Grantee Projects

AK

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

City of Palmer

Alaska

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.

AK

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

Cook Inlet Tribal Council, Inc

Alaska

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

AR

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

Izard County

Arkansas

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

AZ

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

Arizona Criminal Justice Commission

Arizona

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

CA

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.

Mendocino County

California

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.

CA

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.

Yurok Tribe

California

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.

CO

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

Arapahoe County Colorado

Colorado

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

CO

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

Pueblo Department of Public Health and Environment

Colorado

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

CT

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

Connecticut Department of Mental Health and Addiction Services

Connecticut

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

DE

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

Executive Office of the Governor Of Delaware

Delaware

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

FL

Citrus County is applying for a Category 1 award in the amount of $387,581. The Citrus County Sheriff's Office Substance Abuse Social Worker Program will embed social services with law enforcement in order to rapidly respond to drug overdoses where children are impacted. Additionally, the Citrus County Sheriff’s Office intends to provide prevention, response, and diversion from the criminal justice system to individuals who are affected by substance misuse. The Sheriff’s Office will employ two substance misuse social workers to fulfill these goals. The substance misuse social workers will review and follow up on all reports of nonfatal overdoses, including contacting individuals who have experienced an overdose and connecting them with community-based resources. The substance misuse social worker will collaborate with child protective investigators with the Department of Children and Families (DCF), as well as case managers with Youth Family Alternatives (YFA). The social worker will communicate successes in treatment and assist in potential reunification of children and will also collaboratively work with DCF and YFA to connect children with early intervention therapy resources to reduce the likelihood of adverse childhood experiences affecting them. The Sheriff’s Office will also create and introduce a Marchman Act Assessment tool to be used in all non-fatal overdose cases. This project serves Citrus County, Florida, which has an approximate population of 149,657 residents. Partnerships include strong relationships with community partners, DCF, and YFA.

Citrus County

Florida

Citrus County is applying for a Category 1 award in the amount of $387,581. The Citrus County Sheriff's Office Substance Abuse Social Worker Program will embed social services with law enforcement in order to rapidly respond to drug overdoses where children are impacted. Additionally, the Citrus County Sheriff’s Office intends to provide prevention, response, and diversion from the criminal justice system to individuals who are affected by substance misuse. The Sheriff’s Office will employ two substance misuse social workers to fulfill these goals. The substance misuse social workers will review and follow up on all reports of nonfatal overdoses, including contacting individuals who have experienced an overdose and connecting them with community-based resources. The substance misuse social worker will collaborate with child protective investigators with the Department of Children and Families (DCF), as well as case managers with Youth Family Alternatives (YFA). The social worker will communicate successes in treatment and assist in potential reunification of children and will also collaboratively work with DCF and YFA to connect children with early intervention therapy resources to reduce the likelihood of adverse childhood experiences affecting them. The Sheriff’s Office will also create and introduce a Marchman Act Assessment tool to be used in all non-fatal overdose cases. This project serves Citrus County, Florida, which has an approximate population of 149,657 residents. Partnerships include strong relationships with community partners, DCF, and YFA.

FL

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.

City of Port St. Lucie

Florida

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.

GA

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

Georgia Criminal Justice Coordinating Council

Georgia

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

IA

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

City of Clinton

Iowa

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

ID

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

Idaho Department of Health and Welfare

Idaho

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

IL

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

Boone County

Illinois

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

IL

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

DuPage County Health Department

Illinois

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

IN

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

Dubois County

Indiana

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

KS

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

County of Reno

Kansas

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

KS

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 Department of Health and Environment

Kansas

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.

KY

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.

Purchase District Health Department

Kentucky

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.

