Comprehensive Opioid, Stimulant, and Substance Use Program

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City of Palmer

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

Alaska

22nd Judicial Circuit District Attorney's Office

Alabama had the highest prescription opioid rate in the nation at 80.4 prescriptions per 100 people. Covington County is currently ranked 16th in the state of Alabama for opioid prescriptions, with an estimated 85.3 prescriptions per 100 people, translating to a rate almost two times higher than the national average of 43.3 prescriptions per 100 people. There have been no less than 20 overdoses that resulted in death in 2021 and administered at least 80 doses of naloxone. For this project, the 22nd Judicial Circuit District Attorney’s Office in Alabama will expand its diversion program through law enforcement and first responder deflection program, offering treatment and assistance to those that needed it prior to arrest. Their goal will be to reach previously underserved populations without the burden of the arrest. Prevention will be directed at high school students through part-time work-study peer helpers. These students will be hired to maintain communication with students to continue to warn them about the dangers of opioid and drug use. The response will include overdose response kits that will be distributed to all police and fire departments in the county. Advertising campaigns will encourage those present during an overdose to call 911 without fear of arrest, provided they aren’t directly responsible for the overdose. Since options of treatment locally are scarce, a Substance Abuse Counselor will be hired as part of the project to improve local outcomes in treatment through those diverted through the implementation of the new programs and provide family counseling to children and youth impacted by their parent’s substance abuse. A new Community Resource Specialist will assist individuals with finding and securing employment, navigating outside treatment options, securing sober housing, and helping them to overcome any other barriers that may prevent them from long-term recovery. They will also assist the District Attorney in holding a symposium on the warning signs and dangers of opioid addiction, treatment options, and what to do in case of an overdose.

Alabama

City of Searcy

The City of Searcy is applying for a Category 1 award in the amount of $600,000. The Searcy Police Department Comprehensive Opioid, Stimulant, and Substance Abuse (COSSA) project will promote a higher level of cooperation and collaboration among the local agencies; improve the effectiveness of law enforcement to combat illicit opioid use, possession, and distribution and to improve interdiction efforts through training that focuses on up-to-date and relevant information about opioid misuse protocols, the importance of sharing information statewide, and collaboration between Drug Task Force members and law enforcement in general; and support and offer assistance to those affected by opioid use and opioid overdose. This collaborative effort will produce more effective investigations, prosecutions, treatment, and recovery involving opioids. This project serves Searcy, the largest city and county seat of White County, Arkansas, which has a population of 23,660. The project includes partnerships between the Searcy Police Department, the White County Sheriff’s Office, the Prairie County Sheriff’s Office, the Lonoke County Sheriff’s Office, the Central Arkansas Drug Task Force, and health and rehabilitation community partners.

Johnson County

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

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.

Yurok Tribe

The overall goal of the Yurok Wellness and Safety Net Tenders project is to reduce opioid-related overdose (OD) risks and avoidable deaths, disease, and other negative effects on health and social wellbeing among Yurok tribal community members. With strategic assistance from our project partners and guided by the Yurok Tribal Wellness Coalition, serving as our project multidisciplinary coordinating board, the project will implement lifesaving activities in our California geographic catchment area of the Yurok Indian Reservation and Humboldt and Del Norte (HM-DN) counties. Together these counties span over 5,282 square miles in this mountainous region of Northern California. Its thick cover of trees, seemingly endless rural terrain, and washed-out single-lane dirt roads, often inaccessible in the winter, provide cover for covert activities including underground cannabis cultivation and human, sex, and drug trafficking (including opioids, methamphetamine, and cannabis). Project activities include: creating and implementing culturally specific OD reversal and response training first responders and members of other key community sectors including family members from HM and DN counties; dispensing thousands of naloxone, other approved opioid OD devices, and fentanyl test strip kits; improving local data collection; standardization, reporting, and leveraging a harm reduction partner's low threshold buprenorphine access, and developing a screening and diversion program with DN County Justice Partners. The project will be housed under the Yurok Tribal Court to enhance tribal wellness services and referrals to outside community assistance such as shelter, housing, and domestic violence and behavioral health services.

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.

