Grantee Projects

AL

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

22nd Judicial Circuit District Attorney's Office

Alabama

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

AL

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

Alabama Department of Mental Health

Alabama

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

CA

The Alameda County Probation Department (ACPD) is applying for a Category 1a urban area grant in the amount of $1,195,323. Alameda County’s Residential Multi-Service Opportunity Center will expand access to responsive community alternatives to incarceration, as well as the county’s capacity to provide evidence-based mental health and substance use treatment services, built through a collaborative system of care that reduce the impact of opioids, stimulants, and other substances on individuals and communities, including a reduction in the number of overdose fatalities. This project serves Alameda County, a large, urban county with a population of 1.67 million. The project includes partnerships between ACPD and a qualified contracted service provider. Priority considerations addressed in this application include high-poverty area and a persistent poverty county, as well as enhanced public safety in federally designated Qualified Opportunity Zones.

Alameda County Probation Department

California

The Alameda County Probation Department (ACPD) is applying for a Category 1a urban area grant in the amount of $1,195,323. Alameda County’s Residential Multi-Service Opportunity Center will expand access to responsive community alternatives to incarceration, as well as the county’s capacity to provide evidence-based mental health and substance use treatment services, built through a collaborative system of care that reduce the impact of opioids, stimulants, and other substances on individuals and communities, including a reduction in the number of overdose fatalities. This project serves Alameda County, a large, urban county with a population of 1.67 million. The project includes partnerships between ACPD and a qualified contracted service provider. Priority considerations addressed in this application include high-poverty area and a persistent poverty county, as well as enhanced public safety in federally designated Qualified Opportunity Zones.

NY

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

Albany County

New York

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

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.

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.

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.

VA

The Commonwealth's Attorney's Office for the County of Augusta, Virginia, proposes to implement a peer services expansion to its Pathways Program. The project will expand its currently existing Pathways Program to serve the expanding number of justice involved persons with Substance Use Disorder in Augusta County. Project activities include establishment of peer counseling and peer recovery support services both within the Pathways Program and within partnering agencies at intercepts 0 and 1 in the Sequential Intercept Model. Within Pathways, peer counseling and peer recovery support will focus on enhancing client retention, engagement, and quality of outcomes by providing evidence-based peer services. Peers placed within partnering agencies will render on-demand peer services to ordinary agency clients who present as needing services. They will also collaborate with similarly placed peers in other agencies and within Pathways. Expected outcomes include the development of a fully capable peer recovery and peer support organization capable of deploying peers both internally and externally to respond to crisis situations and participant needs in a flexible and efficient manner. Within Pathways, it is expected that client engagement rate, retention rate, and quality of outcomes will improve over their current levels. Within partnering agencies, it is expected that peers will enhance agency outcomes by enabling cross-agency cooperation and more effective engagement with their clients. This project serves Augusta County, a small, semi-rural county with the population of 77, 487. Its direct beneficiaries are those who are experiencing substance use disorder or are in cooccurring mental health and substance use crisis. However, the entire population of Augusta County will indirectly benefit through the increased efficiency and quality of outcomes within the criminal justice and public health agencies involved. The project includes partnerships between Augusta County Sherriff's Department, Blue Ridge Court Services, Valley Community Services Board, Blue Ridge Criminal Justice Board.

Augusta County Board of Supervisors

Virginia

The Commonwealth's Attorney's Office for the County of Augusta, Virginia, proposes to implement a peer services expansion to its Pathways Program. The project will expand its currently existing Pathways Program to serve the expanding number of justice involved persons with Substance Use Disorder in Augusta County. Project activities include establishment of peer counseling and peer recovery support services both within the Pathways Program and within partnering agencies at intercepts 0 and 1 in the Sequential Intercept Model. Within Pathways, peer counseling and peer recovery support will focus on enhancing client retention, engagement, and quality of outcomes by providing evidence-based peer services. Peers placed within partnering agencies will render on-demand peer services to ordinary agency clients who present as needing services. They will also collaborate with similarly placed peers in other agencies and within Pathways. Expected outcomes include the development of a fully capable peer recovery and peer support organization capable of deploying peers both internally and externally to respond to crisis situations and participant needs in a flexible and efficient manner. Within Pathways, it is expected that client engagement rate, retention rate, and quality of outcomes will improve over their current levels. Within partnering agencies, it is expected that peers will enhance agency outcomes by enabling cross-agency cooperation and more effective engagement with their clients. This project serves Augusta County, a small, semi-rural county with the population of 77, 487. Its direct beneficiaries are those who are experiencing substance use disorder or are in cooccurring mental health and substance use crisis. However, the entire population of Augusta County will indirectly benefit through the increased efficiency and quality of outcomes within the criminal justice and public health agencies involved. The project includes partnerships between Augusta County Sherriff's Department, Blue Ridge Court Services, Valley Community Services Board, Blue Ridge Criminal Justice Board.

WI

The Bad River Band of Lake Superior Tribe of Chippewa Indians project will use 100 percent of the grant award to address 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. Primary activities of this grant will support grant objectives to: (1) hire three staff members to assist with development and implementation of comprehensive community services (CCS) in Bad River, as well as provide treatment; (2) create a CCS Advisory Team that will serve as a permanent, multidisciplinary body that will increase cooperation and collaboration to address the issues that arise due to the impacts of illicit opioids, stimulants, and other drugs; (3) create a CCS Team made up of professionals and service providers who will support treatment and recovery related to opioid stimulant, and other substance abuse in a number of different ways; (4) develop a CCS Plan as a living, guiding document for CCS in Bad River; and (4) implement CCS in Bad River. The intended outcomes for this project are to enroll 100 percent of people seeking alcohol and other drug use treatment services through CCS, and to provide greater access and opportunity for treatment and recovery support services to our tribal population located on the Bad River Indian Reservation in Ashland County, Wisconsin.

Bad River Band of Lake Superior Tribe of Chippewa Indians

Wisconsin

The Bad River Band of Lake Superior Tribe of Chippewa Indians project will use 100 percent of the grant award to address 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. Primary activities of this grant will support grant objectives to: (1) hire three staff members to assist with development and implementation of comprehensive community services (CCS) in Bad River, as well as provide treatment; (2) create a CCS Advisory Team that will serve as a permanent, multidisciplinary body that will increase cooperation and collaboration to address the issues that arise due to the impacts of illicit opioids, stimulants, and other drugs; (3) create a CCS Team made up of professionals and service providers who will support treatment and recovery related to opioid stimulant, and other substance abuse in a number of different ways; (4) develop a CCS Plan as a living, guiding document for CCS in Bad River; and (4) implement CCS in Bad River. The intended outcomes for this project are to enroll 100 percent of people seeking alcohol and other drug use treatment services through CCS, and to provide greater access and opportunity for treatment and recovery support services to our tribal population located on the Bad River Indian Reservation in Ashland County, Wisconsin.

MD

The Diversionary Employment: Supported Employment and Peer Recovery Navigation in Baltimore City program will provide residents with substance use disorder (SUD) and justice system involvement with services specifically designed to address their compounded barriers to employment and retention. The program would add a peer recovery specialist (PRS) to the Mayor's Office of Employment Development's existing career center services and establish an in-house, intensive supported employment program, with a growing evidence base, tailored for this population. MOED manages two American Job Centers, along with a network of community job hubs, that co-locate dozens of human services in addition to providing career development and employment navigation support. Embedding a trained peer recovery specialist with their own lived recovery experience in this system will provide guidance to residents with SUD trying to navigate services and support to MOED staff in other service areas whose clients have substance use disorders. The PRS will strengthen existing relationships with recovery centers and work with re-entry programs to mitigate and prevent SUD-affected individuals’ ongoing involvement with the justice system. Supported employment is an evidence-based employment intervention for adults with behavioral health disorders that has demonstrated promise as a model for individuals in recovery. The program recognizes employment as a stabilizing force for this population and provides targeted job development and intensive, ongoing employment retention support along with integrated mental health services. MOED will implement this program in partnership with specialists who will provide supportive employment training, ongoing consultations with staff service providers, and periodic fidelity reviews. The program will be evaluated by a research team with expertise in the supported employment model, the justice system, and substance use disorder. The beneficiaries of the program will be Baltimore City residents with substance use disorder, primarily at Intercept levels 3-5, via referral from MOED’s internal re-entry programs, external re-entry partnerships, court diversion programs, and co-located partners at parole and probation. Individuals at Intercept level 0 will also have access to these services if they are at high risk for justice involvement. Peer recovery navigation services, both supportive and employment-focused, will be provided to 180 individuals. Additionally, the supported employment program will enroll 120 participants for career development services, conducted in concert with participants’ treatment teams, and 66 of those enrolled will obtain and maintain employment that supports their recovery goals.

Baltimore, City of

Maryland

The Diversionary Employment: Supported Employment and Peer Recovery Navigation in Baltimore City program will provide residents with substance use disorder (SUD) and justice system involvement with services specifically designed to address their compounded barriers to employment and retention. The program would add a peer recovery specialist (PRS) to the Mayor's Office of Employment Development's existing career center services and establish an in-house, intensive supported employment program, with a growing evidence base, tailored for this population. MOED manages two American Job Centers, along with a network of community job hubs, that co-locate dozens of human services in addition to providing career development and employment navigation support. Embedding a trained peer recovery specialist with their own lived recovery experience in this system will provide guidance to residents with SUD trying to navigate services and support to MOED staff in other service areas whose clients have substance use disorders. The PRS will strengthen existing relationships with recovery centers and work with re-entry programs to mitigate and prevent SUD-affected individuals’ ongoing involvement with the justice system. Supported employment is an evidence-based employment intervention for adults with behavioral health disorders that has demonstrated promise as a model for individuals in recovery. The program recognizes employment as a stabilizing force for this population and provides targeted job development and intensive, ongoing employment retention support along with integrated mental health services. MOED will implement this program in partnership with specialists who will provide supportive employment training, ongoing consultations with staff service providers, and periodic fidelity reviews. The program will be evaluated by a research team with expertise in the supported employment model, the justice system, and substance use disorder. The beneficiaries of the program will be Baltimore City residents with substance use disorder, primarily at Intercept levels 3-5, via referral from MOED’s internal re-entry programs, external re-entry partnerships, court diversion programs, and co-located partners at parole and probation. Individuals at Intercept level 0 will also have access to these services if they are at high risk for justice involvement. Peer recovery navigation services, both supportive and employment-focused, will be provided to 180 individuals. Additionally, the supported employment program will enroll 120 participants for career development services, conducted in concert with participants’ treatment teams, and 66 of those enrolled will obtain and maintain employment that supports their recovery goals.

WV

The Berkeley County Council, Berkeley County, West Virginia, project continues the Juvenile Opioid Treatment, Intervention and Prevention Program (JOTIPP) in order to expand the opportunity for Berkeley County to support the most vulnerable in the community to the opioid crisis-the children. Continuing the partnership with Berkeley County Schools, the program, hosted by the Berkeley County Recovery Resource Center and the Berkeley County Day Report Center, will: 1) Expand Peer Recovery services to address intervention and treatment needs primarily for students and secondarily, their family members; 2) Expand and strengthen education and prevention activities through small group settings in the 5 high schools, continuing to instill and reinforce resilience and reducing stigma; and 3) Provide funds to CATALIST, an initiative of the Berkeley County Day Report Center whose goal is to provide mental health and wellbeing of at-risk youth and their families. The continuing long-term goal is to curtail opioid use, supporting all citizens to lead productive, health lives. Sixteen percent of Berkeley County's population is school-aged children; by having the ability to provide streamlined services to a large portion of the county at one time allows for an elevated comprehensive, systematic approach to the opioid crisis. The JOTIPP program allows for a reach beyond the student population and connect families to community resources to support those in recovery or seeking recovery from substance use disorder (SUD) reducing opioid use and the number of overdoses. Ensuring programmatic success through comprehensive data analysis is a priority of this program. Therefore, partnership with a research company will guarantee efficiency, effectiveness and impact across both the juvenile programs and adult programs. The project serves Berkeley County, West Virginia with a population of 126,069 and will include partnerships with Berkeley County Schools and Berkeley County Sheriff. A research partner will be selected post-award. This application includes program evaluation which is identified as a priority consideration (13.3% of the budget).

Berkely County Commission

West Virginia

The Berkeley County Council, Berkeley County, West Virginia, project continues the Juvenile Opioid Treatment, Intervention and Prevention Program (JOTIPP) in order to expand the opportunity for Berkeley County to support the most vulnerable in the community to the opioid crisis-the children. Continuing the partnership with Berkeley County Schools, the program, hosted by the Berkeley County Recovery Resource Center and the Berkeley County Day Report Center, will: 1) Expand Peer Recovery services to address intervention and treatment needs primarily for students and secondarily, their family members; 2) Expand and strengthen education and prevention activities through small group settings in the 5 high schools, continuing to instill and reinforce resilience and reducing stigma; and 3) Provide funds to CATALIST, an initiative of the Berkeley County Day Report Center whose goal is to provide mental health and wellbeing of at-risk youth and their families. The continuing long-term goal is to curtail opioid use, supporting all citizens to lead productive, health lives. Sixteen percent of Berkeley County's population is school-aged children; by having the ability to provide streamlined services to a large portion of the county at one time allows for an elevated comprehensive, systematic approach to the opioid crisis. The JOTIPP program allows for a reach beyond the student population and connect families to community resources to support those in recovery or seeking recovery from substance use disorder (SUD) reducing opioid use and the number of overdoses. Ensuring programmatic success through comprehensive data analysis is a priority of this program. Therefore, partnership with a research company will guarantee efficiency, effectiveness and impact across both the juvenile programs and adult programs. The project serves Berkeley County, West Virginia with a population of 126,069 and will include partnerships with Berkeley County Schools and Berkeley County Sheriff. A research partner will be selected post-award. This application includes program evaluation which is identified as a priority consideration (13.3% of the budget).

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%).

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.

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.

CO

The Boulder County Community Services Department is applying for Category 1 funding in the amount of $899,902. Project Recovery will implement evidenced-based treatment and recovery services, recovery housing, peer recovery support services, pre- and post-booking treatment alternatives to incarceration, and medication-assisted treatment (MAT). The project will provide services within a recovery home environment in a collaboration between the Boulder County Jail and Tribe Recovery Homes, a provider of home-based recovery and peer support services, and will feature collaborations with community service providers, including the county’s homeless system and housing authorities, workforce, and physical health service providers. Deliverables include establishment of three recovery homes; service provision to 207 clients over three years; development of referral procedures to identify justice system-involved participants with substance use disorders, with a special focus on individuals experiencing homelessness; and implementation of evidence-based therapeutic programs, peer recovery, and MAT services. The goals of the project are to end the cycle of incarceration, support the recovery and reentry process, reduce incidences of crime and recidivism, and create a safer community. The project serves Boulder County, with a population of 326,196. The project includes partnerships with the Boulder County Jail, Tribe Recovery Homes Inc., the Colorado Mental Wellness Network, Homeless Solutions for Boulder County, and the Boulder Community Health and Colorado Community Health Alliance. The project will engage the OMNI Institute as a research partner. Priority considerations addressed in this application include supporting civil rights by limiting arrests due to substance use disorder and providing treatment and decreasing disproportionate minority confinement; protecting the public from crime and evolving threats by stopping the cycle of homelessness, substance use and incarceration, and the societal costs of substance misuse related to interdiction, law enforcement, prosecution, incarceration, and probation; and building trust between law enforcement and the community by providing alternatives to incarceration that demonstrate law enforcement’s commitment to appropriate care.

Boulder County

Colorado

The Boulder County Community Services Department is applying for Category 1 funding in the amount of $899,902. Project Recovery will implement evidenced-based treatment and recovery services, recovery housing, peer recovery support services, pre- and post-booking treatment alternatives to incarceration, and medication-assisted treatment (MAT). The project will provide services within a recovery home environment in a collaboration between the Boulder County Jail and Tribe Recovery Homes, a provider of home-based recovery and peer support services, and will feature collaborations with community service providers, including the county’s homeless system and housing authorities, workforce, and physical health service providers. Deliverables include establishment of three recovery homes; service provision to 207 clients over three years; development of referral procedures to identify justice system-involved participants with substance use disorders, with a special focus on individuals experiencing homelessness; and implementation of evidence-based therapeutic programs, peer recovery, and MAT services. The goals of the project are to end the cycle of incarceration, support the recovery and reentry process, reduce incidences of crime and recidivism, and create a safer community. The project serves Boulder County, with a population of 326,196. The project includes partnerships with the Boulder County Jail, Tribe Recovery Homes Inc., the Colorado Mental Wellness Network, Homeless Solutions for Boulder County, and the Boulder Community Health and Colorado Community Health Alliance. The project will engage the OMNI Institute as a research partner. Priority considerations addressed in this application include supporting civil rights by limiting arrests due to substance use disorder and providing treatment and decreasing disproportionate minority confinement; protecting the public from crime and evolving threats by stopping the cycle of homelessness, substance use and incarceration, and the societal costs of substance misuse related to interdiction, law enforcement, prosecution, incarceration, and probation; and building trust between law enforcement and the community by providing alternatives to incarceration that demonstrate law enforcement’s commitment to appropriate care.

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.

PA

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

Bucks County

Pennsylvania

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

NJ

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

Burlington County

New Jersey

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

OH

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

Butler County Mental Health and Addiction Recovery Services Board

Ohio

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

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.

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.

MI

Cass County, Inc. applied for Category 1c rural/tribal area grant funding in the amount of $600,000. The Cass County COSSAP Project will employ a collaborative and comprehensive “gap-filling” approach to develop, implement, and/or expand/enhance existing trauma-informed evidence-based programming in order to identify, respond to, treat, and support those affected by illicit opioids, stimulants, and other substances. Objectives include the expansion of access to supervision, treatment, and recovery support services across the criminal justice system. The program will also create co-responder crisis intervention teams of trained law enforcement officers and behavioral health practitioners to connect individuals to trauma-informed and evidence-based co-occurring SUD treatment and recovery support services, as well as provide overdose education and prevention activities, and address the needs of children impacted by substance abuse. The project includes partnerships between 43rd Circuit Court judges, Woodlands Behavioral Healthcare Network, Office of the Sheriff, Office of the Prosecutor, Community Corrections, defense attorney, program coordinator, and the program evaluator. Priority considerations addressed in this application include the challenges that rural communities face and Qualified Opportunity Zone.