KY

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

Whitley County Health Department

Kentucky

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

LA

The City of New Orleans Health Department is applying for a Category 1 award in the amount of $900,000. The Law Enforcement Assisted Diversion (LEAD) program will support a team of LEAD direct service staff. This team will include a case management supervisor overseeing a team of case managers and peer support specialists tasked to provide services within the fidelity of the LEAD model. Major tenants of this approach include providing intensive case management services within a person-centered, trauma-informed, and harm-reduction framework. LEAD case management staff members work to address the root causes of behaviors that led participants to encounters with law enforcement. This approach also benefits the New Orleans Police Department by providing a long-term solution that has historically been addressed through the immediate response of an arrest. Goals of the initiative include reducing municipal arrests and re-arrests in the 8th District related to mental illness and substance use through LEAD diversions to case management, potentially expanding LEAD eligible charges to include simple possession of illicit drugs, and developing and implementing an evaluation plan. This project serves the city of New Orleans, which is contiguous with Orleans Parish and has an estimated population of 390,144. The project includes partnerships with the New Orleans Police Department, the National Alliance on Mental Illness New Orleans, the New Orleans City Attorney’s Office, the Mayor’s Office of Criminal Justice Coordination, the Orleans Public Defender’s Office, the Orleans Parish District Attorney’s Office, and the LEAD National Support Bureau. Priority considerations addressed in this application include a jurisdiction with high rates of overdose deaths and a project that will benefit individuals residing in high-poverty areas or persistent-poverty counties, advance the promotion of civil rights, and build trust between law enforcement and the community.

City of New Orleans

Louisiana

The City of New Orleans Health Department is applying for a Category 1 award in the amount of $900,000. The Law Enforcement Assisted Diversion (LEAD) program will support a team of LEAD direct service staff. This team will include a case management supervisor overseeing a team of case managers and peer support specialists tasked to provide services within the fidelity of the LEAD model. Major tenants of this approach include providing intensive case management services within a person-centered, trauma-informed, and harm-reduction framework. LEAD case management staff members work to address the root causes of behaviors that led participants to encounters with law enforcement. This approach also benefits the New Orleans Police Department by providing a long-term solution that has historically been addressed through the immediate response of an arrest. Goals of the initiative include reducing municipal arrests and re-arrests in the 8th District related to mental illness and substance use through LEAD diversions to case management, potentially expanding LEAD eligible charges to include simple possession of illicit drugs, and developing and implementing an evaluation plan. This project serves the city of New Orleans, which is contiguous with Orleans Parish and has an estimated population of 390,144. The project includes partnerships with the New Orleans Police Department, the National Alliance on Mental Illness New Orleans, the New Orleans City Attorney’s Office, the Mayor’s Office of Criminal Justice Coordination, the Orleans Public Defender’s Office, the Orleans Parish District Attorney’s Office, and the LEAD National Support Bureau. Priority considerations addressed in this application include a jurisdiction with high rates of overdose deaths and a project that will benefit individuals residing in high-poverty areas or persistent-poverty counties, advance the promotion of civil rights, and build trust between law enforcement and the community.

LA

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.

Lafourche Parish Sheriff's Office

Louisiana

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.

LA

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

Orleans Parish District Attorney

Louisiana

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

LA

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

Terrebonne Parish Consolidated Government

Louisiana

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

MA

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

Berkshire Regional Planning Commission

Massachusetts

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%).

MA

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

City of Holyoke

Massachusetts

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

MA

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

City of Holyoke Police Department

Massachusetts

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

MA

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

City of Lowell

Massachusetts

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

MA

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

City of Newburyport

Massachusetts

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

MA

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.

City of Newburyport

Massachusetts

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.

MA

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.

Commonwealth of Massachusetts, Sheriff's Department Hampden

Massachusetts

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.

MA

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

Department of Public Safety

Massachusetts

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

MA

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

Lowell, City of

Massachusetts

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

MA

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

Massachusetts Supreme Judicial Court

Massachusetts

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.

MA

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

Massachusetts Supreme Judicial Court

Massachusetts

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.

MA

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.

Northampton, City of

Massachusetts

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.

MA

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

Town of East Bridgewater

Massachusetts

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

MA

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

Town of Seekonk

Massachusetts

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

MD

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).

St. Mary's County

Maryland

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).

ME

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

Cumberland, County of

Maine

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

MI

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

City of Detroit

Michigan

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

MI

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.

Oakland County

Michigan

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.

MN

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

City of Duluth

Minnesota

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

MS

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

Lamar County Board of Supervisors

Mississippi

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

MS

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.

Mississippi State Department of Health

Mississippi

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.

MT

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

City of Billings

Montana

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

NC

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.

Lenoir County

North Carolina

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.

