Comprehensive Opioid, Stimulant, and Substance Use Program

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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

State of Alaska Department of Health

The Alaska Department of Health, Division of Public Health aims to implement the Alaska FY24 BJA-COSSUP Project to improve the statewide infrastructure to expand and enhance Overdose Fatality Reviews, support population-specific activities across all seven public health regions (Anchorage, Gulf Coast, Interior, Mat-Su, Northern, Southeast, and Southwest), and strengthen partnerships with first responders and corrections through naloxone distribution and post-overdose outreach. Alaska's regions represent a combination of urban, suburban, tribal, rural, frontier, and remote communities. The expected outcomes are reduced overdose deaths, improved public health practices, and strengthened state, tribal, and community partnerships across Alaska. The state seeks to enhance Alaska's Overdose Fatality Reviews by partnering with the Alaska Department of Corrections to review cases of individuals who died within six months of release from prison or jail, and establishing regional reviews supported by tribal health to address Alaska's geographic and cultural diversity. The state aims to support funding opportunities across all seven of Alaska's public health regions to support regional overdose fatality review participation and implement activities specifically aimed at supporting Alaskans disproportionately impacted by substance use and crime, including Alaska Native, criminal justice-involved, homeless, and unstably housed people, that are aligned with the goals and objectives of COSSUP, including future recommendations produced by the regional fatality reviews. Alaska plans to provide targeted outreach and education on overdose response and post-overdose outreach along with naloxone distribution to first responders, and corrections. The activity supports all corrections staff to carry naloxone, and providing kits and resources for individuals leaving incarceration, prioritizing individuals at high risk and facilities in areas with limited community naloxone access. This activity allows the Division of Public Health to significantly expand naloxone distribution for first responders and corrections, to both carry and distribute. The expected outcomes are reduced overdose deaths, improved public health practices, and strengthened state, tribal, and community partnerships across Alaska.

Alaska

Alabama Department of Mental Health

The Alabama Department of Mental Health is applying for a Category 2 award in the amount of $6,000,000. Project Possibilities: A Collaborative Alabama Criminal Justice Project will develop, implement, and expand a combination of law enforcement diversion programs; comprehensive and real-time data collection, analysis, and dissemination; and medication-assisted treatment and peer support recovery support services into existing systems of service in the state of Alabama across Calhoun, Dekalb, Etowah, Jefferson, Madison, Mobile, Montgomery, and Walker counties, serving an approximate population of 2,015,797. The project will serve utilizers identified within and across the criminal justice system including those in need of diversion from and preventing the return to the criminal justice system. Goals are to expand and implement diversion programs/services that provide treatment and recovery support to divert and prevent the return of opioid, stimulant, and other substance abusing/addicted individuals from/to the criminal justice system; extend the state data collection (Central Data Repository or CDR) of substance use information to include non-opioid substances; expand current partnerships to enhance data-sharing and accessibility, analysis, and dissemination of real time data; expand resources to rural areas, thus bridging the gap of care from urban and suburban areas to rural areas, including developing and implementing innovative and evidence-based models of MAT services for individuals interacting with the criminal justice system; and monitor the impact/outcomes of interventions, spreading successful intervention statewide at the completion of the project period to reduce incarceration, recidivism, morbidity, and mortality for adults with a substance use disorder who are cycling through the criminal justice system. The project includes partnerships between the University of Alabama's VitAL program, the Alabama Bureau of Pardons and Paroles, the Recovery Organization of Support Specialist, and People Engaged in Recovery. Priority considerations addressed in this application include serving high poverty areas throughout the state, and the proposed activities will address Office of Justice Programs priority considerations including promoting civil rights, increasing access to justice, and building trust between law enforcement and the community.

Alabama

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).

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.

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.

Pueblo Department of Public Health and Environment

The Pueblo County Department of Public Health and Environment (PDPHE) is applying for Category 1 funding in the amount of $899,280. The Pueblo County Partners for Data (PCPD) and Substance Abuse Response project will expand substance use and treatment datasets using quantitative and qualitative data from existing PCPD partner agencies (safety, health systems, harm reduction, schools, and social services) and new partnerships; facilitate data sharing and integration among partners; cultivate community partner and member use of the data to recognize gaps and make real-time decisions to reduce the impact of substance use on individuals and communities, reduce overdose deaths, and mitigate impacts on crime victims; enhance data infrastructure, including the data software and hardware to effectively manage a larger quantity of data; provide technical assistance to partners to collect data and assist with data organization in a compatible manner; disseminate data to the public, community partners, and community leaders so they are informed and able to make decisions based on substance use trends; and ensure data collection, analysis, and dissemination incorporate a health equity lens with the focus on reducing bias and disparities. The project will be carried out by a core team of five individuals working in the Office of Policy and Strategic Implementation at PDPHE. Deliverables include an enhanced data dashboard with additional quantitative measures such as MAT encounters, social determinants of health, prescriptions, and qualitative measures incorporating local stories; a data network where community partners, members, and researchers can request datasets based on research questions and programmatic or policy needs; a governance agreement to outline how to share, format, translate, link, and integrate data while adhering to appropriate privacy requirements to enhance data infrastructure; and an inclusive Health Equity in Data plan including community member involvement to guide data collection, analysis, and dissemination. The project serves Pueblo County, which has an estimated population of 168,424. The project includes partnerships between the PCPD and the District Attorney’s Office, the county Department of Human Services, local law enforcement agencies, hospitals, Pueblo Triple Aim Corporation, a federally qualified health center, a transitional housing center, the local fire department, and a behavioral health provider. The project will engage an external evaluation team. 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 will also support efforts to protect the public from crime and evolving threats, promote civil rights, and build trust between law enforcement and the community.

Colorado

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

Executive Office of the Governor Of Delaware

Delaware is disproportionately impacted by the abuse of illicit opioids and prescription drugs as seen in our high rates of overdose deaths from heroin and other opioids and lack of accessibility to treatment providers and facilities. Delaware is third in the nation for rates of overdose fatalities. In 2021, 515 Delawareans died from a drug overdose. The Delaware COSSAP Saving Lives will implement new opioid-intervention programs in six geographically diverse localities and establish pre-arrest or post-arrest law enforcement diversion programs for individuals who commit non-violent, drug-related offenses by utilizing community-based substance use disorder and behavioral health services. This project coordinates services statewide and two geographic locations are in rural parts of the state. Grant funds will implement strategies identified in the statewide coordinated plan to provide law enforcement resources to address the opioid epidemic in Delaware (38 percent of funds). Funds will include coordinating social services with law enforcement for response to children impacted during a drug overdose (10 percent of funds). Funds will expand the take-back program for unused controlled substances found in the home, hospitals, and long-term care facilities (2 percent of funds). The project goals include: (1) increase number of law enforcement diversion programs; (2) reduce incidence of overdose deaths; (3) increase transitional housing availability (20 percent of funds); (4) increase services to youth impacted by addiction; and (5) produce an evaluation report. The project includes partnerships between the Criminal Justice Council, Division of Public Health’s Office of Health Crisis Response, Division of Substance Abuse and Mental Health, and Delaware Association of Chiefs of Police. The project includes an evaluator from the University of Delaware.

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.

Criminal Justice Coordinating Council

The Georgia Criminal Justice Coordinating Council (CJCC) project provides a collaborative and effective data-driven response for Georgia's citizens affected by the opioid crisis as well as substance use disorder, while holding substance users accountable and improving public safety. This project will serve a minimum of six geographically diverse localities throughout the state using a competitive request for applications process. Potential projects will respond to the following objectives: criminal justice response in diversion and intervention, prevention and harm reduction, and recovery support. CJCC will also work with the Georgia Council 4 Recovery (formly the Georgia Council on Substance Abuse) to provide law enforcement throughout the state with trauma response training. Each objective is at the core of the state's response to create sustainable solutions that will support substance use recovery, prevention, and enhance public safety for individuals who suffer from substance use disorder, impacted family members, and the communities in which they live. Project activities will address the following allowable uses: supporting the implementation or enhancement of law enforcement and first responder-led diversion programs for individuals with substance use disorders; supporting the implementation of pre/post-booking alternative to incarceration programs within target areas; promoting education and prevention activities that link law enforcement with K12 youth who may be impacted by substance use; supporting data-driven responses at the local level to address the misuse of opioids and other substances, and expanding access to treatment and recovery support. Funding will also be used to conduct a statewide action plan and evaluation which will be led by the Georgia Statistical Analysis Center who will also play a vital role in the data driven response.

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.

City of Clinton

The City of Clinton is applying for Category 1c rural/tribal area grant funding in the amount of $600,000. Clinton’s Opioid and Stimulant Partnership will address stimulant use and provide a broader reach of services to those in need to provide viable resources within the community through the use of an expanded multidisciplinary team that focuses efforts toward community systems working in collaborative efforts to identify, educate, treat, and prevent further instances of substance use addiction, and fatalities within our community. A Drug Abuse Response Team will follow up with overdose victims while connecting them with interventions or treatment options. The program will also update opioid community assessment, expand and enhance a MAT program, as well as partner with community agencies for recovery support services that include peer support/case management and healthcare treatment. This project serves Clinton, Iowa, and its 25,637 residents. The project includes partnerships the City of Clinton Administration, Clinton Police Department, Clinton Fire Department, MercyOne Clinton Medical Center, Clinton Substance Abuse Council, Area Substance Abuse Council, Life Connections, and Bridgeview Mental Health Center. Priority considerations addressed in this application include the disproportional impact on the community by the abuse of illicit opioids, stimulants, or other substances; specific challenges rural communities face; and enhancing public safety in Qualified Opportunity Zones.

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.

Cook County

This project serves Cook County, Illinois’ 5.2 million residents. The purpose of the project is to further develop a regional learning health system approach to substance use disorder (SUD) care for justice-involved individuals. The project works to achieve this through three goals: (1) Expand the Cook County Recovery Home Coordinated Capacity Project; (2) Expand the scope of CCCR-LAN to include improved access to substance use disorder care for individuals on electronic monitoring; and (3) Implement a data-sharing linkage between County Care and Cook County Adult Probation to improve enrollment in Medicaid and engagement with care coordination services among Adult Probation clients.

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.

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

Northern Kentucky Independent District Health Department

The Northern Kentucky Independent District Health Department (NKY Health) proposes to implement the Northern Kentucky Overdose Fatality Review (OFR) Initiative within Kentucky's Boone, Campbell, Grant and Kenton Counties. Through this proposal, a multi-county OFR will utilize strategic partnerships and will enhance and expand multidisciplinary stakeholder collaborations among and between, law enforcement, County Coroners' offices, hospitals, EMS, behavioral health providers, advocacy groups, harm reduction, peer support agencies, and other relevant organizations. NKY Health will work closely with county officials to identify and extend invitations to individuals to represent the diverse population throughout the health district. Through this proposal, NKY Health seeks to establish an OFR Coordinator. Project activities will include identification of stakeholders and OFR partners, development and execution of data-sharing agreements between OFR partners, development and implementation of a data collection tool, and development of an OFR operational manual. During the first year, NKY Health will focus on researching existing data sharing agreements and data collection tools through BJA and other resources; building capacity and partnership development. NKY Health seeks to conduct the first OFR committee meeting in the beginning of project year two. Year three will focus on continued improvements to the OFR process and exploring regional collaborations with neighboring OFRs. Outcomes for this project include the formation of a multi-county OFR in Northern Kentucky, and improved surveillance and response to overdose deaths. Additional outcomes include the implementation of strategies and activities to address overdose deaths, a reduction in overdose deaths in Boone, Campbell, Grant and Kenton Counties, and increased awareness and collaboration for OFRs in the region.

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.

Louisiana Department of Public Safety and Corrections

The Louisiana Department of Public Safety and Corrections (DPS&C) is applying for a Category 2 award in the amount of $5,996,211. The Reentry Health Information Exchange for Justice Involved Individuals with Substance Use Disorders project will create the Louisiana Tulane University Correctional Release Health Information Exchange (LaTU-CRHIE). This project will be a public-private partnership bringing innovation and a collaborative initiative to design and implement a behavioral health information exchange network to be piloted in the selected regions to improve transitions of care for justice-involved individuals with substance use disorders accessing behavioral health services post-release. LaTU-CRHIE will digitally revolutionize and actively address the way Louisiana releases and treats JIIs with SUDs across a continuity of care continuum. DPS&C will work with Tulane University, School of Medicine, Department of Psychiatry and Behavioral Science, and Tulane’s collaborative partner, Delaware Health Information Network, to design and implement a comprehensive behavioral information exchange network to facilitate information for the dissemination, collection, and analysis of information. This project serves Southern Louisiana and 16 selected parishes which make up almost 50 percent of the state’s population. Priority considerations addressed in this application include the fact that twelve of the sixteen parishes selected for this proposal have a poverty rating above the national average and a designation status as a "Medically Underserved Area/Population," specifically in mental health, where only 25 percent of Louisiana’s population needs are being met for the treatment of mental health care and services.