Cass County, Inc.

Michigan

Cass County, Inc. applied for Category 1c rural/tribal area grant funding in the amount of $600,000. The Cass County COSSAP Project will employ a collaborative and comprehensive “gap-filling” approach to develop, implement, and/or expand/enhance existing trauma-informed evidence-based programming in order to identify, respond to, treat, and support those affected by illicit opioids, stimulants, and other substances. Objectives include the expansion of access to supervision, treatment, and recovery support services across the criminal justice system. The program will also create co-responder crisis intervention teams of trained law enforcement officers and behavioral health practitioners to connect individuals to trauma-informed and evidence-based co-occurring SUD treatment and recovery support services, as well as provide overdose education and prevention activities, and address the needs of children impacted by substance abuse. The project includes partnerships between 43rd Circuit Court judges, Woodlands Behavioral Healthcare Network, Office of the Sheriff, Office of the Prosecutor, Community Corrections, defense attorney, program coordinator, and the program evaluator. Priority considerations addressed in this application include the challenges that rural communities face and Qualified Opportunity Zone.

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).

MD

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

Cecil County

Maryland

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

MD

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

Cecil County, Maryland

Maryland

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

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.

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.

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.

NM

The City of Albuquerque applied for Category 1a urban area grant funding in the amount of $1,126,454. The Gateway to Recovery project will aid in the recovery of homeless individuals experiencing substance use disorder (SUD) while they are engaged in services at city-funded emergency homeless shelters through linkages to transitional or recovery housing and peer recovery support services. The solution complements existing strategies to help residents obtain long-term housing. This project serves the city of Albuquerque, with a population estimated at 915,927. The project includes partnerships between Youth Development, Inc and Heading Home. Priority considerations addressed in this application include high rates of overdose deaths of individuals who are intended to benefit from the requested grant residing in high-poverty areas.

City of Albuquerque

New Mexico

The City of Albuquerque applied for Category 1a urban area grant funding in the amount of $1,126,454. The Gateway to Recovery project will aid in the recovery of homeless individuals experiencing substance use disorder (SUD) while they are engaged in services at city-funded emergency homeless shelters through linkages to transitional or recovery housing and peer recovery support services. The solution complements existing strategies to help residents obtain long-term housing. This project serves the city of Albuquerque, with a population estimated at 915,927. The project includes partnerships between Youth Development, Inc and Heading Home. Priority considerations addressed in this application include high rates of overdose deaths of individuals who are intended to benefit from the requested grant residing in high-poverty areas.

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.

ND

The City of Bismarck is applying for Category 1 funding in the amount of $900,000. Supporting First Responders Through Behavioral Health Interventions, Medication Assisted Treatment, and Connections to Care in the Emergency Department, a multidisciplinary overdose prevention, response, and referral model led by first responders, will serve as a bridge to intervene with overdose victims to transition them to medication-assisted treatment (MAT) and substance use disorder (SUD) treatment. Bismarck Police Department will partner with Heartview Foundation, a licensed addiction treatment provider, and Sanford Health Emergency Department to increase utilization of MAT for individuals with opioid use disorder; utilize recovery support services in the Sanford Emergency Department (ED) to develop a bridge between emergency room, law enforcement/first responders, and individuals needing treatment; and increase the availability of naloxone. The project will also increase communication efforts to reduce stigma surrounding SUDs, opioid use disorders (OUDs), and MAT. Deliverables include interventions with 90 individuals who have experienced an opioid overdose, as well as an additional 80 patients referred from the Opioid Overdose Bridge. Sanford Health ED will train ten medical professionals and twelve support staff members on SUD, MAT, and procedures for the Opioid Overdose Bridge. The project serves the Bismarck-Mandan Metropolitan Area in North Dakota, with an estimated population of 126,990. The project includes partnerships with the Bismarck, Mandan, and Lincoln Police Departments, the Burleigh and Morton County Sheriff’s Departments, Bismarck-Burleigh Public Health, Custer Health, Sanford Health Emergency Department, Ministry on the Margins, and Heartview Foundation. The project will engage Dr. Erin Winstanley, Vice Chair of Research, Department of Behavioral Medicine & Psychiatry at West Virginia University School of Medicine, as an evaluation partner. Priority considerations addressed in this application include a high rate of primary treatment admissions for heroin, opioids, and stimulants; high rates of overdose deaths; and a lack of accessibility to treatment providers and facilities.

City of Bismarck

North Dakota

The City of Bismarck is applying for Category 1 funding in the amount of $900,000. Supporting First Responders Through Behavioral Health Interventions, Medication Assisted Treatment, and Connections to Care in the Emergency Department, a multidisciplinary overdose prevention, response, and referral model led by first responders, will serve as a bridge to intervene with overdose victims to transition them to medication-assisted treatment (MAT) and substance use disorder (SUD) treatment. Bismarck Police Department will partner with Heartview Foundation, a licensed addiction treatment provider, and Sanford Health Emergency Department to increase utilization of MAT for individuals with opioid use disorder; utilize recovery support services in the Sanford Emergency Department (ED) to develop a bridge between emergency room, law enforcement/first responders, and individuals needing treatment; and increase the availability of naloxone. The project will also increase communication efforts to reduce stigma surrounding SUDs, opioid use disorders (OUDs), and MAT. Deliverables include interventions with 90 individuals who have experienced an opioid overdose, as well as an additional 80 patients referred from the Opioid Overdose Bridge. Sanford Health ED will train ten medical professionals and twelve support staff members on SUD, MAT, and procedures for the Opioid Overdose Bridge. The project serves the Bismarck-Mandan Metropolitan Area in North Dakota, with an estimated population of 126,990. The project includes partnerships with the Bismarck, Mandan, and Lincoln Police Departments, the Burleigh and Morton County Sheriff’s Departments, Bismarck-Burleigh Public Health, Custer Health, Sanford Health Emergency Department, Ministry on the Margins, and Heartview Foundation. The project will engage Dr. Erin Winstanley, Vice Chair of Research, Department of Behavioral Medicine & Psychiatry at West Virginia University School of Medicine, 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.

MA

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

City of Boston

Massachusetts

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

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.

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.

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.

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.

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.

MA

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

City of Fitchburg

Massachusetts

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

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.

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.

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.

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.

NC

The City of Jacksonville continues to utilize COSSAP 2019 funding with a focus on enhancing the services array with Transitional Housing Services assistance and Residential/Rehabilitation Treatment costs. Individuals identified within the COSSAP program who are eligible for transitional housing services or treatment services due to inability to provide these services for themselves will work with the Jacksonville Police Department’s Substance Abuse Counselor to locate and obtain these services through the Program. In addition, Staff will be expanding the initiative to train and provide access to life saving Naloxone in public buildings and transportation across the City and surrounding area.

City of Jacksonville

North Carolina

The City of Jacksonville continues to utilize COSSAP 2019 funding with a focus on enhancing the services array with Transitional Housing Services assistance and Residential/Rehabilitation Treatment costs. Individuals identified within the COSSAP program who are eligible for transitional housing services or treatment services due to inability to provide these services for themselves will work with the Jacksonville Police Department’s Substance Abuse Counselor to locate and obtain these services through the Program. In addition, Staff will be expanding the initiative to train and provide access to life saving Naloxone in public buildings and transportation across the City and surrounding area.

NC

In 2016, Jacksonville, North Carolina, was ranked in the Castlight Health report (The Opioid Crisis in America’s Workforce) as the 12th top city for opioid abuse rate in the US, with 8.2 percent of people in the community who receive and abuse an opioid prescription. The report stated that approximately 16,000 residents struggle with prescription abuse. Current statistics show a significant problem in the county, including a rise in overdose deaths following the COVID-19 pandemic. The Onslow County rate of death from overdose increased by 85 percent from 2019 to 2021. The 2022 COSSAP project will expand on the successes of the 2019 project and continue to partner with stakeholders in developing and executing a comprehensive effort to respond to, treat, and support those impacted by the opioid and substance use crisis. The project’s goal is to decrease overdose deaths in our community by developing resources that provide services to individuals struggling with opioid and substance use disorders and their family members. The project will be comprised of seven components; (1) redevelopment of a Quick Response Team, a focused effort to allow individuals to be diverted from the justice system at the two lowest levels of the Sequential Intercept Model; Intercept 0 Community Services and Intercept 1 Law Enforcement; (2) support implementation of peer navigators within the community paramedic program for overdose victims encountered through emergency medical services to swiftly direct them to services and assist with case management after encounter; (3) a law assisted diversion program to direct low level drug offenders to treatment and prevent them from entering criminal justice system (4) an overdose fatality review team to bring together various stakeholders with different perspectives to review overdose deaths; (5) child psychology services to provide therapy for children with adverse childhood experiences due to exposure to substance use in additional to a substance use counselor to work with the school system providing education and referral services to families experiencing SUD. The project will also include evaluation utilizing experienced social science research evaluators. This project will serve individuals in the City of Jacksonville (pop 72,447) and the County of Onslow, NC (pop 193,893) and includes partners from the governmental, non-profit and service provider business entities. These partners include: Onslow County, Onslow County Department of Social Services, Onslow County Health Department, Onslow County Emergency Services, the Dix Crisis Center, Integrated Family Services, the Onslow County District Attorney’s Office, District and Superior Court Judges, Onslow County Schools, Onslow Memorial Hospital, and the Onslow County Partnership for Children.

City of Jacksonville

North Carolina

In 2016, Jacksonville, North Carolina, was ranked in the Castlight Health report (The Opioid Crisis in America’s Workforce) as the 12th top city for opioid abuse rate in the US, with 8.2 percent of people in the community who receive and abuse an opioid prescription. The report stated that approximately 16,000 residents struggle with prescription abuse. Current statistics show a significant problem in the county, including a rise in overdose deaths following the COVID-19 pandemic. The Onslow County rate of death from overdose increased by 85 percent from 2019 to 2021. The 2022 COSSAP project will expand on the successes of the 2019 project and continue to partner with stakeholders in developing and executing a comprehensive effort to respond to, treat, and support those impacted by the opioid and substance use crisis. The project’s goal is to decrease overdose deaths in our community by developing resources that provide services to individuals struggling with opioid and substance use disorders and their family members. The project will be comprised of seven components; (1) redevelopment of a Quick Response Team, a focused effort to allow individuals to be diverted from the justice system at the two lowest levels of the Sequential Intercept Model; Intercept 0 Community Services and Intercept 1 Law Enforcement; (2) support implementation of peer navigators within the community paramedic program for overdose victims encountered through emergency medical services to swiftly direct them to services and assist with case management after encounter; (3) a law assisted diversion program to direct low level drug offenders to treatment and prevent them from entering criminal justice system (4) an overdose fatality review team to bring together various stakeholders with different perspectives to review overdose deaths; (5) child psychology services to provide therapy for children with adverse childhood experiences due to exposure to substance use in additional to a substance use counselor to work with the school system providing education and referral services to families experiencing SUD. The project will also include evaluation utilizing experienced social science research evaluators. This project will serve individuals in the City of Jacksonville (pop 72,447) and the County of Onslow, NC (pop 193,893) and includes partners from the governmental, non-profit and service provider business entities. These partners include: Onslow County, Onslow County Department of Social Services, Onslow County Health Department, Onslow County Emergency Services, the Dix Crisis Center, Integrated Family Services, the Onslow County District Attorney’s Office, District and Superior Court Judges, Onslow County Schools, Onslow Memorial Hospital, and the Onslow County Partnership for Children.

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.

WA

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

City of Kirkland

Washington

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

CA

The Long Beach City Prosecutor’s Office (CPO) is applying for Category 1 funding in the amount of $900,000. The Long Beach CPO Law Enforcement Assisted Diversion (LEAD) program will be implemented throughout the entire Long Beach community with a focus on high poverty area zip codes, targeting justice-involved individuals who meet criteria for pre-filing and pre-booking diversion intercepts. The project will expand supportive services through capacity building and training, access to wraparound case management, LEAD awareness building, and collective dialogue. The Long Beach Deputy City Prosecutor will develop guidelines that the Long Beach Police Department can utilize to determine an individual’s candidacy for diversion, develop training materials to be used for capacity building workshops with the Long Beach Police Department and other city departments, and create materials explaining how communities can implement and support diversion initiatives. The project serves the City of Long Beach, which has a population of 464,073. The project includes partnerships between the CPO and the Long Beach Police Department, the Long Beach Department of Health and Human Services, and community-based organizations providing services related to substance use, mental health, and homelessness. The project will engage NPC Research as an evaluation partner. Priority considerations addressed in this application include a high rate of primary treatment admissions for heroin, opioids, and stimulants; high rates of overdose deaths; and a lack of accessibility to treatment providers and facilities. The project also provides an opportunity to build trust between law enforcement and the community and will benefit individuals residing in high-poverty areas.

City of Long Beach

California

The Long Beach City Prosecutor’s Office (CPO) is applying for Category 1 funding in the amount of $900,000. The Long Beach CPO Law Enforcement Assisted Diversion (LEAD) program will be implemented throughout the entire Long Beach community with a focus on high poverty area zip codes, targeting justice-involved individuals who meet criteria for pre-filing and pre-booking diversion intercepts. The project will expand supportive services through capacity building and training, access to wraparound case management, LEAD awareness building, and collective dialogue. The Long Beach Deputy City Prosecutor will develop guidelines that the Long Beach Police Department can utilize to determine an individual’s candidacy for diversion, develop training materials to be used for capacity building workshops with the Long Beach Police Department and other city departments, and create materials explaining how communities can implement and support diversion initiatives. The project serves the City of Long Beach, which has a population of 464,073. The project includes partnerships between the CPO and the Long Beach Police Department, the Long Beach Department of Health and Human Services, and community-based organizations providing services related to substance use, mental health, and homelessness. The project will engage NPC Research as an evaluation partner. Priority considerations addressed in this application include a high rate of primary treatment admissions for heroin, opioids, and stimulants; high rates of overdose deaths; and a lack of accessibility to treatment providers and facilities. The project also provides an opportunity to build trust between law enforcement and the community and will benefit individuals residing in high-poverty areas.

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.

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.

WV

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

City of Martinsburg

West Virginia

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

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

MN

The Minneapolis Health Department (MHD) will work with the University of Minnesota Medical Center (UMMC), Red Lake Nation, and other partners to implement First Step, leveraging existing care systems, incorporating evidence-based treatments, and facilitating partnerships between psychosocial and medical providers to offer effective services to persons with opioid use disorder (OUD). This project expands previous work by adding a Peer Recovery Navigator (PRN) as the initial connection at the emergency department, who will work with the patient until they are discharged and connected with services. The PRN will build rapport and negotiate immediate and short-term goals with the patient. They will provide close follow up with the patient at the community level and help them get established on medication. The goal will be to have the patient engage in medication-assisted treatment through the delivery of a “bupe bundle” in the emergency department as an entry point to recovery, then connect them with support services in the community. The community-based project will be implemented through Red Lake Nation and serve as a referral for UMMC and first responders. An additional point of entry to First Step will be a mobile medical unit which will have the capacity to deliver MAT and serve both as a connection and referral point for the other components. Minneapolis is experiencing a disproportionate impact from opioid-related overdoses compared to the rest of Minnesota. Two communities within Minneapolis are particularly impacted by the opioid crisis, American Indians, and African Americans. The three-year average (2018-2020) mortality rate of opioid overdose among American Indians (215 deaths per 100,000 persons) is almost nine times higher than the city-wide rate (24 deaths per 100,000 persons), and 12 times that of white residents. For the African American community, the average mortality rate, 41 deaths per 100,000 persons, more than doubles that of the white population. One hundred percent of the budget will be used to implement evidence-based substance use disorder treatment related to opioids, stimulants, and other illicit drugs, such as MAT, as well as harm reduction services and recovery support services.

City of Minneapolis

Minnesota

The Minneapolis Health Department (MHD) will work with the University of Minnesota Medical Center (UMMC), Red Lake Nation, and other partners to implement First Step, leveraging existing care systems, incorporating evidence-based treatments, and facilitating partnerships between psychosocial and medical providers to offer effective services to persons with opioid use disorder (OUD). This project expands previous work by adding a Peer Recovery Navigator (PRN) as the initial connection at the emergency department, who will work with the patient until they are discharged and connected with services. The PRN will build rapport and negotiate immediate and short-term goals with the patient. They will provide close follow up with the patient at the community level and help them get established on medication. The goal will be to have the patient engage in medication-assisted treatment through the delivery of a “bupe bundle” in the emergency department as an entry point to recovery, then connect them with support services in the community. The community-based project will be implemented through Red Lake Nation and serve as a referral for UMMC and first responders. An additional point of entry to First Step will be a mobile medical unit which will have the capacity to deliver MAT and serve both as a connection and referral point for the other components. Minneapolis is experiencing a disproportionate impact from opioid-related overdoses compared to the rest of Minnesota. Two communities within Minneapolis are particularly impacted by the opioid crisis, American Indians, and African Americans. The three-year average (2018-2020) mortality rate of opioid overdose among American Indians (215 deaths per 100,000 persons) is almost nine times higher than the city-wide rate (24 deaths per 100,000 persons), and 12 times that of white residents. For the African American community, the average mortality rate, 41 deaths per 100,000 persons, more than doubles that of the white population. One hundred percent of the budget will be used to implement evidence-based substance use disorder treatment related to opioids, stimulants, and other illicit drugs, such as MAT, as well as harm reduction services and recovery support services.