NC

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.

Lincoln County

North Carolina

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.

NC

Onslow County is applying for a Category 1 award in the amount of $899,943. The Onslow County COSSAP 2021 project will provide medication-assisted treatment (MAT), therapeutic counseling, and recovery case management in the Onslow County Detention Center (OCDC). The three target populations are opioid-addicted pregnant women, those currently receiving MAT from a community provider when booked into OCDC, and inmates initially assessed with an opioid dependency and a misdemeanor conviction. In addition, each individual will be connected to appropriate MAT, evidence-based therapeutic counseling, and recovery support services in the community upon release. These services will include recovery housing, health, education/training, and employment support coordinated by the recovery support case manager and a certified peer support specialist. This project serves Onslow County, which has a population of 211,881. The project includes partnerships between Southern Health Partners, Oxford House, Women/Children Housing, Hope is Alive, Coastal Carolina Community College and its Adult High School, NCWorks Career Center, the Onslow County Public Health Department, Goshen Medical Center, the Onslow County Department of Social Services, ACT Associates, and Integrated Family Services.

Onslow County

North Carolina

Onslow County is applying for a Category 1 award in the amount of $899,943. The Onslow County COSSAP 2021 project will provide medication-assisted treatment (MAT), therapeutic counseling, and recovery case management in the Onslow County Detention Center (OCDC). The three target populations are opioid-addicted pregnant women, those currently receiving MAT from a community provider when booked into OCDC, and inmates initially assessed with an opioid dependency and a misdemeanor conviction. In addition, each individual will be connected to appropriate MAT, evidence-based therapeutic counseling, and recovery support services in the community upon release. These services will include recovery housing, health, education/training, and employment support coordinated by the recovery support case manager and a certified peer support specialist. This project serves Onslow County, which has a population of 211,881. The project includes partnerships between Southern Health Partners, Oxford House, Women/Children Housing, Hope is Alive, Coastal Carolina Community College and its Adult High School, NCWorks Career Center, the Onslow County Public Health Department, Goshen Medical Center, the Onslow County Department of Social Services, ACT Associates, and Integrated Family Services.

NC

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

Wake County

North Carolina

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

NJ

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.

Atlantic City (Inc)

New Jersey

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.

NJ

The Camden County Department of Corrections (CCDOC) applied for Category 1a grant funding in the amount of $1,200,000. The Comprehensive Substance Use and Recovery Support Program for Incarcerated Individuals in the Camden County Correctional Facility (CCCF) will expand the department’s capacity to identify, respond to, treat, and support individuals incarcerated in the CCCF with a history of substance use, specifically individuals with a non- opioid use disorder. Through the use of substance use and recovery support services for individuals both pre- and post-release, this project serves Camden County, New Jersey, which has a population of approximately 513,000 across 37 municipalities. The project includes partnerships between Camden County Department of Health and Human Services Office of Mental Health and Addictions, CFG Health Network, and CCDOC’s contracted medical and mental health provider, as well as partnerships with Project HOPE, the Center for Family Services, Volunteers of America, Genesis Counseling Centers, and the New Jersey Division of Mental Health and Addiction Services. These agencies will support CCDOC reentry efforts, providing vital support to individuals such as housing, MOUD, SU, and mental health counseling, employment, and job-readiness training. Priority considerations addressed in this application include a high-poverty area and Qualified Opportunity Zone. There are six objectives of the proposed program. Objective 1 includes the implementation of a substance use screening tool and assessment during the booking and classification phase to effectively identify individuals incarcerated with a substance use disorder. Objective 2 provides substance use counseling and support services for individuals (both in person and via telehealth) while incarcerated in CCCF. Objective 3 provides integrated care coordination for individuals during a period of incarceration to promote and foster health equity of the justice-involved population. Objective 4 provides peer recovery support services to individuals transitioning home following release from the CCCF through the development of Peer Support Teams. Objective 5 provides recovery support housing to individuals that have engaged in substance use and/or receiving MOUD and are housing insecure at the time of release from CCCF. Lastly, Objective 6 is focused on establishing a Reentry Release Center to include a team of CDACs to continue the coordination of services upon release from CCCF.