Orleans Parish District Attorney

The Orleans Parish District Attorney (OPDA)’s office project includes a multidisciplinary coordinating body by consolidating existing anti-opioid committees into a singular body–the Metropolitan Overdose Data to Action Program (MODTAP). The service area of this project is the city of New Orleans, which is home to a diverse community with significant underserved populations and the anchor of a metropolitan area totaling just under one million individuals. This data-driven approach ensures that resources are applied in the right area and at the right time, and best practices are adopted. In New Orleans, the coalition is willing, but the data is weak. While there has been great support for across-the-board efforts in responding to the crisis, the actual utilization of the plethora of data available to drive collaborative decision-making has been lacking. Each stakeholder collects data, makes decisions, and applies resources independently in their own silo. Even in areas where there is general agreement on the efficacy of an agreed-upon strategy, there is no consensus being developed on how to deploy it most effectively. MODTAP would be charged with collecting, reviewing, and disseminating data collected by the member organizations and the local Overdose Mapping Application Program to conduct quarterly overdose fatality reviews (OFR). The OFR process will be supported by evidence-based Risk Terrain Mapping that will guide the policy recommendations and collective actions of MODTAP on a micro-level. In turn, OPDA will use the findings and recommendations by MODTAP to maximize participation in the diversion of substance use disorder-related offenses into non-criminal legal system resolutions. Planned activities for MODTAP are real-time data collection and a post booking treatment alternative-to-incarceration program, including screening to identify candidates for referral to the Law Enforcement Assisted Diversion Program (LEAD).

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 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 Lawrence

The City of Lawrence, MA will implement a comprehensive and connected continuum of care for substance misuse prevention in Lawrence. The purpose is to reduce the disproportionate rates of illicit opioid and stimulant misuse and overdoses in Lawrence, MA, with a focus on males in their thirties and forties, homeless individuals, high-risk youth 14 “ 24 years old, active users of illicit opioids and stimulants, and criminal justice-involved individuals. Project activities include the HUB multidisciplinary partnership coordinating and using real-time data; embedding peers, social workers, and people with lived experience at the community, law enforcement, and court intercepts; and providing education and prevention programs for at-risk youth. The expected outcome is that the city and grant partners are better able to prevent, respond to, and treat those impacted by illicit opioid and stimulant misuse. The project brings together individuals with lived experience and diverse partners that serve populations that have been historically underserved, marginalized, adversely affected by inequality and disproportionality impacted by crime. Subrecipient activities include outreach, education, supportive wrap around peer support, transportation, and training.

City of Lowell

The Lowell Police Department is proposing to enhance and expand the Community Opioid-Outreach Program team (Lowell Police, Fire, Health, Trinity EMS, Lowell House) by adding a youth services coordinator to focus on the needs of children affected by the opioid epidemic, two outreach specialists to expand service to the homeless community by serving as a liaison between agencies to improve communication and connect their various resources, and conduct pro-active outreach to any individuals with substance use disorder before an overdose. Grant funds will support a coordinator, crime analyst, full-time clinical recovery specialist and youth services coordinator, outreach recovery specialist and research team. University of Massachusetts Lowell will serve as the research team comprised of researchers from Center for Community Research & Engagement, School of Criminology and Justice Studies, and Community Health and Sustainability.

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 dba Middlesex Sheriff's Office

The Commonwealth of Massachusetts, dba Middlesex Sheriff’s Office, applied for a Category 1a urban area grant in the amount of $1,152,729. The Involving Families in Treatment of Inmates with Opioid Use Disorder (OUD) Project will reduce opioid overdose deaths and improve treatment outcomes for inmates with opioid use disorder by providing naloxone to family members and involving them in treatment. Through an enhancement of the Medication-Assisted Treatment and Directed Opioid Recovery (MATADOR) Program — which provides naltrexone, buprenorphine, methadone, and case management services — the proposed project activities include: (1) development and implementation of naloxone trainings and naloxone distribution for family members of inmates with OUD; (2) provision of a comprehensive family services program for inmates with substance use disorders, including outreach to engage families in the project, educational programs for families on substance use disorder, family counseling, and support groups, and (3) an evaluation of the project’s impact in improving treatment outcomes and reducing the risk of overdose deaths. This project serves Middlesex County, located in northeastern Massachusetts. Middlesex County, the most populous county in New England, has 1.6 million residents. The project includes partnership with Brandeis University. Priority considerations addressed in this application include a high rate of primary treatment admissions for heroin or other opioids and high rates of overdose deaths.

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.

Massachusetts Supreme Judicial Court

DEC/Diversion Project Description The Massachusetts Middle District Attorney’s Office, in partnership with Open Sky Community Services and the National Alliance for Drug Endangered Children, received funding to support the Worcester County Drug Diversion and Drug Endangered Children Initiative. The Middle District Attorney’s Office is the lead prosecution agency for the 60 communities that make up Worcester County, Massachusetts. The county has 862,111 residents and covers the largest geographical area of any county in the Commonwealth. Over the last eight years, the county’s law enforcement, municipal leaders, medical providers, treatment agencies, and other vested parties have joined forces to assess risk and protective factors related to opioid misuse. These representatives make up the Central Massachusetts Prevention Support Network (PSN), which aims to reduce overdoses and overdose deaths among residents, to prevent first-use of opioids, and to change the trajectory of intergenerational trauma resulting from substance misuse. The project will use data-driven, evidence-based strategies to reduce the number of low-level offenders with a history of substance use disorder that become incarcerated in Central Massachusetts. Through implementation and operation of a pre-arraignment drug diversion program in ten district courts. The effectiveness of this work is being evaluated by Kelley Research Associates. The PSN recognizes the need for greater awareness and response to the impact caregiver substance use has on children. Local data indicates the identification rate of these children is lower than expected in a region the size of Worcester County. Unidentified children inherently lack access to the trauma informed services needed to address their victimization and its long-term impacts. This project will utilize national expertise in assessing community needs and developing appropriate responses through proven practices. The project will achieve the following: (1) expand diversion opportunities for low-level offenders with history of substance misuse; (2) reduce the number of unintentional overdose deaths among low-level offenders and criminal justice system-involved individuals in Worcester County; (3) evaluate the impact of diversion strategies and substance-abuse treatment for low-level offenders with history of substance misuse; (4) operationalize a county-wide Drug Endangered Children Alliance; and (5) Reduce impact of trauma on children in Worcester County.

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 that culturally and linguistic appropriates services are aligned with the United States HHS CLAS standards in Health Care, 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 East Bridgewater

The Town of East Bridgewater project supports the existing Plymouth County Outreach (PCO) program. Ninety-seven percent of this budget will support the allowable use category of law enforcement and first responder deflection and diversion programming and 3% will support real-time data collection. This project serves the area of Plymouth County, which has a population of 541,589.1. PCO is a police directed post-overdose outreach model and serves to make treatment more accessible for those struggling with Substance Use Disorder and their families. The key program components of this project will enhance the current PCO model in three ways. First, the expansion of the reentry strategy to provide recovery support to pre-trial court-based populations including referrals to local resources, sober living scholarships, and transportation vouchers. Second, the expansion of recovery supports to youth including weekly youth recovery support groups and the development of a policy and curriculum for educational SUD classes that schools can add to the existing school drug policy violation disciplinary options. Finally, the creation of an Overdose Fatality Review process to identify gaps in services and resources that contribute to fatal overdose events including six OFR meetings reviewing 12-18 fatal events per year. This project includes partnerships between the 27 police departments in Plymouth County, as well as the Bridgewater State University Police Department, the Plymouth County District Attorney and Sheriff, as well as all local hospitals and treatment facilities. PCO is administered by an Advisory Board that is comprised of Police Chiefs, Physicians, and Public Health experts. Kelley Research Associates (KRA) will serve as the research partner for this project and also maintain the Critical Incident Management System (CIMS) software which records real-time data on all overdoses that occur in Plymouth County. CIMS also manages and documents incident followup 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. Previous COSSAP funding from 2018 and 2020 allowed PCO to establish long-term viability.

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.

Cecil County

The Cecil County Department of Community Services (DCS) is applying for Category 1 funding in the amount of $762,064. The project will enable the expansion of the Cecil County Prevention and Overdose Response and Trauma Support Services initiative (PORTSS), a first responder-led project. The PORTSS team, comprising a coordinator from the Department of Emergency Services, a peer recovery specialist from the Cecil County Health Department, and a case manager from DCS, will help bridge an identified communication gap between responding agencies and service providers and ensure outreach to victims and families. With the addition of the DCS case manager (a social worker), the team will assess needs, coordinate referrals, assist families, and follow up on family engagement. Services to families will include a warm handoff to substance use disorder treatment, trauma therapy for children and their caregivers, revitalization of Cecil’s Handle with Care program, referrals for behavioral/mental health services for children, assistance with accessing community resources (food, housing, utility assistance, etc.), educational assistance, and regular follow-up. The PORTSS team will utilize real-time data from Cecil County’s heroin coordinator, located in the Cecil County Sheriff’s Office (CCSO) and 9-1-1 call logs, enabling it to receive real-time notification of overdose “hot spots.” The PORTSS team will also provide regular training to first responders on adverse childhood experiences, trauma, and ethics. The project serves Cecil County, a largely rural jurisdiction with a population of nearly 103,000. The project includes partnerships with the Cecil County Sheriff’s Office, public schools in the county, the Cecil County Department of Social Services, Voices of Hope, Inc. (a recovery partner), and Bodhi Counseling and Upper Bay Counseling and Support Services, behavioral health providers. 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.

Maryland

Cecil County, Maryland

Cecil County, Maryland, will enhance the community's response to the opioid crisis by offering a public safety-led multidisciplinary team response to serve victims of overdose, their children and family members, and our professional partners. The initiative is entitled the Prevention and Overdose Response and Trauma Services Supports program (PORTSS). Cecil County has previously received COSSAP grant funds and this project will augment and supplement the activities of that grant, while assiduously maintaining separation of financial and programmatic measures. In January 2022, Cecil County officially launched the PORTSS team. The team offers services to overdose victims and family members as Cecil implements a two-generation strategy to reduce substance use disorder and consequent childhood trauma. Services include a warm handoff to treatment, trauma therapy for children and their caregivers, and assistance with accessing community resources. Additionally, the team is continuously collecting, reviewing and sharing data, providing direct therapeutic services to first responders, training and supporting public safety, school staff and other professionals, promoting community awareness, and sharing all available resources to meet the needs of this population. With additional funding, Cecil County intends to continue current efforts and provide new services, including transportation for clients in recovery houses, an annual Trunk-or-Treat/Drug Take-Back event, youth diversion and tobacco, drug, and alcohol education, youth social and emotional learning, a Local Outreach to Survivors of Suicide (LOSS) program, continuing education for local mental health professionals, and a central data sharing system. The nature of the work supported by the PORTSS initiative requires ongoing, uninterrupted service to provide continuous trauma therapy, overdose response, prevention efforts, education, and data management. To avoid the inevitable delays that occur at the start of a new grant cycle, Cecil County is proactively applying for funding mid-cycle, attempting to insure an uninterrupted flow of services.

Maryland

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).

Department of State Police Michigan

The need to expand overdose prevention, SUD treatment, and other harm reduction services is high in Northern Michigan. Like many rural areas, there are few options for community-based SUD care and funding is limited. Both Michigan's Upper Peninsula and its northern Lower Peninsula lack critical community mental health infrastructure to ensure continuity of service after acute drug-related crisis and access to harm reduction resources. This dramatically impacts the health of northern communities, some of which have rates of hepatitis C, a viral infection associated with injection drug use, that exceed Michigan's densely populated urban counties. Moreover, health care and first responder resources are more geospatially dispersed, leading to delays in treatment and access to critical harm reduction interventions. However, current funding is insufficient to meet the demands of innovative prevention programs to support northern counties in reducing morbidities and mortalities associated with SUD and drug overdoses. Therefore, to build infrastructure and increase capacity for SUD services in Northern Michigan and one centrally located, urban community, the Michigan State Police (MSP), in collaboration with the Bay Mills Indian Community, Catholic Human Services, Greater Flint Health Coalition, Harm Reduction Michigan, Nathan's House, and the Michigan Public Health Institute, is proposing several innovative prevention programs. MSP is leading the project with ten counties in Northern and Central Michigan in partnership with local tribal, public health, and community organizations and the University of Michigan School of Nursing as the evaluation partner. The goal of the project is to offer SUD and overdose prevention services that will promote health during critical moments in recovery and prevention. For example, a comprehensive education campaign for K-12, at-risk youth and county-level overdose fatality reviews will be implemented as primary prevention strategies. Likewise, drug checking and other harm reduction services will be used to prevent overdose during active use. For consumers who are newly entering community services, MAT programming will be expanded, and additional behavioral health clinicians will be recruited to offer SUD counseling services. In Genesee County, a comprehensive, interdisciplinary recovery community center that centralizes community-based services will be implemented. To help prevent contact with the justice system, recovery coaches and jail-based SUD care will be implemented to prepare consumers for re-entry. Finally, transitional recovery housing capacity will be bolstered to provide stable housing and extended recovery support. Overall, these projects will build critical infrastructure in Northern and Central Michigan for quality SUD care.

Michigan

Macomb County

Macomb County is applying for a Category 1 award in the amount of $595,168. The Macomb County Prosecutor’s Office/Families Against Narcotics (FAN) REDIRECT Diversion Program will reduce the number of overdoses, assist people in getting treatment for addiction, reduce drug-related crimes, and improve the relationship between law enforcement and the community. The overall goal of REDIRECT is to reduce both drug-related crime and overdose mortalities among high-need/high-risk people in Macomb County who may have committed a minor, non-violent, drug-related offense by offering them a referral to treatment and continuum of care, in lieu of arrest and prosecution of criminal charges. The objectives are to launch REDIRECT in all 18 police departments within the county, provide a continuum of care to participants for 12 months to support their sobriety, and to reduce the stigma of addiction within law enforcement and the community. This project serves Macomb County, which has a population of approximately 873,000. The project includes a partnership with FAN, a grassroots organization known and respected by law enforcement throughout the county. Priority considerations addressed in this application include that the project will benefit individuals residing in a high-poverty area or persistent-poverty county.