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

Opioid substance use has increased both from prescriptions and illegally manufactured fentanyl. The Orleans Parish, Louisiana, Coroner’s office stated that overdose deaths rose by 35 percent in 2021 and fentanyl was present in 94 percent of those autopsies. People with substance use disorder (SUD), including opioid use disorder (OUD), have been hit especially hard by the COVID-19 pandemic. An independent assessment by the Pew Charitable Trust found that low access to treatment is largely driven by the limited number of providers across Louisiana. These considerations will inform New Orleans Emergency Medical Services’ (NOEMS) approach to this program. NOEMS is responsive to the unique considerations of marginalized groups and this project will include several culturally sensitive measures. The project will span across New Orleans, which is coextensive with Orleans Parish, in collaboration with local non-profit behavioral healthcare facility Odyssey House Louisiana (OHL). NOEMS will provide overdose response, wraparound services, harm reduction activities, education, and prevention services to individuals who experience an overdose, including those who do not consent to transport to an emergency department. NOEMS and OHL will implement this program utilizing three trained outreach coordinators on a rapid response team that will link the citizens to treatment, services, education, overdose prevention strategies, and direct services on scene and provide transportation as needed to treatment. Project activities include: (1) deflection and pre-arrest diversion–NOEMS and OHL will collaborate to ensure that as many needs as possible are met at the scene of an overdose. Anyone who is revived from an overdose and does not wish to be transported to an emergency department will be diverted to a treatment program if they request a referral; (2) real-time data collection–the NOEMS program coordinator will collect real-time data from electronic patient care reports on overdose patients; (3) naloxone–with COSSAP funding, the program will purchase 350 Naloxone kits per year for distribution to every person included in this program. The program utilizes 67 percent of the budget for program staff which includes four team members dedicated to this program. The remainder of the budget is used for program related travel, outside evaluation services, supplies and equipment. This program expects to assist 350 individuals affected by opioid overdoses each year (1,050 total).

City of New Orleans EMS

Louisiana

Opioid substance use has increased both from prescriptions and illegally manufactured fentanyl. The Orleans Parish, Louisiana, Coroner’s office stated that overdose deaths rose by 35 percent in 2021 and fentanyl was present in 94 percent of those autopsies. People with substance use disorder (SUD), including opioid use disorder (OUD), have been hit especially hard by the COVID-19 pandemic. An independent assessment by the Pew Charitable Trust found that low access to treatment is largely driven by the limited number of providers across Louisiana. These considerations will inform New Orleans Emergency Medical Services’ (NOEMS) approach to this program. NOEMS is responsive to the unique considerations of marginalized groups and this project will include several culturally sensitive measures. The project will span across New Orleans, which is coextensive with Orleans Parish, in collaboration with local non-profit behavioral healthcare facility Odyssey House Louisiana (OHL). NOEMS will provide overdose response, wraparound services, harm reduction activities, education, and prevention services to individuals who experience an overdose, including those who do not consent to transport to an emergency department. NOEMS and OHL will implement this program utilizing three trained outreach coordinators on a rapid response team that will link the citizens to treatment, services, education, overdose prevention strategies, and direct services on scene and provide transportation as needed to treatment. Project activities include: (1) deflection and pre-arrest diversion–NOEMS and OHL will collaborate to ensure that as many needs as possible are met at the scene of an overdose. Anyone who is revived from an overdose and does not wish to be transported to an emergency department will be diverted to a treatment program if they request a referral; (2) real-time data collection–the NOEMS program coordinator will collect real-time data from electronic patient care reports on overdose patients; (3) naloxone–with COSSAP funding, the program will purchase 350 Naloxone kits per year for distribution to every person included in this program. The program utilizes 67 percent of the budget for program staff which includes four team members dedicated to this program. The remainder of the budget is used for program related travel, outside evaluation services, supplies and equipment. This program expects to assist 350 individuals affected by opioid overdoses each year (1,050 total).

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.

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

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.

NV

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

City of North Las Vegas

Nevada

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

WA

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

City of Olympia

Washington

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

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.

NJ

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

City of Paterson

New Jersey

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

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.

AR

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

City of Searcy

Arkansas

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

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.

OH

The City of Springfield, Ohio, is the applicant and fiscal agent for the project and the Community Development Department will serve as the administrative lead for the City of Springfield, in partnership with Mental Health Recovery Board and McKinley Hall. Nearly half the county population is concentrated in Springfield’s four federally designated Qualified Opportunity Zones. The Recovery Resource and Community Advocacy Project advances racial equity, supporting underserved and marginalized communities. African Americans comprise 9 percent of the county, but at least 18 percent of Springfield residents–nearly a quarter of whom live in poverty and 15 percent are disabled. The black community is disproportionately impacted by incarceration, high rates of homelessness, and overdose fatality. Clark County’s overdose fatality rate has consistently been one of the highest in Ohio at 61 (per 100,000) and is currently climbing, even as rates decrease in other parts of the state. The project expands medication-friendly recovery housing, culturally responsive peer support, substance use disorder (SUD) treatment inside the jail, and increases re-entry access to medically-assisted treatment (MAT) and naloxone. The project includes gender-responsive treatment for women in jail, the first recovery housing for women, access to MAT. The project will also educate and advocate among community and justice agencies for the legal right to continue MOUDs in custody and to bring methadone into the jail for pregnant women. Advocacy and empowerment training is also one of the service deliverables for project participants, with Legal Action Center’s Know Your Rights-MAT presentations, harm reduction, ending race and gender-based health disparities, women’s empowerment training, and MAT anti-stigma outreach and education. Almost 30 percent of funds will support recovery housing, while more than 60 percent will allow local project partner McKinley Hall to increase the evidenced-based treatment services they currently deliver inside the jail, embedding peers, clinicians, and harm reduction services, and to provide care coordination and MAT upon re-entry.

City of Springfield

Ohio

The City of Springfield, Ohio, is the applicant and fiscal agent for the project and the Community Development Department will serve as the administrative lead for the City of Springfield, in partnership with Mental Health Recovery Board and McKinley Hall. Nearly half the county population is concentrated in Springfield’s four federally designated Qualified Opportunity Zones. The Recovery Resource and Community Advocacy Project advances racial equity, supporting underserved and marginalized communities. African Americans comprise 9 percent of the county, but at least 18 percent of Springfield residents–nearly a quarter of whom live in poverty and 15 percent are disabled. The black community is disproportionately impacted by incarceration, high rates of homelessness, and overdose fatality. Clark County’s overdose fatality rate has consistently been one of the highest in Ohio at 61 (per 100,000) and is currently climbing, even as rates decrease in other parts of the state. The project expands medication-friendly recovery housing, culturally responsive peer support, substance use disorder (SUD) treatment inside the jail, and increases re-entry access to medically-assisted treatment (MAT) and naloxone. The project includes gender-responsive treatment for women in jail, the first recovery housing for women, access to MAT. The project will also educate and advocate among community and justice agencies for the legal right to continue MOUDs in custody and to bring methadone into the jail for pregnant women. Advocacy and empowerment training is also one of the service deliverables for project participants, with Legal Action Center’s Know Your Rights-MAT presentations, harm reduction, ending race and gender-based health disparities, women’s empowerment training, and MAT anti-stigma outreach and education. Almost 30 percent of funds will support recovery housing, while more than 60 percent will allow local project partner McKinley Hall to increase the evidenced-based treatment services they currently deliver inside the jail, embedding peers, clinicians, and harm reduction services, and to provide care coordination and MAT upon re-entry.

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.

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.

OH

The Clermont County Mental Health and Recovery Board (CCMHB) is applying for Category 1 funding in the amount of $858,171. The project will enable the expansion of existing Quick Response Teams (QRTs) in Clermont County. The CCMHRB will expand two of the three QRTs, with a focus on improving outreach and treatment connection rates; increase QRT outreach provided by the Clermont County Sheriff Office's (CCSO) QRT; enhance the QRTs to include a mental health professional to address mental health concerns encountered on QRT outreach attempts; and hire a coordinator to implement a "Handle with Care" program to provide support to children who encounter an overdose and/or have had their parents involved in recent drug charges. The goal of the project is to reduce overdoses and provide connection to treatment and support services for individuals with an opioid misuse disorder and/or a stimulant misuse disorder and their families/loved ones. It is estimated that 300 Clermont County residents will be served by the project annually, including youth and adults. The project serves Clermont County, a largely rural county with a population of 208,234. The project includes partnerships with the CCSO, Greater Cincinnati Behavioral Health, Child Focus (a children’s mental health provider), and local school districts and law enforcement agencies. 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.

Clermont County Mental Health and Recovery Board

Ohio

The Clermont County Mental Health and Recovery Board (CCMHB) is applying for Category 1 funding in the amount of $858,171. The project will enable the expansion of existing Quick Response Teams (QRTs) in Clermont County. The CCMHRB will expand two of the three QRTs, with a focus on improving outreach and treatment connection rates; increase QRT outreach provided by the Clermont County Sheriff Office's (CCSO) QRT; enhance the QRTs to include a mental health professional to address mental health concerns encountered on QRT outreach attempts; and hire a coordinator to implement a "Handle with Care" program to provide support to children who encounter an overdose and/or have had their parents involved in recent drug charges. The goal of the project is to reduce overdoses and provide connection to treatment and support services for individuals with an opioid misuse disorder and/or a stimulant misuse disorder and their families/loved ones. It is estimated that 300 Clermont County residents will be served by the project annually, including youth and adults. The project serves Clermont County, a largely rural county with a population of 208,234. The project includes partnerships with the CCSO, Greater Cincinnati Behavioral Health, Child Focus (a children’s mental health provider), and local school districts and law enforcement agencies. 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.

GA

Cobb County is applying for Category 1 funding in the amount of $1,200,000. The Cobb County COSSAP Initiative will feature an alternative-to-incarceration program that serves individuals at high risk for overdose or substance misuse whereby the county jail will offer case management services to opioid-involved offenders, including access to treatment/recovery programs, as well as life skills and other assistance programs. The Zone, a local community recovery organization, will employ a K-12 education consultant who will deliver a six-hour curriculum to elementary, middle, and high school students about substance use disorders that includes information about available resources for detoxification, rehabilitation, accountability courts, intensive outpatient programs, sober living, and aftercare. The project will also train peer support specialists and Crisis Response Team members to be available to law enforcement to respond to drug overdoses, including those where children might be present, through projects initiated by the Cobb County Fire Department and the Marietta Police Department and provide participants of Cobb County Accountability Courts and Pre-trial Diversion with weekly one-on-one recovery coaching, an individualized recovery plan, and job readiness training. Cobb County will also purchase naloxone for community-wide distribution and training. The project serves Cobb County, which has a population of approximately 760,000. The project includes partnerships with the District Attorney's Office (specifically its Major Narcotics Unit and Victim Witness Unit), the Cobb and Douglas Department of Public Health, the Cobb Office of the Medical Examiner, the Cobb County Police Department, Cobb Fire and Emergency Services, and the Zone. The project will engage Applied Research Services (ARS), Inc., as a research/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.

Cobb County

Georgia

Cobb County is applying for Category 1 funding in the amount of $1,200,000. The Cobb County COSSAP Initiative will feature an alternative-to-incarceration program that serves individuals at high risk for overdose or substance misuse whereby the county jail will offer case management services to opioid-involved offenders, including access to treatment/recovery programs, as well as life skills and other assistance programs. The Zone, a local community recovery organization, will employ a K-12 education consultant who will deliver a six-hour curriculum to elementary, middle, and high school students about substance use disorders that includes information about available resources for detoxification, rehabilitation, accountability courts, intensive outpatient programs, sober living, and aftercare. The project will also train peer support specialists and Crisis Response Team members to be available to law enforcement to respond to drug overdoses, including those where children might be present, through projects initiated by the Cobb County Fire Department and the Marietta Police Department and provide participants of Cobb County Accountability Courts and Pre-trial Diversion with weekly one-on-one recovery coaching, an individualized recovery plan, and job readiness training. Cobb County will also purchase naloxone for community-wide distribution and training. The project serves Cobb County, which has a population of approximately 760,000. The project includes partnerships with the District Attorney's Office (specifically its Major Narcotics Unit and Victim Witness Unit), the Cobb and Douglas Department of Public Health, the Cobb Office of the Medical Examiner, the Cobb County Police Department, Cobb Fire and Emergency Services, and the Zone. The project will engage Applied Research Services (ARS), Inc., as a research/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.

MA

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

Commonwealth of Massachusetts dba Middlesex Sheriff's Office

Massachusetts

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

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.

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.

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.

IL

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

Cook County

Illinois

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

IL

Through this funding, Cook County Health will (1) Convene the Cook County Community Recovery Learning and Action Network to address recovery housing capacity and coordination; (2) Develop a real-time regional recovery housing information system; (3) Connect justice-involved patients who are part of the Cook County Health substance use disorder program with recovery home services; (4) Pilot a harm reduction oriented, low barrier recovery home to fill a gap in the current recovery home landscape identified by grant partners; and (5) Provide peer recovery support services to individuals involved in drug court.

Cook County Health

Illinois

Through this funding, Cook County Health will (1) Convene the Cook County Community Recovery Learning and Action Network to address recovery housing capacity and coordination; (2) Develop a real-time regional recovery housing information system; (3) Connect justice-involved patients who are part of the Cook County Health substance use disorder program with recovery home services; (4) Pilot a harm reduction oriented, low barrier recovery home to fill a gap in the current recovery home landscape identified by grant partners; and (5) Provide peer recovery support services to individuals involved in drug court.

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.

CA

The Amador County Sheriff's Office, in Amador County, California, is located approximately 45 miles southeast of Sacramento in a part of California known as the foothills of the Sierra Nevada Mountains. In 2021, the population was estimated at approximately 41,259 residents, which includes a state prison. This project supports a jail-based project in Amador County. The Amador County Sheriff's Office will establish a comprehensive reentry program that involves three core components: (1) Discharge planning; (2) Job training; and (3) Peer recovery support.

County of Amador

California

The Amador County Sheriff's Office, in Amador County, California, is located approximately 45 miles southeast of Sacramento in a part of California known as the foothills of the Sierra Nevada Mountains. In 2021, the population was estimated at approximately 41,259 residents, which includes a state prison. This project supports a jail-based project in Amador County. The Amador County Sheriff's Office will establish a comprehensive reentry program that involves three core components: (1) Discharge planning; (2) Job training; and (3) Peer recovery support.

PA

The Cambria County, Pennsylvania, project will expand access to transitional housing, case management services, and workforce development for individuals who have left incarceration and are on probation services with Cambria County Adult Probation and Parole Services. The project will focus on the following: (1) Partner with Breaking the Barriers to provide recovery housing and case management services to up to 90 individuals over the life of the grant. (2) Partner with Goodwill of the Southern Alleghenies to provide workforce development and education services to up to 100 individuals over the life of the grant. (3) Partner with a researcher to continue to provide research-based strategies to identify treatment/resource needs, address system gaps, and evaluate program effectiveness through objective measures. Planned activities/allowable uses include evidence based substance use disorder treatment related to opioids, stimulants, and other drugs, such as MAT, as well as harm reduction activities and recovery support services for pre-trial and post-trial populations leaving jail or residential treatment programs.

County of Cambria

Pennsylvania

The Cambria County, Pennsylvania, project will expand access to transitional housing, case management services, and workforce development for individuals who have left incarceration and are on probation services with Cambria County Adult Probation and Parole Services. The project will focus on the following: (1) Partner with Breaking the Barriers to provide recovery housing and case management services to up to 90 individuals over the life of the grant. (2) Partner with Goodwill of the Southern Alleghenies to provide workforce development and education services to up to 100 individuals over the life of the grant. (3) Partner with a researcher to continue to provide research-based strategies to identify treatment/resource needs, address system gaps, and evaluate program effectiveness through objective measures. Planned activities/allowable uses include evidence based substance use disorder treatment related to opioids, stimulants, and other drugs, such as MAT, as well as harm reduction activities and recovery support services for pre-trial and post-trial populations leaving jail or residential treatment programs.

VA

The Chesterfield County Sheriff's Office project serves a population of over 500,000. The initiative will allow the Chesterfield County Sheriff's Office to expand evidence-based substance use treatment, peer recovery support services, and recovery housing for justice-involved individuals at multiple intercepts. These services are essential to supporting treatment engagement. The project addresses COSSUP's allowable use of implementing evidence-based substance use disorder treatment related to opioids, stimulants, and other drugs and recovery support services for pre-trial and post-trial populations leaving jail. Deliverables include providing case management, treatment, and discharge planning for 300 individuals, providing recovery housing for 130 justice-involved individuals, providing peer recovery support services to up to 240 justice-involved individuals, and providing evidence-based supervision and treatment to up to 240 individuals on pretrial supervision over the life of the grant.

County of Chesterfield

Virginia

The Chesterfield County Sheriff's Office project serves a population of over 500,000. The initiative will allow the Chesterfield County Sheriff's Office to expand evidence-based substance use treatment, peer recovery support services, and recovery housing for justice-involved individuals at multiple intercepts. These services are essential to supporting treatment engagement. The project addresses COSSUP's allowable use of implementing evidence-based substance use disorder treatment related to opioids, stimulants, and other drugs and recovery support services for pre-trial and post-trial populations leaving jail. Deliverables include providing case management, treatment, and discharge planning for 300 individuals, providing recovery housing for 130 justice-involved individuals, providing peer recovery support services to up to 240 justice-involved individuals, and providing evidence-based supervision and treatment to up to 240 individuals on pretrial supervision over the life of the grant.

