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.

City of Palmer

Alaska

Cook Inlet Tribal Council, Inc

The Cook Inlet Tribal Council, Inc. (CITC)’s project will expand the accessibility of peer recovery support services and will ultimately decrease the prevalence of substance use in the Anchorage, Alaska, Metropolitan Statistical Area (MSA). Specifically, CITC, in partnership with Southcentral Foundation—a prominent Tribal 501(c)(3) nonprofit primary and behavioral healthcare services provider—will establish a specialized and flexible team of Peer Support Workers who will work in clinical and non-clinical settings. The project will complement the US Bureau of Justice Assistance’s efforts to reduce substance use and its impacts via its focused fundable activities. The project will incorporate 8 main activities that will closely complement CITC’s and Southcentral Foundation’s respective existing behavioral healthcare continua. Those activities, which are linked to the project’s deliverables, and goals, objectives, and outcomes, will be: (1) individual-based peer mentoring sessions; (2) group-based peer mentoring sessions; (3) naloxone use trainings; (4) brief interventions; (5) referrals to primary and behavioral healthcare services; (6) referrals to wrap-around services; (7) case management; and (8) data management. CITC expects to (1) serve 150 unduplicated residents via individual-based peer recovery support services; (2) provide 624 group-based peer recovery support sessions to residents; (3) provide 90 unduplicated residents who are receiving substance detoxification services via Southcentral Foundation with referrals to non-peer-related substance use disorder (SUD) treatment and recovery services; and (4) produce a memorandum of agreement between CITC and Southcentral Foundation, a group-based peer mentoring plan, a services coordination plan, and a services catalogue. With its 398,328 residents, the Anchorage MSA represents over 54 percent of Alaska’s total population, and of those residents, 57,072 are Alaska Native/American Indian (AN/AI) (race alone or in combination). The project’s target population will be AN/AI adults who have SUDs and seek SUD treatment and recovery services but will also serve non-AN/AI individuals. Among all racial groups in Alaska, AN/AI residents have the highest poverty and unemployment rates and the highest opioid-related naloxone intervention, hospitalization, and death rates.

Cook Inlet Tribal Council, Inc

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 Department of Mental Health

Alabama

Jefferson County Commission

Jefferson County Commission applied for Category 1a urban area funding in the amount of $1,189,215. The Jefferson County Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) will extend peer recovery services to include expanded pretrial supervision, as well as provide evidence-based treatment, including medication-assisted treatment (MAT), to individuals at high risk for overdose. This project serves a population of more than 500,000 in Jefferson County, Alabama. The project includes partnerships between the University of Alabama Department of Psychiatry — Substance Abuse Division, Jefferson County Sheriff's Office, and a local evaluator. Priority considerations addressed in this application include providing services to Qualified Opportunity Zones, addressing persistent poverty, and serving a region that has been disproportionately impacted by substance abuse.

Arkansas Department of Finance and Administration

The Arkansas Department of Finance and Administration is applying for a Category 2 statewide area grant in the amount of $6,000,000. The Arkansas COSSAP Project will address the opioid epidemic strategically and continue providing support to areas that have been disproportionally impacted by the abuse of illicit opioids, stimulants, and other substances, as indicated by a high rate of treatment admissions for substances other than alcohol; high rates of overdose-related deaths; and lack of accessibility to treatment and recovery services. The primary focuses of the proposed projects are comprehensive, real-time, regional information collection, analysis, and dissemination; the development of peer recovery services and treatment alternatives to incarceration; and continued Comprehensive Opioid Abuse Site-based Program (COAP) overdose investigations involving peer recovery services and the implementation of strategies identified in the Comprehensive Opioid Abuse Strategic Plan. This project serves specific counties where high rates of opioid deaths have been identified in COAP Category 2; however, the specific subrecipients for the proposed projects have not been selected. The project includes partnerships between the Department of Finance and Administration Office of Intergovernmental Services (DFA-IGS), Department Human Services, Office of State Drug Director, and the Single State Authority, in addition to a new partnership between DFA-IGS and the Arkansas Coroners’ Association. Priority considerations addressed in this application include providing services to rural communities and the fact that the individuals (populations) intended to benefit from the project reside in high-poverty and/or persistent-poverty counties.

Arkansas Department of Finance and Administration

The Arkansas Department of Finance and Administration will: • Support an overdose crime scene team consisting of a criminal investigator and a peer recovery specialist to assist law enforcement task forces/agencies in a minimum of six geographically diverse sites (counties, regions, or localities) within the state. • Increase access and enrollment to treatment, increase education and awareness, and evaluate the grant strategies identified in 25 localities within the state to address offenders who may be opioid abusers. The sites to receive subawards will be selected through a competitive process. Subawardees will be required to use overdoes detection mapping application program. An independent evaluator will be selected after the grant is awarded.

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.

Hoopa Valley Tribal Council

The Hoopa Valley Tribal Court is applying for a Category 1C award in the amount of $600,000. The Hoopa Tribal Wellness Court Pre-Booking Enhancement will support ongoing operations and service expansion under its Adult Tribal Healing to Wellness Court. This project intends to increase and standardize services for individuals with substance use disorder and opioid use disorder. While many of these individuals are court-involved, services will also be made available to anyone seeking assistance, with priority for special populations. The special populations include pregnant women, individuals with or at-risk of HIV/AIDS, older adults caring for a minor child due to foster care involvement, and individuals entering the community from incarceration. This project utilizes a hub-and-spoke model to centralize service delivery for Wellness Court participants and increase favorable outcomes as they journey to health. Funding for medication-assisted treatment is requested to help assure that individuals working through opioid misuse have the support needed through full recovery. This project serves enrolled citizens of the Hoopa Valley Tribe, American Indian/Alaska Natives (AI/AN), and AI/AN citizens enrolled in other tribes living within the jurisdictional boundaries of the Hoopa Valley Tribe. The Hoopa Valley Tribe and its reservations are within Humboldt County, California. The project includes partnerships between the K’ima:w Medical Center, the Court's Probation Services, and the Judicial Project Advisory Team.

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.

City of Alamosa

The City of Alamosa applied for Category 1c tribal/rural area grant funding in the amount of $599,997. The Specialized Case Management program will provide a non-arrest, community partner pathway to connect addicted individuals to intensive case management and harm-reduction resources using the evidence- based TASC Specialized Case management and Let Everyone Advance with Dignity (LEAD) model. The City of Alamosa is creating a system of care that will allow individuals to receive appropriate levels of service and treatment to address root challenges rather than utilizing a criminal justice system clearly not equipped to address substance use disorder effectively. The Specialized Case Management program will provide a third pathway into intensive case management, service coordination, and connection to harm- reduction resources. This project serves approximately 50,000 residents in the 12th Judicial District. The project includes partnerships between the City of Alamosa, Center for Restorative Programs, and the 12th Judicial District Office of the District Attorney. Priority considerations addressed in this application include the disproportionate impact of opioids and other substances on the region, the specific challenges faced by rural communities, and the high poverty area served by the project.