Camden County

New Jersey

The Camden County Department of Corrections (CCDOC) applied for Category 1a grant funding in the amount of $1,200,000. The Comprehensive Substance Use and Recovery Support Program for Incarcerated Individuals in the Camden County Correctional Facility (CCCF) will expand the department’s capacity to identify, respond to, treat, and support individuals incarcerated in the CCCF with a history of substance use, specifically individuals with a non- opioid use disorder. Through the use of substance use and recovery support services for individuals both pre- and post-release, this project serves Camden County, New Jersey, which has a population of approximately 513,000 across 37 municipalities. The project includes partnerships between Camden County Department of Health and Human Services Office of Mental Health and Addictions, CFG Health Network, and CCDOC’s contracted medical and mental health provider, as well as partnerships with Project HOPE, the Center for Family Services, Volunteers of America, Genesis Counseling Centers, and the New Jersey Division of Mental Health and Addiction Services. These agencies will support CCDOC reentry efforts, providing vital support to individuals such as housing, MOUD, SU, and mental health counseling, employment, and job-readiness training. Priority considerations addressed in this application include a high-poverty area and Qualified Opportunity Zone. There are six objectives of the proposed program. Objective 1 includes the implementation of a substance use screening tool and assessment during the booking and classification phase to effectively identify individuals incarcerated with a substance use disorder. Objective 2 provides substance use counseling and support services for individuals (both in person and via telehealth) while incarcerated in CCCF. Objective 3 provides integrated care coordination for individuals during a period of incarceration to promote and foster health equity of the justice-involved population. Objective 4 provides peer recovery support services to individuals transitioning home following release from the CCCF through the development of Peer Support Teams. Objective 5 provides recovery support housing to individuals that have engaged in substance use and/or receiving MOUD and are housing insecure at the time of release from CCCF. Lastly, Objective 6 is focused on establishing a Reentry Release Center to include a team of CDACs to continue the coordination of services upon release from CCCF.

NJ

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

County of Hudson

New Jersey

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

NJ

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

New Jersey State Parole Board

New Jersey

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

NM

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.

Bernalillo County

New Mexico

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.

NM

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.

Pueblo of Pojoaque

New Mexico

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.

NM

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

Rio Arriba County

New Mexico

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.

NV

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

City of Henderson

Nevada

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

NV

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

Nevada Office of the Attorney General

Nevada

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

NY

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

Cayuga County

New York

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

NY

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

Chautauqua County

New York

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.

NY

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

City of New York

New York

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

NY

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

County of Greene

New York

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

NY

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

Niagara County

New York

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

NY

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.

Seneca Nation of Indians

New York

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.

NY

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.

St. Lawrence County

New York

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.

NY

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

The City of Ithaca

New York

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

NY

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

Ulster County

New York

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.

NY

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

New York

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.

OH

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

City of Columbus

Ohio

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.

OH

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.

County of Marion

Ohio

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.

OH

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

Cuyahoga, County of

Ohio

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.

OH

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.

Erie County

Ohio

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.

OH

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

Fairfield County

Ohio

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

OH

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

Hancock County

Ohio

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

OH

Hocking County is applying for Category 1 funding in the amount of $539,464. The Hocking County Overdose Prevention and Harm Reduction Project will expand the county’s deflection programming from a Quick Response Team (QRT) called QRT Hocking Overdose Partnership Endeavor (HOPE) into one that partners with outside agencies by funding positions that link students and families to treatment and services for substance use disorders. The project will subcontract with a mental health practitioner within the Logan-Hocking School District (LHSD) and a deflection specialist within the Hocking County Health Department who will work directly with overdose victims and their families or those identified as being at a higher risk for having an overdose, as well as monitor a new crisis hotline within the health department and facilitate outreach and education into the community. LHSD will house the mental health practitioner within the high school and middle school in order to meet with students who have encountered an overdose or drug use, either among themselves or their families. The practitioner will be responsible for participating in the Handle with Care Program, an evidenced-based program designed to assist children in their school setting if a law enforcement encounter has happened inside their home. A multifaceted public awareness and education campaign will be created to increase the number of families who call the hotline. The goal of the project is to expand collaboration and partnerships among providers and agencies in Hocking County and to expand the existing framework of services to include stationary positions within fixed, strategic locations where students and families affected by the drug crisis frequent. The project serves Hocking County, a rural area with a population 28,264. The project includes partnerships with the LHSD and the Hocking County Health Department. The project will engage Wes Gilkey as a research partner. Priority considerations addressed in this application include the promotion of civil rights, support to crime victims, and building of trust between law enforcement and the community.