Seminole County

Seminole County has drafted an evidence-based four-part plan to combat opioid use, abuse, overdose, and arrest which conforms to the following activities: (1) naloxone for law enforcement and first responders (18 percent of budget); (2) court programming to prioritize and expedite treatment and recovery services for individuals at high risk for overdose, as well as services for children and youth impacted by their parents’ or other family members’ substance abuse (25 percent of budget); (3) embedding social workers, peers, and/or persons with lived-in experience at any intercept of the Sequential Intercept Model. This program component will hire a social worker to conduct screenings and plan and implement an Education and Community Outreach program, with special attention to targeted, high-need communities (31 percent of budget); (4) 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 (16 percent of budget). The program service area is Seminole County, Florida and the program's expected outcome is to achieve a tangible drop in opioid overdose, use, and arrest, expand the workforce serving citizens with addiction, expand recovery support services, and remove barriers to access to support in historically underserved populations. The county works in accordance with the SAMSHA Sequential Intercept Model (SIM), Ohio Risk Assessment System (ORAS), Alcohol Use Disorders Identification Test (AUDIT), and Drug Abuse Screening Test (DAST) to consistently assess and facilitate communication and coordinate services across criminal justice, medical and service provider agencies. To implement successful programs, the county will partner with the 18th Judicial Circuit Court Administration, The Seminole County Sheriff’s Office, the Florida Department of Health, Brooke Research & Consulting, LLC, and the Public Safety Coordinating Council.

Lake County

The Lake County, Illinois, Health Department and Community Health Center project serves Lake County, Illinois, with a population of 711,239. The purpose of this project is to provide wraparound evidenced-based treatment for consumers of the A Way Out 3.0 program including medication-assisted treatment (MAT), recovery support services, peer support, case management, and transitional and recovery housing. A Way Out 3.0 will serve as an evidence-based treatment initiative for individuals at high risk of overdose and substance abuse and as a pre-booking and post-booking alternative to incarceration. The project will focus on increasing access to treatment, increasing treatment success rates, reducing overdoses, and providing community outreach. This project will aim to have 90 percent of consumers with opioid use scheduled to receive services or treatment within 24 hours of initial contact; 70 percent of consumers will successfully complete their first treatment episode; and 90 percent of consumers will receive information regarding MAT and/or naloxone. Additionally, peer support groups will be offered bi-weekly for consumers, and one community outreach session will be conducted by the A Way Out team per month. Priority considerations addressed in this application include a high rate of primary treatment episodes for heroin and other opioids, high rates of overdose deaths, and a lack of accessibility to treatment providers and facilities. An individual from Rosalind Franklin University of Medicine and Sciences will serve as the evaluator for the project.

Kansas Department of Health and Environment

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

Kansas

Purchase District Health Department

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

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.

Berkshire Regional Planning Commission

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

Massachusetts

City of Fitchburg

The Fitchburg Police Department is applying for Category 1 funding in the amount of $504,063. The Fitchburg Outreach Initiative, a multidisciplinary program established in partnership with Community Health Link of Worcester, will incorporate referrals, prevention, response, case management, and education. This program is based on successful law enforcement diversion programs such as LEAD and PAARI. The Fitchburg Outreach Initiative will hire a full-time substance misuse clinician to be embedded within the police department to respond to opioid overdoses, substance use disorders, and co-occurring disorders in the City of Fitchburg. The clinician will provide follow-up and post encounter outreach to overdose survivors and their families. Additionally, the program will divert low-level offenders experiencing substance use disorders away from the criminal justice system and into treatment when it is safe and appropriate to do so. The Fitchburg Outreach Initiative will also launch an educational campaign highlighting prevention and resources available to families and survivors. The project serves the City of Fitchburg, which has a population of 40,882 residents. The project includes a partnership with Community Health Connections, a multi-faceted social and behavioral service agency that provides detox services, inpatient clinics, outpatient clinics, 24/7 urgent care for substance use disorders, a homeless shelter, mental health services, recovery services for youth, and family support services. Additional partnerships have since been created with GAAMHA which is an organization that provides a wide range of services including recovery support. 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 Newburyport

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

Commonwealth of Massachusetts, Sheriff's Department Hampden

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

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

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

Northampton, City of

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

Massachusetts

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).