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.

Pueblo Department of Public Health and Environment

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 Department of Mental Health and Addiction Services

Connecticut

District of Columbia Office of the Chief Medical Examiner

The District of Columbia Office of the Chief Medical Examiner (DC-OCME) has applied and been granted a Category 1a rural area grant in the amount of $1,200,000. DC-OCME Toxicology Opioid and Illicit Drug Surveillance (TOIDS) will reduce the impact of opioids, stimulants, and other substances on individuals and communities, including a reduction in the number of overdose fatalities, as well as mitigate the impacts on crime victims by supporting comprehensive, collaborative initiatives like conducting forensic toxicology laboratory testing of illicit drug misuse and novel testing for opioids. In addition, it will be analyzing comprehensive, real-time, regional information collection, analysis, and dissemination; and streamlining the forensic toxicology lab testing methodology through Lean Sigma Six (LSS) training of staff and LSS reform of the lab. Products include a sustainable LSS lab and staff, a comprehensive reference of new opioids, and free online resources on DC-OCME’s web page. DC-OCME will disseminate best practices with community partner and advocates. This project serves the District of Columbia with a population of 702,455. The project includes partnerships between the Network for Victim Recovery of D.C., D.C. Forensic Nurse Examiners, D.C. Metropolitan Police Department, D.C. Department of Transportation, D.C. Office of Victim Services and Justice Grants, and D.C. Department of Health. Priority considerations addressed in this application include the poverty priority, the persistent poverty counties priority, and Qualified Opportunity Zones.

Executive Office of the Governor of Delaware

The Executive Office of the Governor of Delaware - Criminal Justice Council will implement new opioid-intervention programs in five geographically diverse localities: Dover (Kent County), Smyrna (Kent County), Millsboro (Sussex County), Seaford/Laurel (Sussex County), and Georgetown/Lewes/Milton (Sussex County). The project goals are to: (1) increase the number of law enforcement diversion programs; (2) reduce overdose deaths; (3) increase transitional housing availability; and (4) increase services for youth impacted by opioid overdoses. One initiative will involve establishing pre-arrest or post-arrest law enforcement diversion programs (using the Police Assisted Addiction and Recovery Initiative [PAARI] model) for individuals who commit low level, nonviolent, drug-related offenses by utilizing community-based substance abuse and behavioral health services. The project will also include identifying cases where youth are impacted by an overdose and providing evidence-based responses, providing transitional or post recovery housing for individuals, and improving the collection/integration of data by purchasing a statewide case management system for law enforcement and Delaware’s Division of Substance Abuse and Mental Health.

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.

New Castle County

The New Castle County Division of Police is proposing to expand Hero Help, a law enforcement led diversion by creating a team (substance abuse clinician, nurse, police officer, case manager, victim advocate) embedded in the patrol division, to respond immediately to 9-1-1 calls for service. Grant funds support a full-time project coordinator, nurse, child victim advocate (respond to overdose where children are impacted) and a licensed clinician. Additionally, to improve analytic capacity, develop a data collection tool to capture near real-time fatal and nonfatal overdoses. University of Delaware, Center for Drug and Health Studies, and Daniel O’Connell will serve as the research partner.

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.

Palm Beach County Board of County Commissioners

COSSAP funding supports a care coordinator/housing specialist assisting Clients in finding a recovery housing placement using Recovery Housing Vouchers. Recovery support services are provided by engagement with a peer recovery support specialist and using the enhancement funding through the Recovery Support Services Funds. This intervention program prioritizes and expedites recovery support services to individuals at high risk for overdose. The Office of Behavioral Health and Substance Use Disorders (OBHSUD) seeks to fund a comprehensive person-centered, recovery-oriented approach with the goal of ensuring housing stability to support persons involved with the criminal justice system who have a substance use disorder. This demonstration program focuses on achieving housing stability given its key predictive value in achieving long-term recovery outcomes. The program team participates and works closely with the County’s strategic government and community partners as well as its research partner, Florida Atlantic University, to define and measure housing stability standards, and other recovery support interventions in the recovery residence environment in order to determine their impact on long-term recovery outcomes.

Pinellas County dba Board of County Commissioners

The Pinellas County CARE Team Expansion will enhance current overdose response by increasing connections and engagements in community substance use treatment services, providing peer support to overdose survivors and families, conducting overdose fatality reviews to identify trends and potential gaps in the system of care, and increasing first responder and community access to naloxone. This project serves Pinellas County, Florida, with an estimated population of 970,532. The project includes partnerships between Pinellas County Human Services and Pinellas County Safety and Emergency Services.

Fulton County

The County of Fulton applied for Category 1a urban grant funding in the amount of $1,200,000. The Comprehensive Opioid, Stimulant, and Substance Abuse Program will expand Fulton County’s comprehensive efforts to identify, respond to, treat, and support those impacted by substance use disorders and reduce impact on the criminal justice system. The Fulton County Department of Behavioral Health and Developmental Disabilities (DBHDD) and its partners will expand pre-arrest diversion, case management, and training for law enforcement personnel to the city of Atlanta and two other jurisdictions using the Law Enforcement Assisted Diversion model; provide recovery support services including transitional or recovery housing through Fulton DBHDD and its local partners; and offer evidence-based treatment including medication-assisted treatment through partner Grady Hospital. This project serves the city of Atlanta (population 498,044). The project includes partnerships between the Atlanta Fulton Pre-Arrest Diversion Initiative, Grady Hospital, Mary Hall Freedom House, Atlanta Recovery Center, Trinity Community Ministries, Sober Living of America, There’s Another Option, Highsmith Collins, Atlanta Police Department, and the Fulton County Offices of the District Attorney, Public Defender, and Solicitor General. Priority considerations addressed in this application include Qualified Opportunity Zones, high-poverty areas, and a lack of accessibility to treatment providers, facilities, and emergency medical services. Dr. Kevin Baldwin from Applied Research Services serves as the lead evaluator for the proposed project.

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.

Boone County

Boone County applied for Category 1c rural/tribal area grant funding in the amount of $599,000. The Boone County Support Outreach Recovery Team will to fill the identified need for a community law enforcement officer to work with the individuals who have been arrested and fill the identified need for an addiction counselor to work with the county’s jailed population. The second purpose of this program is to fill the identified need for an addiction counselor who will work as a recovery coach with Boone County’s jailed population. This individual will deliver services such as moral reconation therapy and substance abuse counseling. This project serves Boone County, Illinois (population 53,606). The project includes partnerships between the Boone County Health Department, the multidisciplinary team, the Rosecrance, and the Belvidere Police Department.