TX

The Dallas County Criminal Justice Department project focuses on supporting and enhancing its Pretrial Diversion Assessment Program (PTDAP). The funding request is to hire 3 full-time program clinicians to complete pretrial diversion evidenced based assessments, 1 full-time program coordinator to support the program, and funding for program evaluation and research. The grant will expand access to treatment and recovery support services for individuals with substance use disorders in the criminal justice system, specifically first-time felony offenders charged with a low-level, non-violent offense. Dallas County's PTDAP started in July 2021 and needs continued and expanded funding to support the growing program and to continue operation. The project will complete evidence-based risk-need-responsivity assessments on pretrial defendants by a program clinician. This will provide individualized recommendations for the appropriate pretrial diversion program, treatment, and recovery support services. When the defendant successfully completes his/her pretrial diversion program, his/her case is dismissed and expunged, preventing a felony conviction. The PTDAP will serve any eligible defendant within Dallas County, an urban county with a population of approximately 2.6 million. It is estimated that around 600 defendants a year in Dallas County would qualify for the PTDAP. The primary activities of the PTDAP are to provide a post-booking treatment alternative-to-incarceration program, pretrial diversion program; to enable court programming to prioritize and expedite treatment and recovery services for individuals at high-risk of overdose and substance use disorder; and to increase access to evidenced-based treatment. The project goal is to expand and expedite pretrial diversion for firsttime felony offenders with eligible offenses, by leveraging a streamlined process and evidence-based assessments to determine the individual's needs for treatment, recovery support, resources, and appropriate diversion programs, reducing the number of defendants sent to prison, state jail, or released on probation and resulting in a conviction. The project's objectives include increasing referrals and assessments to racial minority groups and underserved communities to advance racial equity, reduce time to expedite the pretrial diversion process, and expand access to needed evidence-based substance use treatment and recovery support. This includes utilizing the assessments to screen defendants for needed for cognitive-behavioral treatment, Mediation Assisted Treatment (MAT), and other treatment and support to address those who have significant substance use history and are at higher risk of overdose.

County of Dallas

Texas

The Dallas County Criminal Justice Department project focuses on supporting and enhancing its Pretrial Diversion Assessment Program (PTDAP). The funding request is to hire 3 full-time program clinicians to complete pretrial diversion evidenced based assessments, 1 full-time program coordinator to support the program, and funding for program evaluation and research. The grant will expand access to treatment and recovery support services for individuals with substance use disorders in the criminal justice system, specifically first-time felony offenders charged with a low-level, non-violent offense. Dallas County's PTDAP started in July 2021 and needs continued and expanded funding to support the growing program and to continue operation. The project will complete evidence-based risk-need-responsivity assessments on pretrial defendants by a program clinician. This will provide individualized recommendations for the appropriate pretrial diversion program, treatment, and recovery support services. When the defendant successfully completes his/her pretrial diversion program, his/her case is dismissed and expunged, preventing a felony conviction. The PTDAP will serve any eligible defendant within Dallas County, an urban county with a population of approximately 2.6 million. It is estimated that around 600 defendants a year in Dallas County would qualify for the PTDAP. The primary activities of the PTDAP are to provide a post-booking treatment alternative-to-incarceration program, pretrial diversion program; to enable court programming to prioritize and expedite treatment and recovery services for individuals at high-risk of overdose and substance use disorder; and to increase access to evidenced-based treatment. The project goal is to expand and expedite pretrial diversion for firsttime felony offenders with eligible offenses, by leveraging a streamlined process and evidence-based assessments to determine the individual's needs for treatment, recovery support, resources, and appropriate diversion programs, reducing the number of defendants sent to prison, state jail, or released on probation and resulting in a conviction. The project's objectives include increasing referrals and assessments to racial minority groups and underserved communities to advance racial equity, reduce time to expedite the pretrial diversion process, and expand access to needed evidence-based substance use treatment and recovery support. This includes utilizing the assessments to screen defendants for needed for cognitive-behavioral treatment, Mediation Assisted Treatment (MAT), and other treatment and support to address those who have significant substance use history and are at higher risk of overdose.

GA

Fulton County Department of Behavioral Health and Disabilities (DBHDD), in partnership with Atlanta Policing Alternatives and Diversion Initiative (PAD), supports the Fulton County Diversion and Deflection Recovery Program (FDR) to respond to substance use, promote public safety, and support access to SUD treatment and recovery services for individuals in Fulton County, Georgia. Annually, DBHDD provides services for over 2,600 people with mental health issues and SUD/COD at five sites throughout Fulton County. Services include screening, assessment, specialty outpatient treatment, and individual and group therapy provided through contracts with community-based providers. This project builds upon the successes of DBHDD's FY20 COSSAP to expand to Fulton County's most underserved areas and increase deflection and diversion across the county. Fulton County is the largest county in Georgia and has experienced a drastic increase in arrests of people with SUD for low-level offenses, delaying or denying vital treatment while also overcrowding jails and the court. In 2021, the City of Atlanta and Fulton County partnered to establish The Center for Diversion and Services (The Center) to provide an alternative to placing people in jail or in the detention center who suffer from behavioral health issues. The FDR program will: (i) provide training to new law enforcement officers and ongoing quarterly professional development for existing officers to promote diversion to The Center, expanding to several precincts within Fulton County; (ii) provide intensive care navigation for at least 425 diverted participants and increased access to recovery housing for those in need; (iii) provide evidence-based mobile behavioral health services to diverted individuals in recovery housing; and (iv) conduct deflection outreach to targeted areas of high crime and high usage in North and South Fulton to connect individuals with needed SUD services before they reach involvement with the criminal justice system. The program's expected outcomes are to increase diversion to The Center year-over-year, reduce recidivism in Fulton County, and increase access to evidence-based behavioral health treatments to individuals in recovery housing. Beneficiaries of this program include individuals with SUD, local law enforcement agencies, and all Fulton County residents. FDR will implement the following allowable activities: Law enforcement deflection and diversion; Naloxone for first responders; Pre-booking and post-booking treatment alternative-to-incarceration programs; Evidence-based SUD treatments and harm reduction activities; Recovery housing and peer support; Embedding peers; and Field initiated projects.

County of Fulton

Georgia

Fulton County Department of Behavioral Health and Disabilities (DBHDD), in partnership with Atlanta Policing Alternatives and Diversion Initiative (PAD), supports the Fulton County Diversion and Deflection Recovery Program (FDR) to respond to substance use, promote public safety, and support access to SUD treatment and recovery services for individuals in Fulton County, Georgia. Annually, DBHDD provides services for over 2,600 people with mental health issues and SUD/COD at five sites throughout Fulton County. Services include screening, assessment, specialty outpatient treatment, and individual and group therapy provided through contracts with community-based providers. This project builds upon the successes of DBHDD's FY20 COSSAP to expand to Fulton County's most underserved areas and increase deflection and diversion across the county. Fulton County is the largest county in Georgia and has experienced a drastic increase in arrests of people with SUD for low-level offenses, delaying or denying vital treatment while also overcrowding jails and the court. In 2021, the City of Atlanta and Fulton County partnered to establish The Center for Diversion and Services (The Center) to provide an alternative to placing people in jail or in the detention center who suffer from behavioral health issues. The FDR program will: (i) provide training to new law enforcement officers and ongoing quarterly professional development for existing officers to promote diversion to The Center, expanding to several precincts within Fulton County; (ii) provide intensive care navigation for at least 425 diverted participants and increased access to recovery housing for those in need; (iii) provide evidence-based mobile behavioral health services to diverted individuals in recovery housing; and (iv) conduct deflection outreach to targeted areas of high crime and high usage in North and South Fulton to connect individuals with needed SUD services before they reach involvement with the criminal justice system. The program's expected outcomes are to increase diversion to The Center year-over-year, reduce recidivism in Fulton County, and increase access to evidence-based behavioral health treatments to individuals in recovery housing. Beneficiaries of this program include individuals with SUD, local law enforcement agencies, and all Fulton County residents. FDR will implement the following allowable activities: Law enforcement deflection and diversion; Naloxone for first responders; Pre-booking and post-booking treatment alternative-to-incarceration programs; Evidence-based SUD treatments and harm reduction activities; Recovery housing and peer support; Embedding peers; and Field initiated projects.

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).

OH

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

County of Hamilton

Ohio

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

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.

AL

Jefferson County, Alabama, services an area with a population of over 500,000. The initiative will allow Jefferson County to expand evidence-based substance use treatment and peer recovery support services to a pretrial population at high risk for overdose. 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 a pre-trial population leaving jail.

County of Jefferson

Alabama

Jefferson County, Alabama, services an area with a population of over 500,000. The initiative will allow Jefferson County to expand evidence-based substance use treatment and peer recovery support services to a pretrial population at high risk for overdose. 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 a pre-trial population leaving jail.

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.

NC

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

County of Lenoir

North Carolina

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

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.

WI

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

County of Oneida

Wisconsin

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

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.

CA

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

County of San Luis Obispo

California

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

CA

Continuation funding from the BJA FY 2023 Comprehensive Opioid, Stimulant, and Substance Use Site-based Program (COSSUP), will enable Stanislaus County, California, to expand and enhance comprehensive programs to identify, respond to, treat, and support those impacted by the overdose crisis and the impacts of used and misuse of opioids, stimulants, or other substances. Lead agency for the project is County of Stanislaus, a unit of local government in California. Project partners are Stanislaus County Behavioral Health and Recovery Services, Center for Human Services and Stanislaus County Health Services Agency. County of Stanislaus's population is over 500,000. The project goal is to reduce the impact of the use and misuse of opioids, stimulants, and other substances on individuals and communities, as well as to mitigate the impacts on crime victims by supporting comprehensive, collaborative initiatives. This will be accomplished by embedding COAP-funded staff with the current Community Assessment, Response, and Engagement (CARE) Multidisciplinary Team (Evidence-based practice) colocated in Modesto, California. The project objectives are to support comprehensive, locally driven response to the use and misuse of opioids, stimulants, and other substances that expand access to treatment and recovery support services; support law enforcement-led deflection programs; and promote education and prevention activities. This will be accomplished by implementing a multidisciplinary overdose prevention, response, and deflection/diversion model led by law enforcement (CARE MDT); providing evidence-based SUD treatment such as Motivational Interviewing as well as harm reduction activities, including educating users on the proper use of Naloxone; and providing access to transitional/recovery housing and recovery support services. The project deliverables are to maintain a working relationship with the BJA supported COSSUP training and TA providers and to establish/maintain a multidisciplinary coordinating body that focused on addressing the issues that arise due to the use and misuse of opioids, stimulants, and other substances. The multidisciplinary coordinating body will be the CARE MDT, who will also collaborate closely with the Stanislaus County Opioid Safety Coalition. The will support: (1) Personnel costs; (2) Travel costs for BJA-required training and convening; (3) Program Supplies; (4) Recovery Housing; (5) Emergency Housing Vouchers. The service area is Stanislaus County, California including all towns and rural hamlets. The target population served by this grant will be primarily homeless individuals impacted by the overdose crisis in Stanislaus County.

County of Stanislaus

California

Continuation funding from the BJA FY 2023 Comprehensive Opioid, Stimulant, and Substance Use Site-based Program (COSSUP), will enable Stanislaus County, California, to expand and enhance comprehensive programs to identify, respond to, treat, and support those impacted by the overdose crisis and the impacts of used and misuse of opioids, stimulants, or other substances. Lead agency for the project is County of Stanislaus, a unit of local government in California. Project partners are Stanislaus County Behavioral Health and Recovery Services, Center for Human Services and Stanislaus County Health Services Agency. County of Stanislaus's population is over 500,000. The project goal is to reduce the impact of the use and misuse of opioids, stimulants, and other substances on individuals and communities, as well as to mitigate the impacts on crime victims by supporting comprehensive, collaborative initiatives. This will be accomplished by embedding COAP-funded staff with the current Community Assessment, Response, and Engagement (CARE) Multidisciplinary Team (Evidence-based practice) colocated in Modesto, California. The project objectives are to support comprehensive, locally driven response to the use and misuse of opioids, stimulants, and other substances that expand access to treatment and recovery support services; support law enforcement-led deflection programs; and promote education and prevention activities. This will be accomplished by implementing a multidisciplinary overdose prevention, response, and deflection/diversion model led by law enforcement (CARE MDT); providing evidence-based SUD treatment such as Motivational Interviewing as well as harm reduction activities, including educating users on the proper use of Naloxone; and providing access to transitional/recovery housing and recovery support services. The project deliverables are to maintain a working relationship with the BJA supported COSSUP training and TA providers and to establish/maintain a multidisciplinary coordinating body that focused on addressing the issues that arise due to the use and misuse of opioids, stimulants, and other substances. The multidisciplinary coordinating body will be the CARE MDT, who will also collaborate closely with the Stanislaus County Opioid Safety Coalition. The will support: (1) Personnel costs; (2) Travel costs for BJA-required training and convening; (3) Program Supplies; (4) Recovery Housing; (5) Emergency Housing Vouchers. The service area is Stanislaus County, California including all towns and rural hamlets. The target population served by this grant will be primarily homeless individuals impacted by the overdose crisis in Stanislaus County.

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.

NC

The Craven County Sheriff’s Office is a unit of local government in New Bern, North Carolina, a rural area in Eastern North Carolina. Working with community partners, The Craven County Sherriff’s Office proposes to provide jail-based and re-entry programs to: (1) expand or enhance pre-booking or post-booking treatment or intervention programs that serve individuals at high risk for overdose or substance abuse; (2) expand or enhance embedding social workers, peers, and/or persons with lived experience at any intercept of the Sequential Intercept Model to assist persons in the criminal justice system and their families navigate the justice system and increase their connection to treatment and recovery support services (66 percent of the budget), and (3) expand and enhance evidence-based treatment and recovery support services including transitional or recovery housing (15 percent of the budget), transportation (7 percent of the budget), and peer recovery support services (12 percent of the budget). Funding from this grant will increase access to behavioral health treatment and services, improve linkage to peer specialists and recovery support, and provide transitional recovery housing to the most vulnerable individuals leaving the Craven County Jail.

Craven County Government

North Carolina

The Craven County Sheriff’s Office is a unit of local government in New Bern, North Carolina, a rural area in Eastern North Carolina. Working with community partners, The Craven County Sherriff’s Office proposes to provide jail-based and re-entry programs to: (1) expand or enhance pre-booking or post-booking treatment or intervention programs that serve individuals at high risk for overdose or substance abuse; (2) expand or enhance embedding social workers, peers, and/or persons with lived experience at any intercept of the Sequential Intercept Model to assist persons in the criminal justice system and their families navigate the justice system and increase their connection to treatment and recovery support services (66 percent of the budget), and (3) expand and enhance evidence-based treatment and recovery support services including transitional or recovery housing (15 percent of the budget), transportation (7 percent of the budget), and peer recovery support services (12 percent of the budget). Funding from this grant will increase access to behavioral health treatment and services, improve linkage to peer specialists and recovery support, and provide transitional recovery housing to the most vulnerable individuals leaving the Craven County Jail.

GA

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

Criminal Justice Coordinating Council

Georgia

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

NJ

The County of Cumberland (Inc) is applying for Category 1 funding in the amount of $900,000. Fighting Relapse Effort Employing Drug Offense Monitoring Plus (FREEDOM+) is a collaborative diversionary program that will offer treatment and key peer recovery supports as a critical intervention that interrupts perpetuated criminal behavior. Additional harm reduction, prevention, and intervention efforts like Narcan distribution and education, fentanyl test strips, the U.S. Drug Enforcement Administration's National Drug Take Back Initiative, and integrating Law Enforcement Assisted Diversion (LEAD) and Police Assisted Addiction and Recovery Initiative (PAARI) programs are the "plus" part of this project to support community members fighting to be substance free. The FREEDOM+ program aims to drive those caught in the cycle of relapse and drug-seeking behavior toward treatment on threat of legal consequence, while setting up the participant for success with compassionate peer recovery support services. This project serves an estimated 600 defendants who will be offered, through their defense counsel, an opportunity to participate in FREEDOM+, with hopes that the offered opportunity and supports will motivate as many as 50 percent of participants to remain compliant into sustained recovery. The project includes partnerships with the Cumberland County Department of Human Services (CCDHS), which is a primary partner in implementing FREEDOM+, and its substance misuse programs. CCDHS operates a state licensed treatment facility where they will administer Comprehensive Drug and Alcohol Evaluations and provide a quality, evidenced-based, multi-faceted approach to address substance use problems for individuals and families. CCDHS also operates the Capital Recovery Center, which will be instrumental in managing the progress of defendants participating in FREEDOM+ and providing holistic peer recovery supports. This project will engage Rutgers University’s Walter Rand Institute (WRI) as evaluator. FREEDOM+ advances the U.S. Department of Justice priorities in three ways: by increasing access to justice, protecting the public from crime and evolving threats, and building trust between law enforcement and the community. In addition, Cumberland County meets the Office of Justice Programs priority of being a high-poverty area.

Cumberland County (Inc)

New Jersey

The County of Cumberland (Inc) is applying for Category 1 funding in the amount of $900,000. Fighting Relapse Effort Employing Drug Offense Monitoring Plus (FREEDOM+) is a collaborative diversionary program that will offer treatment and key peer recovery supports as a critical intervention that interrupts perpetuated criminal behavior. Additional harm reduction, prevention, and intervention efforts like Narcan distribution and education, fentanyl test strips, the U.S. Drug Enforcement Administration's National Drug Take Back Initiative, and integrating Law Enforcement Assisted Diversion (LEAD) and Police Assisted Addiction and Recovery Initiative (PAARI) programs are the "plus" part of this project to support community members fighting to be substance free. The FREEDOM+ program aims to drive those caught in the cycle of relapse and drug-seeking behavior toward treatment on threat of legal consequence, while setting up the participant for success with compassionate peer recovery support services. This project serves an estimated 600 defendants who will be offered, through their defense counsel, an opportunity to participate in FREEDOM+, with hopes that the offered opportunity and supports will motivate as many as 50 percent of participants to remain compliant into sustained recovery. The project includes partnerships with the Cumberland County Department of Human Services (CCDHS), which is a primary partner in implementing FREEDOM+, and its substance misuse programs. CCDHS operates a state licensed treatment facility where they will administer Comprehensive Drug and Alcohol Evaluations and provide a quality, evidenced-based, multi-faceted approach to address substance use problems for individuals and families. CCDHS also operates the Capital Recovery Center, which will be instrumental in managing the progress of defendants participating in FREEDOM+ and providing holistic peer recovery supports. This project will engage Rutgers University’s Walter Rand Institute (WRI) as evaluator. FREEDOM+ advances the U.S. Department of Justice priorities in three ways: by increasing access to justice, protecting the public from crime and evolving threats, and building trust between law enforcement and the community. In addition, Cumberland County meets the Office of Justice Programs priority of being a high-poverty area.

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.