Oakland County

The Oakland County Sheriff’s Office (OCSO) provides law enforcement services to the citizens of Oakland County, Michigan–a population of more than 1.2 million residents. The county’s overdose crisis is a public safety and health emergency that threatens the well-being of individuals who misuse drugs and impacts the safety of communities. Prescription drugs and prescription drug abuse are driving an epidemic of overdose deaths that include the boundaries of Oakland County. Mutual trust is essential to maintain public safety and a partnership between law enforcement and the mental health community to provide applicable services and enhanced response to persons in crisis is needed. This grant seeks to expand an existing law enforcement deflection and diversion program and educate community members on the crisis response concept and 100 percent of the budget will be dedicated to these activities. The program will provide the ability to expand individual agency Crisis Intervention Team (CIT) trained law enforcement officers, along with the creation of a county-wide crisis response team made up of dedicated CIT law enforcement officers who receive advanced training and respond where the need arises, like a county-wide task force. The crisis response program will include 12 communities that contract with the OCSO for law enforcement services and 39 local and multijurisdictional law enforcement agencies within Oakland County. The Crisis Response Unit will provide training to teachers, counselors, and citizens in the crisis response concept. The training is not a certification in CIT but will enhance an understanding around crisis response and mental health. By creating a county-wide crisis response unit and increasing CIT training, officers will be better equipped to respond to individuals experiencing a crisis and divert them to mental health agencies to receive appropriate care. The anticipated outcome of this program is a decrease in overdose deaths within Oakland County.

City of Duluth

The City of Duluth is applying for a Category 1 award in the amount of $899,982. The Substance Use Response Team of the City of Duluth Police Department’s Lake Superior Drug and Violent Crime Task Force (LSDVCTF) proposes a program model that would expand upon the services it currently provides, allow for the program to assist more individuals regardless of drug of choice, and shorten times between overdose events and contact from the team, thereby allowing for quicker access to treatment. This project serves the entire LSDVCTF region, which includes St. Louis, Carlton, and Lake Counties in Minnesota, as well as the city of Superior in Wisconsin. This entire region has a total population of 288,732. The project includes partnerships between St. Louis County Public Health and Human Services, St. Louis County Drug Court, the Center for Alcohol and Drug Treatment, and SOAR Career Solutions. This project will engage Dr. Jeff Maahs from the University of Minnesota Duluth as the research partner for this project. Priority considerations addressed in this application include services and referrals in designated Qualified Opportunity Zones.

City of Duluth

Through this project the City of Duluth will expand, refine, and sustain its successful, evidence-informed approach toward integrating Peer Recovery Specialists into the criminal justice system to provide individuals with substance use disorders with Peer and harm reduction-based services. The City of Duluth's Substance Use Response (SURT) operates across the Arrowhead region of North East Minnesota, including St. Louis, Carlton, and Lake Counties in Minnesota and the City of Superior, Wisconsin. The region has a population of 273,944 and is approximately 12,000 square miles. The SURT is a Peer Recovery led deflection program housed within the Duluth Police Department. Existing programming includes three interrelated components: the maintenance of an opioid-overdose database providing near real-time data on overdose trends across the region; client-focused services, which include all of the six pathways to deflection as well as the ability to provide participants with rapid STI screenings and on-site clinical substance use assessments; and naloxone training and distribution to law enforcement, community partners, and the general public.Through this project SURT will expand into additional intercepts of the criminal-legal system by embedding a social worker into the local jail to provide reentry services, partnering with a local reentry organization to provide ongoing wraparound reentry case management, and collaborating with a prosecutor-led diversion program to provide peer and harm reduction services to program participants. Additional Peer Recovery support services will be offered with the implementation of opt-out rapid STI testing for incarcerated people at the regional correctional facility and increasing naloxone saturation efforts among criminal justice partners. The expected outcomes are improvements in regional reentry services, increases in various populations' access to harm reduction services, and improvements in outreach efforts related to the overdose epidemic. The intended beneficiaries of all program components are individuals with high needs and high barriers to accessing substance use, behavioral health, and harm reduction services through more traditional venues, which oftentimes are individuals with intersectional, historically marginalized identities.

Minnesota

Carter County Courthouse

The Carter County Courthouse is located in the southeastern Missouri Ozarks. The proposed initiative aims to address the opioid, stimulant, and substance use disorder (SUD) crisis in Carter County, a community of 5,303 residents severely impacted by high rates of addiction and limited access to healthcare and treatment services. Carter County has experienced a significant increase in both fatal and nonfatal overdoses, with a 50% rise in annual drug-related overdose deaths in 2022. From 2019 to 2023, Missouri saw nearly a 75% increase in overall overdoses, primarily driven by fentanyl. Suicides are also becoming more common, with over one in three involving a substance use disorder. Carter County residents report substance use as the most pressing health issue in the community. The goals of the project are to reduce the harm caused by opioids, stimulants, and other substances to individuals, families, and the community; lower recidivism and nonfatal overdose rates; and reduce preventable deaths where substance use is a factor, including overdoses and suicides. This project will be implementedin collaboration with the Carter County Courthouse, Family Counseling Center, and Washington University in St. Louis. The Carter County Courthouse will implement a prosecutor-led diversion program, distribute Narcan, and offer case management services working closely with recovery and housing agencies. The Family Counseling Center will provide peer support and patient navigation services to ensure a continuum of care between organizations, emergency department discharges, and law enforcement interventions. Additionally, a drug take-back program will be implemented to reduce the availability of unused medications.The intended beneficiaries of this project are individuals with SUDs, their families, and the broader community affected by substance use. The project evaluation will measure performance, utilizing data from court systems, healthcare providers, and community surveys. This will track treatment engagement, overdose rates, and recidivism, alongside focus groups to capture the lived experiences of those affected by SUDs. Washington University will serve as a research partner. The Carter County Hope Coalition, a multidisciplinary body, will help guide efforts, ensuring community involvement and interorganizational collaboration. By integrating these components, the project aims to reduce the harm caused by substance use, lower overdose and suicide rates, and enhance long-term recovery outcomes for Carter County residents.

Missouri

St. Louis County, Missouri

The Saint Louis County Department of Public Health will be implementing the Substance Use Public Health Emergency Response (SUPHER) Program, which will implement a range of allowable grant activities, including embedding support staff at any intercept of the Sequential Intercept model, evidence-based substance use disorder treatment (such as MAT, harm reduction activities, and recovery support services) for populations leaving the jail, real-time data collection, and other field-initiated projects that bring together justice, behavioral health, and public health practitioners. The SUPHER Program will design, develop, and refine outreach within DPH Corrections Medicine (CM) to identify, refer, and coordinate induction/maintenance of Medication Assisted Treatment (MAT) and increase linkage to care and social services navigation for justice involved individuals. The SUPHER program will also create a multi-disciplinary coordinating body of justice services, behavioral health, and public health practitioners to establish an overdose fatality review (OFR) board to review cases, share and provide data, and identify intervention points for outreach and education. Lastly, the SUPHER program will assist and expand Project EAGLE FANG, a project within the toxicology lab of DPH's Medical Examiner (ME) office that tests drug paraphernalia obtained from the scene of fatal overdoses and will allow SUPHER to identify emerging trends in drugs associated with fatal overdose. It is through these three objectives that SUPHER will work towards the goal of addressing the needs of justice involved individuals (JIIs) and reduce drug overdoses. This program serves Saint Louis County, Missouri, with approximately 1 million residents. The program includes partnerships with the Saint Louis County Department of Justice Services (DJS) Buzz Westfall Center, DPH CM, and DPH's ME Office that continues to build upon system changes for OUD prevention, treatment and recovery that have been activated. This project will focus explicitly on reaching high-risk and vulnerable populations (justice-involved persons, racial minorities, active drug users, and at-risk youth) through continued implementation of Missouri's Medication First treatment model for OUD, the aim is to increase access to evidence-based medications and improve transitions of care upon discharge.

Missouri

Lamar County Board of Supervisors

The Lamar County Board of Supervisors applied for Category 1c rural/tribal area grant funding in the amount of $599,981. The Lamar County Guardian Project objectives are to divert 100 individuals with SUD from jail and into community-based treatment and to provide counseling and case management services to 150 individuals suffering SUD while inside the correctional facility. All 250 individuals would be provided with case management and outreach services provided by staff and volunteers under this project umbrella. This project serves Lamar County, Mississippi, which has a population of 63,300. The project includes Healthcorr, LLC, a provider servicing the Lamar County Jail. Healthcorr, LLC will provide a Licensed Clinical Social worker to be staffed in the Jail. This position will provide booking assessments, counseling services, medical referrals, and tools needed to be successful outside of Jail. This position will also accept referrals from law enforcement for outpatient treatment services in lieu of collecting additional chargers. Lamar County Jail will provide a Substance Use Officer to act in a case management role on a case by case basis. This officer will be the liaison between courts, medical facilities, treatment facilities and additional correctional facilities. This position will offer assistance once released in order to remain successful sober. Priority considerations addressed in this application include the lack of accessibility to treatment providers and facilities and emergency medical services, and rural challenges.

Mississippi State Department of Health

The Mississippi State Department of Health (MSDH) project is titled Mississippi COSSAP Advanced Response Enhancement System (MCARES). 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 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. 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. Guided by MSDH, the applicant agency, MCARES will be implemented statewide. 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. In the absence of funded community-based organizations, the MSDH has leveraged its status as a centralized public health system, utilizing the MSUD Lead Pharmacist and five regional Pharmacists to assist centralized public health departments to support care continuity and risk reduction for patients receiving MOUD services, including medical assisted treatment (MAT), naloxone distribution, patient education, care coordination, and data driven decision making for rapid response. MCARES goals conform to the following COSSAP Category 2 allowable uses: (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; (2) expansion of naloxone distribution for first responders and direct distribution to end users (e.g., individuals experiencing a drug overdose); 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. To attain these goals, MCARES will implement activities to achieve the following outcomes: expanded naloxone access to individuals suffering from a nonfatal overdose and increased MOUD for under-insured and uninsured Mississippians. Subgrantees faced several barriers, resulting in a rescope of several activities. Due to several essential leadership position changes at the Mississippi Bureau of Narcotics that were responsible for ensuring the Bureau’s participation in the funded project, the funds originally intended to support the creation of at least three transportable response units to deliver community-based demand and supply reduction efforts in response to overdose alerts were reallocated to purchase medications and medication supplies to increase availability and meet the need for naloxone for first responders. Additionally, the Mississippi Public Health Institute was unable to identify community-based organizations for mini grants to participate in the project due to partner agency barriers. In the absence of funded community-based organizations, the MSDH has leveraged its status as a centralized public health system, utilizing the MSUD Lead Pharmacist and five regional Pharmacists to assist centralized public health departments to support care continuity and risk reduction for patients receiving MOUD services, including medical assisted treatment (MAT), naloxone distribution, patient education, care coordination, and data driven decision making for rapid response.

Mississippi

Mississippi State Department of Health

The Mississippi State Department of Health (MSDH) is applying for a Category 2 statewide area grant in the amount of $6,000,000. The Mississippi Opioid, Stimulant, and Substance Abuse Program will implement universal SUD screening with comprehensive evidence-based SUD interventions delivered through collaboration between patient and provider. They will improve the timeliness and quality of drug overdose information on death certificates and the transfer of this information electronically to support the rapid exchange of death information. The program will select an appropriate web-based naloxone administration training portal to train law enforcement and other first responders on administration of naloxone and expand the availability of naloxone to those that receive training. Also, the program will extend and expand access to evidence-based treatment interventions through MSDH county health departments. This project serves all citizens of the state of Mississippi, a predominately rural state with a population of 2.9 million residents. The project includes partnerships between the Mississippi Public Health Institute, Mississippi Office of Forensics Laboratories, and the University of Mississippi Medical Center. Priority considerations addressed in this application include rural, high-poverty areas, and Qualified Opportunity Zones.

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.

City of Jacksonville

In 2016, Jacksonville, North Carolina, was ranked in the Castlight Health report (The Opioid Crisis in America’s Workforce) as the 12th top city for opioid abuse rate in the US, with 8.2 percent of people in the community who receive and abuse an opioid prescription. The report stated that approximately 16,000 residents struggle with prescription abuse. Current statistics show a significant problem in Onslow County, including a rise in overdose deaths following the COVID-19 pandemic. The Onslow County rate of death from overdose increased by 85 percent from 2019 to 2021. The 2022 COSSAP project has expanded on the successes of the 2019 project and we continue to partner with stakeholders in developing and executing a comprehensive effort to respond to, treat, and support those impacted by the opioid and substance use crisis. The project’s goal is to decrease overdose deaths in our community by developing resources that provide services to individuals struggling with opioid and substance use disorders and their family members. The project is comprised of six components; (1) support implementation of peer navigators within the community paramedic program for overdose victims encountered through emergency medical services to swiftly direct them to services and assist with case management after encounter; (2) a law assisted diversion program to direct low level drug offenders to treatment and prevent them from entering criminal justice system (3) an overdose fatality review team to bring together various stakeholders with different perspectives to review overdose deaths; (4) child psychology services to provide therapy for children with adverse childhood experiences due to exposure to substance. (5) A substance use counselor to work with the school system providing education and referral services to families experiencing SUD. (6) Evaluation utilizing experienced social science research evaluators. This project will serve individuals in the City of Jacksonville (pop 72,879) and the County of Onslow, NC (pop 213,676) and includes partners from the governmental, non-profit and service provider business entities. These partners include: Onslow County, Onslow County Department of Social Services, Onslow County Health Department, Onslow County Emergency Services, Integrated Family Services, the Onslow County District Attorney’s Office, District and Superior Court Judges, Onslow County Schools, Onslow Memorial Hospital, and the Onslow County Partnership for Children.