Macomb County

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

Oakland County

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

Hennepin County

The Hennepin County Sheriff’s Office (HCSO) is applying for Category 1 funding in the amount of $1,067,674. The Peer Support and Community Outreach Program will enable HCSO to expand peer recovery support services to individuals in custody, as well as recovery support services including transitional or recovery housing. It will also expand community access to drug-take services. The HCSO, in partnership with Bold North Recovery and Consulting, will conduct community outreach and education efforts among residents at community events, which will feature distribution of medication disposal bags, education about the dangers of opioids, signs of addiction, treatment options, and the proper administration of naloxone. The HCSO will partner with Heritage Health Solutions to pilot Heritage CARES, a virtual peer recovery support services program, for which Heritage Health Solutions will provide training to key detention staff members. The project will conduct 24 community education sessions annually and distribute 1,200 drug disposal pouches and 2,499 naloxone kits. It will also provide virtual peer recovery support services for up to 435 residents. The project serves Hennepin County, which has a population of 1.3 million residents spanning 600 square miles. The project includes partnerships with Bold North Recovery and Consulting and Heritage Health Solutions. A priority consideration addressed in this application is building trust between law enforcement and the community.

Mississippi State Department of Health

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

Mississippi

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 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.

North Carolina

County of Lenoir

Lenoir County's project is a regional project serving two rural counties in eastern North Carolina-Lenoir and Greene Counties-with a combined population of greater than 50,000. The grant will expand evidence-based substance use treatment, recovery housing, and case management services for justice-involved individuals at multiple intercepts. Specifically, under this project, Lenoir and Greene County will: Provide recovery housing and case management services to up to 157 individuals over the life of the grant; Provide transportation support to up to 300 individuals over the life of the grant; Provide monthly structured, supervised visitation for children impacted by parental substance use in the family court system; Support identifiable and accessible prescription drug take-back programs for unused, controlled substances in the home; Provide evidence-based substance use disorder treatment related to opioids, stimulants, and other drugs, as well as harm reduction activities and recovery support services; Partner with a researcher to continue to provide research-based strategies to identify treatment/resource needs, address system gaps, and evaluate program effectiveness through objective measures.

Lenoir County

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

Lincoln County

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

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.

Bernalillo County

Bernalillo County in New Mexico will use grant funds to expand access to treatment and recovery support services across behavioral health, primary care, criminal justice, and emergency management services. Grant funds will be used to hire a full-time coordinator and two case managers. The county and partners will engage in comprehensive planning; create a mobile harm reduction center staffed by a nurse and the two case managers; increase medication-assisted treatment (MAT) for off reservation urban Indians; provide transitional housing for underserved youth and their families; and provide MAT to incarcerated youth. The University of New Mexico Institute for Social Research will serve as the research partner for the proposed project.

Pueblo of Pojoaque

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

New Mexico

Rio Arriba County

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

New Mexico

Chautauqua County

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

New York

Seneca Nation of Indians

The goal of the Seneca Nation project is to combat the substance abuse epidemic plaguing the Seneca Nation’s communities through collaboration between numerous entities within the Seneca Nation, community groups, and local organizations. The following objectives have been identified to assist in reaching this goal: (1) establishment of a multi-disciplinary team board comprised of Seneca Nation entities and community organizations to address gaps in data collection within communities and Indian Country, create a strategic plan for the development of an inpatient treatment facility, and identify potential solutions to solving the substance abuse epidemic plaguing our Territories; (2) collaborate with the legal entities to assist individuals in obtaining needed resources for treatment, in addition to addressing any barriers that may exist for the people struggling with addiction; (3) provide trainings centered on Seneca culture and evidence-based practices for Behavioral Health and Seneca Strong; and (4) provide peer support, groups, individuals and community education surrounding the opiate epidemic through collaboration with internal and external entities.