OH

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

Cuyahoga County

Ohio

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

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.

TX

The Dallas County District Attorney’s Office is applying under Category 1A for grant funding in the amount of $1,194,189 to develop the Dallas County Criminal Justice Opioid Response Plan. This project will take place in Dallas County, population 2.6 million, the 2nd largest county in Texas and the 8th largest county in the U.S. The program will (1) hire a program manager to develop a strategic plan for handling opioid-involved individuals upon entry into jail and continuing throughout the criminal justice system; (2) hire a clinical assessor to provide consistent recommendations for treatment; (3) fund evidence-based residential treatment, transitional housing, and Narcan; and (4) provide ongoing analysis of the program. Dr. Jennifer Gonzalez of the Meadows Mental Health and Policy Institute will serve as the project’s research partner. Priority considerations addressed in this application include (1) high rates of overdose deaths and (2) high rates of primary treatment admissions for heroin or other opioids. In addition, priority consideration is included for applications that offer enhancements to public safety in Qualified Opportunity Zones.

Dallas County

Texas

The Dallas County District Attorney’s Office is applying under Category 1A for grant funding in the amount of $1,194,189 to develop the Dallas County Criminal Justice Opioid Response Plan. This project will take place in Dallas County, population 2.6 million, the 2nd largest county in Texas and the 8th largest county in the U.S. The program will (1) hire a program manager to develop a strategic plan for handling opioid-involved individuals upon entry into jail and continuing throughout the criminal justice system; (2) hire a clinical assessor to provide consistent recommendations for treatment; (3) fund evidence-based residential treatment, transitional housing, and Narcan; and (4) provide ongoing analysis of the program. Dr. Jennifer Gonzalez of the Meadows Mental Health and Policy Institute will serve as the project’s research partner. Priority considerations addressed in this application include (1) high rates of overdose deaths and (2) high rates of primary treatment admissions for heroin or other opioids. In addition, priority consideration is included for applications that offer enhancements to public safety in Qualified Opportunity Zones.

TX

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

Dallas County Hospital District

Texas

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

IL

DeKalb County Court Services is applying for Category 1 funding in the amount of $900,000. The DeKalb County Comprehensive Opioid, Stimulant, and Other Substance Use Disorder Project will serve clients involved with the DeKalb County Court system by providing immediate access to treatment services for persons with substance use disorders (SUDs) who come into the criminal justice system and recovery services after treatment. Clients can enter the program at any point in the criminal justice system, from a first appearance in court through a time when they may be sentenced and supervised by the court. Services will be provided to the individual whether the client resides in the community or is incarcerated awaiting trial. The program in DeKalb County will cover treatment costs for eligible clients in need of immediate help for SUDs, assist with transportation getting to and from treatment, and help fund medication-assisted treatment. The project will also create new opportunities to enhance post-treatment success by providing additional recovery support services, including hiring and training a dedicated peer recovery support specialist. The project coordinator will train personnel in DeKalb County Court Services on the administration of naloxone. Policies and procedures will be developed with input from all partners in the criminal justice system, including a diversion plan that can be used to keep clients from obtaining a conviction if they successfully complete the program. The project serves DeKalb County, which has a population of 104,897. The project includes partnerships between DeKalb County Court Services and the DeKalb County Drug Overdose Prevention Program, local city and county government officials, the local judiciary, the State’s Attorney’s Office, the Public Defender’s Office, local law enforcement agencies, and local/regional service providers. The project will engage 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.

DeKalb County (Inc)

Illinois

DeKalb County Court Services is applying for Category 1 funding in the amount of $900,000. The DeKalb County Comprehensive Opioid, Stimulant, and Other Substance Use Disorder Project will serve clients involved with the DeKalb County Court system by providing immediate access to treatment services for persons with substance use disorders (SUDs) who come into the criminal justice system and recovery services after treatment. Clients can enter the program at any point in the criminal justice system, from a first appearance in court through a time when they may be sentenced and supervised by the court. Services will be provided to the individual whether the client resides in the community or is incarcerated awaiting trial. The program in DeKalb County will cover treatment costs for eligible clients in need of immediate help for SUDs, assist with transportation getting to and from treatment, and help fund medication-assisted treatment. The project will also create new opportunities to enhance post-treatment success by providing additional recovery support services, including hiring and training a dedicated peer recovery support specialist. The project coordinator will train personnel in DeKalb County Court Services on the administration of naloxone. Policies and procedures will be developed with input from all partners in the criminal justice system, including a diversion plan that can be used to keep clients from obtaining a conviction if they successfully complete the program. The project serves DeKalb County, which has a population of 104,897. The project includes partnerships between DeKalb County Court Services and the DeKalb County Drug Overdose Prevention Program, local city and county government officials, the local judiciary, the State’s Attorney’s Office, the Public Defender’s Office, local law enforcement agencies, and local/regional service providers. The project will engage 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.

NC

The North Carolina Controlled Substances Reporting System improvement program improves the exchange of information and collection of data on controlled substances II-V among states by increasing the number of prescribers regularly using the prescription drug monitoring program; provide a training program for system users based on their identified needs; produce and disseminate educational materials using online resources and cross-sector expertise; and support collaborations among law enforcement, public health officials, and prosecutors by increasing the system’s ability to respond to sector needs.

Department of Health and Human Services

North Carolina

The North Carolina Controlled Substances Reporting System improvement program improves the exchange of information and collection of data on controlled substances II-V among states by increasing the number of prescribers regularly using the prescription drug monitoring program; provide a training program for system users based on their identified needs; produce and disseminate educational materials using online resources and cross-sector expertise; and support collaborations among law enforcement, public health officials, and prosecutors by increasing the system’s ability to respond to sector needs.

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.

MI

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

Department of State Police Michigan

Michigan

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

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.

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.

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.

MA

The Essex Medicated Assisted Treatment Recovery Project (EMATRP) will be expanding and enhancing its current MAT program and support services pre- and post- release through these initiatives: (1) enhancing the current MAT program with care continuum coordinators, (2) providing pre-release harm-reduction education for all MAT participants to include naloxone upon release for 3,000 inmates, and (3) partnering with Spectrum for clinical stabilization services beds to provide participants with transitional housing and peer recovery for up 825 inmates. This project serves Essex County in Massachusetts with a population of 800,017. The project includes partnerships between Wellpath. Priority considerations addressed in this application include high-poverty area and Qualified Opportunity Zone.

Essex County Sheriff's Department

Massachusetts

The Essex Medicated Assisted Treatment Recovery Project (EMATRP) will be expanding and enhancing its current MAT program and support services pre- and post- release through these initiatives: (1) enhancing the current MAT program with care continuum coordinators, (2) providing pre-release harm-reduction education for all MAT participants to include naloxone upon release for 3,000 inmates, and (3) partnering with Spectrum for clinical stabilization services beds to provide participants with transitional housing and peer recovery for up 825 inmates. This project serves Essex County in Massachusetts with a population of 800,017. The project includes partnerships between Wellpath. Priority considerations addressed in this application include high-poverty area and Qualified Opportunity Zone.

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.

MD

Maryland has taken numerous steps to combat the increasing number of overdoses and deaths resulting from the heroin and opioid crisis. Some of these efforts include creating workgroups, enacting legislation, and declaring a State of Emergency. Although Maryland remains committed to addressing this crisis, overdose deaths continue to significantly impact the state at an alarming rate. According to the CDC, the overdose death rate in Maryland increased from 20.9 deaths per 100,000 in 2015 to 44.6 in 2020. Based on the Overdose Detection Mapping Application Program (ODMAP), overdose deaths in Maryland increased by 8.28 percent, from 12,581 in 2018 to 13,623 in 2021. During the same time, heroin and non-fatal/fatal overdoses increased by 3.7 percent, while fentanyl overdoses increased 108 percent. Furthermore, there were a total of 32,405 overdoses in Maryland between January 2020 and June 2, 2022. For the Maryland Efforts to Expand the Fight Against Opioids (MEEFAO) project, the Governor’s Office of Crime Prevention, Youth, and Victim Services (GOCPYVS) is partnering with the Maryland Department of Health, the Opioid Operational Command Center, the Maryland Judiciary, and more to respond to the growing challenges resulting from the opioid epidemic. The Maryland Statistical Analysis Center will also be engaged to support action-oriented research, performance management, and evaluation of all selected sites. The evaluation of MEEFAO is expected to contribute to the national body of knowledge as it relates to best practices. The expected outcomes of MEEFAO will also decrease opioid overdose deaths, decrease recidivism rates, improve relationships between law enforcement and the community, and improve social and behavioral outcomes in the community.

Executive Office of the State of Maryland

Maryland

Maryland has taken numerous steps to combat the increasing number of overdoses and deaths resulting from the heroin and opioid crisis. Some of these efforts include creating workgroups, enacting legislation, and declaring a State of Emergency. Although Maryland remains committed to addressing this crisis, overdose deaths continue to significantly impact the state at an alarming rate. According to the CDC, the overdose death rate in Maryland increased from 20.9 deaths per 100,000 in 2015 to 44.6 in 2020. Based on the Overdose Detection Mapping Application Program (ODMAP), overdose deaths in Maryland increased by 8.28 percent, from 12,581 in 2018 to 13,623 in 2021. During the same time, heroin and non-fatal/fatal overdoses increased by 3.7 percent, while fentanyl overdoses increased 108 percent. Furthermore, there were a total of 32,405 overdoses in Maryland between January 2020 and June 2, 2022. For the Maryland Efforts to Expand the Fight Against Opioids (MEEFAO) project, the Governor’s Office of Crime Prevention, Youth, and Victim Services (GOCPYVS) is partnering with the Maryland Department of Health, the Opioid Operational Command Center, the Maryland Judiciary, and more to respond to the growing challenges resulting from the opioid epidemic. The Maryland Statistical Analysis Center will also be engaged to support action-oriented research, performance management, and evaluation of all selected sites. The evaluation of MEEFAO is expected to contribute to the national body of knowledge as it relates to best practices. The expected outcomes of MEEFAO will also decrease opioid overdose deaths, decrease recidivism rates, improve relationships between law enforcement and the community, and improve social and behavioral outcomes in the community.

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

Franklin County, Ohio, in collaboration with Franklin County Public Health, Columbus Public Health, and the Franklin County Sheriff’s Office, along with a number of community-based providers, propose to implement Integrated Substance Use Proactive Engagement and Response (iSUPER), a multi-layered, multi-agency initiative intended to contribute to our local collective understanding of best practices through (1) increased access to treatment and recovery supports for justice-involved individuals and underserved populations at greatest risk for overdose; (2) expanded distribution of naloxone to law enforcement and other first responders; (3) strengthened harm reduction efforts through the deployment of five vending machines dispensing an array of harm reduction and medical supplies in our hardest-hit neighborhoods; (4) expanded emergency recovery housing options; and (5) increased linkage to peer support services. Services through iSUPER will be dedicated to six Franklin County zip codes with the highest rates of overdose, along with justice-involved individuals released from the Franklin County Correctional Center and assessed as at risk for an opioid use disorder. During the 3-year grant program, it is anticipated that 6,141 individuals will be directly served through iSUPER.

Franklin County Board of Commissioners

Ohio

Franklin County, Ohio, in collaboration with Franklin County Public Health, Columbus Public Health, and the Franklin County Sheriff’s Office, along with a number of community-based providers, propose to implement Integrated Substance Use Proactive Engagement and Response (iSUPER), a multi-layered, multi-agency initiative intended to contribute to our local collective understanding of best practices through (1) increased access to treatment and recovery supports for justice-involved individuals and underserved populations at greatest risk for overdose; (2) expanded distribution of naloxone to law enforcement and other first responders; (3) strengthened harm reduction efforts through the deployment of five vending machines dispensing an array of harm reduction and medical supplies in our hardest-hit neighborhoods; (4) expanded emergency recovery housing options; and (5) increased linkage to peer support services. Services through iSUPER will be dedicated to six Franklin County zip codes with the highest rates of overdose, along with justice-involved individuals released from the Franklin County Correctional Center and assessed as at risk for an opioid use disorder. During the 3-year grant program, it is anticipated that 6,141 individuals will be directly served through iSUPER.

NC

The Gaston County Government is applying for Category 1 funding in the amount of $899,999. The Gaston County Comprehensive Project to Improve Outcomes for Children Impacted by Substance Abuse will align county entities, substance misuse treatment providers, law enforcement agencies, courts, health care providers, and the faith-based community to provide an integrated system of referrals and services for children victimized by the opioid crisis. Under the supervision of Gaston County Health and Human Services’ (HHS) Children and Family Division, a therapeutic center will be established to provide therapeutic services for children in foster care who have been referred to the center by courts, direct therapeutic services for children lacking health insurance, counseling and therapeutic services for foster care children removed from their homes because of substance misuse, a county initiative to support rehabilitation rather than incarceration for opioid users, and outpatient substance misuse treatment. Gaston County HHS will also initiate a Therapeutic Visitation Center for the targeted population.

Gaston County

North Carolina

The Gaston County Government is applying for Category 1 funding in the amount of $899,999. The Gaston County Comprehensive Project to Improve Outcomes for Children Impacted by Substance Abuse will align county entities, substance misuse treatment providers, law enforcement agencies, courts, health care providers, and the faith-based community to provide an integrated system of referrals and services for children victimized by the opioid crisis. Under the supervision of Gaston County Health and Human Services’ (HHS) Children and Family Division, a therapeutic center will be established to provide therapeutic services for children in foster care who have been referred to the center by courts, direct therapeutic services for children lacking health insurance, counseling and therapeutic services for foster care children removed from their homes because of substance misuse, a county initiative to support rehabilitation rather than incarceration for opioid users, and outpatient substance misuse treatment. Gaston County HHS will also initiate a Therapeutic Visitation Center for the targeted population.

NC

The purpose of the Gaston County, North Carolina, project is to initiate the following activities: (1) bring together multiple county entities—substance abuse treatment providers, law enforcement, courts, health care providers, and the faith-based community—to collaborate in implementing a law enforcement assisted diversion program (LEAD); (2) augment treatment and recovery services for individuals who are at high risk for overdose and recidivism and are participants in recovery court; and (3) incorporate transitional/recovery housing assistance and certified peer recovery support services into both the LEAD and the recovery court programs. The expected outcomes are to improve public safety, reduce criminal recidivism, and reduce the associated costs of legal and criminal-justice-service utilization. The service area is all of Gaston County, the seventh largest county in North Carolina, with a population of 230,226. The project expects to serve approximately 50 participants yearly: 25 through LEAD and 25 within the recovery court. The Gaston County Police Department is the lead agency and partners include the District Attorney’s Office, Olive Branch Ministry—an affiliate of the North Carolina Harm Reduction Coalition, and the Gaston County Controlled Substance Coalition. The Coalition is a permanent task force of community leaders that will serve as the multi-disciplinary body for the project. The District Attorney’s Office will assign an Assistant District Attorney to both the Operational and Coordinating Groups. Olive Branch Ministry will provide training for stakeholders in the principles of harm reduction and will provide certified peer support specialists. The project will also identify a contracted source to provide evidence-based clinical assessments and individualized treatment plans. The Gaston County Police Department will supervise three full-time positions: a LEAD case manager, a recovery court case manager, and a project coordinator. Case management will focus on the whole individual and stress comprehensive assessment, service planning, and service coordination. The project coordinator’s roles and responsibilities will include consulting with the multi-disciplinary coalition, overseeing the programmatic and financial components of the grant, collaborating with stakeholders to develop program resources (e.g., policies, protocols, and screening forms), arranging trainings, troubleshooting stakeholders’ concerns, identifying resources, facilitating meetings, developing information-sharing systems in collaboration with the coalition, and streamlining communication.

Gaston County

North Carolina

The purpose of the Gaston County, North Carolina, project is to initiate the following activities: (1) bring together multiple county entities—substance abuse treatment providers, law enforcement, courts, health care providers, and the faith-based community—to collaborate in implementing a law enforcement assisted diversion program (LEAD); (2) augment treatment and recovery services for individuals who are at high risk for overdose and recidivism and are participants in recovery court; and (3) incorporate transitional/recovery housing assistance and certified peer recovery support services into both the LEAD and the recovery court programs. The expected outcomes are to improve public safety, reduce criminal recidivism, and reduce the associated costs of legal and criminal-justice-service utilization. The service area is all of Gaston County, the seventh largest county in North Carolina, with a population of 230,226. The project expects to serve approximately 50 participants yearly: 25 through LEAD and 25 within the recovery court. The Gaston County Police Department is the lead agency and partners include the District Attorney’s Office, Olive Branch Ministry—an affiliate of the North Carolina Harm Reduction Coalition, and the Gaston County Controlled Substance Coalition. The Coalition is a permanent task force of community leaders that will serve as the multi-disciplinary body for the project. The District Attorney’s Office will assign an Assistant District Attorney to both the Operational and Coordinating Groups. Olive Branch Ministry will provide training for stakeholders in the principles of harm reduction and will provide certified peer support specialists. The project will also identify a contracted source to provide evidence-based clinical assessments and individualized treatment plans. The Gaston County Police Department will supervise three full-time positions: a LEAD case manager, a recovery court case manager, and a project coordinator. Case management will focus on the whole individual and stress comprehensive assessment, service planning, and service coordination. The project coordinator’s roles and responsibilities will include consulting with the multi-disciplinary coalition, overseeing the programmatic and financial components of the grant, collaborating with stakeholders to develop program resources (e.g., policies, protocols, and screening forms), arranging trainings, troubleshooting stakeholders’ concerns, identifying resources, facilitating meetings, developing information-sharing systems in collaboration with the coalition, and streamlining communication.

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.