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 Health

Through this funding, Cook County Health will (1) convene the Cook County Community Recovery Learning and Action Network to address recovery housing capacity and coordination; (2) begin development of a real-time, regional recovery housing information system, including collection, analysis, and dissemination across partners; (3) with partners, conduct a feasibility study for a low barrier, harm reduction and recovery-oriented, transitional housing model for justice-involved individuals with SUD to address gaps in the current recovery housing landscape. Work towards a pilot in years 2 and 3; and (4) support recovery home beds and recovery support services for corrections-involved individuals. This project serves Cook County, Illinois, which has 5.2 million residents. The project includes partnerships with transitional and recovery housing providers, substance use treatment providers, criminal justice partners, state agencies, community-based partners, and public health organizations. Priority considerations addressed in this application include high-poverty areas, and this project will offer enhancements to public safety in economically distressed communities (Qualified Opportunity Zones).

Indiana Family and Social Services Administration

The Indiana County Leaders Collaboration for Change (ICLCC) will establish and/or build upon existing collaborative relationships between first responders, the criminal justice system, child welfare and foster care, behavioral health, primary care and addiction service providers to identify, develop (or) enhance, and implement specific countywide programs designed to reduce the impact of opioids, stimulants, and other substances on individuals and communities. The counties will achieve this by developing (or) enhancing and implementing one or more of the following within their county: Law Enforcement Assisted Diversion (LEAD) model programs (new to Indiana), prebooking or postbooking treatment alternative-to-incarceration programs, education and prevention programs to connect law enforcement in schools, embed social services with law enforcement to rapidly respond to drug overdoses where children are impacted, and expand access to evidence-based treatment and recovery support services across the criminal justice system. This project serves individuals across Knox, Wayne, Fayette, Floyd, Clark, Allen, and Madison counties. The project includes partnerships between the Division of Mental Health and Addiction and seven county coalitions. Priority considerations addressed in this application include rural, high-poverty, and economically distressed regions.

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.

County of Reno

Kansas

Purchase District Health Department

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

Whitley County

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.

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).

St. Tammany Parish Government

St. Tammany Parish will develop an information system to analyze and track the opioid client population across justice system and health intercepts in order to reduce cases of overdose and increase treatment and recovery service access. Key partners for this project include the 22nd Judicial District Court, the Safe Haven Advisory Board, St. Tammany Parish Hospital, the St. Tammany Parish Sheriff’s Office and Jail, and the District Attorney’s Office.

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%).

Berkshire Regional Planning Commission

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 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 Administrative Office of the Trial Court

The Trial Court of Massachusetts, on behalf of six states (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont), will establish a New England Regional Judicial Opioid Initiative (RJOI). This project will support comprehensive cross-system planning and collaboration among officials who work in multiple justice and justice related settings while staying focused on the judiciary and judiciary stakeholders (e.g. law enforcement, pre-trial services, the courts, probation and parole, child welfare, reentry, prescription drug monitoring programs (PDMPs), and emergency medical services, as well as health-care providers, public health partners, and agencies that provide substance use disorder treatment and recovery support services). The New England RJOI will also develop and enhance public safety, behavioral health, and public health information-sharing partnerships that leverage key public health and public safety data sets and implement interventions based on this information. The project will have a researcher and is presently completing contract negotiations for these services. Please note that Abby Kuschel currently leads this initiative as Project Director, not Jessica Fix. Ms. Fix is registered in JustGrants as Grant Award Administrator and is responsible for administrative/fiscal oversight. We are unable to update this field as it locked in the web form.

Massachusetts Supreme Judicial Court

The Massachusetts Middle District Attorney’s Office, in partnership with AdCare Hospital 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 seven 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 Opioid Task Force, 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. The Task Force 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 Supreme Judicial Court

Massachusetts

Massachusetts Supreme Judicial Court

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

Massachusetts Supreme Judicial Court

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.

Town of East Bridgewater

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.

Cecil County

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.

Cecil County, Maryland

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).

Cumberland County

The County of Cumberland applied for Category 1b suburban area grant funding in the amount of $899,824. The Bridges for ME: Person-Centered Recovery and Reentry Project will focus on the development of an advisory council with at least five community partners and memorandums of understanding with five diverse treatment providers and annual screenings of 1,200 people for SUD/OUD conditions, while offering of 600 people resource referrals and naloxone. The project will also provide an annual provision of group support and reintegration planning to 200 people in jail, as well as intensive reentry services for 150 individuals receiving community service, including MAT and peer navigator services for 60 days. This project serves Cumberland County, population 281,674. The project includes partnerships between Cumberland County Jail, Maine Pretrial Services, Co-occurring Collaborative Serving Maine, Amistad, SMART, Maine Department of Corrections Probation, Portland Police Department, MAT providers Catholic Charities Maine, Spurwink Adult Behavioral Health Services, Maine Behavioral Healthcare IMAT, Northern Light Portland Internal Medicine, and Discovery House. Priority considerations addressed in this application include Cumberland County as a region disproportionately impacted by substance abuse.

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.

Department of State Police Michigan

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.

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

The City of Duluth applied for Category 1b suburban area grant funding in the amount of $899,055. The City of Duluth FY 2020 COSSAP Lake Superior Diversion and Substance Use Response Team Project will improve community outreach to overdose events by expanding outreach efforts to those with amphetamine-related substance use disorders and those who experience amphetamine-related overdoses. The program will reduce barriers between outreach contact and treatment, and maintain or expand current opioid response functions. This project serves St. Louis, Carlton, and Lake counties in Minnesota, as well as the city of Superior in Wisconsin. This region has a population of approximately 289,727 people. The project includes partnerships between St. Louis County Public Health and Human Services, St. Louis County Drug Court, and the Center for Alcohol and Drug Treatment. Priority considerations addressed in this application include Qualified Opportunity Zones.

City of Saint Paul

The City of St. Paul Police Department (SPPD) applied for Category 1b suburban area grant funding in the amount of $412,125. The Recovery Access Program (RAP) includes an embedded Licensed Alcohol and Drug Counselor (LADC) from the nonprofit organization People Incorporated to assist in connecting individuals with a substance use disorder or substance use related concerns to applicable services and supports, as well as responding after a non-fatal overdose incident to offer services and harm reduction resources. An SPPD officer is assigned to RAP to assist with the Naloxone Plus Model and Drug Surveillance Program. Funds are also used to hire an internal SPPD data analyst to collect and manage program performance and evaluation data for the purposes of program improvement and program sustainability beyond grant funding. This project serves the city of St. Paul’s population of about 310,000 individuals. The project includes partnerships with the University of Wisconsin-Madison Population Health Institute. Priority considerations addressed in this application include Qualified Opportunity zones and high-poverty area.