St. Lawrence County

St. Lawrence County, New York, will expand medication-assisted treatment (MAT), peer support, and harm reduction activities for underserved and high risk populations, including incarcerated individuals and victims of recent overdose. This project will serve the 108,505 residents of St. Lawrence County, located in northern New York State, immediately south of the U.S. border with Canada. The project’s service area may extend beyond County borders, to neighboring Franklin, Jefferson, and Lewis Counties. St. Lawrence County is large, rural, and subject to harsh winter weather. Typical barriers to treatment are made worse by transportation challenges including limited bus routes, shortage of drivers for public transit and volunteer transportation, rising fuel prices, and an unreliable medical transportation program. The Washington/Baltimore HIDTA Overdose Detection Mapping Application Program (ODMAP), an overdose mapping tool used by the County, indicates a 265 percent increase in the number of overdoses reported from 2019 to 2021. In addition, data from the St. Lawrence County Drug Task Force indicates significant increases in drug-related felonies (64 percent) and misdemeanors (90 percent) from 2018 to 2021. The County’s Opioid Treatment Program (OTP) will expand to provide MAT services at the County Correctional Facility; continue to support the Peer Support Services established through FY2020 COSSAP (which has helped reduce “no-shows” from 50 percent to 15 percent); provide client, staff, and community education on overdose prevention and access to harm reduction resources through a new Harm Reduction/Transportation Specialist; establish new harm reduction services including needle exchange and syringe disposal; and coordinate community awareness and stigma reduction media campaigns and community events. Direct oversight of the project will be provided by the St. Lawrence County Opioid Rural Response (SLCORR) Committee, whose purpose is to reduce the morbidity and mortality of substance use disorder (SUD), including opioid use disorder (OUD). SLCORR is led by the St. Lawrence County Community Services Board (SLCCSB) and includes the following stakeholders: St. Lawrence County Community Services, St. Lawrence County Overdose Prevention Program, Seaway Valley Prevention Council, Maximizing Independent Living Center (MILC), and New Hope Transformation Ministries (dba Grace House), a transitional living residence.

New York

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.

Ulster County

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

City of Columbus

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

Ohio

County of Marion

The Marion County Prosecutors Office in Marion County, Ohio, project will enhance the Prosecutor Intervention Program for people suffering from substance use disorders (SUD)/opioid use disorders (OUD). The target population for the program are individuals with SUD/OUD who encounter the criminal justice system and are charged by law enforcement with a low-level offense. It is well known that incarceration is not a suitable solution for people suffering with SUD/OUD, so the overarching goal of this program is to divert individuals from incarceration and instead place them in appropriate treatment, ensuring compliance with the treatment program, and help them achieve long-term recovery. The service area is all of Marion County, OH. Marion County is in North Central Ohio and encompasses 404 square miles. As of the 2020 census, the population of the county is 65,359 (census.gov, 2020) and has been identified as a rural area by the Federal Office of Rural Health Policy. In 2020, the Age-Adjusted rate of Unintentional Drug Overdose Deaths in Marion County was 60.6, 15 points higher than the Ohio average of 45.6 (Ohio Department of Health 2020 Drug Overdose Data). The Marion County Prosecutor Intervention Program (PIP) allows the Prosecuting Attorney to divert individuals struggling with SUD/OUD from the criminal justice system to appropriate treatment services. An assigned project coordinator works with each client to ensure: 1) Connections to appropriate treatment and community resources; 2) Stable housing; 3) and follow up engagement. Marion County has a unique level of collaboration within the county. Local law enforcement, EMS and fire, regional hospitals, Marion County Courts, and local treatment agencies recognize the need for additional services for the population struggling with SUD/OUD. The creation of the PIP program has strengthened the relationships and collaboration efforts of county agencies, creating a solid foundation to enhance their capability of responding and providing emergency treatment for those struggling with SUD/OUD as well as working to reduce overall recidivism rates and overpopulation of the jail system.