AZ

Gila County is a small and rural county in Arizona with about 54,000 people. Mental health problems, homelessness, and drug-overdose levels are on the rise in Gila County. The death rate due to drug overdoses is approximately 49.9 per 100,000 population, which is the highest rate in the state. Fentanyl and fentanyl-combination overdoses are rising, with the drug’s apparent increasing accessibility. Education regarding opioid use is lacking, primarily because the stigma placed on opioid users is still very prevalent in this community. Gila County Health and Emergency Management (GCHEM) seeks to provide more education about naloxone and the opioid epidemic to Gila County residents and decrease the number of overdoses in the county. The hope is by increasing the education levels about the dangers of illicit drug use to the community’s youth, educating the elderly population of the importance of taking the correct dosages of medications, and working with all members of the community to increase naloxone distribution levels, the number of drug induced deaths will decrease. GCHEM seeks to work in partnership with the Gila County Probation Office, Gila County schools, senior centers, treatment centers, and community stakeholders to increase the awareness of the ongoing opioid epidemic within their own community and protect the vulnerable populations in Gila County, including the elderly and youths.

Gila County

Arizona

Gila County is a small and rural county in Arizona with about 54,000 people. Mental health problems, homelessness, and drug-overdose levels are on the rise in Gila County. The death rate due to drug overdoses is approximately 49.9 per 100,000 population, which is the highest rate in the state. Fentanyl and fentanyl-combination overdoses are rising, with the drug’s apparent increasing accessibility. Education regarding opioid use is lacking, primarily because the stigma placed on opioid users is still very prevalent in this community. Gila County Health and Emergency Management (GCHEM) seeks to provide more education about naloxone and the opioid epidemic to Gila County residents and decrease the number of overdoses in the county. The hope is by increasing the education levels about the dangers of illicit drug use to the community’s youth, educating the elderly population of the importance of taking the correct dosages of medications, and working with all members of the community to increase naloxone distribution levels, the number of drug induced deaths will decrease. GCHEM seeks to work in partnership with the Gila County Probation Office, Gila County schools, senior centers, treatment centers, and community stakeholders to increase the awareness of the ongoing opioid epidemic within their own community and protect the vulnerable populations in Gila County, including the elderly and youths.

WA

The County of Grays Harbor is applying for a Category 1 award in the amount of $600,000. The Grays Harbor County Jail System of Care Expansion project will expand services by increasing capacity in the Grays Harbor County Jail to serve individuals who have a psychostimulant disorder as well. This expansion would include additional staff time for medical monitoring, managing recovery groups, and bolstering re-entry supports. The project will develop and implement a comprehensive plan to reduce the risk of overdose death and enhance treatment and recovery service engagement among the pretrial and post-trial populations leaving the county jail. This includes implementing medication-assisted treatment, cognitive behavioral treatment, wellness recovery planning, and re-entry care navigation within the county jail and supporting the transition to community-based services once released from custody. The goal of this expanded system of care is to increase the number of affected individuals returning to the community with established sobriety and behavioral health supports, decrease morbidity and mortality for those individuals, and decrease recidivisms among this population. This project serves Grays Harbor County, which has a population of just over 75,000 people. The project includes partnerships between the Grays Harbor Sheriff’s Office, Coastal Community Action Program (CCAP), Community Integrated Health Services (CIHS), and the Grays Harbor County Commissioners.

Grays Harbor County

Washington

The County of Grays Harbor is applying for a Category 1 award in the amount of $600,000. The Grays Harbor County Jail System of Care Expansion project will expand services by increasing capacity in the Grays Harbor County Jail to serve individuals who have a psychostimulant disorder as well. This expansion would include additional staff time for medical monitoring, managing recovery groups, and bolstering re-entry supports. The project will develop and implement a comprehensive plan to reduce the risk of overdose death and enhance treatment and recovery service engagement among the pretrial and post-trial populations leaving the county jail. This includes implementing medication-assisted treatment, cognitive behavioral treatment, wellness recovery planning, and re-entry care navigation within the county jail and supporting the transition to community-based services once released from custody. The goal of this expanded system of care is to increase the number of affected individuals returning to the community with established sobriety and behavioral health supports, decrease morbidity and mortality for those individuals, and decrease recidivisms among this population. This project serves Grays Harbor County, which has a population of just over 75,000 people. The project includes partnerships between the Grays Harbor Sheriff’s Office, Coastal Community Action Program (CCAP), Community Integrated Health Services (CIHS), and the Grays Harbor County Commissioners.

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.

GU

The Guam Behavioral Health and Wellness Center (GBHWC) applied for Category 1b suburban area grant funding in the amount of $900,000. The Guam Family Recovery Program will provide swift American Society of Addiction Medicine assessments and placement when deemed appropriate. The program will also offer peer support services to identified clients and decrease the time from arrest to access possible treatment for clients suffering from the ills of substance use. A total of 450 assessments will be performed throughout the grant period. This project serves the community of Guam. The project includes partnerships between GBHWC, Department of Corrections, Superior Court of Guam, TOGHE, OASIS, and the Salvation Army Lighthouse Recovery Center.

Guam Behavioral Health and Wellness Center

Guam

The Guam Behavioral Health and Wellness Center (GBHWC) applied for Category 1b suburban area grant funding in the amount of $900,000. The Guam Family Recovery Program will provide swift American Society of Addiction Medicine assessments and placement when deemed appropriate. The program will also offer peer support services to identified clients and decrease the time from arrest to access possible treatment for clients suffering from the ills of substance use. A total of 450 assessments will be performed throughout the grant period. This project serves the community of Guam. The project includes partnerships between GBHWC, Department of Corrections, Superior Court of Guam, TOGHE, OASIS, and the Salvation Army Lighthouse Recovery Center.

CO

In June of 2019, Gunnison County, Colorado, was awarded the Health Resources Service Administration (HRSA) Rural Communities Opioid Response Planning grant (RCORP) to better understand the current services and resources to prevent, treat and support people who are recovering from substance use disorder (SUD). The Consortium initially consisted of six key organizations: Gunnison County Juvenile Services, Gunnison County Health and Human Services, the Health Coalition of the Gunnison Valley, the Center for Mental Health, Gunnison Valley Hospital, and Western Colorado University. Over the past three years this group has grown to over 30 individuals/organizations representing diverse sectors of the community including parents, youth, and individuals with lived experience. This Consortium completed a needs and gaps analysis report and developed a three-year strategic plan. The Consortium, now titled Grasp, will oversee the implementation efforts of the Comprehensive Opioid, Stimulant, and Substance Abuse program. Grasp is dedicated to the prevention, treatment, and recovery of SUD across the lifespan. Program activities include: (1) strengthen diversion program and explore alternative to ticketing for youth and adults; (2) education and prevention programs to connect law enforcement agencies with K-12 students; (3) increase services for children and youth impacted by their parents’ or other family members’ substance use with wraparound services and using the sequential intercept model with the embedded clinical social worker; (4) increase medication-assisted treatment (MAT) and rural ambulatory medically supervised withdrawal services in Gunnison and Crested Butte; (5) implement harm reduction strategies and expand upon naloxone distribution; (6) support recovery housing in the community and on Western Colorado University’s campus; (7) data collection and reporting. Program goals include: (1) improve the quality and sustainability of rural behavioral health care services through supporting rural health care providers to offer coordinated, evidence-based, trauma-informed SUD, and other care services; (2) reduce drug-related arrests for people aged 35 and younger in Gunnison County and reduce recidivism at the jail; (3) address structural- and system- level barriers to improve rural residents’ access to quality, integrated SUD, and other behavioral health care services.

Gunnison County

Colorado

In June of 2019, Gunnison County, Colorado, was awarded the Health Resources Service Administration (HRSA) Rural Communities Opioid Response Planning grant (RCORP) to better understand the current services and resources to prevent, treat and support people who are recovering from substance use disorder (SUD). The Consortium initially consisted of six key organizations: Gunnison County Juvenile Services, Gunnison County Health and Human Services, the Health Coalition of the Gunnison Valley, the Center for Mental Health, Gunnison Valley Hospital, and Western Colorado University. Over the past three years this group has grown to over 30 individuals/organizations representing diverse sectors of the community including parents, youth, and individuals with lived experience. This Consortium completed a needs and gaps analysis report and developed a three-year strategic plan. The Consortium, now titled Grasp, will oversee the implementation efforts of the Comprehensive Opioid, Stimulant, and Substance Abuse program. Grasp is dedicated to the prevention, treatment, and recovery of SUD across the lifespan. Program activities include: (1) strengthen diversion program and explore alternative to ticketing for youth and adults; (2) education and prevention programs to connect law enforcement agencies with K-12 students; (3) increase services for children and youth impacted by their parents’ or other family members’ substance use with wraparound services and using the sequential intercept model with the embedded clinical social worker; (4) increase medication-assisted treatment (MAT) and rural ambulatory medically supervised withdrawal services in Gunnison and Crested Butte; (5) implement harm reduction strategies and expand upon naloxone distribution; (6) support recovery housing in the community and on Western Colorado University’s campus; (7) data collection and reporting. Program goals include: (1) improve the quality and sustainability of rural behavioral health care services through supporting rural health care providers to offer coordinated, evidence-based, trauma-informed SUD, and other care services; (2) reduce drug-related arrests for people aged 35 and younger in Gunnison County and reduce recidivism at the jail; (3) address structural- and system- level barriers to improve rural residents’ access to quality, integrated SUD, and other behavioral health care services.

OH

Hamilton County, Ohio, is situated at the southernmost tip of the state, bordering Kentucky and Indiana and has an estimated 826,139 residents. Hamilton County includes 49 distinct cities, villages, and townships, the largest of which is Cincinnati. In 2021, Hamilton County suffered 454 overdose deaths and continues to witness 50-70 overdoses per week. As the opioid epidemic worsens, the Hamilton County Justice Center has become the largest detox facility in Hamilton County, with 6,000 individuals detoxing annually. Hamilton County needs intentional and strategic interventions to deflect individuals out of the criminal justice system and into evidence-based care and treatment that is most appropriate to address their needs. This project is lead by the Hamilton County Addiction Response Coalition (HC ARC) and involves Hamilton County’s Co-Responder Deflection Pilot (HC CORE), which is a collaborative, co-responder intervention to assist individuals with substance use disorder, mental health disorder, co-occurring disorders, or experiencing homelessness, with a specially trained team of law enforcement and peer navigators who create community-based pathways to treatment, recovery support services, housing, case management, or other needs-based services. HC CORE will involve all six Police Treatment and Community Collaborative (PTACC) deflection pathways as a referral source to a single, co-responder program: (1) self-referral, (2) active outreach, (3) intervention, (4) prevention, (5) post-overdose response, and (6) community-based response. HC CORE will employ its own peer navigation team to ensure that care and case management are provided through a local and neutral lens, also ensuring that the CORE peer navigators will work with the participant from the point of first encounter, onward. The CORE Case Plan will include activities and services that enrich and stabilize the lives of the participants. By embedding peer navigators with law enforcement for deflection efforts, HC CORE will incorporate real-time data collection, drug take-back programs, harm reduction activities, and recovery support services to successfully serve individuals at all stages within the continuum of care model.

Hamilton County

Ohio

Hamilton County, Ohio, is situated at the southernmost tip of the state, bordering Kentucky and Indiana and has an estimated 826,139 residents. Hamilton County includes 49 distinct cities, villages, and townships, the largest of which is Cincinnati. In 2021, Hamilton County suffered 454 overdose deaths and continues to witness 50-70 overdoses per week. As the opioid epidemic worsens, the Hamilton County Justice Center has become the largest detox facility in Hamilton County, with 6,000 individuals detoxing annually. Hamilton County needs intentional and strategic interventions to deflect individuals out of the criminal justice system and into evidence-based care and treatment that is most appropriate to address their needs. This project is lead by the Hamilton County Addiction Response Coalition (HC ARC) and involves Hamilton County’s Co-Responder Deflection Pilot (HC CORE), which is a collaborative, co-responder intervention to assist individuals with substance use disorder, mental health disorder, co-occurring disorders, or experiencing homelessness, with a specially trained team of law enforcement and peer navigators who create community-based pathways to treatment, recovery support services, housing, case management, or other needs-based services. HC CORE will involve all six Police Treatment and Community Collaborative (PTACC) deflection pathways as a referral source to a single, co-responder program: (1) self-referral, (2) active outreach, (3) intervention, (4) prevention, (5) post-overdose response, and (6) community-based response. HC CORE will employ its own peer navigation team to ensure that care and case management are provided through a local and neutral lens, also ensuring that the CORE peer navigators will work with the participant from the point of first encounter, onward. The CORE Case Plan will include activities and services that enrich and stabilize the lives of the participants. By embedding peer navigators with law enforcement for deflection efforts, HC CORE will incorporate real-time data collection, drug take-back programs, harm reduction activities, and recovery support services to successfully serve individuals at all stages within the continuum of care model.

OH

Hamilton County applied for Category 1A grant funding in the amount of $1,000,000. The Hamilton County Addiction Response Coalition (HC ARC), under the proposed quick response team (QRT) expansion program, will address and has already addressed a number of the overarching goals of the solicitation, specifically, encouraging cross-system planning and collaboration among officials who work in law enforcement, pretrial services, courts, probation and parole, child welfare, reentry, prescription drug monitoring programs, and emergency medical services, as well as health care providers, public health partnerships, and agencies that provide substance abuse treatment and recovery support services. The QRT expansion plans to engage current community stakeholders, as well as new community stakeholders and partnerships beyond the coalition to target hot-spot areas. The QRT will continue to expand its on-the-ground efforts by utilizing HC ARC member organizations to not only provide outreach and resources to individuals suffering from addiction, but also the organizations they frequent to arm them with tools and resources. HC ARC has established a coordinated multidisciplinary response team that includes law enforcement, treatment providers, government representatives from the county and city, and a program administrator. This project serves Hamilton County, population 817,473. The project includes partnerships between Hamilton County Public Health Department and the Talbert House. There are no priority considerations addressed in this application.

Hamilton County Addiction Response Coalition

Ohio

Hamilton County applied for Category 1A grant funding in the amount of $1,000,000. The Hamilton County Addiction Response Coalition (HC ARC), under the proposed quick response team (QRT) expansion program, will address and has already addressed a number of the overarching goals of the solicitation, specifically, encouraging cross-system planning and collaboration among officials who work in law enforcement, pretrial services, courts, probation and parole, child welfare, reentry, prescription drug monitoring programs, and emergency medical services, as well as health care providers, public health partnerships, and agencies that provide substance abuse treatment and recovery support services. The QRT expansion plans to engage current community stakeholders, as well as new community stakeholders and partnerships beyond the coalition to target hot-spot areas. The QRT will continue to expand its on-the-ground efforts by utilizing HC ARC member organizations to not only provide outreach and resources to individuals suffering from addiction, but also the organizations they frequent to arm them with tools and resources. HC ARC has established a coordinated multidisciplinary response team that includes law enforcement, treatment providers, government representatives from the county and city, and a program administrator. This project serves Hamilton County, population 817,473. The project includes partnerships between Hamilton County Public Health Department and the Talbert House. There are no priority considerations addressed in this application.

OH

The Hancock County Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board is applying for a Category 1 award in the amount of $600,000. The Recovery Community Organization Outreach Project in Hancock County, Ohio, will enhance recovery support services (RSS) and peer recovery support services (PRSS) and increase access to transitional or recovery housing for individuals 18 years and older who have a history of opioid, stimulant, or other substance use disorders and are either at risk or involved in the criminal justice system in Hancock County. The project activities will aim to expand availability and access to recovery housing and peer recovery support services, increase coordination of services between criminal justice and recovery support service systems, and conduct an evaluation of the project’s impact. The main goals of the proposed project are to reduce the impact of opioids, stimulants, and other substances on individuals and the community (i.e., reduce recidivism and nonfatal overdoses) and reduce the number of overdose fatalities. This project serves Hancock County, which has a population of approximately 75,000 people. The project includes partnerships between FOCUS: Recovery and Wellness Community, LOFT (a youth drop-in center program), Recovery Homes, Family Resource Center, the Hancock County Sheriff’s Office, the Adult Probation Department, Findlay Municipal Court, and the Findlay Mayor’s Office. This project will engage Brandeis University’s Institute for Behavioral Health as the research partner.

Hancock County

Ohio

The Hancock County Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board is applying for a Category 1 award in the amount of $600,000. The Recovery Community Organization Outreach Project in Hancock County, Ohio, will enhance recovery support services (RSS) and peer recovery support services (PRSS) and increase access to transitional or recovery housing for individuals 18 years and older who have a history of opioid, stimulant, or other substance use disorders and are either at risk or involved in the criminal justice system in Hancock County. The project activities will aim to expand availability and access to recovery housing and peer recovery support services, increase coordination of services between criminal justice and recovery support service systems, and conduct an evaluation of the project’s impact. The main goals of the proposed project are to reduce the impact of opioids, stimulants, and other substances on individuals and the community (i.e., reduce recidivism and nonfatal overdoses) and reduce the number of overdose fatalities. This project serves Hancock County, which has a population of approximately 75,000 people. The project includes partnerships between FOCUS: Recovery and Wellness Community, LOFT (a youth drop-in center program), Recovery Homes, Family Resource Center, the Hancock County Sheriff’s Office, the Adult Probation Department, Findlay Municipal Court, and the Findlay Mayor’s Office. This project will engage Brandeis University’s Institute for Behavioral Health as the research partner.

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.

MN

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

Hennepin County

Minnesota

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

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.

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).

AL

This project serves Jefferson County, Alabama with a population of over 500,000. The purpose of the project is to expand peer recovery services and evidence-based treatment, including medication-assisted treatment (MAT), to individuals at high-risk for overdose who are habitual offenders. The project addresses the allowable use of providing 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 (90 percent of the budget). The project includes a partnership with the University of Alabama (UAB) Department of Psychiatry Substance Abuse Division and includes program evaluation which is identified as a priority consideration (10 percent of the budget).

Jefferson County, Alabama

Alabama

This project serves Jefferson County, Alabama with a population of over 500,000. The purpose of the project is to expand peer recovery services and evidence-based treatment, including medication-assisted treatment (MAT), to individuals at high-risk for overdose who are habitual offenders. The project addresses the allowable use of providing 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 (90 percent of the budget). The project includes a partnership with the University of Alabama (UAB) Department of Psychiatry Substance Abuse Division and includes program evaluation which is identified as a priority consideration (10 percent of the budget).

