. MAAP will also work with county stakeholders to ensure children impacted by substance misuse receive required services. The project serves Milwaukee County, which comprises 19 municipalities and has a population of 945,726. The project includes partnerships with the Medical College of Wisconsin, the Milwaukee County Assistant District Attorney, the Milwaukee County House of Corrections, the Milwaukee County Opioid Fatality Review team, the Milwaukee County Medical Examiner’s Office, the Milwaukee Fire Department Opioid Response Initiative, the Wisconsin Department of Health Service, and the Milwaukee County Office of Emergency Management. The project will engage Dr. Jennifer Hernandez-Meier of the Departments of Emergency Medicine and Psychiatry at the Medical College of Wisconsin as the primary research and evaluation partner. Priority considerations addressed in this application include a high rate of primary treatment admissions for heroin, opioids, and stimulants, high rates of overdose deaths, and a lack of accessibility to treatment providers and facilities.

Wisconsin

County of Oneida

The Oneida County Health Department proposes to advance the Oneida County Community Response Team (OC CRT) Law Enforcement and First Responder Deflection and Referral to Treatment Program and establish recovery housing, both of which involve the progression of peer recovery coach services. The purpose is to improve current comprehensive, multi-disciplinary, evidence-based, community centered referral to treatment programs at multiple intercepts of the criminal justice system and establish recovery supports that enhance treatment and health outcomes for individuals experiencing substance use concerns. Project activities include expanding law enforcement and first responder participation in OC CRT deflection activities, as well as, collaboration with the newly formed Criminal Justice Coordinative Committee to establish comprehensive diversion programs at multiple intercepts of the sequential model. The project emphasizes developing peer recovery coach services, as well as, the integration of social workers to provide case management and care coordination services. In addition, the project aims to build an Advancing Recovery Capital Workgroup focused on establishing recovery housing, including recovery support services, in the region. Expected outcomes include: improved coordination of public health and response agency efforts through multi-disciplinary teams, increased number of evidence-based interventions within the criminal justice system, decreases recidivism rates, increased linkages to care and engagement in treatment, increased availability of recovery support resources, improved housing stability, and reduced morbidity and mortality associated with substance use. Beneficiaries of this project include various organizations involved at different intercepts of the criminal justice system by reducing recidivism rates and the burden of addressing behavioral health concerns within the system. Individuals experiencing substance use concerns will experience improved health outcomes and the ability to become productive members of society. The general community benefits from reduced property and public order crime. Most importantly, by supporting caregivers experiencing substance use concerns, the project improves social determinants of health for children living in these environments and helps impact family cycles of addiction. Subrecipient activities include: law enforcement and first responders will participate in follow-up contact interventions; recovery support services will provide case management, care coordination, and skill building services; recovery housing subrecipient will coordinate and provide guidance on steps to establishing recovery housing, finding and updating suitable locations, and training on systems of operation; data analysis subrecipient will complete process and outcome evaluation and reporting activities.

Wisconsin

Cabell County

Cabell County is applying for Category 1 funding in the amount of $1,130,000. The project will enable the expansion of the Huntington Quick Response Team (QRT) by building on existing cross-system planning and collaboration among law enforcement agencies, emergency medical services, fire departments, health care providers, public health agencies, the faith community, and agencies that provide substance misuse treatment and recovery support services. The QRT team connects overdosed individuals to a treatment facility within 72 hours of an overdose event and provides training on naloxone administration; it also focuses on community engagement and building readiness. The team will create operational protocols to guide its activities. The project will also create a follow-up response team that will provide active outreach to individuals who have previously interacted with the QRT to evaluate their current treatment and/or recovery progress and will offer access to services by which they can acquire skills required to join the workforce. The goals of the project are to reduce the number of overdoses in Cabell County and to reduce the number of frequent visitors with substance use disorders to Cabell County’s health care system. The project serves Cabell County, with a population of approximately 100,000. The project will include partnerships with the Huntington Police Department, the Cabell Huntington Health Department, Cabell County Emergency Medical Services, treatment providers from Prestera Center, and the faith community. The project will engage Dr. Nandini Manne from the Department of Public Health at Marshall University as a research partner. Priority considerations addressed in this application include a high rate of primary treatment admissions for heroin, opioids, and stimulants; high rates of overdose deaths; and a lack of accessibility to treatment providers and facilities.

City of Martinsburg

The City of Martinsburg, West Virginia, is partnering with the Martinsburg Initiative (TMI), to expand its substance use prevention and police social work program. The purpose of this project is to develop a comprehensive, multidisciplinary,trauma informed approach by building upon the mission of The Martinsburg Initiative: prevent substance use, build strong families, and empower the community. The project will create a position of project coordinator and add two social workers to the police department to cover all shifts. It will add a peer support specialist to the team to help with recovery services and add two school-based social workers to North and South Middle School. Additionally, a Crisis Intervention Team (CIT) will also be created, trained, and implemented to address individuals with substance use and unmet needs leading to substance use. The project will have three components as primary activities covering prevention, intervention, and treatment. In prevention, school social workers will provide prevention education using the evidence-based curriculum Too Good for Drugs and TMI prevention programs, identified individuals and families will be provided Naloxone, and overdose risk screenings and education will be provided. In intervention, law enforcement referrals will be received at Intercept points 0 and 1 of the Sequential Intercept Model for justice involved individuals at risk for substance use or overdose due to unmet behavioral health or socio-economic needs; case management of identified individuals; referrals, screenings, and evidence based interventions of identified at risk students in the middle schools; and connection to proper community resources to address the risk factors of substance use and overdose. In treatment, access to treatment will be expanded due to a coordinated referral system to local treatment centers and connections from the peer support specialist to help navigate the system and recovery services. This project is expected to have numerous expected outcomes to include the creation of CIT, improved response to substance use and mental health calls, reduced overdoses and overdose deaths particularly juveniles, reduced rates of recidivism, reduced stigma, more diversion into treatment, and increased resiliency in children. The service area is Martinsburg and intended beneficiaries include individuals and children struggling with substance use and their families. By addressing substance use as a public health issue, it aims to improve health and wellbeing of all members of the community.