Minnesota Department of Public Safety—Bureau of Criminal Apprehension

The Minnesota Department of Public Safety (DPS) will support the “Timely Treatment, Strengthened Service, and Effective Evaluation for Overdose Prevention: Linkage to Care Across Minnesota” project to achieve the following objectives in eight sites: • Reduce opioid misuse and opioid overdose death by supporting local efforts to implement effective opioid overdose prevention projects. • Support local efforts to implement treatment and recovery support linkage activities serving individuals vulnerable for drug overdose. • Support implementation of local multidisciplinary intervention models to bring together stakeholders with different perspectives and different information to identify drug overdose prevention strategies. • Enhance access to naloxone among people who use drugs to decrease overdose deaths. • Enhance successful local multidisciplinary overdose prevention activities to decrease overdose deaths. • Evaluate the extent to which additional funding to eight opioid overdose prevention projects, referred to as “Tackling Opioid Use With Networks (TOWN)”, impact the incidence of overdose in communities. • Create a TOWN Manual in collaboration with the communities to support the expansion and sustainability of the TOWN model. The eight sites will implement three evidence-based activities: (1) peer recovery specialists in emergency departments; (2) treatment linkage by emergency medical services; and (3) overdose fatality review teams. The project will also enhance six Minnesota Department of Public Safety-funded syringe services programs by providing each site with naloxone to distribute to participants who use opioids. Dr. Catherine Diamond from the Minnesota Department of Health will lead the project evaluation.

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 LEAD Program will develop a trauma-informed, comprehensive, community-based response to divert individuals experiencing opioid or stimulant misuse/abuse from the criminal justice system to treatment. The objectives are to (1) divert 100 individuals with SUD from the criminal justice system to treatment and case management service providers, and (2) provide harm-reduction case management services to 150 individuals with SUD. A total of 250 individuals will be served over the project period. This project serves Lamar County, Mississippi, which has a population of 63,300. The project includes partnerships between Pine Belt Mental Healthcare Resources’ Grant and Research Department. 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) 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.

Buncombe County Health and Human Services

Buncombe County Department of Health and Human Services (DHHS) proposes to connect individuals at risk of overdose with substance use treatment and peer support; provide transitional or recovery housing for individuals with opioid use disorder (OUD) leaving the jails or the emergency department; develop programs to address the opioid epidemic in rural areas; develop and implement a comprehensive plan to reduce the risk of overdose death and enhance treatment and recovery service engagement among the pretrial and post-trial populations leaving jails; and support the timely collection and integration of data to provide an understanding of drug trends, support program evaluation, inform clinical decision-making, identify at-risk individuals or populations, and support investigations. Buncombe County DHHS, the Sheriff’s Office, and Emergency Medical Services will implement the Overdose Detection Mapping Application Program (ODMAP).

Burke County

Burke County will support the continuation of its law enforcement-assisted diversion (LEAD) program and implement and pilot the Helping Achieve Recovery through Burke Opioid Use Reduction (HARBOUR) program which is patterned after the Recovery Community Center (RCC) model. The goals of the project include: (1) reduce overdose incidents and deaths; (2) give low-level offenders the opportunity to access treatment with long-term recovery support instead of criminal justice system involvement, thereby reducing recidivism rates and long-term costs to the taxpayers; (3) provide treatment and long-term recovery support along with maximizing the ability of those in recovery to reintegrate into the community. Partners include Burke County Sheriff’s Office, Morganton Department of Public Safety, Valdese Police Department, Drexel Police Department, Glen Alpine Police Department, Burke United Christian Ministries, Burke Council on Alcoholism and Chemical Dependency, Inc. (dba Burke Recovery), Catawba Valley Behavioral Health, and Burke County Health Department.

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 the 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 will expand on the successes of the 2019 project and 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 will be comprised of seven components; (1) redevelopment of a Quick Response Team, a focused effort to allow individuals to be diverted from the justice system at the two lowest levels of the Sequential Intercept Model; Intercept 0 Community Services and Intercept 1 Law Enforcement; (2) 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; (3) a law assisted diversion program to direct low level drug offenders to treatment and prevent them from entering criminal justice system (4) an overdose fatality review team to bring together various stakeholders with different perspectives to review overdose deaths; (5) child psychology services to provide therapy for children with adverse childhood experiences due to exposure to substance use in additional to a substance use counselor to work with the school system providing education and referral services to families experiencing SUD. The project will also include evaluation utilizing experienced social science research evaluators. This project will serve individuals in the City of Jacksonville (pop 72,447) and the County of Onslow, NC (pop 193,893) 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, the Dix Crisis Center, 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.

City of Jacksonville

North Carolina

Henderson County/Henderson County Health Department

The Henderson County Health Department, through the County of Henderson, applied for Category 1b grant funding in the amount of $900,000. The funds will be used to expand access to recovery support services. The program seeks to provide peer-delivered services with a focus on rehabilitation and recovery, utilizing North Carolina certified peer support specialists and care coordinators. Services provided by the certified peers include psychosocial rehabilitation, habilitation, family support and training, short-term crisis intervention, and empowerment. This project serves a suburban area or medium-sized county with a population between 100,000 and 500,000. The project includes partnerships between Henderson County’s Behavioral Health Summit, Free Clinix, and Hope RX.

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.

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.

Onslow, County of

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.

Surry County

North Carolina

Surry County Government

Surry County Government applied for Category 1c grant funding in the amount of $595,568. The project will establish an accessible continuum of care to reduce the impact of substance use on the community. Currently, two essential components are lacking in the community: (1) data analysis to link needs, treatment, and services; apprise cost effectiveness; and track impact outcomes countywide; and (2) transportation assistance for people needing treatment. This proposal outlines a plan to implement these two critical elements. This project serves Surry County, North Carolina, which has a population of 73,232. The project includes partnerships between preventive, treatment, recovery, social, and justice service agencies in the county. Priority considerations addressed in this application include: rural, Qualified Opportunity Zones, a high rate of treatment admissions, high rates of overdose and overdose death, and a high rate of drug-related crime.

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.

Bergen County

The County of Bergen applied for a Category 1a urban area grant in the amount of $1,200,000. The BCPO-COSSAP Project will establish a comprehensive, evidence-based response to the opioid crisis. This response will be composed of multiple teams and initiatives, including a 24/7 hotline utilized primarily by law enforcement, the Arrest Initiative, Bergen County's Central Municipal Diversion Program, and a county-level Overdose Fatality Review Team. These teams will work independently and share data to best coordinate response needs for opioid and addiction needs across Bergen County. This project serves Bergen County, which is home to 948,046 residents. The project includes partnerships between the Bergen County Police Chiefs Association; Bergen County police departments; Newark Community Solutions, Center for Court Innovation; The Center for Alcohol and Drug Resources, a division of Children’s Aid and Family Services; Bergen County Health Department and Division of Mental Health and Addiction Services; and Bergen New Bridge Medical Center. Priority considerations addressed in this application include Bergen County’s 12 Qualified Opportunity Zones.