North Carolina

County of Guilford

The Guilford County (NC) Sheriff's Office is teaming with three community partners in order to address the opioid crisis in two county detention centers. According to the North Carolina Department of Health and Human Services, from 2018 to 2022 Guilford County had an 85% increase in the number of opioid overdose deaths. The proposed project focuses on law enforcement deflection and diversion; availability of naloxone for law enforcement, jail staff, and other justice system practitioners; and evidence-based substance use disorder treatment related to opioids, stimulants, and other illicit drugs, such as medication-assisted treatment, contingency management, and motivational interviewing. Additional areas to be addressed include incorporating harm reduction activities and recovery support service engagement with the pre-trial and post-trial populations in and reentering the community from local jails, and embedding social workers, peers, and/or persons with lived experience to assist persons with justice involvement and their families navigate the justice system and to increase their connection to treatment and recovery support services. The goal of the project is to reduce the substance use disorder recidivism rate by 50% to 9 persons per week in Year 3, through comprehensively addressing the issues related to the substance use disorders of individuals while in the jail and post-release.

Jackson County Government

Jackson County, North Carolina seeks to implement a comprehensive program designed to positively impact the overdose crisis and community-wide effects of illicit opioids, stimulants, and other substances. This program willexpand evidence-based substance use disorder treatment, medication assisted treatment (MAT), within the Jackson County Jail and subsequently increase access to health, behavioral health, housing, and other community resources. The MAT Services will be provided in combination with counseling and behavioral therapies. Additionally, by providing targeted connectivity to community resources, Project Inside Out will meet participants where they are when they are ready.The confines of the detention center can be a place where the journey to sobriety can finally begin.The uniqueness of this program couples MAT services and aggressive in-reach of community resources. -Community Resources come to individuals inside the jail-prior to release. In addition to implementation of the Certified Peer Support Services operating in tangent with the MAT program, Project Inside Out will develop a comprehensive custodial care plan and infrastructure, which will provide treatment for individuals while in custody and ensuring continuation beyond release. The program will improve the quality of life of participants while on the inside (mitigating self-harm, potential suicide) and utilize technology to accomplish frequent Peer Support; as well as the outside (connectivity and placement within service delivery systems) to reduce homelessness and ensure post-release continuum of care for health and behavioral health services. It will establish a research/evaluation component to evaluate the project to provide additional input to improve the body of knowledge regarding SUD and evidence-based practices for law enforcement and detention programs. And, the program will create a Post Release Overdose Prevention component (PROP) which will convene stakeholder meetings and input/gather and analyze data regarding post-release overdoses as well as overall strategies for post-release SUD treatment. Additionally, the PROP group will develop effective mitigation strategies to include actionable items to prevent post-release overdoses and more effectively serve returning citizens.

North Carolina

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.

Onslow, County of

The Onslow County, North Carolina, project will expand evidence-based substance use treatment in the Onslow County Detention Center (OCDC), Court programming to identify need for services for children and youth impacted by their parent/family substance use, recovery housing support and comprehensive, real-time, information collection, analysis and trends. Onslow County is in the southeastern coastal plain of North Carolina and has an estimated population of 209,491. There are also approximately 45,079 active-duty marines and sailors stationed at Camp Lejeune and New River Air Station. Onslow County has experienced the ravages of the opioid epidemic at a higher level than many communities in the state, and has worked since 2016 to strategically develop services and resources to support their citizens. The overarching goal of this application is to provide linkages for those affected by an opioid use disorder or other substance disuse to treatment services and resources. This includes both those incarcerated, and the children and families affected by substance use. Project activities include establishing a therapeutic community within the OCDC for individuals with substance use disorders. Inmates will be provided evidence-based treatment such as individual and group counseling, family support when appropriate, strategies for relapse prevention to include harm reduction, community and social support systems, and crisis contingency planning. Case plans will be developed with inmate and community resource connections made upon release. Referrals will be made to Oxford House for safe, sober housing while partnering to increase recovery housing inventory within the County. In addition, a Licensed Clinical Addictions Specialist will coordinate with the Courts, (including the new Veterans Treatment Court), the Department of Social Services (DSS), Child Protective Services (CPS) and the OCDC to provide immediate linkages to appropriate services for children, youth, and families in cases where substance misuse is identified. Comprehensive, real-time data will be collected and analyzed by the Project Manager and a multi-disciplinary workgroup of service provider agencies and community stakeholders to monitor progress to goals and guide the program. Onslow County currently has a FY 2021 Comprehensive Opioid, Stimulant, and Substance Abuse Site-based Program providing medication assisted treatment (MAT) and case management in the Onslow County Detention Center.

North Carolina

Surry County

The Government of Surry County, North Carolina, project will establish services targeting underserved groups experiencing addiction. The underserved comprise three groups: incarcerated persons, persons with substance use disorder disabilities, and juveniles impacted by family substance use. Each is at high-risk for justice involvement, discrimination, and poor outcomes. This project will provide supports to minimize inequity among these populations through the provision of substance use treatment in the county detention center, quality recovery housing, and substance use prevention and treatment for youth. Each of these components will include navigation to community resources with a collaborative, trauma-informed approach by organizations focused on meeting the unique needs of individuals and families. The goals are to prevent future addictions, steer the addicted to recovery, and establish trust between the afflicted and the professionals poised to help them succeed. In conjunction with this project, a professional advisory committee will promote equity throughout the planning and implementation of services. Surry County Government will manage the delivery of treatment services within the county detention center. Additionally, two subrecipients will deliver services to the recovery and juvenile communities. New Hope New Beginnings (a nonprofit dedicated to helping people achieve substance-free success) will head the recovery housing portion. Surry Friends of Youth (a local youth-serving nonprofit) will provide support, prevention education, and treatment to juveniles impacted by addiction. Preexisting collaborative relationships between grant recipients will allow any Surry County residents affected by addiction to access services. This project will benefit persons suffering from addiction will benefit from treatment and of social connection and resources and the families and neighbors of individuals entering recovery will benefit from decreased trauma and the knowledge that recovery can be achieved. Expected outcomes of this project include decreases in overdose, crime, recidivism, incarceration, homelessness, child victimization and other risk factors correlated with relapse and substance use. Research partners will perform evaluations using the results-based accountability framework. All programming will rely on evidence-based best practices with a focus on building the relationships necessary to foster successful recovery.

North Carolina

Transylvania County

Transylvania County seeks to support the Bridging Reentry: Expanding Access to Treatment and Holistic CARE (BREATH-C), a project of the CARE Coalition. BREATH-C's purpose is to reduce the impact of substance misuse on justice-involved Transylvania County residents and the county as a whole. The CARE Coalition will partner with Transylvania County Sheriff's Office and two sub-awardees: Love and Respect Community for Recovery and Wellness, which provides peer support services and research and evaluation services. Goal 1 of the project is to expand access to, and engagement with, substance use disorder (SUD) treatment and pre- and post-release recovery and reentry support services for inmates in the Transylvania County Detention Center. This will be accomplished by implementing SUD treatment, reentry support services, treatment and recovery services access, transitional housing, peer support services, and other aspects of community reentry. Goal 2 of the project is to evaluate increases in access to, and engagement with, jail-based SUD treatment and pre- and post-release recovery and reentry support services and determine the effects of expanded services on detainee misconduct, recidivism, and charging offenses. This will be accomplished by evaluating Detention Center detainee SUD and co-occurring disorder prevalence, risks, and needs to inform prevention, treatment, and recovery programming, and conducting outcome evaluation

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.

City of Paterson

This project serves the City of Paterson, New Jersey, which has a resident population of 159,732 residents (US Census 2020). The purpose of the project is to expand the work of the Paterson Coalition for Opioid Assessment and Response (COAR). Based on preliminary and still ongoing data collection, COAR is proposing the following interventions to be carried through September 2025, via a COSSAP award: (1) continuation and expansion of the City’s inaugural Opioid Response Team (ORT) and ORT-trained community partners to perform proactive outreach in overdose “hot spot” areas, as identified based on the collective data and research of COAR; (2) continuation and expansion of the ORT’s Post-Overdose Response-styled approach to target individuals in need of outreach as to assure that anyone who overdoses is met with helpful information about recovery options and ongoing case support by the ORT in a timely fashion; (3) support for the ORT’s collaboration with the local hospital’s emergency department to assure that all individuals seeking treatment are met with a high-skill social worker and peer who, together, have the ability to navigate and build a realistic, attainable, and personalized continuum-of-care to support each client, regardless of how complex their needs may be; and (4) support for staff members 100 percent dedicated to managing and building capacity/sustainability of COAR’s initiatives over time. COAR members and regular stakeholders include: law enforcement entities from the local (Paterson Police Department), county (Passaic County Prosecutor’s Office), and state (NJ State Police/Office of the Attorney General); addiction and health professionals from local (Paterson Department of Health and Human Services/Division of Health), county (Passaic County Department of Health and Human Services/Division of Mental Health and Addiction Services), and regional (St. Joseph’s University Health); community-based partners who work hands-on to develop policy (Health Coalition of Passaic County) and programs to support the region’s substance-using residents; and traditional Narcan distributors (Paterson Fire Department and Paterson Emergency Medical Services).

New Jersey

County of Camden

The Camden County Department of Correction (CCDOC) will use this award to implement the NuEntry Peer Led Program (NPLP) to expand its capacity to identify, treat, and support individuals incarcerated in the Camden County Correctional Facility (CCCF) with a history of substance use disorder (SUD), especially those suffering from non-opioid substance use. Activities under the NPLP involve integrating care coordination during incarceration, embedding peers as part of a Sequential Intercept Model and developing Peer Support Teams for post-release support, providing recovery support housing, and enhancing family reunification efforts. Each of these activities is designed to promote continuity of care, reduce the likelihood of relapses, and improve community reintegration outcomes. The project also includes conducting a comprehensive system assessment to identify barriers and implement targeted interventions and establishing a research-driven database to understand the incarcerated population with SUDs. In 2023, 2,163 individuals in the CCCF reported a history of substance use, with only 41% receiving counseling and support services during incarceration. The NPLP aims to address critical gaps in SUD treatment within the criminal justice system; to better address racial disparities in treatment access; and to have lasting impacts on public health and community well-being by reducing reincarceration rates, minimizing recidivism, achieving equitable access to SUD services, and understanding post-COVID healthcare needs for incarcerated populations.

County of Hudson

The County of Hudson, New Jersey, project will serve the County of Hudson, which has an urban population of 702,463 residents. The purpose of this project is to expand upon several current initiatives that help prevent drug overdoses and reduce incidence of substance use across the county. The allowable activities incorporated within the project include law enforcement and first responder deflection and diversion; real-time data collection; services for families impacted by their family member's substance use; and embedding behavioral health professionals, peers, and/or persons with lived experience along the Sequential Intercept Model. Primary activities include: continuation of the Overdose Fatality Review Team (OFRT) bi-monthly meetings and decedent reviews for overdose fatalities; oversight of the OFRT sub-committee which develops recommendations for preventing and reducing overdose; embedding a Community Navigator within the Department of Health and Human Services to conduct outreach to residents most at risk of engaging in substance use,misuse or relpase; community-wide naloxone kit distribution; crisis intervention trainings to the Hudson County police officers; and launching a mobile unit outreach program in collaboration with the Hudson County Sheriff's Office. Overall, the project will support the implementation and expansion of several evidence-based, data-driven solutions at the intersection of public health, public safety, and behavioral health. This project is critical to ensuring best practices at all levels of care to improve outcomes of justice-involved individuals with SUDs and reduce overdoses in the long-term.

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.

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

City of North Las Vegas

The project serves the city of North Las Vegas with a population of approximately 216,961. The purpose of the project is to expand recovery support services and discharge planning for individuals leaving a correctional setting and returning to the community. The project addresses the allowable use of providing evidence-based recovery support services (80 percent of the budget) and transitional or recovery housing (10 percent of the budget). The project includes partnerships with Elevation Health Services. This application also includes program evaluation which is identified as a priority consideration (10 percent of the budget).

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.

Albany County

The Albany County, New York, project focuses on evaluating, supporting, and expanding the Albany Law Enforcement Assisted Diversion (LEAD) program. The program will support law enforcement deflection and diversion, an embedded clinician at the Albany County Department of Mental Health, and a field-initiated project bringing together justice and a behavioral health practitioner. The clinician will serve LEAD clients at intercepts identified using the Sequential Intercept Model (SIM), which bridges longstanding gaps in such services. A robust program of external evaluation would be provided through a partnership with the University at Albany’s School of Public Health, paired with enhanced data analysis and reporting across the initiative. Such evaluation will identify barriers to program implementation; assess program acceptability and benefits from the community perspective; and assess whether the program leads to desired outcomes. The findings are expected to contribute significantly to existing literature on engagement among individuals with substance use disorders who are justice-involved and individuals who are unlikely to participate in office-based clinical services. The project includes the adoption of LEAD in two or more municipalities and the addition of social contact referrals, which will serve as a second pathway into LEAD to go beyond pre-arrest diversions that have been in place in the City of Albany since 2016. With this change and expansion to additional jurisdictions, the program will serve approximately 75 additional clients. Among other benefits, this expansion is expected to advance racial equity by facilitating an increased emphasis on referrals of black individuals, who historically have represented 60 percent or more of arrests in Albany but only 38 percent of all diversions. Case management is provided by Catholic Charities Care Management Services, which has been serving Albany LEAD clients since 2016 and engages in a range of harm reduction-based programs on behalf of New York State and other funders.