Ohio

Cuyahoga, County of

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

Ohio

Erie County

The Erie County, Ohio, Health Department (ECHD) project will expand prevention and harm reduction services to combat the opioid epidemic in Erie County. The Erie County Pathways project will focus on providing enhanced care to law enforcement/first responders dealing with behavioral or mental health issues, and youths through school programming. ECHD has identified five primary objectives for this project: (1) developing a pathway and increase services for first responders who are able to access behavioral and mental health care and services in a secure manner; (2) enhancement of Erie County drug take back programs by securely collecting opioids and other illicit substances for disposal during twice-yearly destruction events and distribution of Deterra; (3) partnering with Erie County school districts to expand prevention programs for adolescents; (4) Post overdose response: funding the Erie County Sheriff’s office 9-11 Dispatch for the Drug Overdose Response Team to conduct visits with non-fatal overdose survivors ; (5) Increase referrals/prevention education for mental health and substance use treatment and recovery services. The project includes the following activities: (1) drug take back programs and prevention education outreach for adolescents as well as distribution of Deterra bags for the community (10 percent); (2) law enforcement/first responder mental health and substance use program (25 percent); (3) Implement Botvin Life Skills. Collect pre-post survey data from schools that implement Botvin educational programming/create evaluation (10 percent); (4) Increase referral for mental health and substance use treatment/recovery services through prevention education as well as referral systems for schools, responders and the SUD community (15 percent); (5) education/prevention programming connecting law enforcement and schools (20 percent); (6) evidence-based substance use disorder (SUD) and opioid use disorder (OUD) prevention, and referral support services (10 percent); and (7) Participate and provide prevention education during community events and school events (10 percent). The target service area for this project is Erie County, Ohio, with a population of about 74,000 individuals. The three-year project will develop, implement, and coordinate alcohol and other drug prevention/treatment/recovery care to strengthen and expand access to treatment and recovery for those struggling with addiction. Target populations are adults and adolescents. ECHD operates the Erie County Community Health Center through which integrated health care plans will be developed for individuals struggling with SUD/OUD as well as family members/caregivers.

Ohio

Ohio Office of Criminal Justice Services

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

Ohio

City of Jay

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

Oklahoma

Ponca Tribe of Oklahoma

The Ponca Tribe of Indians of Oklahoma, headquartered in White Eagle, Oklahoma, with tribal jurisdiction extending to parts of Kay and Noble Counties, has a membership of 3,522. The tribe operates a small, ambulatory health clinic, White Eagle Health Center with a user population approaching 5,000 consisting of infants, children, adolescents, adults, and elders. The White Eagle Health Center service area encompasses four additional counties which are resident to four other rural tribes each with limited access to mental health and substance use disorder treatment services. The purpose of the project is to provide evidence-based treatment (30% of budget), recovery support services (40% of budget), tribal and county court-based intervention programming (20% of budget), naloxone distribution for law enforcement and first responders (5% of budget), and identifiable and accessible take back programming for unused controlled substances (5% of budget). The goals of the program are to: 1) Increase the accessibility of EBPs for American Indian/Alaskan Native (AI/AN) clients diagnosed with a substance use disorder 2) Reduce recovery support barriers for clients diagnosed with a substance use disorder; 3) Equip tribal law enforcement, other first responders and community members with the necessary education and equipment for administering Naloxone for the purpose of reversing opioid overdose; and 4) Establish reoccurring opportunities to facilitate the proper disposal of controlled substances by AI/AN community members. The project includes partnerships between the White Eagle Health Center, White Eagle Health Center-Behavioral Health Department, Ponca Tribal Court, Ponca Tribal Transit, Ponca Tribe Domestic Violence Services, and Ponca Indian Child Welfare. Data collection protocols will be developed to effectively measure the success of the program's objectives. This information will assist the COSSUP Project in reporting required performance measures to the Bureau of Justice Assistance. An annual report will be created to disseminate to stakeholders, community members, and other interested parties to increase investment in this program and provide a model for treating those impacted by illicit opioids, stimulants, and other drugs of abuse.

Oklahoma

Municipio de Bayamon

The Municipality of Bayamon in Puerto Rico applied under Category 1B for grant funding in the amount of $890,070 for the purpose of implementing a Bayamon Whole-of-Community Opioid Overdose and Crime Reduction Initiative. This project serves the Bayamon population of approximately 207,960. Its primary deliverables include planning documents for information sharing, naloxone deployment and training, public safety and K-12 schools education and early threat detection, Safe Community response initiatives, and treatment outreach improvements to support high-impact overdose victims such as homeless individuals, veterans, and youths. For priority considerations, the applicant meets the criteria for an above 20 percent high-poverty area, as U.S. Census data indicates Bayamon's poverty rate is 37.4 percent. In addition, Bayamon has documented in Qualified Opportunity Zone reports 60 Census track areas with 58 that are designated as low-income communities.