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 and Peer Navigator within the Department of Health and Human Services who will receive clients via referrals from parole/probation officers and the courts, including family court and recovery court; launching a family support program which provides light case management and referrals/linkages to services to affected family members of justice-involved individuals with SUDs; community-wide naloxone kit distribution; crisis intervention trainings to the Hudson County Regional SWAT Team and other 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.

Rio Arriba County

New Mexico

Sierra County

Sierra County in New Mexico will develop a crisis intervention team to assist law enforcement officers in developing a law enforcement diversion program, provide jail-based opioid and behavioral health services, provide skill-building and treatment, assist incarcerated individuals transitioning to community-based services once released from custody, add community behavior health treatment planning and services, and conduct opioid education programs in schools. This project will engage Ann Hays Egan of New Ventures Consulting as the research partner for this project.

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.

City of Henderson

Nevada

Nevada Office of the Attorney General

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

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.

Albany County

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).

Cayuga County

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.

Chautauqua County

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.

City of New York

New York

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 Opioid and Recovery Coordination (DDORC) 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 DDORC, 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).

County of Greene

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.

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 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 four 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. 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 misdemeanor court system and permanent supportive housing 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 misdemeanor justice involved 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, and the Butler County General Health District, as well as the YWCA Hamilton and the Butler County Area Courts.

Butler County Mental Health and Addiction Recovery Services Board

Ohio

Butler County of Ohio

Butler County of Ohio applied for Category 1B grant funding in the amount of $900,000. The Butler County COSSAP project aims to reduce the impact of opioids, stimulants, and other substances on individuals within its communities, through reducing the number of overdose fatalities, as well as mitigating the impacts of on crime victims by supporting comprehensive, collaborative initiatives. This project serves Butler County, home to a population of 382,000. The project includes a partnership with Miami University’s Center for School-based Mental Health Programs. Priority considerations addressed in this application include rural challenges in a high-poverty area and Qualified Opportunity Zone.

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.

City of Columbus

Ohio

City of Columbus, Department of Public Safety

The City of Columbus Department of Public Safety applied for grant funding in the amount of $1200,000 under Category 1A. This project serves the 1,316,756 residents of the city of Columbus and Franklin County, Ohio. The Rapid Response Emergency Addiction Crisis Team (RREACT) EMS Outreach Unit is a unit within the Division of Fire’s Training and Emergency Medical Services Bureau and is supported by the Division of Police’s Crisis Response Team. RREACT EMS outreach members include firefighters/paramedics, Crisis Intervention Team (CIT) certified peace officers, a substance use case manager, a registered SUD nurse, a family case manager, and trauma specialist. This multidisciplinary outreach team goes directly into communities to connect with opioid users who survive overdose, but then refuse EMS transport to the emergency room. The goal of the outreach unit is to proactively create connections and build relationships with opioid users. RREACT follows up with addicted individuals in the community within 48 hours of nonfatal overdose; checks in on their immediate health and wellness; provides resource information, and creates opportunities for users to link with harm-reduction supplies, treatment programs, and social service supports. 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. Gretchen Hammond with Mighty Crow, Inc. serves as the evaluator for the proposed project. The applicant is eligible for COSSAP priority consideration based on overdose rates in Franklin County and the City of Columbus and the project’s impact on increased public safety in Qualified Opportunity Zones.

City of Dayton, Ohio

The Dayton Police Department (DPD) — serving the city of Dayton, Ohio (population 146,040) — sought grant funding from COSSAP Category 1b in the amount of $899,964 to provide services in Dayton, mitigating the incidence of overdose/overdose deaths and addressing a substantial increase in opioids, stimulants, and other illicit substance use. DPD will support development, implementation, and expansion of a comprehensive, quick-response model by adding additional staff of certified peer support personnel, including in-reach services with the Montgomery County Jail, and targeting veterans and other identified at-risk populations. DPD will apply best-practice law enforcement strategies, including installation of FLOCK Safety License Plate Reader units and upgrading family-friendly interview rooms into evidence-based prevention programs operated by WestCare Ohio, and will contract with Cordata Health Initiatives to implement a customizable database designed for and currently being utilized by COSSAP-funded programs in Ohio to track and report quick-response and peer-lead services. Priority considerations addressed in this application include Qualified Opportunity Zones.

County of Hamilton

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

Cuyahoga County

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

Cuyahoga County

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.

Cuyahoga, County of

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.

Fairfield County

Ohio

Franklin County

Franklin County, Ohio, applied for grant funding under Category 1A in the amount of $1,200,000. This project will serve individuals incarcerated at the Franklin County Jail and screened as at-risk for substance use dependency and drug-related overdose. The purpose of the project is to (a) reduce drug-related overdoses and deaths, (b) increase peer support and treatment referral and linkage, (c) increase access to medication-assisted treatment pre- and post-release, and (d) decrease recidivism. The Fast Track to Treatment initiative includes partnerships with the Franklin County Sheriff’s Office, Franklin County Municipal Court, Southeast Inc., Alvis180, and PrimaryOne Health. Priority considerations addressed in this application include a program model that focuses services in a county with a demonstrated disproportionate number of drug overdose deaths (43.3 overdoses per 100,000 as compared to the U.S. rate of 20.7 overdose deaths per 100,000) and program implementation intended to improve public safety by targeting services in federally designated Qualified Opportunity Zones. Dr. Gretchen Clark-Hammond, CEO of Mighty Crow, shall serve as program evaluator for the proposed project.

Franklin County Municipal Court

Franklin County Municipal Court applied under Category 1A for grant funding in the amount of $903,289 to support and enhance its MAT, Assessment, Referral, Care and Hope (MARCH) project. This project serves Franklin County and the areas surrounding Columbus, Ohio, with an estimated population of 922,223. The purpose of the project is to continue to fund, expand, and enhance the court’s MAT program — an innovative and effective collaborative effort among Franklin County and City of Columbus justice and government stakeholders. Grant funds would continue to support the positions of MAT project manager and one community case manager through 2023. Enhancements would add an additional community case manager and a contracted peer support specialist to significantly increase the capacity of the program, opening more days to in-custody referrals and facilitating the offering of a full-time behavioral health walk-in clinic. The project includes partnerships between Franklin County Municipal Court, Columbus City Attorney, Office of Justice Policy and Programs, Franklin County Sheriff’s Office, Franklin County ADAMH Board, and a variety of community behavioral health providers. The MARCH program will enhance public safety in Qualified Opportunity Zones.

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.