New York

Cayuga County

The Comprehensive Substance Use Diversion Program strives to reduce overdose fatalities in Cayuga County, New York, by embedding recovery peer support and other targeted services at specific points of contact for individuals with substance use disorder and diverting them from justice-involvement toward treatment and recovery. Local surveillance data shows that fatal overdoses overwhelmingly involve opioids and psychostimulants and increasingly impact women. This program puts a priority on providing services for women and people of color who have been historically underserved and will address specific challenges for people in crisis, people entering the legal and/or child welfare system, and people who have been released from treatment and/or incarceration. The diversion program will use the Sequential Intercept Model to expand or complement existing services in each of the intercepts and other points of contact. The program intends to fill six identified gaps: (1) naloxone education and distribution to rural law enforcement/first responders to enhance public safety and response during overdose emergencies; (2) embedded peer support and advocacy in child welfare departments (before justice involvement) to increase positive relationships, treatment retention, family unifications; (3) 911 diversion of people in crisis to mental health professionals to provide immediate care and stabilization and diversion from law enforcement and emergency room; (4) rapid linkage to MOUD and enhanced programming for Intervention Court participants and outreach to increase referrals to Intervention Court, prioritize treatment over incarceration, improve health and social outcomes; (5) enhanced post-incarceration/post-treatment peer support to ensure continued recovery support, promote treatment retention, provide support for securing job training and housing options; (6) embedded peer support and advocacy in child welfare departments (after justice involvement) to promote positive relationships, treatment retention, family unifications. The program will implement the following activities/allowable uses: (1) naloxone for law enforcement and first responders (12 percent); (2) embedding peer support in different settings (39 percent); (3) law enforcement/first responder diversion programs (2 percent); (4) court programming to prioritize and expedite treatment and recovery services for individuals at high risk of overdose (13 percent); (5) evidence-based substance use disorder treatment related to opioids, stimulants, and other illicit drugs (0 percent); (6) recovery housing with peer support (5 percent); and (7) pursue comprehensive, real-time, regional information collection, analysis, and dissemination via the development of a publicly-accessible overdose data dashboard (8 percent).

New York

Chautauqua County

The Chautauqua County Sheriff’s Department is applying for Category 1 funding in the amount of $899,910. The Chautauqua Comprehensive Addiction Response and Evaluation System (Chautauqua CARES) is a county-wide, multi-sector network of law enforcement, behavioral health, and other community agencies collaborating to increase the accessibility, timeliness, and effectiveness of support for individuals with substance use disorders and their families. Chautauqua CARES will work to more fully incorporate law enforcement and behavioral health care roles in helping individuals and families struggling with addiction. The project will include development of a law enforcement diversion program for nonviolent drug offenders and support an expanded treatment program within the county jail. Chautauqua CARES will serve to coordinate and oversee standardized training, ordering of supplies, and evaluation of naloxone administration by first responders throughout the county and will further expand and raise the profile of drug take-back activities in the county. Chautauqua CARES will support law enforcement’s involvement in prevention efforts through coordinated school-based and other outreach activities. Goals for the program include increasing the number of county residents receiving services for substance use disorder and reducing the numbers of fatal overdoses in the county. The program will be overseen by the Chautauqua County Sheriff’s Department. The project serves Chautauqua County, which has a population of 126,903. The project includes partnerships with the Unified Court System Eighth Judicial District, the Chautauqua County District Attorney’s Office, the Chautauqua County Public Defender’s Office, the Chautauqua County Office of Probation, the Jamestown Police Department, the Chautauqua County Department of Mental Hygiene, the Chautauqua Substance Abuse Response Partnership, the Chautauqua County Department of Health and Human Services, Prevention Works, and HOPE Chautauqua. 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 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

County of Chautauqua

Chautauqua County will implement Chautauqua CARES to increase access to evidence-based substance use disorder (SUD) treatment and services, including peer support services; enhance existing harm reduction, diversion and youth prevention programming; improve local data collection; and advance racial equity in its SUD response. Chautauqua County's opioid burden is the highest in New York State and double the statewide average. Intended beneficiaries are individuals who are at risk of incarceration or recidivism and who have (SUD), histories of substance misuse or overdose, or a high risk of overdose. The projects primary activities will be offering preventive health and social supports at the CARES Re-Entry Hub; substance use education and prevention programs for youth in local high schools with higher risk of substance use, misuse, or justice involvement; pre-booking and post-booking diversion through magistrate-level training to increase referrals to SUD treatment and recovery support services; the expansion of a First Responder Deflection Program; and improved use and sharing of comprehensive, real-time data between law enforcement, treatment, prevention, and other community-based organizations addressing substance use in Chautauqua County.

County of Greene

Greene County is a fully rural county in upstate New York with a high burden of overdose. In 2021 the county rate of opioid involved overdose deaths was double the upstate New York average. That same year, Greene County ranked 2nd of 57 upstate New York counties for overdose deaths involving opioids and it ranked 1st for deaths involving heroin. Fentanyl drives the epidemic, with 88% of deaths in the last two years involving fentanyl, often in combination with stimulants, heroin or other substances. Fatality rates are particularly high in the Mountain Top, a remote region of the Catskill Mountains. Greene County Public Health will establish data driven Overdose Task Force and aim to reduce overdose fatalities, and to decrease sub-county disparities in fatality rates. Specifically, Greene County will expand epidemiological surveillance of overdose trends and disparities in overdose volume and assess access and linkage to treatment and recovery resources. Greene County will also expand MAT services, focusing on linkage to care for justice-involved people and we will enhance Law Enforcement and First Responder Leave Behind and Diversion programs, as well as other novel programs for First Responder overdose response. All of this work will be guided collaboratively by the Task Force, a group of multidisciplinary stakeholders led jointly by Public Health and Public Safety. Specific project goals include: 1) utilize real-time overdose and other substance use related data to describe and address overdose risks, barriers and facilitating factors for substance use treatment and recovery, and disparities in accessing substance use related services; 2) increase access to evidence-based substance disorder treatment by expanding MAT services available at Greene County Public Health and build linkage to care systems between public health and public safety that specifically target justice-involved individuals; 3) increase coordination between public health and public safety partners through support of law enforcement diversion and overdose response programs and overdose-related EMS services; and 4) implement and convene a data-driven multidisciplinary coordinating body lead by Greene County Public Health with participation from public safety partners and other county and community-based agencies that serve people who use drugs. Greene County Public Health will coordinate this project in partnership with the Greene County Sheriff's Office and Albany Medical Center's Divisions of Prehospital Care and Addiction Medicine, sub-recipients, as well as with support from the Regional Emergency Medical Organization (REMO).

New York

Monroe County

The Monroe County Research Strategy and Development (RSD) Division will create and implement a Monroe County Overdose Fatality Review (OFR) Board with a fully embedded research team. The Monroe County OFR Board will be a multidisciplinary team including community-based organizations, law enforcement, medical examiners, educational institutions, health care systems, and other stakeholders. The Board will apply a collaborative approach to the review and analysis of selected fatal overdose cases in Monroe County and will provide recommendations to align and maximize resources across systems, identify potential prevention initiatives, and strengthen community access and understanding of treatment options. In conjunction, RSD will conduct research to evaluate and address findings from the OFR process. This analysis will be combined with other local data sources relating to substance overdose deaths, which will allow for a comprehensive county-wide approach utilizing scientific methodology to identify and better target effective interventions to support those most at risk. Project activities will include bringing together stakeholders with different perspectives and different data sets to improve public health and clinical practices; conducting case reviews, prioritizing real-time data collection analysis, and dissemination; sharing research findings on local opioid, stimulant and substance use trends within MC and providing an analysis of current substance misuse policies and interventions; and implementing a comprehensive plan to reduce the risk of overdose death and enhance treatment and recovery engagement through recommendations. Community Based Participatory Research (CBPR), along with other research methods, strategies, and tools, will be utilized to ensure appropriate measures are implemented for representation of historically underserved and marginalized populations adversely affected by inequality, and disproportionately impacted by crime, violence, and/or victimization. Due to the County's immigrant and deaf population, supplementary linguistic needs will be incorporated. Subrecipient activities include prevention implementation and harm reduction services with additional support and focus on those who have been identified as high-risk populations and/or have historically faced barriers accessing services.

New York

Niagara County

The project serves all of Niagara County, New York, along with sub-recipient agency Community Missions Inc and partners including probation, law enforcement and public health, will create Niagara County PATH-3D (Presenting Alternatives for Treatment and Healing – Deflect, Destigmatize, attend to Diversity, Equity and Inclusion), a two-pronged, harm-reduction approach connecting individuals to recovery supports and treatment while diverting from criminal justice involvement. PATH-3D will expand the community’s quick response to opioid overdose team (QRT) to include response to overdoses of any drug type and add Family Peer Support (CRPA-F). QRT will expand referral sources beyond law enforcement, including other first responders, hospitals, providers, and self-referral. Dispatched to conduct follow-up with individuals post overdose, the QRT will engage an individual and assess for and assist with a broad range of social, medical, and recovery support needs. Family support will be provided, including for a fatal overdose. The QRT will connect with 40 percent of individuals referred, will link 50 percent of those served with recovery supports, and affect a 10 percent decrease in overdoses countywide. PATH-3D will also create a probationer response team (PRT), embedding a licensed clinician and CRPA into probation to assist probationers at risk of violation or revocation due to substance related issues. The PRT will engage probationers, assess, develop individual plans, and connect participants to recovery supports. Recognizing the disparate impact of overdose and criminal justice involvement on black, indigenous, and people of color in the community, PATH-3D will select program design and activities promoting racial equity and removing barriers to access for historically underserved and marginalized individuals.

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.

Butler County Mental Health and Addiction Recovery Services Board

Butler County Ohio is in southwest Ohio comprised of suburban and rural communities. The Butler County COSSUP Project aims to increase access to treatment and recovery supports services for residents of Butler County through engagement, data collection, and recovery support enhancement. The project has 4 key objectives: 1) Expand use and data collection for the county-wide data dashboard, including cross-sector analysis and integration of data from other sources, to inform strategies and policies. 2) Assess the needs of under-served populations across Butler County and increase engagement in services amongst those groups. 3) Decrease the number of individuals who are incarcerated to improve post substance use/overdose outcomes by working with the Post Classification Assessor. 4) Improve comprehensive care to residents of Butler County impacted by substance use. The Butler County Prevention Coalition and Addiction Task Force (BCPCATF) will serve as the multi-disciplinary coordinating body for the project. The BCPCATF will work in conjunction with partners to implement strategic activities to address these objectives. The BCPCATF will work with community sectors to ensure proper data sharing and allow for a cross-system analysis to inform strategies and decision making. Miami University will coordinate with the BCPCATF to convene listening sessions with under-served populations in Butler County to assess the needs of these groups and strategize solutions for increase engagement in services. Additionally, the Butler County COSSUP Project will implement peer recovery support services through the COSSUP Connections program to increase engagement with treatment and recovery support services. The Butler County COSSUP Project will work with community partners through the coordination of the BCPCATF. Through strategic planning and specific workgroups, the project will focus on county-wide data analysis, engaging and assessing the needs of under-served populations, increasing access to treatment and resources for individuals, and providing comprehensive care through the implementation of peer recovery support services in specific needs areas. Partner organizations include subrecipients Miami University, Community Behavioral Health, Butler County General Health District, and the Butler County Jail.

Ohio

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) Explore and look into interviewing 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 a Next of Kin Interviewer and 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

Fairfield County

The South-Central Ohio Major Crimes Unit and its Outreach/Overdose Response Team (Project FORT) serves Fairfield County which is situated in south central Ohio adjacent to Columbus, the state capital. According to 2021 US Census estimates, the population of Fairfield County is 161,064 with the area bearing a distinctly Appalachian feel in both geography and demographics. With an average of 3,280 overdose events occurring each day in Ohio Fairfield County has observed a huge increase in the use of Fentanyl/Fentanyl analogues and psychostimulants like Methamphetamine. In 2018 73 percent of all drug overdoses involved Fentanyl or a Fentanyl analogue while deaths associated with Methamphetamine have increased by 487.5 percent since 2014. This shift from traditional opiates has had a dramatic impact on the number of incarcerations in Fairfield County. In just five years recidivism rates have increased by 77 percent in Fairfield County. The Major Crimes Unit/Project FORT through a new collaboration with Fairfield County Reentry Program seeks to lower recidivism rates as well as reducing overdoses and overdose deaths targeting individuals in rural areas. The initiative will provide enhanced access to treatment and recovery services and Medically Assisted Treatment for individuals being released from jail. This project would provide an aftercare plan and care team for everyone that would include: (1) connections to appropriate treatment and community resources; (2) Peer Support/Recovery Coach; and (3) follow up engagement with Project FORT. Additionally, the Major Crimes Unit would add a full-time overdose death investigator who would create a comprehensive response plan to overdose and overdose deaths, liaison with local law enforcement and conduct follow up investigations with a goal of bring closure to these grieving families and hold those responsible for these tragic and unnecessary deaths accountable. With COSSAP funding, Project FORT will work to decrease recidivism rates and increase the number of individuals engaging in treatment and recovery services through breaking the cycle of incarceration for those struggling with substance use disorder by providing: (1) immediate connection to treatment/recovery services upon release; (2) follow-up care; (3) enhanced access to recovery housing; (4) transportation to treatment/recovery services; and (5) comprehensive investigation of overdose deaths.