Hocking County

Ohio

Hocking County is applying for Category 1 funding in the amount of $539,464. The Hocking County Overdose Prevention and Harm Reduction Project will expand the county’s deflection programming from a Quick Response Team (QRT) called QRT Hocking Overdose Partnership Endeavor (HOPE) into one that partners with outside agencies by funding positions that link students and families to treatment and services for substance use disorders. The project will subcontract with a mental health practitioner within the Logan-Hocking School District (LHSD) and a deflection specialist within the Hocking County Health Department who will work directly with overdose victims and their families or those identified as being at a higher risk for having an overdose, as well as monitor a new crisis hotline within the health department and facilitate outreach and education into the community. LHSD will house the mental health practitioner within the high school and middle school in order to meet with students who have encountered an overdose or drug use, either among themselves or their families. The practitioner will be responsible for participating in the Handle with Care Program, an evidenced-based program designed to assist children in their school setting if a law enforcement encounter has happened inside their home. A multifaceted public awareness and education campaign will be created to increase the number of families who call the hotline. The goal of the project is to expand collaboration and partnerships among providers and agencies in Hocking County and to expand the existing framework of services to include stationary positions within fixed, strategic locations where students and families affected by the drug crisis frequent. The project serves Hocking County, a rural area with a population 28,264. The project includes partnerships with the LHSD and the Hocking County Health Department. The project will engage Wes Gilkey as a research partner. Priority considerations addressed in this application include the promotion of civil rights, support to crime victims, and building of trust between law enforcement and the community.

OH

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

Montgomery, County of

Ohio

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

OK

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.

City of Jay

Oklahoma

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.

OK

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

Oklahoma County Criminal Justice Advisory Council

Oklahoma

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

OK

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.

Ponca Tribe of Oklahoma

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.

OR

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

Clackamas County, Health Housing and Human Services

Oregon

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

OR

The Confederated Tribes of the Grand Ronde Community of Oregon (the Tribe) is applying for a Category 1 award in the amount of $598,977. The Grand Ronde Opioid and Stimulant Site-Based Project will improve community awareness of drug use and help develop collaborative expanded prevention and intervention programs in treatment and counseling, transitional housing, and community school prevention and education. The objectives include creating a men’s transition house program for a house that a state marijuana tax grant is buying, including creating policies and procedures, providing household supplies, and linking to health care, employment training, and education support services; hiring a school resource officer and creating a program at the local public school district that the Tribe’s members attend; helping with start-up and operations of a new medication-assisted treatment (MAT) clinic in Portland by buying methadone dispensers and providing a peer support specialist; and performing additional outreach and education in Grand Ronde based on expanding programs to address drug use and addiction and assisting with comprehensive program development. This project serves the Tribe’s six-county service area, which includes the Reservation community of Grand Ronde on the Polk-Yamhill county line, adjacent to the city (and the school district) of Willamina. It also includes Salem, where the Tribe just opened a MAT clinic, and Multnomah County, which includes the Tribe’s in-development Portland MAT clinic. The Tribe has 5,572 members, although the Portland MAT project will focus on serving the Tribe’s members in the Portland metropolitan area as well as descendants and other Native Americans. There are 22,598 just in the core tri-county area of Portland. The Tribe will also serve other local area residents, as capacity allows, who need care and want to use the Tribe’s recovery model. The project includes partnerships between Tribal departments with their own authority working with each other (Tribal Police Department, Health and Wellness, Social Services, and Education) and the Willamina Public School District. Priority considerations addressed in this application include the fact that Willamina and Grand Ronde are in a federal low-income opportunity zone. The project will advance the promotion of civil rights and benefit individuals residing in high-poverty areas or persistent-poverty counties.