AR

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

Johnson County

Arkansas

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

MA

The Middle District Attorney’s Office (MDAO) proposes to implement the Spencer Area Peer Recovery Support Center Project. This project responds to Category 1 objectives: 1) locally driven responses to the use and misuse of opioids, stimulants, and other substances that expand access to treatment and recovery support services and 2) promote education and prevention activities. The MDAO is the prosecution agency for the 60 communities in Worcester County, Massachusetts. The county has 862,111 residents and covers the largest geographical area of any Massachusetts county. This project was guided by the county’s law enforcement, municipal leaders, medical providers, treatment agencies, educational institutions, and others participating in the District Attorney’s Central Massachusetts Opioid Task Force. This multi-disciplinary group works together to assess risk and protective factors related to the opioid epidemic and support the development and implementation of strategic and collaborative solutions. COSSUP funding for the Spencer Area Peer Recovery Support Center Project will establish and operate a new peer-based recovery support center based in the area of Spencer Massachusetts. This project will improve access to services in the thirteen-town region of central western Massachusetts. Efforts will also include education and prevention programming for students, youth, and professionals across Worcester County and the distribution of Naloxone to first responders and families. As aligned with COSSUP priorities this project will accomplish the following: 1) Reduce the number of opioid overdoses and overdose deaths in Worcester County; 2) Decrease the incidence of Opioid Use Disorder in Worcester County; 3) Increase the number of individuals receiving treatment and recovery support services in Worcester County; and 4) Increase the use of evidence-based programming in schools and youth groups in Worcester County.

Judiciary Courts of The Commonwealth of Massachusetts

Massachusetts

The Middle District Attorney’s Office (MDAO) proposes to implement the Spencer Area Peer Recovery Support Center Project. This project responds to Category 1 objectives: 1) locally driven responses to the use and misuse of opioids, stimulants, and other substances that expand access to treatment and recovery support services and 2) promote education and prevention activities. The MDAO is the prosecution agency for the 60 communities in Worcester County, Massachusetts. The county has 862,111 residents and covers the largest geographical area of any Massachusetts county. This project was guided by the county’s law enforcement, municipal leaders, medical providers, treatment agencies, educational institutions, and others participating in the District Attorney’s Central Massachusetts Opioid Task Force. This multi-disciplinary group works together to assess risk and protective factors related to the opioid epidemic and support the development and implementation of strategic and collaborative solutions. COSSUP funding for the Spencer Area Peer Recovery Support Center Project will establish and operate a new peer-based recovery support center based in the area of Spencer Massachusetts. This project will improve access to services in the thirteen-town region of central western Massachusetts. Efforts will also include education and prevention programming for students, youth, and professionals across Worcester County and the distribution of Naloxone to first responders and families. As aligned with COSSUP priorities this project will accomplish the following: 1) Reduce the number of opioid overdoses and overdose deaths in Worcester County; 2) Decrease the incidence of Opioid Use Disorder in Worcester County; 3) Increase the number of individuals receiving treatment and recovery support services in Worcester County; and 4) Increase the use of evidence-based programming in schools and youth groups in Worcester County.

HI

The First Circuit Court of the State of Hawaii is applying for a Category 1 award in the amount of $996,657. The COSSAP Hawaii program will provide treatment, recovery support services, and family court interventions by implementing and expanding comprehensive efforts to identify, respond to, treat, and support those impacted by drugs of misuse in the adult and juvenile justice system on Oahu, Hawaii. This program will help both the Family Court’s Juvenile Client Services Branch and the Adult Client Services Branch provide much-needed client treatment and support services currently impacted by a budget shortfall due to the COVID-19 pandemic. This project serves Oahu, Hawaii, which has a population greater than 500,000. The project includes partnerships between the Hawaii State Department of Health, Alcohol and Drug Abuse Division and new and existing community providers to deliver the contracted services for the juvenile and adult activities for this project. Priority considerations addressed in this application include high poverty areas for adults and juveniles in the First Circuit criminal and juvenile justice system that are from neighborhoods on Oahu that are disproportionately impacted by poverty, homelessness, and substance use and have limited access to services in their community.

Judiciary Courts of the State of Hawaii

Hawaii

The First Circuit Court of the State of Hawaii is applying for a Category 1 award in the amount of $996,657. The COSSAP Hawaii program will provide treatment, recovery support services, and family court interventions by implementing and expanding comprehensive efforts to identify, respond to, treat, and support those impacted by drugs of misuse in the adult and juvenile justice system on Oahu, Hawaii. This program will help both the Family Court’s Juvenile Client Services Branch and the Adult Client Services Branch provide much-needed client treatment and support services currently impacted by a budget shortfall due to the COVID-19 pandemic. This project serves Oahu, Hawaii, which has a population greater than 500,000. The project includes partnerships between the Hawaii State Department of Health, Alcohol and Drug Abuse Division and new and existing community providers to deliver the contracted services for the juvenile and adult activities for this project. Priority considerations addressed in this application include high poverty areas for adults and juveniles in the First Circuit criminal and juvenile justice system that are from neighborhoods on Oahu that are disproportionately impacted by poverty, homelessness, and substance use and have limited access to services in their community.

OK

The Tulsa County District Court, Fourteenth Judicial District of Oklahoma, is applying for Category 1 funding in the amount of $1,200,000. The project will launch the Tulsa County Anti-Recidivism Misdemeanor Diversion (TURN) Program, a court-based intervention program (mixed pre- and post-plea model) that expedites treatment and recovery services for justice-involved individuals with substance use disorders, mental illnesses, and co-occurring SUDs/MIs who are at high risk for overdose. TURN requires that participants engage with service and treatment providers in exchange for dismissed charges, no court fines or fees, and fewer court dates, among other benefits. By prioritizing stabilization and long-term social success, TURN will improve outcomes for individuals whose current primary source of treatment is the Tulsa County Jail. Deliverables include 1,000 misdemeanor cases diverted out of the criminal justice system and 800 alternative sentence recommendation outcomes. The program will be administered by Tulsa County Alternative Court Programs (TCACP), a division of the court. The project serves Tulsa County (OK), with an estimated 2019 population of 651, 552. The project includes partnerships with the Tulsa County District Attorney, the Tulsa County Public Defender, the Oklahoma Department of Mental Health and Substance Abuse Services, the Mental Health Association of Oklahoma, Oklahoma Family & Children’s Services, the Tulsa Police Department, and the Tulsa County Sheriff’s Office. The project will engage Oklahoma State University’s National Center for Wellness and Recovery as an evaluation partner. Priority considerations addressed in this application include protecting the public from crime and evolving threats in a region disproportionately impacted by substance use, as evidenced by a lack of accessibility to treatment providers and facilities.

Judiciary Courts of the State of Oklahoma

Oklahoma

The Tulsa County District Court, Fourteenth Judicial District of Oklahoma, is applying for Category 1 funding in the amount of $1,200,000. The project will launch the Tulsa County Anti-Recidivism Misdemeanor Diversion (TURN) Program, a court-based intervention program (mixed pre- and post-plea model) that expedites treatment and recovery services for justice-involved individuals with substance use disorders, mental illnesses, and co-occurring SUDs/MIs who are at high risk for overdose. TURN requires that participants engage with service and treatment providers in exchange for dismissed charges, no court fines or fees, and fewer court dates, among other benefits. By prioritizing stabilization and long-term social success, TURN will improve outcomes for individuals whose current primary source of treatment is the Tulsa County Jail. Deliverables include 1,000 misdemeanor cases diverted out of the criminal justice system and 800 alternative sentence recommendation outcomes. The program will be administered by Tulsa County Alternative Court Programs (TCACP), a division of the court. The project serves Tulsa County (OK), with an estimated 2019 population of 651, 552. The project includes partnerships with the Tulsa County District Attorney, the Tulsa County Public Defender, the Oklahoma Department of Mental Health and Substance Abuse Services, the Mental Health Association of Oklahoma, Oklahoma Family & Children’s Services, the Tulsa Police Department, and the Tulsa County Sheriff’s Office. The project will engage Oklahoma State University’s National Center for Wellness and Recovery as an evaluation partner. Priority considerations addressed in this application include protecting the public from crime and evolving threats in a region disproportionately impacted by substance use, as evidenced by a lack of accessibility to treatment providers and facilities.

WI

The Juneau County, Wisconsin, Sheriff’s Office project will provide case management, therapy ,and a crisis liaison within the jail. The primary objective of this project is to assess substance use disorder (SUD) and co-occurring mental health disorders that affect recidivism. The focus of the project is to provide jail-based programming and evidence-based substance use treatment, as well as harm reduction activities and recovery support services. Additionally, transition planning by the jail case manager will assist inmates in accessing treatment, medication, and prescriptions upon release from the jail. All grant funds will be used to provide these services. Activities for this project include: (1) assess case management needs through evidence-based assessments, refer clients to mental health and medical programs that address co-occurring disorders and SUD. This may include access to medication-assisted treatments that are available through established providers. The goals of the project are to provide assistance with stabilizing SUD and co-occurring mental health disorders that focus on reducing recidivism and increasing medication compliance. The project serves all Juneau County inmates. Juneau County has a population of 26,718 people and the jail can hold 157 inmates.

Juneau County

Wisconsin

The Juneau County, Wisconsin, Sheriff’s Office project will provide case management, therapy ,and a crisis liaison within the jail. The primary objective of this project is to assess substance use disorder (SUD) and co-occurring mental health disorders that affect recidivism. The focus of the project is to provide jail-based programming and evidence-based substance use treatment, as well as harm reduction activities and recovery support services. Additionally, transition planning by the jail case manager will assist inmates in accessing treatment, medication, and prescriptions upon release from the jail. All grant funds will be used to provide these services. Activities for this project include: (1) assess case management needs through evidence-based assessments, refer clients to mental health and medical programs that address co-occurring disorders and SUD. This may include access to medication-assisted treatments that are available through established providers. The goals of the project are to provide assistance with stabilizing SUD and co-occurring mental health disorders that focus on reducing recidivism and increasing medication compliance. The project serves all Juneau County inmates. Juneau County has a population of 26,718 people and the jail can hold 157 inmates.

WV

The Justice and Community Services (JCS) Section of the West Virginia Division of Administrative Services (DAS), which is the State Administrative Agency for criminal justice-related activities in the state, is applying under Category 2 for grant funding in the amount of $6,000,000 under the FY 2020 Comprehensive Opioid, Stimulant, and Substance Abuse Site-based Program (COSSAP) grant program. The purpose of the project is two-fold. First, the project will establish a cutting-edge approach to pre-arrest diversion by integrating quick response teams, LEAD, and the West Virginia Angel Initiative (Angel) to establish the WV QLA Early Intervention Program. This program will be implemented into the following nine counties: Berkeley, Cabell, Kanawha, McDowell, Mercer, Monongalia, Raleigh, Wood, and Wyoming. The total population of these counties is 763,728 and accounts for 61 percent of the overdose fatalities within West Virginia. Second, the project will assist county commissions and non-profit organizations to assist with the recruitment, retention, and training of peer recovery coaches throughout the state. Coaches will be required to possess the following credentials to be funded under this initiative: 1) a high school diploma or recognized equivalent; 2) experience with substance use challenges; 3) involved with a personal support and/or recovery system; 4) reside in stable, recovery-oriented housing the last six (6) months; 5) have no involvement with the legal system within the last six (6) months and/or pending legal issues; and 7) no intensive behavioral health involvement within the last six (6) months, including intensive services, detoxification services, and/or residential treatment services. JCS has partnered with the West Virginia Office of Drug Control Policy and West Virginia Department of Health and Human Resources Bureau for Behavioral Health in the implementation, monitoring, oversight, and sustainment of the proposed project. Priority considerations addressed in this application include rural and high-poverty areas.

Justice and Community Services

West Virginia

The Justice and Community Services (JCS) Section of the West Virginia Division of Administrative Services (DAS), which is the State Administrative Agency for criminal justice-related activities in the state, is applying under Category 2 for grant funding in the amount of $6,000,000 under the FY 2020 Comprehensive Opioid, Stimulant, and Substance Abuse Site-based Program (COSSAP) grant program. The purpose of the project is two-fold. First, the project will establish a cutting-edge approach to pre-arrest diversion by integrating quick response teams, LEAD, and the West Virginia Angel Initiative (Angel) to establish the WV QLA Early Intervention Program. This program will be implemented into the following nine counties: Berkeley, Cabell, Kanawha, McDowell, Mercer, Monongalia, Raleigh, Wood, and Wyoming. The total population of these counties is 763,728 and accounts for 61 percent of the overdose fatalities within West Virginia. Second, the project will assist county commissions and non-profit organizations to assist with the recruitment, retention, and training of peer recovery coaches throughout the state. Coaches will be required to possess the following credentials to be funded under this initiative: 1) a high school diploma or recognized equivalent; 2) experience with substance use challenges; 3) involved with a personal support and/or recovery system; 4) reside in stable, recovery-oriented housing the last six (6) months; 5) have no involvement with the legal system within the last six (6) months and/or pending legal issues; and 7) no intensive behavioral health involvement within the last six (6) months, including intensive services, detoxification services, and/or residential treatment services. JCS has partnered with the West Virginia Office of Drug Control Policy and West Virginia Department of Health and Human Resources Bureau for Behavioral Health in the implementation, monitoring, oversight, and sustainment of the proposed project. Priority considerations addressed in this application include rural and high-poverty areas.

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

Kenton County Fiscal Court applied for Category 1b suburban area grant funding in the amount of $900,000. The Comprehensive Opioid, Stimulant, and Substance Abuse Site-based Program will develop, implement, and expand Law Enforcement Assisted Diversion to policing agencies with pre-arrest diversion coordinators to reduce incarceration and lower the cost to communities and provide a case manager for those leaving incarceration to reduce recidivism. The program will also contract a peer support specialist to assist quick response teams responding to overdoses to establish connections, provide harm-reduction information, and easy access to naloxone. In addition, the program will provide supportive services to those wanting treatment and those in recovery. Supportive services will include referrals to community partners, case management, transportation, recovery housing, assistance with identification and an Indigent Essentials Backpack. This project serves Kenton, Pendleton, and Grant counties with a total population of 205,701. The project includes partnerships between Mental Health America, Northern Kentucky Community Action, Life Learning Center, Transitions, Sun, Alexandria’s Angels, Erlanger Police social workers, and the City of Falmouth.

Kenton County Fiscal Court

Kentucky

Kenton County Fiscal Court applied for Category 1b suburban area grant funding in the amount of $900,000. The Comprehensive Opioid, Stimulant, and Substance Abuse Site-based Program will develop, implement, and expand Law Enforcement Assisted Diversion to policing agencies with pre-arrest diversion coordinators to reduce incarceration and lower the cost to communities and provide a case manager for those leaving incarceration to reduce recidivism. The program will also contract a peer support specialist to assist quick response teams responding to overdoses to establish connections, provide harm-reduction information, and easy access to naloxone. In addition, the program will provide supportive services to those wanting treatment and those in recovery. Supportive services will include referrals to community partners, case management, transportation, recovery housing, assistance with identification and an Indigent Essentials Backpack. This project serves Kenton, Pendleton, and Grant counties with a total population of 205,701. The project includes partnerships between Mental Health America, Northern Kentucky Community Action, Life Learning Center, Transitions, Sun, Alexandria’s Angels, Erlanger Police social workers, and the City of Falmouth.

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.

CA

The project serves Kings County, California, which has a population of approximately 150,373. The purpose of the project is to build strong coordination between in-custody and community-based treatment, establish a job training program for individuals reentering the community from jail, and establish virtual peer recovery support services for individuals leaving jail. The project addresses the allowable use of establishing evidence-based substance use disorder treatment related to opioids, stimulants, and other illicit drugs, such as medication-assisted treatment (MAT), with a focus on building strong coordination between in-custody and community-based treatment and recovery support services (100 percent of the budget). The project includes a partnership with Kings County Jobs Training Office, Wellpath, and Heritage Health Solutions.

Kings County

California

The project serves Kings County, California, which has a population of approximately 150,373. The purpose of the project is to build strong coordination between in-custody and community-based treatment, establish a job training program for individuals reentering the community from jail, and establish virtual peer recovery support services for individuals leaving jail. The project addresses the allowable use of establishing evidence-based substance use disorder treatment related to opioids, stimulants, and other illicit drugs, such as medication-assisted treatment (MAT), with a focus on building strong coordination between in-custody and community-based treatment and recovery support services (100 percent of the budget). The project includes a partnership with Kings County Jobs Training Office, Wellpath, and Heritage Health Solutions.

WA

The Kittitas County Sheriff's Office project will serve those incarcerated at the Kittitas County Jail located in Ellensburg, Washington, including both Kittitas County residents as well as other clients from other areas of the state as well. As of 2020, Kittitas County has an estimated population of 44,337 and the jail's daily population is steadily rising since the pandemic, but currently an average of 98 people incarcerated daily. The request for this funding is to develop a project that will expand and enhance evidence-based medication for opioid use disorder (MOUD), as well as recovery support services within the Kittitas County Jail. The Kittitas County Jail currently has a FY 2020 COSSUP grant this project will continue the services, while enhancing the program to continue to lower recidivism and having a positive effect on the entire community they serve. According to the Rural Health Grants Eligibility Analyzer, Kittitas County is eligible for Rural Health Grants. According to the most available stats in 2018, The ration of Kittitas County residents to primary care physicians is 1710:1. The University of Washington released stats in January of 2023 that states crime lab data for police evidence testing indicate a 186% increase in the number of cases positive for opioids statewide between 2002- and 2018-2020, with increases in most counties. The Kittitas County Jail houses all persons who are booked within the 2,297.3 square miles and serve all local Law Enforcement agencies as well as the United State Marshalls and Washington State Department of Corrections. The program is designed to enhance and increase staff training, screening, delivery of onsite services including intake, induction, dosing, care coordination and post-release coordination. The Kittitas County Sheriff's Office will seek a MOUD partner that is committed to enhancing the already established programming and consist of medical providers carrying certifications in Addiction and Emergency Medicine, Internal, OB/GYN, and Family Medicine, as well as other specialties. The program will include a researcher to develop and provide the necessary data as required and to further find ways to increase its capabilities by utilizing a mixed method approach consisting of participant interviews, MAT retention rates, and recidivism statistics.