Ohio

Hancock County

The Hancock County Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board in Ohio proposes a comprehensive and multi-disciplinary collaborative approach to address and prevent the illicit use of opioids, stimulants, and other substances and its adverse consequences within a predominantly rural county. The proposed Criminal Justice Connections – Extending Our Reach (CJC-EOR) project will reduce the impact of illicit opioids, stimulants, and other substances on individuals and communities by using a multi-level approach. The project aims to: (1) expand and enhance an existing LEAD® program; (2) implement a school and/or community-based prevention/early intervention service program for children and family members who are negatively impacted by substance use and/or criminal justice involvement; (3) develop a sustainable co-responder model between criminal justice and behavioral health systems; (4) enhance the use of Overdose Detection Mapping Application Program (ODMAP) in collaboration with community partners; and (5) expand the local workforce through formalized relationships with area institutions of higher education. The proposed project will also evaluate the system level approach which further connects public safety, criminal justice, treatment, and recovery systems to provide a greater continuum of care for individuals with substance use disorder. Activities include: law enforcement and first responder deflection and diversion (30 percent); real-time data collection (15 percent); education and prevention programs to connect law enforcement agencies with K-12 students (20 percent); 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 (5 percent); and embedding social workers, peers, and/or persons with lived experience at any intercept of the Sequential Intercept Model (30 percent). The Hancock County ADAMHS Board will collaborate with Brandeis University’s Institute for Behavioral Health researchers for this project to evaluate the impact of the proposed initiatives.

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

Oklahoma County Criminal Justice Advisory Council

The Misdemeanor Diversion Expansion is a community-based diversion from prosecution program that expedites the delivery of substance use and co-occurring disorder (SUD/COD) treatment at SAMHSA Sequential Intercept 3: Jails/Courts. Grant funds will be used to hire key personnel to increase the participant capacity of MDP and enable long-term developmental planning of diversion programs in Oklahoma County. The Oklahoma County Criminal Justice Advisory Council (CJAC) provides residents of Oklahoma County with effective, efficient criminal justice reform. There are two intended subrecipients of grant funds for the project: the Diversion Hub and Red Rock Behavioral Services. Beneficiaries of services provided through the Misdemeanor Diversion Expansion are individuals with active misdemeanor cases in the Oklahoma County District Court who are at high risk for a substance use or co-occurring disorder. The project aims to reduce justice involvement and correlated overdose risk for this population through the delivery of social and treatment services and the development of data-driven responses to gaps in services. Primary activities include case management to increase the capacity of misdemeanor diversion; case management to identify candidates for diversion and support MDP graduates; treatment case management that enables the on-site provision of Medication Assisted Treatment; Peer Recovery Support that outreaches to individuals struggling with treatment engagement; data collection and analysis that identifies critical relationships between risk factors, program outcomes, and gaps in services; and development management to apply data to improve program structure and create infrastructure for future diversion programs. Four-hundred and fifty cases will be diverted from traditional prosecution and managed by an MDP case manager. Four-hundred and fifty cases will be screened for MDP qualifications and assisted after MDP graduation. Three hundred and fifty cases will be provided with on-site treatment case management services. Two hundred and fifty cases will be provided with on-site therapeutic treatment services. Copies of data analysis and developmental reports will be supplied to the Bureau of Justice Assistance.

Oklahoma

Tulsa County District Attorney

The Community Approach to Vulnerable Adult Treatment (CATVAT) is a treatment-focused diversion project that ameliorates the impact of substance use on vulnerable adults in Tulsa County by diverting their court cases appropriately, providing wraparound services, and preventing possible future victimization, at SAMHSA Sequential Intercept 3: Jails/Courts and Intercept 2: Initial Court Hearings/Initial Detention. Grant funds will be used to retain and hire personnel include two prosecutors and three case managers who will handle substance-involved vulnerable adult cases holistically. There is one intended subrecipient of grant funds, Family and Children's Services. Beneficiaries of services provided through the grant project are vulnerable adults in Tulsa County who commit offenses or become victims due to untreated substance use, mental illness, or co-occurring disorders. CATVAT is a collaborative, multidisciplinary program to alleviate the impacts of substance use on individuals with one or more factors that categorize them as vulnerable, including advanced age, Serious Mental Illness, intellectual disability, and other characteristics. Primary activities include joint staffing by CATVAT prosecutors and case managers of complicated vulnerable adult cases to determine treatment needs, divert criminal cases, detect victimization, prosecute individuals appropriately, and provide social services to prevent future victimization. 400 cases will be diverted from traditional prosecution; 300 court-ordered outpatient cases will be managed; 100 cases ineligible for COO will be managed; 400 screenings for SUD/MI of jail inmates 65 years and older will be conducted; 200 cases will be prosecuted with diversion consideration; 100 victim cases will be managed; 300 victim case follow-ups will be conducted; and 500 cases will be jointly staffed. The requested $1,600,000 will be budgeted between the following allowable uses of Category 1 funds: Pre-booking or post-booking treatment alternative-to-incarceration programs (55%), and embedding social workers, peers, and/or persons with lived experience at any intercept of the Sequential Intercept Model (45%).

Oklahoma

Tulsa County District Attorney

The Tulsa County, Oklahoma, District Attorney’s Tulsa County Collaborative Jail Reentry (TCJR) Initiative is a collaborative effort between the Tulsa County District Attorney and Family and Children’s Services, a nonprofit behavioral and mental health provider and proposed subrecipient. Grant funding will provide for a prosecutor to attend daily bond docket and otherwise serve as an early identifier of possible diversion candidates in the Tulsa County Jail. This prosecutor will work jointly with a data specialist to improve tracking and identification protocols, and case managers to locate the best alternatives to prosecution for eligible candidates who have a substance use disorder and/or mental illness. The case managers, together with a licensed clinical social worker and a peer recovery support specialist, will provide the candidates with treatment inside the jail and connect them with treatment and support services after release, thereby establishing a continuum of care between incarceration and community living. The TCJR Initiative aims to reduce Tulsa County’s high substance use and overdose rates by deploying essential personnel to make treatment accessible within the jail and after release, and by bolstering the ability of agency personnel to track and share data to inform prosecutorial decision-making about diversion eligibility. The target population is Tulsa County Jail inmates with substance use disorders and/or mental illnesses. Objectives include: 1) identify inmates in need of treatment services (2) connect inmates with treatment services inside the jail, (3) help inmates stay connected to treatment and supportive services after release; and (4) improve data tracking and sharing capabilities to inform prosecutorial decision-making Program measurements and performance targets include: (1) 2,000 inmates identified as needing treatment services; (2) 600 inmates connected to treatment services inside the jail; (3) 400 inmates assisted with treatment and support services after release; and (4) report on data upgrades and utilization. The budget includes (1) real-time data collection (10 percent); (2) pre-booking or post-booking treatment alternative-to-incarceration programs (55 percent); (3) evidence-based substance use disorder treatment related to opioids (25 percent); (4) transitional or recovery housing and peer recovery support services (10 percent).

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. The LEAD program, launched in 2018, is set to end in 2025 due to ongoing staffing challenges. However, the LEAD model has been integrated into the county's deflection program, ensuring continued outreach and engagement with law enforcement while continuing to serve the same population. The Children, Family & Community Connections Division implements LEAD Plus by supporting deflection efforts through coordinating substance use and overdose prevention initiatives that expand access to care and enhance public safety capacity. Key partners included in this project include the Clackamas County District Attorney’s Office, Clackamas County Sheriff’s Office, local police departments, Clackamas County’s Health, Housing and Human Services Department, and local behavioral health, housing, and substance use prevention and treatment professionals.

Lincoln County Sheriff's Office Search and Rescue

The Lincoln County Sheriff’s Office (LCSO) is applying for a Category 1 award in the amount of $599,999. The LCSO-SBIRT project will implement a screening, brief intervention, treatment, and referral to treatment (SBIRT) program aligned to the COSSAP funding purpose of expanding comprehensive efforts to identify, respond to, treat, and support people impacted by illicit opioids, stimulants, and other drugs. This project serves Lincoln County, with the service population being adults 18 years of age and older who are booked into the Lincoln County Jail and who prescreen positive for risky substance use behaviors. The LCSO SBIRT program will serve 200 people over the life of the project. The project includes partnerships between ReConnections; Amy Yates, LCSW, Justice Counselor; and Data Specialist Brooke O’Byrne. Priority considerations addressed in this application include the fact that Lincoln County has five high-poverty census tracts in an area disproportionately impacted by substance use (e.g., lack of community treatment and high rates of overdose deaths), and the project will advance justice and build trust between law enforcement and the community.

Lackawanna County Government

Fatal substance overdoses throughout Lackawanna County, Pennsylvania, have increased in 2020 and 2021 after seeing a significant decrease in 2019, despite expansive efforts to combat substance use disorder within the county. In response to this public health crisis, Lackawanna County has implemented several innovative initiatives to address the opioid epidemic and reduce overdose deaths, including the Lackawanna County District Attorney Office (LCDAO) led Lackawanna County overdose fatality review (OFR) team. The Lackawanna County OFR is a multidisciplinary group that conducts extensive case reviews and examines local overdose fatality data to find the root causes of addiction, understand the factors that ultimately led to an overdose, identify gaps in treatment and missed opportunities for intervention, and generate data-driven recommendations to decrease overdose fatalities throughout the county. The project will serve the residents of Lackawanna County to reduce the amount of both fatal and non-fatal overdoses through a focus on program implementation and improvement. The funding will support the OFR’s ability to conduct evaluations of the next of kin interview process, provide mentorship, guidance, and technical support to developing OFR teams, conduct an external evaluation of Lackawanna County OFR Team, establish an awareness and education campaign, and implement recommendations generated by the Lackawanna County OFR team. The Lackawanna County District Attorney’s Office will engage in a subgrant with the University of Pittsburgh Program Evaluation and Research Unit (PERU) to support the Lackawanna County District Attorney’s Office as a research and evaluation partner. PERU will provide support related to problem analysis, evaluations, assessment of implementation, and strategic planning of interventions. All funds requested by the Lackawanna County District Attorney’s Office will be allocated to the category of real-time data collection and the goals and objectives of the proposed program will be related to the implementation of recommendations generated by and improvement of the established county OFR team.

Pennsylvania

Montgomery County

Montgomery County, Pennsylvania, continues to experience a high number of opioid and substance abuse overdoses. In 2020 and 2021, there were over 2,100 911 calls for service compared to an average of 432 from 2017-2019. According to the Montgomery County Department of Public Safety, there was an increase of 472 percent in overdose calls for service in 2020 compared to 2019. The isolation effects of COVID-19 may be correlated to the dramatic increase in the number of opioid and other substance overdoses. The Department of Public Safety (DPS) realizes that the robust, data-sharing and monitoring platform known as the Emergency Medical Overdose Surveillance System (EMODSS) is a critical asset for a data-driven approach to problem resolution. The County of Montgomery will expand real-time data collection, engage wider stakeholder use, and expand the platform to make appropriate data available to more county agencies/departments, program partners and the public. DPS will improve the Department’s use of this intelligence technology, both as an investigative tool and a data-hosting source. DPS will continue to develop data-sharing agreements with other county offices, as well as external data-sharing partners, to gain access to more in-depth drug-related incident data. This project will significantly expand the data capabilities of Health and Human Services with the County of Montgomery. The Liberty High Intensity Drug Trafficking Area (HIDTA) and Delaware Valley Intelligence Center (DVIC) will also benefit from data sharing through EMODSS. Data analytics capabilities will be greatly improved with this project. EMODSS stores public safety, coroner, naloxone distribution, public health, and qualitative data about drug use patterns of non-fatal and fatal overdose victims. The staff funded under this grant will work with all stakeholders to outline specific data sets that can be integrated into the secure platform EMODSS is built upon. Data will be used to identify prevention, education, intervention, diversion, recovery, and enforcement strategies that can be implemented throughout the life of the grant and beyond. A complete analysis of the data will allow the county to identify communities and individuals at greatest risk for drug misuse, abuse, and overdose, whic will help the County’s Opioid Response Task Force to brainstorm, plan and implement data-driven responses and programs and target resources for maximum impact.

Pennsylvania

Northumberland County

Northumberland County is applying for a Category 1 award in the amount of $595,168. The Northumberland County Opioid and Substance Use Response Program will address the numerous issues and difficulties faced by individuals suffering from substance use in the area. The programs to be procured through this grant are as follows: the hiring of a wellness nurse to assist Children and Youth Services; the hiring of a certified recovery specialist to assist a local recovery club; the hiring of a project coordinator; the use of DJ Choices, a prevention advocacy group that will conduct assemblies at local schools; trainings for individuals and families suffering from substance use; and the implementation of sober events. This project serves Northumberland County, which has a population of 90,843. The project includes partnerships between Northumberland County’s Opioid Coalition, the Greater Susquehanna Valley United Way, the Oasis Recovery Club, and Crossroads Counseling Inc. This project will engage Brandn Green, PhD, of JG Research and Evaluation as the research partner for this project.