Hancock County

Ohio

Montgomery County

Public Health - Dayton & Montgomery County, a local governmental health department, is applying for Category 1 funding in the amount of $1,200,000. The Linkage to Hope Project will enhance data sharing among partners, advance data collection and analysis, and expand the current Certified Peer Recovery Support (CPRS) services into the criminal justice system, thereby filling a gap in the continuum of care for those who are in active addiction. The project will expand a comprehensive real-time data system to include regional information, collection, analysis, and dissemination, integrating hospital and criminal justice data systems into a care coordination platform that enables the CPRS services to respond to individuals in active addiction. The project will also expand current overdose fatality review (OFR) efforts by integrating qualitative data collection to contextualize overdose trends as well as barriers to care following fatal and nonfatal overdoses. The data will be used to develop program and policy recommendations and improve coordination and collaboration between agencies and community conditions to prevent future overdose deaths. The project will also prototype a risk stratification system to identify the largest risk factors of addicted individuals in order to determine the level of risk of future overdoses and expand 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 goals of the project are to provide support and direct connection to additional resources that will decrease future criminal justice involvement and increase individuals’ likelihood of moving towards recovery. The project serves Montgomery County, which has a population of 531,987; 38 percent of the population has a poverty rate above 20 percent. The project includes partnerships with the Montgomery County Criminal Justice Council, Ascend Innovations, Cordata, the Montgomery County Coroner’s Office, the Montgomery County Common Pleas Court, the City of Dayton Police Department, the Montgomery County Sheriff’s Office, and the Greater Dayton Area Hospital Association. The project will engage Ascend Innovations, Eastway Behavioral Healthcare, and Wright State University’s Center for Interventions, Treatment, and Addictions Research as data analysis and evaluation partners. Priority considerations addressed in this application include high rates of overdose deaths and a lack of accessibility to treatment providers and facilities. The project will also benefit individuals residing in high-poverty areas.

Montgomery County

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.

Montgomery, County of

Ohio

Ohio Office of Criminal Justice Services

The Ohio Office of Criminal Justice Services (OCJS) applied under Category 2 on behalf of the State of Ohio for grant funding in the amount of $6,000,000 for the First Responder Diversion Programs in Ohio project. Through this grant, first responder diversion (FRD) programs will be created and/or expanded in rural and urban areas across Ohio. The project serves Cuyahoga, Fairfield, Franklin, Hamilton, Lawrence, Lorain, and Mansfield counties. Federally designated Qualified Opportunity Zones and high-poverty areas were a consideration in identifying several of the pilot sites. The project partners include OCJS, Cordata, Talbert House, the University of Cincinnati, and drug task forces in participating FRD sites.

Ross County Health District

Ross County Health District applied for Category 1c rural/tribal area grant funding in the amount of $600,000. The Ross County Peer Recovery Service Center will expand access to treatment and recovery support services for individuals at high risk of overdose involving opioids, stimulants, and other substances through a new program of countywide coordination of recovery support services. System coordination will occur early in the individual’s involvement with the criminal justice system, identifying key recovery sites for navigation and service connection. The project will employ a dedicated peer recovery services coordinator who works out of the Ross County Community Action Commission (RCCAC) through a newly developed service line: a countywide Peer Recovery Service Center (PRS Center). In addition, dedicated recovery housing capacity will be a part of the recovery support system, as will an enhanced network of peer recovery supporters. The Ross County Peer Recovery Service Center will enhance the applicant’s current integrated service delivery system that promotes public health, sustained recovery, and safety for the community. This project serves Ross County, with a population of 76,666. The project includes partnerships between the Ross County Health District, RCCAC, Ross County Sheriff’s Office and Ross County Jail, Ross County Probation, Post Overdose Response Team, Ross County Common Pleas Court, Ohio University-Chillicothe, the Peer Recovery and Outreach Center.

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 Catalyst 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 SUD/COD treatment services. Two-hundred cases will be provided with Peer Recovery Support. Copies of data analysis and developmental reports will be supplied to the Bureau of Justice Assistance.

Oklahoma County Criminal Justice Advisory Council

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).

Tulsa County District Attorney

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%).

Tulsa County District Attorney

Oklahoma

Clackamas County, Health Housing and Human Services

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

Crook County

The Crook County Health Department’s Comprehensive Opioid, Stimulant, and Substance Abuse Prevention Program will identify and implement an evidence-based law enforcement and first responder diversion program; build capacity with the school district and law enforcement for education and prevention programs for K-12; enhance real-time data collection, analysis, and dissemination; increase access and accessibility to harm reduction strategies such as naloxone distribution and medication take-back programs; and assess needs and capacity for supporting medication-assisted treatment within the local jail, in addition to local recovery and support services. This project serves Crook County, a rural community in Oregon with a population of 25,562. The project includes partnerships between the Crook County Health Department, the Crook County Sheriff’s Office, the Prineville Police Department, BestCare Treatment Services, Rimrock Trails Treatment Services, the Crook County School District, Central Oregon Health Counsel, the Pain Standards Taskforce, St. Charles Health Systems, and Crook County Fire and Rescue. Those who will benefit from CCHD’s COSSAP project include individuals with opioid use and other substance use disorders, community partner organizations, and the community as prevention curriculum is implemented into Crook County School District K-12 and outreach and educational materials are provided to the entire population.

Lincoln County

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.

Allegheny County

Allegheny County applied for grant funding under Category 1a in the amount of $1,199,505 to build needed pre-arrest diversion pathways to harm-reduction services for individuals with SUD/COD, by implementing the Law Enforcement Assisted Diversion program within a number of municipalities in Allegheny County. This project supports diversion from the criminal justice system at a crucial point: pre-arrest, so that police officers can divert individuals to long-term case management. Additionally, police departments who are participating in LEAD can proactively refer individuals they regularly come into contact with to a case manager, instead of waiting for an arrest. Case managers can support individuals for as long as they need, helping the individual access services and resources they're interested in.

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.

Lackawanna County Government

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.

Pennsylvania Commission on Crime and Delinquency

The Pennsylvania Commission on Crime and Delinquency will sponsor the Forensic Drug Chemistry Surveillance Project to support counties in establishing new quantitative, real-time forensic drug chemistry analysis workflow protocols. These new protocols will identify responsive strategies that enhance investigations by connecting cases and promoting rapid dissemination of critical information. Accurate, complete, and timely forensic drug chemistry data within a region can help law enforcement plan strategic and immediate responses based on local needs, and larger public safety investigative agencies will be able to use the drug intelligence to monitor trends and intercept drug trafficking routes. Improved drug testing will also enhance public information sharing about the dangers of drugs in the community. The University of Pittsburgh School of Pharmacy Program Evaluation and Research Unit will serve as a research partner.

Pennsylvania State Police

The Pennsylvania State Police will use funds to implement Project TRIAD, which will synchronize innovative, technology-driven enforcement strategies, leveraging information received through community input. Project TRIAD is named for its three component parts: Component 1–Targeted Enforcement; Component 2–Problem Oriented Policing through Community Partnerships; and Component 3–Public Outreach. In addition, a research component will be funded to assess impact.