Kittitas, County of

Washington

The Kittitas County Sheriff's Office project will serve those incarcerated at the Kittitas County Jail located in Ellensburg, Washington, including both Kittitas County residents as well as other clients from other areas of the state as well. As of 2020, Kittitas County has an estimated population of 44,337 and the jail's daily population is steadily rising since the pandemic, but currently an average of 98 people incarcerated daily. The request for this funding is to develop a project that will expand and enhance evidence-based medication for opioid use disorder (MOUD), as well as recovery support services within the Kittitas County Jail. The Kittitas County Jail currently has a FY 2020 COSSUP grant this project will continue the services, while enhancing the program to continue to lower recidivism and having a positive effect on the entire community they serve. According to the Rural Health Grants Eligibility Analyzer, Kittitas County is eligible for Rural Health Grants. According to the most available stats in 2018, The ration of Kittitas County residents to primary care physicians is 1710:1. The University of Washington released stats in January of 2023 that states crime lab data for police evidence testing indicate a 186% increase in the number of cases positive for opioids statewide between 2002- and 2018-2020, with increases in most counties. The Kittitas County Jail houses all persons who are booked within the 2,297.3 square miles and serve all local Law Enforcement agencies as well as the United State Marshalls and Washington State Department of Corrections. The program is designed to enhance and increase staff training, screening, delivery of onsite services including intake, induction, dosing, care coordination and post-release coordination. The Kittitas County Sheriff's Office will seek a MOUD partner that is committed to enhancing the already established programming and consist of medical providers carrying certifications in Addiction and Emergency Medicine, Internal, OB/GYN, and Family Medicine, as well as other specialties. The program will include a researcher to develop and provide the necessary data as required and to further find ways to increase its capabilities by utilizing a mixed method approach consisting of participant interviews, MAT retention rates, and recidivism statistics.

TN

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

Knox, County of

Tennessee

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

PA

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

Lackawanna County Government

Pennsylvania

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

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.

IL

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

Lake County

Illinois

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

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.

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.

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.

MT

The County of Lewis and Clark applied to Category 1c grant funding and received $600,000. It proposes to implement the Medication-Assisted Treatment (MAT) Bridges Project, which will support the delivery of treatment in the County's Detention Center for individuals with opioid use disorders (OUD). MAT medications, in combination with counseling and behavioral therapies, provide an evidence-based, holistic patient approach to the treatment of opioid dependency. The County requested funding for medications, supplies, medical appointments, and personnel, to implement the MAT Bridges program in the County's Detention Center. The MAT Bridges program is projected to increase retention in treatment for individuals upon release into the community and decrease recidivism rates for MAT Bridges participants. This project serves an estimated population of 73,832, including both rural and urban communities in the county. The project includes partnerships between the County’s Criminal Justice Services Department, Sheriff's Office and community providers.

Lewis and Clark County

Montana

The County of Lewis and Clark applied to Category 1c grant funding and received $600,000. It proposes to implement the Medication-Assisted Treatment (MAT) Bridges Project, which will support the delivery of treatment in the County's Detention Center for individuals with opioid use disorders (OUD). MAT medications, in combination with counseling and behavioral therapies, provide an evidence-based, holistic patient approach to the treatment of opioid dependency. The County requested funding for medications, supplies, medical appointments, and personnel, to implement the MAT Bridges program in the County's Detention Center. The MAT Bridges program is projected to increase retention in treatment for individuals upon release into the community and decrease recidivism rates for MAT Bridges participants. This project serves an estimated population of 73,832, including both rural and urban communities in the county. The project includes partnerships between the County’s Criminal Justice Services Department, Sheriff's Office and community providers.

KY

The Lexington-Fayette Urban County Government (LFUCG) project includes a First Responder diversion program and will provide naloxone as leave behind kits for ambulance first responders. This project will be implemented in Lexington-Fayette County, a jurisdiction represented by a merged city-county government, in central Kentucky. CPOOL has four specific objectives. The first objective of CPOOL is to hire two qualified Social Workers and a Peer Support Specialist to enhance a multidisciplinary response team of law enforcement, fire and emergency services, treatment providers, recovery advocates, and other community partners. Second, CPOOL will increase the rate of successful client contacts and referrals to services for individual survivors of drug overdose identified by emergency response by the Lexington Division of Fire and Emergency Medical Services (LDFEMS). The third objective is through the implementation of a naloxone Leave Behind program by the ambulance crews that have responded to the 911 call for the non-fatal overdose. The fourth objective is to provide reentry support to individuals who are preparing to leave treatment and transition back home, including to help connect to support services, treatment providers, and recovery housing as needed. In CPOOL, there will be continued collaboration with substance use treatment providers like Hope Center, Chrysalis House, and Isaiah House; support programs Voices of Hope; and policy makers such as the Kentucky Office of Drug Control Policy. Additionally, LFUCG will work directly with the Training and Technical Assistance provider selected by BJA. CPOOL meets one area of Priority Consideration. LFUCG will work with the University of Kentucky Center on Drug and Alcohol as a research partner to complete an evaluation on the project.

Lexington-Fayette Urban County Government

Kentucky

The Lexington-Fayette Urban County Government (LFUCG) project includes a First Responder diversion program and will provide naloxone as leave behind kits for ambulance first responders. This project will be implemented in Lexington-Fayette County, a jurisdiction represented by a merged city-county government, in central Kentucky. CPOOL has four specific objectives. The first objective of CPOOL is to hire two qualified Social Workers and a Peer Support Specialist to enhance a multidisciplinary response team of law enforcement, fire and emergency services, treatment providers, recovery advocates, and other community partners. Second, CPOOL will increase the rate of successful client contacts and referrals to services for individual survivors of drug overdose identified by emergency response by the Lexington Division of Fire and Emergency Medical Services (LDFEMS). The third objective is through the implementation of a naloxone Leave Behind program by the ambulance crews that have responded to the 911 call for the non-fatal overdose. The fourth objective is to provide reentry support to individuals who are preparing to leave treatment and transition back home, including to help connect to support services, treatment providers, and recovery housing as needed. In CPOOL, there will be continued collaboration with substance use treatment providers like Hope Center, Chrysalis House, and Isaiah House; support programs Voices of Hope; and policy makers such as the Kentucky Office of Drug Control Policy. Additionally, LFUCG will work directly with the Training and Technical Assistance provider selected by BJA. CPOOL meets one area of Priority Consideration. LFUCG will work with the University of Kentucky Center on Drug and Alcohol as a research partner to complete an evaluation on the project.

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.

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.

WV

The County of Logan, Southwestern Regional Day Report Center's Fresh Start Program, is a comprehensive alternative-to-incarceration program designed to reduce clients’ risk of relapse and recidivism while improving their quality of life through treatment, peer support, and community connectedness. Due to the pervasive opioid and stimulant epidemic, Fresh Start has expanded and diversified its approach to those impacted. Enhancements include providing participants with further educational and certification opportunities, developing an internship program for participants who are near completion of the program, and helping participants repair relationships through family-centered activities. This project serves a target population of high-risk individuals as measured by the Level of Service Case Management Inventory with an elevation in the moderate to high range for the Alcohol or Other Drug Problems subscale and who meet criteria as suffering from an opioid or stimulant use disorder as classified in the Diagnostic and Statistical Manual of Mental Disorders – 5th Edition. The project includes partnerships between chief probation officers, the region's adult drug court and family treatment court, the West Virginia Supreme Court, the West Virginia Food and Farm Coalition, Grow Appalachia, the Hungry Lambs Food Initiative, West Virginia University Extension Services, county health departments, West Virginia Jobs and Hope, and the West Virginia Military Authority.

Logan County Commission

West Virginia

The County of Logan, Southwestern Regional Day Report Center's Fresh Start Program, is a comprehensive alternative-to-incarceration program designed to reduce clients’ risk of relapse and recidivism while improving their quality of life through treatment, peer support, and community connectedness. Due to the pervasive opioid and stimulant epidemic, Fresh Start has expanded and diversified its approach to those impacted. Enhancements include providing participants with further educational and certification opportunities, developing an internship program for participants who are near completion of the program, and helping participants repair relationships through family-centered activities. This project serves a target population of high-risk individuals as measured by the Level of Service Case Management Inventory with an elevation in the moderate to high range for the Alcohol or Other Drug Problems subscale and who meet criteria as suffering from an opioid or stimulant use disorder as classified in the Diagnostic and Statistical Manual of Mental Disorders – 5th Edition. The project includes partnerships between chief probation officers, the region's adult drug court and family treatment court, the West Virginia Supreme Court, the West Virginia Food and Farm Coalition, Grow Appalachia, the Hungry Lambs Food Initiative, West Virginia University Extension Services, county health departments, West Virginia Jobs and Hope, and the West Virginia Military Authority.

CA

The County of Los Angeles is applying for Category 1a urban area grant funding in the amount of $1,200,000. The Los Angeles County Department of Health Services Office of Diversion and Reentry (ODR) will (1) expand law enforcement referral opportunities to divert individuals who commit low-level drug and prostitution offenses as a result of unmet health, behavioral health, and socioeconomic needs away from the criminal justice system and into supportive services by broadening eligibility criteria to include individuals with histories of stimulant, opioid and/or other substance use; (2) reduce the number of individuals in Hollywood with unmet substance use, mental health, housing, employment, or health needs entering the criminal justice system for low-level offenses; and (3) increase access to harm-reduction services and case management, including overdose education and access to naloxone for Hollywood LEAD (Law Enforcement Assisted Diversion) participants. This project serves the City of Los Angeles (population 3,949,776). The project includes partnerships between ODR, Los Angeles Police Department, Los Angeles County District Attorney’s Office, Los Angeles City Attorney’s Office, Community Health Project Los Angeles (service provider), and Dr. Ricky Bluthenthal from the University of Southern California.

Los Angeles County

California

The County of Los Angeles is applying for Category 1a urban area grant funding in the amount of $1,200,000. The Los Angeles County Department of Health Services Office of Diversion and Reentry (ODR) will (1) expand law enforcement referral opportunities to divert individuals who commit low-level drug and prostitution offenses as a result of unmet health, behavioral health, and socioeconomic needs away from the criminal justice system and into supportive services by broadening eligibility criteria to include individuals with histories of stimulant, opioid and/or other substance use; (2) reduce the number of individuals in Hollywood with unmet substance use, mental health, housing, employment, or health needs entering the criminal justice system for low-level offenses; and (3) increase access to harm-reduction services and case management, including overdose education and access to naloxone for Hollywood LEAD (Law Enforcement Assisted Diversion) participants. This project serves the City of Los Angeles (population 3,949,776). The project includes partnerships between ODR, Los Angeles Police Department, Los Angeles County District Attorney’s Office, Los Angeles City Attorney’s Office, Community Health Project Los Angeles (service provider), and Dr. Ricky Bluthenthal from the University of Southern California.

LA

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

Louisiana Department of Public Safety and Corrections

Louisiana

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

KY

Louisville Jefferson County Metro Government is applying for a Category 1a urban area grant in the amount of $1,200,000. The MAT Expansion Project, known as IMPACT—Innovative Medication Program for Addiction Care and Treatment, aims to increase access to medications for Opioid Use Disorder in the jail. The project will expand in-custody access to MAT to reduce overdose deaths, reduce criminal behavior, and improve treatment retention and treatment outcomes for the population with moderate to severe opioid use disorder (OUD). Goals of the project include: increase access to MAT to incarcerated individuals already enrolled in a community opioid treatment program or office-based opioid treatment program prior to arrest, increase access to MAT by initiating two FDA-approved medications (methadone and buprenorphine) for OUD, improve treatment retention by providing in-custody behavioral therapies for substance use disorder and referral and linkage to care in the community upon release, and developing protocols to control medication diversion and offer ongoing staff training to address safety and security and the stigma associated with MAT as a treatment modality. This project serves the Louisville Metro City/County with a combined population estimated of 771,517. The project includes partnerships between Yescare, and the MORE Center.

Louisville Jefferson County Metro Government

Kentucky

Louisville Jefferson County Metro Government is applying for a Category 1a urban area grant in the amount of $1,200,000. The MAT Expansion Project, known as IMPACT—Innovative Medication Program for Addiction Care and Treatment, aims to increase access to medications for Opioid Use Disorder in the jail. The project will expand in-custody access to MAT to reduce overdose deaths, reduce criminal behavior, and improve treatment retention and treatment outcomes for the population with moderate to severe opioid use disorder (OUD). Goals of the project include: increase access to MAT to incarcerated individuals already enrolled in a community opioid treatment program or office-based opioid treatment program prior to arrest, increase access to MAT by initiating two FDA-approved medications (methadone and buprenorphine) for OUD, improve treatment retention by providing in-custody behavioral therapies for substance use disorder and referral and linkage to care in the community upon release, and developing protocols to control medication diversion and offer ongoing staff training to address safety and security and the stigma associated with MAT as a treatment modality. This project serves the Louisville Metro City/County with a combined population estimated of 771,517. The project includes partnerships between Yescare, and the MORE Center.

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.

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.

MI

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

Macomb County

Michigan

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

IN

The County of Marion is applying for a Category 1 award in the amount of $1,163,404. The Marion County Sheriff's Office’s (MCSO) Increasing MAT Capacity program will increase medication-assisted treatment (MAT) program capacity to fund a full scale, comprehensive MAT program that focuses on three parts: continuation, induction, and community connectivity. MAT in this program refers to the use of U.S. Food and Drug Administration (FDA)-approved medications, in combination with counseling and behavioral therapies, to treat substance use disorders as a medical disorder. There are three FDA-approved medications used to treat opioid use disorder (OUD), and two will be used in this program: buprenorphine and naltrexone. This program will screen all arrestees at Marion County Jail Intake for OUD, continue MAT treatment for patients that self-report at Marion County Jail Intake to be currently enrolled in a MAT program, identify at-risk patients and induct on MAT, and ensure patients are connected to health insurance and MAT in the community prior to their release. This project serves Marion County, which includes the city of Indianapolis, Indiana, and has a population of approximately 101,020. The project includes partnerships between MCSO, MCSO’s Behavioral Management Team, Wellpath, and Midtown Community Mental Health. Priority considerations addressed in this application include that the individuals who will benefit from the project live in high-poverty areas.

Marion County

Indiana

The County of Marion is applying for a Category 1 award in the amount of $1,163,404. The Marion County Sheriff's Office’s (MCSO) Increasing MAT Capacity program will increase medication-assisted treatment (MAT) program capacity to fund a full scale, comprehensive MAT program that focuses on three parts: continuation, induction, and community connectivity. MAT in this program refers to the use of U.S. Food and Drug Administration (FDA)-approved medications, in combination with counseling and behavioral therapies, to treat substance use disorders as a medical disorder. There are three FDA-approved medications used to treat opioid use disorder (OUD), and two will be used in this program: buprenorphine and naltrexone. This program will screen all arrestees at Marion County Jail Intake for OUD, continue MAT treatment for patients that self-report at Marion County Jail Intake to be currently enrolled in a MAT program, identify at-risk patients and induct on MAT, and ensure patients are connected to health insurance and MAT in the community prior to their release. This project serves Marion County, which includes the city of Indianapolis, Indiana, and has a population of approximately 101,020. The project includes partnerships between MCSO, MCSO’s Behavioral Management Team, Wellpath, and Midtown Community Mental Health. Priority considerations addressed in this application include that the individuals who will benefit from the project live in high-poverty areas.

MA

The Massachusetts Administrative Office of the Trial Court applied for a Category 2 statewide grant in the amount of $6,000,000. Project NORTH (Navigation, Outreach, Recovery, Treatment, and Hope) will increase treatment engagement and retention, decrease risk of overdose, and reduce risk of justice-system involvement. The objectives of the project are to increase access to evidence-based treatment and care coordination, decrease barriers to treatment retention, increase recovery support and recovery capital, and increase access to overdose-prevention education and naloxone distribution. This project serves 62 communities in 9 counties and 2.7 million people. Locations include Barnstable, Boston, Brockton, Chelsea, Haverhill, Fall River, Lawrence, Lowell, Lynn, New Bedford, Pittsfield, Quincy, Springfield, Taunton, and Worcester. The project includes partnerships with nine licensed treatment providers whose catchment areas overlap with 15 high-need court locations, the University of Massachusetts Chan Medical School’s Center of Excellence for Specialty Courts, and the Massachusetts Alliance for Sober Housing. Priority considerations in this application include rural regions, high-poverty areas, and Qualified Opportunity Zones. Please note that Marisa Hebble, Senior Manager for Behavioral Health in the Massachusetts Trial Court, currently leads this initiative as Project Director.

Massachusetts Administrative Office of the Trial Court

Massachusetts

The Massachusetts Administrative Office of the Trial Court applied for a Category 2 statewide grant in the amount of $6,000,000. Project NORTH (Navigation, Outreach, Recovery, Treatment, and Hope) will increase treatment engagement and retention, decrease risk of overdose, and reduce risk of justice-system involvement. The objectives of the project are to increase access to evidence-based treatment and care coordination, decrease barriers to treatment retention, increase recovery support and recovery capital, and increase access to overdose-prevention education and naloxone distribution. This project serves 62 communities in 9 counties and 2.7 million people. Locations include Barnstable, Boston, Brockton, Chelsea, Haverhill, Fall River, Lawrence, Lowell, Lynn, New Bedford, Pittsfield, Quincy, Springfield, Taunton, and Worcester. The project includes partnerships with nine licensed treatment providers whose catchment areas overlap with 15 high-need court locations, the University of Massachusetts Chan Medical School’s Center of Excellence for Specialty Courts, and the Massachusetts Alliance for Sober Housing. Priority considerations in this application include rural regions, high-poverty areas, and Qualified Opportunity Zones. Please note that Marisa Hebble, Senior Manager for Behavioral Health in the Massachusetts Trial Court, currently leads this initiative as Project Director.

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.