County of Lancaster Administration Building

The Lancaster County Opioid Action Network project represents the work of over 40 public, private, civic, and faith-based partners working together over the past three years to address a range of community problems, especially opioid related crime, misuse, and overdose. The project attempts to reduce misuse by 20% in year one and by 30% in year two. With support from a Research Team, an extensive assessment of the problem will take place, including examination of underlying contributors. A series of strategies are along with a tracking system to provide real time feedback to practitioners. Based on cursory data analysis, several strategies are and include replication of Law Enforcement Assisted Diversion (LEAD), increased access to treatment resources, support for first responders impacted by the traumatic explosion of opioid deaths, and an overdose awareness and education component. The project will provide resources for training of every law enforcement officer in the county on LEAD (Law Enforcement Assisted Diversion), promote visible prescription drug take back strategies, and assist with training, handling, and distribution of Naloxone. Priority considerations include Opportunity Zone, Poverty, and Rural.

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

County of Codington

Codington County proposes to implement a multi-pronged approach to reducing the impact of illicit opioids, stimulants, and other substances in the community. The proposed project will address overdose awareness and protection with Naloxone distribution; coordinate recovery support efforts through peer coaching and trainings with Face It TOGETHER and Straight Up Care; provide financial assistance to sustain local efforts to provide transitional and emergency housing to justice impacted individuals; and develop a Pre-trial Diversion program with a caseworker, as well as re-entry support with case management support in the detention center. Expected outcomes include the institutionalization of the multidisciplinary coordinating team to provide ongoing support for individuals impacted by substance use, a reduction in the frequency of returns to jail, and the sustainment of a community referral system to connect individuals to resources.

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

County of Hamilton

The Hamilton County, Tennessee, Office of Economic and Community Development, in partnership with The Hamilton County Sheriff's Office, contracted medical provider Quality Correctional Health Care, and sub-recipient The McNabb Center will collaboratively implement a Medication-Assisted Treatment (MAT) Program at the Hamilton County Jail and Detention Center. This initiative is focused on the expansion of medications for opioid use disorder (MOUD) access to inmates with substance use disorder (SUD) through on-site induction and the launch of a pilot MAT program for qualifying male participants in a dedicated therapeutic pod space, which is expected to serve approximately 270 incarcerated individuals. The project will also provide counseling and resources to improve the continuum of care for inmates during re-entry and establish a Strategic Advisory Committee, a Treatment Team, and a Data Team for the project. Additionally, this project will seek a research partner to implement a program evaluation that supports continuous learning and long-term impact assessment for participating individuals. Expected outcomes from these efforts include reductions in overdose deaths and recidivism, an improved criminal justice system response to incarcerated individuals with SUD, increased re-entry resources and opportunities, and the reduction of the impact of illicit opioids on the Hamilton County community.

Rutherford County

Rutherford County is applying for Category 1 funding in the amount of $471,807. The Rutherford County Emergency Medical Services (RCEMS) COSSAP Program will improve tracking, analysis, and dissemination of medicolegal data as relates to drug-related deaths and improve death investigation procedures within Rutherford County. The project will fund personnel to implement and manage the new Office of the State Medical Examiner (OSCME)-provided comprehensive case management system by collecting real-time comprehensive information regarding death investigations to include specifically overdose and drug-related deaths; and form a comprehensive opioid, stimulant, and substance misuse fatality review by liaison with OSCME, law enforcement officials, public health agencies, and other interested entities. The two new medicolegal death investigators will be available to assist the Operations Support Death Investigations Supervisor and the County Medical Examiner with those cases that do not reach the threshold for full autopsy performance but do require a thorough external examination with toxicology testing. This would allow for improved efficiency and timeliness for forensic results required for death certification, reporting to investigating law enforcement agencies, reporting to family of the decedents, and for any subsequent adjudication procedures and final disposition arrangements. Tracking of new drugs into the jurisdiction during review of toxicology reports on all medical examiner forensic cases will guide local and regional law enforcement efforts as it relates to crime prevention and identification of evolving threats. The project serves Rutherford County, which has a population of approximately 350,000. The project includes partnerships between RCEMS, OSCME, and the Rutherford County Sheriff’s Office. 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.

Tennessee

Tennessee Department of Mental Health and Substance Abuse Services

The Tennessee Department of Mental Health and Substance Abuse Services is applying for category 2 in the amount of $6,000,000. This project will increase local community’s capacity to respond to the presence of Substance Use Disorders (SUDs) among justice involved individuals and reduce the impact of SUDs among justice involved individuals. This project will include partnerships with the Tennessee Department of Health to support the expansion of Medication Assisted Treatment (MAT) in COSSAP jail sites and the Tennessee Bureau of Investigation to support Drug Endangered Children Task Forces, Field Based Drug Testing, and overdose data mapping. This project serves to support ten new implementation project sites; 1) Blount, 2) Roane, 3) Anderson, 4) Bradley, 5) Dickson, 6) Cheatham, 7) Roane, 8) Tipton, 9) Grundy and 10) Montgomery counties. Priority Considerations: Qualified Opportunity Zones: All 10 sites targeted for this COSSAP project have Qualified Opportunity Zones in their county: See Attachment 6. High-Poverty Areas or Persistent-Poverty Counties: Two of the targeted counties: Grundy and Cocke are rated by the TN Dept of Economic and Community Development as “Distressed”, while the other eight (8) counties are rated as “Transitional”. Poverty rates for all targeted counties are above the national average (12.3%) with Grundy (28.5%), Cocke (25.0%) and Bradley (18.0%) all exceeding the Statewide poverty rate of 16.7%. Address Specific Challenges That Rural Communities Face: Six of the ten sites selected have more than (50%) of their population residing in rural areas, which Grundy County having (100%) of its population residing in a rural area.

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

City of Longview

The City of Longview proposes to implement the program, reducing overdose deaths and substance use in the Longview, Texas area. The purpose is to implement an opioid use intervention strategy and develop an education campaign focused on the harms of opioid use. The intervention strategy will increase the capacity of the City of Longview Community Health Section by adding a Community Health Paramedic (CHP). The CHP will respond to 911 calls involving substance use or overdose components providing immediate medical assistance, screenings, referrals to treatment, and follow-up care. The public education campaign will be managed by the city's Partners in Prevention Division and the Coalition for a Drug Free Youth. This will include the addition of drug drop boxes, syringe disposal boxes, and a public naloxone vending machine. Expected outcomes include alternative response to 911 calls involving substance use, increased referrals to treatment, and a reduction in opioid overdose and emergency department transports. The University of Texas at Tyler's School of Nursing will provide program evaluation, focusing on data collection and analysis.

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

County of Chesterfield

The Chesterfield County Sheriff's Office project serves a population of over 500,000. The initiative will allow the Chesterfield County Sheriff's Office to expand evidence-based substance use treatment, peer recovery support services, and recovery housing for justice-involved individuals at multiple intercepts. 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 case management, treatment, and discharge planning for 300 individuals, providing recovery housing for 130 justice-involved individuals, providing peer recovery support services to up to 240 justice-involved individuals, and providing evidence-based supervision and treatment to up to 240 individuals on pretrial supervision over the life of the grant.

Page County Government

The County of Page is applying for a Category 1 award in the amount of $600,000. The Page County Jail Medication-Assisted Treatment (MAT) Enhancement Re-Entry (JMATER) Program will address the growing opioid problem and the negative consequences of substance misuse and related crimes through evidence-based treatment and recovery services, peer support, and abstinence monitoring. The JMATER program will expand and enhance the current Jail MAT Re-Entry (JMATR) Program by adding in-house treatment and recovery services by hiring two dedicated substance use treatment staff members—a re-entry case manager and a substance use disorder therapist. These positions will allow for more timely responses to the treatment needs of program participants. Given the increasing pattern of drug misuse in Page County, referrals to JMATER are expected to exceed 50 eligible high-risk/high-need participants in the first year. Current trends indicate most referrals will be for probation violations or possession of Schedule I or II substances or prescription drugs as well as initial drug possession charges. The JMATER Program will provide 24-hour emergency/crisis intervention, case management, individual/group therapy, peer support, access to inpatient detoxification and residential treatment centers, transitional housing, an intensive outpatient program, trauma-informed services, and access to medication-assisted treatment induction and follow-up care through a telehealth system. The enhanced JMATER Program will help to reduce the substantial jail overcrowding and high arrest rates in Page County. This project serves Page County, a rural Virginia community with a total population of approximately 24,000. The project includes partnerships between local organizations and community-based partners, the Commonwealth of Virginia Department of Corrections, Strength in Peers, Gemeinshaft Home, the Page County Sheriff's Office Foundation, and the Town of Luray Police Department. This project will engage Dr. Debra Stanley as the evaluation partner for this project. Priority considerations addressed in this application include the fact that the targeted county is a high-poverty qualified opportunity zone rural area serving an economically distressed community.

Virginia

City of Kirkland

The Kirkland City Jail project will implement a holistic, evidence-based, comprehensive opioid, stimulant, and substance use site-based program that would provide lifesaving screening for substance use disorder, on-site medication-assisted treatment (MAT) options, drug-harm diversion support services, and transitional reentry planning for incarcerated individuals struggling with substance use disorder. By partnering with peer and community resources, the Kirkland City Jail's comprehensive opioid, stimulant, and substance use site-based program will (1) establish an in custody care infrastructure designed to provide quality treatment for individuals, (2) reduce the devastating impacts of substance use disorder, such as withdrawal, recidivism, overdose, and death, on individuals, families, and the surrounding community, (3) mitigate the consequences associated with substance use disorder, such as in-custody violence, self-harm, and withdrawal symptoms, (4) improve the quality of life for individuals suffering from a substance use disorder, (5) provide training and education for staff, individuals, families, and the community on substance use disorder and the stigma associated with MAT as a treatment modality. The Kirkland City Jail will partner with a substance use disorder treatment provider for on-site MAT medication management for patients with existing prescriptions, MAT medication, such as methadone, buprenorphine (brand names Suboxone, Subutex, and others), and extended release naltrexone (ER-naltrexone, brand name Vivitrol) induction for qualified individuals without a prescription, in-person or virtual behavioral therapy, drug-harm diversion resources, and comprehensive transitional reentry planning. A Kirkland City Jail comprehensive opioid, stimulant, and substance use site-based program will help bridge the gap between public safety and public health by providing life-saving treatment options for incarcerated individuals with substance use disorders before and after transitioning back into the community. The program will serve surrounding communities with an estimated population of 164,355.

Washington

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

Grays Harbor County

Grays Harbor Public Health proposes to continue, expand, and enhance access to the established substance use disorder (SUD) System of Care in the Grays Harbor County Jail. The purpose is to identify and address all underlying mental health and SUD conditions and provide wrap-around care for historically marginalized and underserved individuals with criminal-justice involvement, and to facilitate successful recovery and reintegration into positive community life after incarceration. Project activities include developing a mental health/co-occurring path to the established SUD System of Care; providing all three forms of medications for opioid use disorder (MOUD) as clinically indicated; implementing evidence-based mental health screening, assessment and medication management; engaging with re-entry peer counselors in identifying social supports for return to the community including housing and stabilization; and providing access to therapeutic programming, SUD assessments, and individual interventions based on criminogenic risks. The county's reentry provider, Coastal Community Action Program, is a proposed subawardee and will provide mental health assessments and treatment, linkage to social and housing supports upon re-entry, and therapeutic programming during incarceration to bolster recovery skills and address reentry goals.Expected outcomes include development of an expanded Behavioral Health System of Care (BHSoC); provision of evidence-based services; reduction in recidivism and subsequent increase in public safety in Grays Harbor County; increased quality of life and health outcomes for participants served; and systemwide quality improvement through quarterly partner meetings.

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

Quinault Indian Nation

The Adult and Family Healing to Wellness Courts (AFHWC) of the Quinault Indian Nation (QIN) project will address the lack of integrated assistance, particularly for people who may be eligible for diversion from County Superior Court. Persons in AFHWC are currently not prioritized for services or treatment in Behavioral Health or Substance Dependency Treatment, causing further hardship for families whose loved ones may have initially committed to but subsequently abandoned treatment prior to the issuance of a court order. With the possibility of securing a joint jurisdiction agreement with the Grays Harbor Superior Court before the end of 2023, as well as the opportunity to redirect qualifying cases to the Tribal Court's supervision, the Tribal Court requires more assistance to centralize its services and assist families in their recovery. This is an important step because of the prevalence of addiction in the community and the scarcity of preventative assistance services. In order to accomplish this, the QIN AFHWC will collaborate with the Quinault Wellness Center to deliver evidence-based, culturally inclusive recovery support tools to our community's most vulnerable residents. This three-year initiative will provide stabilizing services in a community heavily struck by drug use disorders with the help of trained Peer Recovery Supports who are also AFHWC Alum. The project design incorporates the Sequential Intercept Model from SAMHSA as well as the ten Key Components of Tribal Healing to Wellness Court best practices. It also includes systems of care to address the unique needs of those with cooccurring disorders. This initiative will assist address system gaps upstream of encountering the judicial system while also giving support to individuals who are already in it.