Chester County

The Chester County Sheriff’s Office is applying for Category 1 funding in the amount of $599,193. The Chester County COSSAP Program will implement a Law Enforcement Assisted Diversion (LEAD) program for the county, for which each of the county’s 35 law enforcement officers will receive training from the LEAD National Support Bureau and for which a case manager will be hired by a treatment service provider. It will also expand evidence-based treatment services into two venues, for which a treatment specialist will be housed in the county detention facility to provide counseling along with medication-assisted treatment (MAT); provide training for all law enforcement officers on the administration of Narcan, an inventory of which will be secured for use by officers in the field; and install three new drug disposal boxes in areas in the county with the highest density of populations at greatest risk of prescription painkiller overdose. The goal of the project is to ensure victim protection and public safety while promoting civil rights and social justice. It is anticipated that the project will serve 50 low-level, non-violent offenders. The project serves Chester County, which has an estimated population of 32,184. The project includes partnerships between the sheriff’s office and the county solicitor’s office, the Hazel Pittman Center (a local public substance misuse treatment agency), the Empowering Communities for Health Outcomes (ECHO) Coalition, the Chester County Detention Center, and local emergency medical services and fire departments. The project will engage two researchers with the Pacific Institute for Research & Evaluation and Southeast Center for Strategic Community Development as evaluation partners. 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.

County of Lancaster Administration Building

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

Greenville County

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

South Carolina

Oglala Sioux Tribe of Pine Ridge Indian Reservation

The Oglala Sioux Tribe (OST), Circles of Care Program/Division of Behavioral Health (Circles of Care), will collaborate with OST Justice Programs to plan, implement, and evaluate a tribal-wide strategic plan promoting wellness, addiction recovery, and the reduction of criminal recidivism using the sequential intercept model. During the past seven years the OST has successfully: 1. Integrated medical professionals into the addiction treatment process through medication assisted treatment: 2. Implemented a recovery support/client navigator approach; and 3. Initiated the utilization of best and promising practices for direct service and population level interventions. The cycling and recycling of individuals through the tribal justice system has been identified as a major social problem resulting in significant strain on tribal systems. The OST will utilize funding to continue capacity development within the tribal justice system and behavioral health infrastructure to address several of the well-known barriers to recovery and persistent drivers of criminal recidivism. The Pine Ridge Reservation is the homeland of the Oglala Sioux Tribe and is among the largest land-based reservations in the nation. Pine Ridge consists of over 3.5 thousand square miles with a population of over 30,000. Circles of Care and OST Justice Programs are committed to developing a streamlined process to increase access to behavioral health services at all points of the OST criminal justice system. Circles of Care will coordinate Tribal resources to link more than 300 participants annually with targeted case management, substance use education and treatment, and recovery support services. Through the delivery of well-integrated and high quality services, Circles of Care aims to achieve four measurable objectives: 1. Increase the proportion of individuals entering the OST Justice System that are provided behavioral health screening and assessment by 15% annually; 2. Increase the number of eligible participants that successfully complete their targeted case management goals by 25% annually; 3. Increase participant score within key quality of life metrics by 10% from baseline to service completion annually; and 4. Reduce the proportion of individuals within the OST justice system that reoffend within 2-years post reentry by 5% annually.

South Dakota

Tennessee Department of Mental Health and Substance Abuse Services

Tennessee Department of Mental Health and Substance Abuse Services, Division of Substance Abuse Services (TDMHSAS-DSAS) will work to enhance collaboration with law enforcement and other first responders to mitigate the impact of illicit opioids, stimulants, and other drugs through the Tennessee Resource Engagement Specialty Teams (TN-REST). TDMHSAS-DSAS has identified six service areas with high rates of prescription misuses among youth and high counts/rates of fatal overdose involving illicit drugs: Knox County, Davidson County, Shelby County, Northeast, Upper Cumberland, and Southwest. The TN-REST project aims to complete the following activities: (1) increase the support and resources for law enforcement/other first responders through community partnerships to provide additional training and naloxone to law enforcement/first responders (38.5 percent of total annual budget); (2) leverage community partnerships to increase drug take back events in underserved areas (10 percent); and (3) create peer support positions to serve in a deflection and diversion program (38 percent). TDMHSAS-DSAS estimates that TN-REST will host at least 85 drug take back events, distribute at least 34,200 units of naloxone to law enforcement, and provide peer support services/coordination to at least 5,400 individuals.