City of Charleston

The City of Charleston is applying for Category 1 funding in the amount of $900,000. The Charleston County Addiction Crisis Task Force Police Assisted Peer Recovery Program, a law enforcement diversion program that will fund three positions: one project coordinator to provide data collection and analysis services to all law enforcement agencies in Charleston County and two peer support specialists to support law enforcement officers while conducting outreach. The project will also expand Charleston’s existing partnership with the Police Assisted Addiction and Recovery Initiative (PAARI) to include officer training, oversight of peer support specialists, and the design of multimedia products to inform officers and the community of this outreach initiative. The project will fund Critical Incident Management Software (CIMS) to facilitate communication between police-based outreach programs and treatment facilities to track follow-up success, with support from Kelley Research Associates (KRA) and ODMAP to facilitate real-time overdose follow-up communication across the county. The peer support specialists will deploy with trained QRT officers for the purpose of engaging individuals who recently suffered an overdose or presented signs of a substance use disorder during an interaction with law enforcement. They will be responsible for developing recovery plans to support overdose survivors as they transition to treatment. Harm reduction kits that include fentanyl test strips, clean injection equipment, naloxone, gloves, and information on local resources so that overdose deaths and other negative health outcomes associated with drug use can be reduced will be made available to survivors and at other locations. The goal of the project is to achieve a 15 percent reduction in the number of days from overdose to outreach. The project serves the City of Charleston, which is the nexus of the Charleston-North Charleston-Summerville Metropolitan Statistical Area and has a population estimated at 713,000, with an estimated 411,000 in Charleston County. The project includes partnerships with the Charleston Police Department, the Charleston County Sheriff’s Office, the North Charleston Police Department, and the Mt. Pleasant Police Department, all of which have officers serving on the Charleston County Addiction Crisis Task Force (ACT Force). The project will engage Kelley Research Associates to implement the CIMS and to evaluate the program. 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 benefit individuals residing in high-poverty areas.

City of Charleston

South Carolina

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.

Greenville County

South Carolina

Lancaster County

The entire county of Lancaster is 98,012 residents. The proposed project will provide resources for training of every law enforcement officer in the county on LEAD (Law Enforcement Assisted Diversion); promote visible prescription drug takeback strategies; and assist with training, handling, and distribution of naloxone. Priority considerations include the presence of a Qualified Opportunity Zone, poverty, and rural challenges. This application is for Category 1c grant funding.

City of Gallatin

The Gallatin Police Department (Sumner County, Tennessee, population 191,283) — in partnership with the Sumner County Sheriff’s Office, local treatment provider Volunteer Behavioral Health, local courts, and scientific consultants — requests $892,085 from the Bureau of Justice Assistance FY 2020 Comprehensive Opioid, Stimulant, and Substance Abuse Site-based Program (Category 1b: Competition ID BJA-2020-17024) to implement a law enforcement-led substance abuse response to address the county’s increasing substance abuse problem. The proposed community-based strategy to address substance abuse and overdose risk will be implemented through enhancing connections to treatment; delivering evidence-based recovery services including needs assessment, individualized treatment plans, case management, medicated assisted treatment (MAT); providing a police-led awareness and prevention program to the county’s K-12 population, as well as a provision of Narcan to officer first responders. OJP priorities addressed include serving a designated Qualified Opportunity Zone, high-poverty areas, evidence-based services delivery, and program evaluation.

Metropolitan Government of Nashville and Davidson County

The Metro Public Health Department proposes to implement the Opioid Overdose Reduction Program which will implement a robust overdose monitoring and data reporting system, to drive the strategic planning of the Overdose Reduction Workgroup, a multi-disciplinary team of over 26 agencies and organizations. The program will conduct an analysis of the severity of the opioid crisis in Nashville and provide much needed data to community stakeholders. Additionally, they will implement an Overdose Fatality Review Team to further investigate overdose causes, trends and opportunities for earlier intervention. Grant funding is requested for: a full-time comprehensive opioid abust program coordinator and full-time epidemiologist, .35 FTE opioid response coordinator will carry out project requirements.

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.

Rutherford County

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.

City of Houston Health Department

Texas

Arlington County Government

Arlington County Department of Human Services’ Behavioral Health Division (BHD) applied for grant funding under Category 1B in the amount of $899,815 over three years. This project will serve Arlington County (population 235,000) and is particularly focused on response in high-poverty regions of the county where opioid use and opioid overdoses remain prevalent. The project also works across traditional jurisdictional boundaries to provide wraparound services for individuals identified as high risk or otherwise involved in the Arlington criminal justice system. The purpose of this project is to improve access to and treatment in the detoxification program; provide early intervention to people arrested on substance use-related charges and identify alternatives to incarceration; improve recovery options by adding a reentry program to an established residential program; maintain collaboration between the police and BHD to address opioid overdoses and activity hotspots; assess and provide interventions for children and families impacted by substance use; and evaluate the use of evidence-based treatment and outcomes. The proposed addition of 1.0 FTE therapist and 1.0 FTE case manager will allow BHD to enhance services along the Sequential Intercept Model. The therapist will be focused on establishment, implementation, and evaluation of evidence-based programming in a variety of treatment settings and will be the clinical lead for the creation of diversion service plans and “Plans of Safe Care” for substance-exposed infants. The case manager will serve as the lead clinical staff for co-response with police and fire services to the community, and will provide community outreach, education, and naloxone distribution. Both positions will expand the reach of MAT programming in the county and will address gaps identified through comprehensive community assessment. A key feature of the proposal is a collaboration with an academic partner, Dr. Taxman from George Mason University, to evaluate performance, including outcomes and outputs, along with the development of fidelity assessments to measure evidence-based practice adoption. The project expands upon existing partnership with the police and fire departments, Child Protective Services, the offices of the sheriff, the public defender, and the Commonwealth’s attorney.

Arlington County Government

Virginia

Chesterfield County

Chesterfield County Sheriff’s Office is applying for grant funding in the amount of $1,192,430. This project serves the metro Richmond area with a population of over 500,000 and is submitted under Subcategory 1a. The purpose of the project is to provide specialized pretrial supervision to individuals at high risk for overdose and expand reentry planning and medication-assisted treatment to inmates. The project includes partnerships between the Chesterfield County Sheriff’s Office, Chesterfield Community Corrections Services, Chesterfield Mental Health Supportive Services, other local agencies and a local evaluator. Priority considerations addressed in this application include providing services to Qualified Opportunity Zones, addressing persistent poverty, and serving a region that has been disproportionately impacted by substance abuse.

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 on 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.

Page County Government

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.

City of Kirkland

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.

City of Olympia

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.