West Virginia

Monongalia County

The Monongalia County Health Department project service area includes all of Monongalia County. This encompasses urban and rural areas where community concerns include resident struggles with substance use disorder (SUD), access to treatment options, and stigma surrounding these issues. In 2019, Monongalia County was found to have the fifth highest frequency of overdose deaths in the state, with 71% of these deaths involving opioids. The county was one of five awarded a grant in 2019 by the West Virginia Department of Health and Human Resources to develop a Quick Response Team (QRT). The goal of that funding was to reduce the numbers of unintentional opioid overdose deaths and increase the numbers of individuals participating in treatment and rehabilitation. QRT is comprised of emergency medical services, 911, law enforcement, Peer Recovery Support Specialists (PRSS), public health officials, social service providers, faith-based organizations, and local pharmacies. The main goals of this project are consistent with COSSUP's goals to reduce the impact of the use and misuse of opioids, stimulants, and other substances on individuals and communities, including a reduction in the number of overdose fatalities, as well as to mitigate the impacts on crime victims by supporting comprehensive, collaborative initiatives.

Laramie County Government

Laramie County, Wyoming, project focuses on Law Enforcement Assisted Diversion (LEAD), a community-based, harm-reduction intervention for individuals with law violations driven by unmet behavioral health needs. The program will expand case management capacity and hours of availability, address increasing use, and overdose within the community, and provide expanded hours and resources for client support. LEAD provides a non-punitive, health-centered approach to ensure that individuals struggling with substance use or mental illness are diverted from the criminal justice system while decreasing recidivism and improving public safety. Consistent with LEAD’s Guiding Principles, this model, based on harm reduction principles, seeks to connect high-need drug offenders to culturally competent, community-based service providers at the earliest law enforcement contact and keep individuals out of the criminal justice system. Laramie County is the most populous county in Wyoming with an estimated population of 100,863 residents, and home to the state capitol, Cheyenne. LEAD is a multi-agency collaborative between the Laramie County government, Laramie County Sheriff’s Office, Cheyenne Regional Medical Center, the Cheyenne Police Department, Healthworks, Volunteers of America, and Crossroads Health Clinic. LEAD will build on existing efforts to address the needs of repeat drug offenders through an initiative based on shared planning, decision-making, data sharing, and evaluation that will: (1) expand outreach and hours of service to eligible individuals within the county; (2) enhance coordination of service delivery through the existing social service network; (3) increase referrals to substance use and mental health treatment centers; and (4) improve collaboration and communication among law enforcement agencies and social services providers. From the perspective of the Sequential Intercept Model, LEAD intercepts the individual and diverts the behavioral problem at the point of law enforcement response (Intercept 1) to channel drug-involved individuals into a community-based intervention whenever possible and appropriate. Expected outcomes of this project include reduced recidivism for low-level drug offenders in Laramie County, strengthened collaboration across county and city departments and community-based organizations to better meet the needs of individuals with a history of substance use, mental health disorders, or low-level drug offenses, and increased community public health and safety.

Wyoming

Grantee Projects

City of Palmer

City of Palmer

Izard County

Izard County

Johnson County

Johnson County

Arizona Criminal Justice Commission

Arizona Criminal Justice Commission

County of San Luis Obispo

County of San Luis Obispo

Mendocino County

Mendocino County

Arapahoe County Colorado

Arapahoe County Colorado

Connecticut Department of Mental Health and Addiction Services

Connecticut Department of Mental Health and Addiction Services

City of Port St. Lucie

City of Port St. Lucie

Orange County

Orange County

Georgia Criminal Justice Coordinating Council

Georgia Criminal Justice Coordinating Council

Idaho Department of Health and Welfare

Idaho Department of Health and Welfare

Boone County

Boone County

DuPage County Health Department

DuPage County Health Department

Dubois County

Dubois County

The Health & Hospital Corporation of Marion County

The Health & Hospital Corporation of Marion County

County of Reno

County of Reno

Kansas Department of Health and Environment

Kansas Department of Health and Environment

Purchase District Health Department

Purchase District Health Department

Whitley County Health Department

Whitley County Health Department

Lafourche Parish Sheriff's Office

Lafourche Parish Sheriff's Office

Terrebonne Parish Consolidated Government

Terrebonne Parish Consolidated Government

Berkshire Regional Planning Commission

Berkshire Regional Planning Commission

City of Boston

City of Boston

City of Holyoke

City of Holyoke

City of Holyoke Police Department

City of Holyoke Police Department

City of Newburyport

City of Newburyport

City of Newburyport

City of Newburyport

Commonwealth of Massachusetts, Sheriff's Department Hampden

Commonwealth of Massachusetts, Sheriff's Department Hampden

Department of Public Safety

Department of Public Safety

Lowell, City of

Lowell, City of

Massachusetts Supreme Judicial Court

Massachusetts Supreme Judicial Court

Northampton, City of

Northampton, City of

Town of Seekonk

Town of Seekonk

St. Mary's County

St. Mary's County

Cumberland, County of

Cumberland, County of

City of Detroit

City of Detroit

Ottawa County Community Mental Health

Ottawa County Community Mental Health

Saint Louis County

Saint Louis County

Mississippi State Department of Health