Confederated Tribes of the Grand Ronde Community of Oregon

Oregon

The Confederated Tribes of the Grand Ronde Community of Oregon (the Tribe) is applying for a Category 1 award in the amount of $598,977. The Grand Ronde Opioid and Stimulant Site-Based Project will improve community awareness of drug use and help develop collaborative expanded prevention and intervention programs in treatment and counseling, transitional housing, and community school prevention and education. The objectives include creating a men’s transition house program for a house that a state marijuana tax grant is buying, including creating policies and procedures, providing household supplies, and linking to health care, employment training, and education support services; hiring a school resource officer and creating a program at the local public school district that the Tribe’s members attend; helping with start-up and operations of a new medication-assisted treatment (MAT) clinic in Portland by buying methadone dispensers and providing a peer support specialist; and performing additional outreach and education in Grand Ronde based on expanding programs to address drug use and addiction and assisting with comprehensive program development. This project serves the Tribe’s six-county service area, which includes the Reservation community of Grand Ronde on the Polk-Yamhill county line, adjacent to the city (and the school district) of Willamina. It also includes Salem, where the Tribe just opened a MAT clinic, and Multnomah County, which includes the Tribe’s in-development Portland MAT clinic. The Tribe has 5,572 members, although the Portland MAT project will focus on serving the Tribe’s members in the Portland metropolitan area as well as descendants and other Native Americans. There are 22,598 just in the core tri-county area of Portland. The Tribe will also serve other local area residents, as capacity allows, who need care and want to use the Tribe’s recovery model. The project includes partnerships between Tribal departments with their own authority working with each other (Tribal Police Department, Health and Wellness, Social Services, and Education) and the Willamina Public School District. Priority considerations addressed in this application include the fact that Willamina and Grand Ronde are in a federal low-income opportunity zone. The project will advance the promotion of civil rights and benefit individuals residing in high-poverty areas or persistent-poverty counties.

OR

Tillamook County, Oregon, will implement a project that is consistent with the goals, objectives, and intended outcomes of the Comprehensive Opioid, Stimulant, and Substance Use Program (COSSUP), which include reducing overdose deaths, promoting public safety, and supporting access to substance use disorder (SUD) treatment and recovery services, as well as evidence-based, culturally relevant interventions for adults and affected family members at any intercept point of the justice system. The purpose of the project is to continue to build upon the work and accomplishments of Opioid Use Response in Tillamook County (OUR Tillamook), a countywide, community-based, and multisectoral consortium that was formed in 2019 to address the opioid epidemic afflicting a rural, coastal region that is home to nearly 28,000 people residing in an area just over 1,100 square miles. The COSSUP initiative will address identified gaps and opportunities to expand prevention, treatment, and recovery services for individuals experiencing substance use disorder (SUD), and will primarily target opioid use disorder (OUD) experienced by low-income and uninsured/underinsured residents. Specific project activities will include: 1) delivering crisis intervention training to local law enforcement and first responders to assist efforts to deflect and divert individuals away from adult or juvenile justice systems; 2) the purchase of NARCAN (naloxone) and related supplies for law enforcement and first responders to administer and distribute in the field to prevent or reverse rural opioid overdoses and build community trust and participation; 3) continuing education and prevention programs that connect law enforcement agencies with K-12 students utilizing the Hazelden Betty Ford Foundation school-based prevention curriculum; and 4) hiring a peer support specialist to create a law enforcement liaison program to build bridges of support and collaboration between law enforcement officers and people with OUD in the justice system. By the end of the 36-month project period, expected outcomes will include: 1) the completion of mental health and SUD/OUD specific crisis intervention and de-escalation training for all law enforcement agencies and first responders; 2) administration or distribution of up to 100 doses of NARCAN per month in rural cases of confirmed or suspected opioid overdose; and 3) the continued delivery of the Hazelden Betty Ford Foundation school-based prevention program with active law enforcement participation at three local K-12 school districts during the grant period.