City of Madison

The Madison Area Recovery Initiative (MARI) aims to reduce overdose deaths in Dane County where synthetic opioids, such as fentanyl, have replaced heroin and prescription drugs as the main cause of fatal incidents. There has also been an increase in overdose deaths involving cocaine, largely due to fentanyl being mixed with cocaine. The highest rates of drug overdose deaths are among those aged 35-54 with31% occurring among people who identify as Black, Indigenous, People of Color. Black individuals are over 4.5 time more likely to die from an overdose compared to Dane County's population as a whole. The Madison Police Department and its partners offer a comprehensive proposal to prevent overdose deaths and expand access to treatment, recovery, and support services. Key activities include expanding drug take-back programs, increasing diversion activities through MARI, and creating a self-referral pathway for individuals on probation and parole. The program will also provide transportation for MARI participants to access assessment and treatment services. Other initiatives include expanding the Resource Team (RT) to include juvenile outreach, peer led support groups in Dane County Jail, and outreach to communities outside of Madison. Additionally, RT will provide fatal overdose grief support and improve coordination of narcotics task force search warrants to support households impacted by investigations The program will improve access to real-time overdose incident information to emerging drug trends and ensure Naloxone is available for law enforcement, first responders, jail staff, and other justice system practitioners. Education and prevention programs will connect law enforcement with K-12 students. The program will explore alternative to incarceration programs with Dane County Jail, improve coordination with the District Attorney's Opiate Diversion Program, and expedite treatment. It will expand access to evidence-based treatment by coordinating transportation for medication-assisted treatment (MAT) screenings prior to jail booking and funding for assessment, and inpatient care. Two Peer Support Specialists will be embedded in the MPD Mental Health Unit to support justice involved individuals. The initiative will support individuals re-entering the community post incarceration, providing harm reduction resources, transitional housing, and recovery support.

Wisconsin

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 Milwaukee

Milwaukee County is the most populated county in Wisconsin with an estimated population of 946,687 people in 2020, about 16 percent of the state’s total population. Milwaukee is also the most diverse county in Wisconsin accounting for 62 percent of the state’s total black population. It has the greatest overdose burden in the state, leading in both count and rates. For the first time in 2021, the rate of fatal overdoses was higher among the black population in Milwaukee County than white and Hispanic counterparts. The black population in Milwaukee experienced a 51.7 percent increase in fatal overdose rates from 2020 to 2021, compared to only a 4.8 percent rate increase among the white population. The substances involved in fatal overdoses saw distinct shifts, with a 42 percent increase in the number of cocaine and fentanyl related overdoses from 2020-2021, which was disproportionately experienced by the black population. Milwaukee partners have been limited in identifying the cause of these recent changes. Mi

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

City of West Allis

This project will target suburban Milwaukee County, expanding access to evidence-based treatment for stimulant use disorder and harm reduction through the Community Paramedic-led Stimulant Treatment and Access to Resources (CP-STAR). Overdoses often involve synthetic opioids, as well as stimulants particularly psychostimulants and cocaine. This trend is mirrored in suburban municipalities of Milwaukee County , where some area saw up to 3.75 times increases in methamphetamine involvement from 2018. CP teams can address overdose in multiple ways, including providing harm reduction, connection to treatment, peer support, withdrawal management, and initiation of Medications for Opioid Use Disorder (MOUD). This project, led by West Allis Fire Department (WAFD), will use CP teams to address the impact of opioids and fentanyl in the specified communities. WAFD will leverage and position existing resources to address the burden of these substances. CP-STAR will serve a suburban Milwaukee population of 354,820 people spanning 1,189 miles of 18 geographically fragmented municipalities. The WAFD in partnership with the Medical College of Wisconsin (MCW) will conduct a comprehensive investigation into local drug trends, treatment resources, and harm reduction practices for the stimulant users at risk of fentanyl exposure. They will also assess the current inventory of CP practices in suburban Milwaukee, identifying assets and gaps. These results will inform Goals 2-5, bolstering immediate response to municipalities underserved by MIH, while working with municipalities to provide sustainable services for stimulants and fentanyl. This approach will lead to increased engagement in harm reduction and treatment, and decreases in substance use and overdoses. CP-STAR will provide hands-on training, consultation and follow-up with suburban municipalities to ensure training infusion into everyday practice. Finally, the project will assess CP demand to fully engage in addressing stimulants, uncovering new ways CPs might provide services or support treatment outside clinical settings. When feasible, CP-STAR will pilot these new activities. MCW will collect a number of process and outcome measures at county, municipal, CP, and patient levels and facilitate the dissemination of outcomes and deliverables.

Wisconsin

County of Milwaukee

The Milwaukee County Behavioral Health Services (BHS) proposes to address health inequities among individuals with opioid and/or stimulant use disorder and their families, who have been historically underserved, marginalized, and negatively affected by continued poverty, segregation, and inequality. The project, Enhancing Post-Overdose Outreach Programs and Access to Real-Time Overdose and Emerging Drug Trend Data in Black and Brown Communities, will serve Milwaukee. The project aims to reduce the impact of opioids, stimulants, and other substances on Black and Hispanic individuals and communities by: (1) expanding evidence-informed best practices for post-overdose outreach programs by providing social work support to community members following fatal and non-fatal overdoses; and (2) enhancing the Overdose Public Health and Safety Team (OD-PHAST) infrastructure, the multidisciplinary coordinating body that focuses on addressing the issues that arise due to the use of opioids, stimulants, and other substances. Activities to achieve the project's goal and objectives include: (1) adding a social worker to the Milwaukee County Office of Emergency Management (OEM) Community Paramedic nonfatal overdose team, (2) adding a bilingual social worker to the Milwaukee County Medical Examiner's Office (MCMEO) fatal overdose outreach team, (3) expanding data exchange with correctional facilities providing medication-assisted treatment for residents with opioid use disorder, (4) refining the OD-PHAST recommendation implementation process, and (5) establishing an OD-PHAST governing committee. Measurable objectives are to: increase the number of deflection and diversion programs; increase collaborations and prevention programming across disciplines; increase capacity and strategies implemented in historically underserved and marginalized communities; and increase the capacity of partners to access and use data.

Winnebago County

The Winnebago County Health Department (WCHD) project will leverage existing coalition work, create best practices in prevention, and address the county’s increasing number of overdose deaths. The Winnebago County Overdose Fatality Review (OFR) Team has been a platform for community change to address system issues, yet the number of overdoses continues to rise. While partners recognize the benefits of the work, there is an identified need to increase the level of response and improve the collected metrics. The project includes: 1) Real-time data collection. WCHD will contract with a researcher to continue regular OFR monthly reviews to: (1) collect overdose data; (2) understand aggregate data trends; (3) report findings to the OFR governing committees; (4) build collaborative partnerships throughout the community to drive coordinated action related to substance use; (5) increase capacity for the implementation of current and new OFR recommendations to continue addressing the main purpose of OFRs, to prevent overdose deaths. In addition, WCHD will contract with a researcher who will evaluate the current state of the work and impact in the community through data analysis, utilization of the CDC Overdose Data2Action Evaluation tool, and provide data to COSSAP to help drive future action. 2) Embedding social workers, peers, and/or persons with lived experience at any intercept of the Sequential Intercept Model. WCHD will contract with Fox Cities Victim Crisis Response to respond on-scene to address the grief and needs of next-of-kin by connecting them to support services and conducting next-of-kin interviews to better understand the circumstances that led to an overdose death and to prevent future overdoses. 3) law enforcement and first responder deflection and diversion; and peer recovery support services. WCHD will contract with Solutions Recovery, Inc. to implement a WC-OFR recommended, data-driven rapid response program that is being created in summer 2022 for full launch in fall 2022, and to create sustainability of the program over three years. Through this COSSAP funding, Winnebago County will have the expanded resources to implement recommendations and changes driven by data that holistically affect individuals and families who have been overlooked, forgotten, and left on their own to change their lives. Creating a new person-centered customer service model of care, support, navigation, and hope will change the trajectory of overdose deaths in Winnebago County.

Wisconsin

Winnebago County

The Winnebago County District Attorney’s Office (WCDAO) is applying for Category 1 funding in the amount of $1,897,863. Stimulant and Opioid Addiction Recovery (SOAR) will develop a diversion strategy using evidence-based components for people with substance use disorder (SUD) and felony drug-possession cases and will improve data infrastructure, engaging stakeholders that include local justice, health, and service agencies and community-based service providers. SOAR will operate in two phases, the first beginning with the defendant being arrested or summoned to an initial court appearance. Phase 1 includes a 24/7 drug-monitoring program; Phase 2 consists of a post-charge diversion agreement. The project will collaborate with a recovery-services and training facility in Winnebago County that will provide certified peer support specialists. A local pharmacy will provide naltrexone shots to participants who are interested in pursuing that path. Pragmatic field tests of process improvements will document performance and feasibility of implementation. The project’s goal is to identify and respond to the needs of persons with SUD who are currently excluded from diversion programs. Deliverables include improved data collection to characterize and respond to SUD; a screening tool for treatment and diversion for persons with SUD; and improvements in domains important to the justice system, social-service agencies, the community, and SUD-involved persons, such as increased treatment engagement and reduced recidivism. The project serves Winnebago County, a largely rural county with a population of approximately 170,000. The project includes partnerships between WCDAO and the Winnebago County Department of Human Services, the Winnebago County Department of Public Health, Options Lab, the Winnebago County Circuit Court, the Wisconsin State Public Defender’s Office, and Fox Valley Peer-based Response, Information, Support, and Maintenance. The project will engage the New York University's Marron Institute 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.

Wisconsin

Wisconsin Department of Justice

The Wisconsin Department of Justice (WI DOJ), the State Administering Agency (SAA) will expand on the previous strategic efforts in Wisconsin, utilizing expertise gained from the FY19 Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) grant administered by the WI DOJ. This project aims to reduce the impact of opioid, stimulant, and substance misuse by expanding pre-arrest diversion programs, implementing technology solutions, and conducting comprehensive evaluations. Project activities include awarding subgrants to ten new geographically diverse Deflection sites, providing technology upgrades to existing sites, and conducting process and impact evaluations. New sites will implement the six pathways of Deflection, focusing on infrastructure development, training, and technology integration. Existing sites will receive support to modernize processes through technology implementation for screening, case management, and participant engagement. The WI DOJ's Bureau of Justice Information and Analysis will conduct evaluations to assess program implementation, operations, and impact on recidivism and cost-effectiveness. Expected outcomes include expanded access to treatment and recovery support services, strengthened public safety and public health collaborations, and reduced substance use impact on individuals and communities. Deliverables will include implementation of ten new Deflection sites, technology upgrades for existing sites, validation of the Proxy screening tool, process and impact evaluations, and development of public and program-specific data dashboards. The project will serve the entire state of Wisconsin, encompassing urban, suburban, rural, and tribal communities. It will prioritize expanding services to underserved rural areas and tribal nations, with a focus on addressing racial disparities in overdose deaths. Intended beneficiaries include individuals at risk of substance use-related justice system involvement, law enforcement agencies, behavioral health providers, and communities affected by substance misuse. Subrecipient activities will include implementing pre-arrest diversion programs, establishing processes for participant identification and referral, providing stabilization services, utilizing peer support specialists, and participating in data collection efforts. Ten new Deflection sites will receive up to $500,000 each to implement these activities. Known Deflection sites will receive funding to implement technology solutions for improving program efficiency and effectiveness. All subrecipients will collaborate with the WI DOJ and evaluation team to support comprehensive data collection and evaluation efforts.

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.

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

State of Alaska Department of Health

State of Alaska Department of Health

Alabama Department of Mental Health

Alabama Department of Mental Health

Izard County

Izard County

Arizona Criminal Justice Commission

Arizona Criminal Justice Commission

Mendocino County

Mendocino County

Pueblo Department of Public Health and Environment

Pueblo Department of Public Health and Environment

Connecticut Department of Mental Health and Addiction Services

Connecticut Department of Mental Health and Addiction Services

Executive Office of the Governor Of Delaware

Executive Office of the Governor Of Delaware

City of Port St. Lucie

City of Port St. Lucie

Criminal Justice Coordinating Council

Criminal Justice Coordinating Council

Georgia Criminal Justice Coordinating Council

Georgia Criminal Justice Coordinating Council

City of Clinton

City of Clinton

Idaho Department of Health and Welfare

Idaho Department of Health and Welfare

Boone County

Boone County

Cook County

Cook County

DuPage County Health Department

DuPage County Health Department

The Health & Hospital Corporation of Marion County

The Health & Hospital Corporation of Marion County

County of Reno

County of Reno

Northern Kentucky Independent District Health Department

Northern Kentucky Independent District Health Department

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

Louisiana Department of Public Safety and Corrections

Louisiana Department of Public Safety and Corrections

Orleans Parish District Attorney

Orleans Parish District Attorney

Berkshire Regional Planning Commission

Berkshire Regional Planning Commission

City of Holyoke Police Department

City of Holyoke Police Department

City of Lawrence

City of Lawrence

City of Lowell

City of Lowell

City of Newburyport

City of Newburyport

City of Newburyport

City of Newburyport

Commonwealth of Massachusetts dba Middlesex Sheriff's Office

Commonwealth of Massachusetts dba Middlesex Sheriff's Office

Commonwealth of Massachusetts, Sheriff's Department Hampden

Commonwealth of Massachusetts, Sheriff's Department Hampden

Massachusetts Supreme Judicial Court

Massachusetts Supreme Judicial Court

Massachusetts Supreme Judicial Court

Massachusetts Supreme Judicial Court

Northampton, City of

Northampton, City of

Town of East Bridgewater

Town of East Bridgewater

Town of Seekonk

Town of Seekonk

Cecil County

Cecil County

Cecil County, Maryland