City of Seattle

Washington

King County

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

King County

Washington

Makah Indian Tribe of the Makah Indian Reservation

In the Comprehensive Opioid Abuse Site-Based Program application, the Makah Tribe is proposing to utilize funding under Category 1: Local or Tribal Applicants, Subcategory 1c. The applicant intends to utilize funds from this application to continue funding the two FTE positions from the previous application: the COSSAP case manager and one coordinator, who will implement the LEAD program, develop MAT protocols, and help further expand the Sisuk Houses. There are no priority considerations for this application.

City of Menomonie

The City of Menomonie Police Department (MPD) is applying for Category 1 funding in the amount of $584,202. Project Hope will benefit juveniles and adults in the City of Menomonie and Dunn County by employing strategies that provide alternatives to arrest and access to treatment opportunities. Project initiatives include the evidence-based Botvin LifeSkills program for juveniles, formation of a Quick Response Team (QRT) based on the Police Assisted Addiction and Recovery Initiatives (PAARI) model, implementation of a juvenile offender diversion program, an amnesty program focused on providing treatment opportunities, creation of a sworn behavioral health officer position, utilization of software analytics to identify potential clients in need of treatment, and mentoring services for juveniles. MPD will partner with the Dunn County Department of Public Health to promote a local needle exchange program and to share information on how to acquire naloxone to raise awareness of resources available for individuals suffering from an opioid or methamphetamine addiction. Project Hope will also work with children suffering from adverse childhood experiences; once children are identified as being impacted by substance use, they will be offered services such as therapy and counseling. The project serves Dunn County, with a population of 45,368, and specifically the City of Menomonie, with a population of 16,404. The project includes partnerships with the Menomonie Fire Department, the Dunn County Department of Human Services, and the Dunn County Criminal Justice Collaborating Council. Priority considerations addressed in this application include building trust between law enforcement and the community; a high rate of primary treatment admissions for heroin, opioids, and stimulants; and high rates of overdose deaths.

City of Milwaukee

The Milwaukee Fire Department (MFD) is applying for Category 1 funding in the amount of $1,200,000. The project will expand the Milwaukee Overdose Response Initiative (MORI), the city’s only first responder program, connecting individuals who have experienced a non-fatal overdose with community resources. MORI will provide immediate follow-up to all individuals in Milwaukee who have overdosed with emergency medical services (EMS) contact with a team of MFD community paramedics and peer support specialists. The team will link overdose survivors with education, resources, and treatment services and will ensure victims and families are supported with the goal of connecting all patients to opportunities for long-term recovery. MORI continuously collects and analyzes available EMS and dispatch data on all fatal and non-fatal overdoses in the city, using the data to deploy strategic outreach by the MORI team. The project aims to increase access to evidence-based medication-assisted treatment and recovery services for an estimated 1,650 people per year. It will also increase access to harm reduction materials, including naloxone, as well as other supportive resources for patients and family/friends. The project serves the City of Milwaukee, with an estimated population of 590,157. The project includes partnerships with WisHope, Community Medical Services, and CleanSlate, all of which provide peer support specialists, and with Milwaukee drug courts. The project will engage the Medical College of Wisconsin 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.

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.

City of West Allis

Wisconsin

Menominee Indian Tribe of Wisconsin

The Menominee Indian Tribe of Wisconsin will develop a Police Assisted Addiction and Recovery Initiative (PAARI) model of law enforcement diversion to reduce opioid abuse and the number of overdose fatalities. Grant funds will be used to support a program coordinator, who will assist in implementing the program; a clinical therapist; and three peer support specialists. The applicant agreed to make data available through the Overdose Detection Mapping Application Program (ODMAP).

Milwaukee County

Milwaukee County, with an estimated population of 945,726, through the Milwaukee County Medical Examiner’s Office and in collaboration with the Milwaukee Community Justice Council, the Medical College of Wisconsin, and a variety of public health and public safety partners, sought $1,200,000 in Subcategory 1a grant funding to create a Milwaukee Overdose Public Health and Safety Team (OD-PHAST). This project would expand and further coordinate current efforts to address overdoses, as well as overall substance misuse issues across the county. The OD-PHAST project aims to: (1) expand the delivery and analysis of near real-time data between multiple public health and public safety partners; (2) utilize both aggregate data and insights from case reviews to develop strategies and recommendations for changes to reduce the likelihood of future overdose incidents; (3) increase capacity to deliver timely toxicology findings to public health and safety partners; (4) enrich understanding of fatal overdose risk factors through expanded next-of-kin interviews; and (5) connect families impacted by overdose, particularly children, to services to mitigate the impact of the trauma experienced. Priority considerations addressed in this application include high-poverty areas and Qualified Opportunity Zones.

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.

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.

Winnebago County

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

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.

Laramie County

Wyoming

Grantee Projects

City of Palmer

City of Palmer

Cook Inlet Tribal Council, Inc

Cook Inlet Tribal Council, Inc

Alabama Department of Mental Health

Alabama Department of Mental Health

Jefferson County Commission

Jefferson County Commission

Arkansas Department of Finance and Administration

Arkansas Department of Finance and Administration

Arkansas Department of Finance and Administration

Arkansas Department of Finance and Administration

Izard County

Izard County

Arizona Criminal Justice Commission

Arizona Criminal Justice Commission

Hoopa Valley Tribal Council

Hoopa Valley Tribal Council

Mendocino County

Mendocino County

City of Alamosa

City of Alamosa

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

District of Columbia Office of the Chief Medical Examiner

District of Columbia Office of the Chief Medical Examiner

Executive Office of the Governor of Delaware

Executive Office of the Governor of Delaware

Executive Office of the Governor Of Delaware

Executive Office of the Governor Of Delaware

New Castle County

New Castle County

City of Port St. Lucie

City of Port St. Lucie

Palm Beach County Board of County Commissioners

Palm Beach County Board of County Commissioners

Pinellas County dba Board of County Commissioners

Pinellas County dba Board of County Commissioners

Fulton County

Fulton County

Georgia Criminal Justice Coordinating Council

Georgia Criminal Justice Coordinating Council

City of Clinton

City of Clinton

Boone County

Boone County

Boone County

Boone County

Cook County Health

Cook County Health

Indiana Family and Social Services Administration

Indiana Family and Social Services Administration

The Health & Hospital Corporation of Marion County

The Health & Hospital Corporation of Marion County

County of Reno

County of Reno

Purchase District Health Department

Purchase District Health Department

Whitley County

Whitley County

Lafourche Parish Sheriff's Office

Lafourche Parish Sheriff's Office

Orleans Parish District Attorney

Orleans Parish District Attorney

St. Tammany Parish Government

St. Tammany Parish Government

Berkshire Regional Planning Commission

Berkshire Regional Planning Commission

City of Holyoke Police Department

City of Holyoke Police Department

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