County of Tillamook

Oregon

Tillamook County, Oregon, will implement a project that is consistent with the goals, objectives, and intended outcomes of the Comprehensive Opioid, Stimulant, and Substance Use Program (COSSUP), which include reducing overdose deaths, promoting public safety, and supporting access to substance use disorder (SUD) treatment and recovery services, as well as evidence-based, culturally relevant interventions for adults and affected family members at any intercept point of the justice system. The purpose of the project is to continue to build upon the work and accomplishments of Opioid Use Response in Tillamook County (OUR Tillamook), a countywide, community-based, and multisectoral consortium that was formed in 2019 to address the opioid epidemic afflicting a rural, coastal region that is home to nearly 28,000 people residing in an area just over 1,100 square miles. The COSSUP initiative will address identified gaps and opportunities to expand prevention, treatment, and recovery services for individuals experiencing substance use disorder (SUD), and will primarily target opioid use disorder (OUD) experienced by low-income and uninsured/underinsured residents. Specific project activities will include: 1) delivering crisis intervention training to local law enforcement and first responders to assist efforts to deflect and divert individuals away from adult or juvenile justice systems; 2) the purchase of NARCAN (naloxone) and related supplies for law enforcement and first responders to administer and distribute in the field to prevent or reverse rural opioid overdoses and build community trust and participation; 3) continuing education and prevention programs that connect law enforcement agencies with K-12 students utilizing the Hazelden Betty Ford Foundation school-based prevention curriculum; and 4) hiring a peer support specialist to create a law enforcement liaison program to build bridges of support and collaboration between law enforcement officers and people with OUD in the justice system. By the end of the 36-month project period, expected outcomes will include: 1) the completion of mental health and SUD/OUD specific crisis intervention and de-escalation training for all law enforcement agencies and first responders; 2) administration or distribution of up to 100 doses of NARCAN per month in rural cases of confirmed or suspected opioid overdose; and 3) the continued delivery of the Hazelden Betty Ford Foundation school-based prevention program with active law enforcement participation at three local K-12 school districts during the grant period.

OR

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

Lincoln County Sheriff's Office Search and Rescue

Oregon

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

PA

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

City of Erie

Pennsylvania

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

PA

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

Montgomery County

Pennsylvania

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

PA

The York/Adams Drug and Alcohol Commission proposes to establish a new program to connect persons leaving prison with the appropriate evidence-based treatment and support services, which may include medication-assisted treatment; connect individuals who are on work-release with treatment and nontreatment services; and establish an integrated data system containing all law enforcement naloxone utilizations, emergency medical services naloxone utilizations, and hospital emergency department admissions and encourage prescription drug monitoring program usage.

York County

Pennsylvania

The York/Adams Drug and Alcohol Commission proposes to establish a new program to connect persons leaving prison with the appropriate evidence-based treatment and support services, which may include medication-assisted treatment; connect individuals who are on work-release with treatment and nontreatment services; and establish an integrated data system containing all law enforcement naloxone utilizations, emergency medical services naloxone utilizations, and hospital emergency department admissions and encourage prescription drug monitoring program usage.

PR

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.

Municipio de Bayamon

Puerto Rico

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.

SC

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.

Chester County

South Carolina

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.

SC

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.

County of Lancaster Administration Building

South Carolina

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.

SC

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

Greenville County

South Carolina

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.

TN

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

Bradley County

Tennessee

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

TN

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

Rutherford County

Tennessee

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

TN

Substance use disorder (SUD) and related issues are a burden on the citizens of Rutherford County, Tennessee. In 2021, there were 3,841 fatal overdoses in Tennessee, of which 141 were in Rutherford County. According to the latest CDC data, Tennessee is reported to have the 11th highest rate of overdose deaths per 100,000 population. Rutherford County's 2021 overdose fatality rate was 34 per 100,000 persons. Funding will be utilized to develop the Sheriff's Harm Reduction Program (SHARP). SHARP will reduce SUD and overdose in persons encountering law enforcement while reducing recidivism and incarceration for drug related offenses within the jurisdiction of Rutherford County, Tennessee. This project is in collaboration with Prevention Coalition for Success, Rutherford County Adult Detention Center, Rutherford County Correctional Work Center, Rutherford County Medical Examiner, Rutherford Opioid Board, 16th Judicial District Recovery Court, and Rutherford County Re-Entry Program. All participants listed above are stakeholders in regard to rehabilitation, recidivism and re-entry of incarcerated persons into the community. SHARP will accomplish this by embedding two Certified Peer Support Specialists (CPSS) into Rutherford County Adult Detention Center and Rutherford County Correctional Work Center. These CPSS will assist individuals with navigation of the behavioral healthcare system and recovery resources for incarcerated persons. The Tennessee Department of Mental Health and Substance Abuse Services describes CPSS as having the ability to support others in achieving their personal recovery goals by promoting self-determination, personal responsibility, and empowerment in self-directed recovery. SHARP will also utilize funding for transportation of SUD individuals to behavioral healthcare facilities. SHARP will fill a substantial gap in service provision in Rutherford County, by providing treatment services for incarcerated persons. SHARP's aim is to detect incarcerated individuals struggling with SUD and give them the opportunity to access the services they need by identifying effective behavioral interventions andbolstering community and supervision services to curtail use. We will connect individuals to establish evidence-based treatment services for those struggling with SUD. Through SHARP, this vulnerable population will receive greater access to treatment and recovery services, which will reduce the impact and misuse of opioids, stimulants, and other substances, and reduce overdose fatalities in Rutherford County. The project will leverage the strides Rutherford County has made in recognizing and addressing SUD in every population and address our shortcomings in intercepting and addressing SUD problems within our correction facilities.