Tennessee Department of Mental Health and Substance Abuse Services

The Tennessee Department of Mental Health and Substance Abuse Services is applying for a Category 1 award in the amount of $900,000. The Hamilton County Coalition COSSAP project will continue the work of the Hamilton County Police and Community Overdose Response Team (P-CORT) to support treatment and recovery service initiation for individuals residing in Hamilton County, Tennessee, referred to the program for a recent overdose and substance use disorder, while also expanding the services to include individuals who reside in one of the surrounding counties but who use drugs and frequently overdose in Hamilton County. This project serves Hamilton, Marion, Grundy, Sequatchie, Bledsoe, Rhea, Meigs, McMinn, Bradley and Polk Counties, with a total population of 659,773 people. The project includes partnerships between the Chattanooga Police Department, the Hamilton County Sheriff’s Office, the Hamilton County Drug Court, the Drug Enforcement Administration, the Family Justice Center Council on Alcohol Dependency, the Teen and Adult Challenge, Safe Harbor, the Grundy Recovery Alliance Community Endeavor, Cempa Community Care, the Hamilton County Health Department, Restoration Recovery, Wade In the Water Medical, Oxford House of Tennessee, Greater New Home Baptist Church, Thompkins Baptist Church, and Tennessee Lifeline Peer Recovery Support. This project will engage Dr. Carolyn Audet, Associate Professor in the Department of Health Policy at Vanderbilt University, as the research partner. Priority considerations addressed in this application include the project benefiting individuals residing in high-poverty areas or persistent-poverty counties, as well as the fact that Hamilton County is in a region of Tennessee that has been disproportionately impacted by high rates of opioid deaths and high rates of primary treatment admissions for heroin, opioids, and stimulants.

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.

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.

Quinault Indian Nation

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

City of West Allis

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

Wisconsin

County of Oneida

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

Wisconsin

Winnebago County

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

Wisconsin

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.

Grantee Projects

City of Palmer

City of Palmer

22nd Judicial Circuit District Attorney's Office

22nd Judicial Circuit District Attorney's Office

City of Searcy

City of Searcy

Johnson County

Johnson County

Mendocino County

Mendocino County

Yurok Tribe

Yurok Tribe

City of Port St. Lucie

City of Port St. Lucie

Seminole County

Seminole County

Lake County

Lake County

Kansas Department of Health and Environment

Kansas Department of Health and Environment

Purchase District Health Department

Purchase District Health Department

Lafourche Parish Sheriff's Office

Lafourche Parish Sheriff's Office

Berkshire Regional Planning Commission

Berkshire Regional Planning Commission

City of Fitchburg

City of Fitchburg

City of Newburyport

City of Newburyport

Commonwealth of Massachusetts, Sheriff's Department Hampden

Commonwealth of Massachusetts, Sheriff's Department Hampden

Massachusetts Supreme Judicial Court

Massachusetts Supreme Judicial Court

Massachusetts Supreme Judicial Court

Massachusetts Supreme Judicial Court

Northampton, City of

Northampton, City of

St. Mary's County

St. Mary's County

Macomb County

Macomb County

Oakland County

Oakland County

Hennepin County

Hennepin County

Mississippi State Department of Health

Mississippi State Department of Health

Mississippi State Department of Health

Mississippi State Department of Health

City of Jacksonville

City of Jacksonville

County of Lenoir

County of Lenoir

Lenoir County

Lenoir County

Lincoln County

Lincoln County

Atlantic City (Inc)

Atlantic City (Inc)

Bernalillo County

Bernalillo County

Pueblo of Pojoaque

Pueblo of Pojoaque

Rio Arriba County

Rio Arriba County

Chautauqua County

Chautauqua County

Seneca Nation of Indians

Seneca Nation of Indians

St. Lawrence County

St. Lawrence County

Ulster County

Ulster County

Ulster County

Ulster County

City of Columbus

City of Columbus

County of Marion