Rutherford, County of

Tennessee

Substance use disorder (SUD) and related issues are a burden on the citizens of Rutherford County, Tennessee. In 2021, there were 3,841 fatal overdoses in Tennessee, of which 141 were in Rutherford County. According to the latest CDC data, Tennessee is reported to have the 11th highest rate of overdose deaths per 100,000 population. Rutherford County's 2021 overdose fatality rate was 34 per 100,000 persons. Funding will be utilized to develop the Sheriff's Harm Reduction Program (SHARP). SHARP will reduce SUD and overdose in persons encountering law enforcement while reducing recidivism and incarceration for drug related offenses within the jurisdiction of Rutherford County, Tennessee. This project is in collaboration with Prevention Coalition for Success, Rutherford County Adult Detention Center, Rutherford County Correctional Work Center, Rutherford County Medical Examiner, Rutherford Opioid Board, 16th Judicial District Recovery Court, and Rutherford County Re-Entry Program. All participants listed above are stakeholders in regard to rehabilitation, recidivism and re-entry of incarcerated persons into the community. SHARP will accomplish this by embedding two Certified Peer Support Specialists (CPSS) into Rutherford County Adult Detention Center and Rutherford County Correctional Work Center. These CPSS will assist individuals with navigation of the behavioral healthcare system and recovery resources for incarcerated persons. The Tennessee Department of Mental Health and Substance Abuse Services describes CPSS as having the ability to support others in achieving their personal recovery goals by promoting self-determination, personal responsibility, and empowerment in self-directed recovery. SHARP will also utilize funding for transportation of SUD individuals to behavioral healthcare facilities. SHARP will fill a substantial gap in service provision in Rutherford County, by providing treatment services for incarcerated persons. SHARP's aim is to detect incarcerated individuals struggling with SUD and give them the opportunity to access the services they need by identifying effective behavioral interventions andbolstering community and supervision services to curtail use. We will connect individuals to establish evidence-based treatment services for those struggling with SUD. Through SHARP, this vulnerable population will receive greater access to treatment and recovery services, which will reduce the impact and misuse of opioids, stimulants, and other substances, and reduce overdose fatalities in Rutherford County. The project will leverage the strides Rutherford County has made in recognizing and addressing SUD in every population and address our shortcomings in intercepting and addressing SUD problems within our correction facilities.

TX

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

City of Houston Health Department

Texas

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

VA

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

City of Harrisonburg

Virginia

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

WA

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

City of Seattle

Washington

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

WA

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

King County

Washington

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

WA

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

Lummi Indian Business Council

Washington

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

WA

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.

Quinault Indian Nation

Washington

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.

WI

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

City of Madison

Wisconsin

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

WI

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

City of Milwaukee

Wisconsin

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

WI

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

City of West Allis

Wisconsin

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.

WI

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

Winnebago County

Wisconsin

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

WI

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

Winnebago County

Wisconsin

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.

WV

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.

Cabell County

West Virginia

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.

WV

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

Monongalia County

West Virginia

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

WY

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

Laramie County Government

Wyoming

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