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IA Discretionary Funding Fiscal Year 2019

Center: TI

Grantee: IOWA STATE UNIVERSITY
Program: Rural Opioids Technical Assistance Grants
City: AMES
State: IA
Grant Award Number: 5 H79 TI081892-02
Congressional District: 4
FY 2019 Funding: $550,000
Project Period: 2018/09/30 - 2020/09/29

The purpose of this proposed project is to supplement our recent RHSE demonstration grant with additional demonstration states supporting rural county sites. These states will be implementing a multi-step, Extension-powered prevention T/TA capacity-building system guided by the scientifically-proven PROSPER Delivery System. The PROSPER Delivery System remains one of the few models proven as efficacious for the high-quality delivery of evidence-based programs, and it currently is the only system designed for use within Extension that has been shown to reduce opioid misuse through a randomized controlled trial. Our primary prevention T/TA and capacity-building goals will be pursued with an innovative partnership among Iowa State University (ISU) Extension and Outreach, the PROSPER Network Organization based in the ISU Partnerships in Prevention Science Institute, and Public Health partners. PROSPER?s positive results to date are expected to be enhanced by the proposed multi-step T/TA capacity-building system that adapts the original PROSPER model, adding programming content and prevention strategies to specifically address the risks of opioid and prescription drug misuse. The proposed T/TA capacity-building system--called PROSPERing Step-by-step, State by state (P2S)--entails: (1) Mobilizing and Organizing for the P2S System; (2) Conducting Supplemental Training at the County Level for P2S Implementation; and (3) Conducting Core Programming/ Prevention Activities. This will be followed by P2S planning that includes strategies for conducting specialty trainings (e.g., media, environmental strategies) and capacity building for sustainability. Notably, the proposed project will leverage support through a companion PROSPER Rx RHSE grant that is developing capacity-building materials, strategies and programming for community-based actions to address opioid misuse. Significantly, this project will demonstrate a T/TA model that can be readily scaled up. It will initiate groundwork for this scale up among Extension and Public Health stakeholders and prospective P2S trainees in additional states, enhancing their capacity to support a comprehensive community systems approach to address the opioid epidemic and achieve positive impacts for their youth and families.


Grantee: JUDICIARY COURTS OF THE STATE OF IOWA
Program: FAMILY TREATMENT DRUG COURTS
City: DES MOINES
State: IA
Grant Award Number: 5 H79 TI080291-03
Congressional District: 3
FY 2019 Funding: $425,000
Project Period: 2017/09/30 - 2022/09/29

Abstract Iowa Children?s Justice (ICJ) proposes the Iowa Court Collaborative Family Preservation Project (ICCFP), a coordinated, multi-system approach designed to enhance the sanctioning power of family treatment drug courts with effective treatment services that promote successful family preservation and reunification to the diverse population of high-risk participants and children with substance abuse/child welfare and co-occurring mental health related needs. More specifically, working in collaboration with the Iowa Department of Human Services and the Iowa Department of Public Health, the three-pronged strategy for change includes enhancing the capacity of communities to respond to mental health and co-occurring needs, the implementation of an evidence based practice within six individual family treatment drug court settings, and enhancing community capacity and collaboration to respond to and address access to the assessment and treatment needs of substance-exposed children. Since 2007, the Iowa Family Treatment Courts (FTC) have expanded from six sites to our current 13 sites. In an in-depth evaluation of those sites, results indicate that the Family Treatment Courts (FTC) showed effectiveness in reunification rates and placement into substance abuse treatment as well as reducing subsequent treatment episodes, and a significantly greater reduction in these areas than the matched and referred comparison groups. Based on national research, it was decided to improve the family drug treatment courts further by adding enhanced services of recovery support, Strengthening Families Program, and adding Mental Health providers to the six Family Treatment Court Teams to enhance services to the participants. Based on the positive outcomes in the first six courts, the principle goals of this project are to support the addition of the enhanced services to our six newer family treatment courts. Goal 1: Enhance family treatment drug court team capacity to better serve families by adding recovery support to address the engagement, accountability, and referral needs of the participants in the six sites. Goal 2: Increase child and family functioning with an evidence-based family intervention across the sites. Strengthening Families is an EBP that has been shown to improve treatment outcomes and child and family functioning. Goal 3: Develop evidence-based assessment and treatment center to serve substance-exposed infants, children and youth, as well as to train identified professionals in each site to increase capacity to assess the children and provide treatment. Goal 4: Enhance the treatment teams and community steering committees to access services for substance abuse, mental health and co-occurring disorders with the addition of mental health and co-occurring professional representation.


Grantee: PRIMARY HEALTH CARE, INC.
Program: GBHI
City: Des Moines
State: IA
Grant Award Number: 5 H79 TI080466-02
Congressional District: 3
FY 2019 Funding: $400,000
Project Period: 2018/09/30 - 2023/09/29

The Polk County Integrated Housing and Health Service Program for Homeless Individuals project will provide support for 400 individuals in Central Iowa who experience homelessness and have substance use disorders (SUDs) or co-occurring mental and substance abuse disorders (CODs). The project will provide a comprehensive system of integrated services to support placement in permanent housing. Primary Health Care, Inc. (PHC), a Federally Qualified Health Center and Health Care for the Homeless provider, will lead the project in collaboration with Central Iowa Shelter & Services and Prelude Behavioral Services, and will build on the successful county-wide Centralized Intake system to provide increased access to permanent housing, behavioral health services, and other supportive services for individuals and families experiencing homelessness. This project will help clients improve their quality of life and achieve self-sufficiency by supporting them in their efforts to maintain recovery from mental health and substance use disorders. The project will utilize the Critical Time Intervention (CTI) model to provide emotional and practical support during the transition to stable housing. Grant funds will be used to hire four full-time CTI Workers to help clients find housing and link them to supports, including primary care, mental health care, substance abuse counseling, and other services. This project will use evidence-based protocols and engage an extensive network of providers to ensure clients have access to a full continuum of services. Grant funds will also be used to hire a fulltime Outreach Therapist (CADC/LISW) and a full-time Peer Recovery Support Specialist. An additional full-time volunteer Peer Recovery Support Specialist will support this project. Project goals and objectives include: increasing the number of clients who obtain and maintain permanent housing; enrolling clients in benefits; screening and referring clients to mental health and substance abuse services; providing clients with supportive services that improve their chances at long-term housing and recovery; and establishing care for clients? physical health. The project?s progress toward achieving goals will be monitored by a Steering Committee and an experienced evaluator will oversee data collection and analysis.


Grantee: SAC & FOX TRIBE OF THE MISSISSIPPI IN IOWA
Program: Tribal Opioid Response Grants
City: TAMA
State: IA
Grant Award Number: 5 H79 TI081770-02
Congressional District: 1
FY 2019 Funding: $98,639
Project Period: 2018/09/30 - 2020/09/29

The Meskwaki Opioid Prevention and Assistance project will be used to prevent and fight against opioid misuse by Native Americans located with the Meskwaki Health Clinic Service Area. This project hopes to serve over 800 individuals: Tribal Employees ? 122; MSS Employees ? 88; Elders ? 40; Youth ? 250; Community Members ? 300, through the two years of the project. Annually the goal is to provide services to 400 individuals annually. Measures for this project include: the number of individuals served, the number of community events attended, the number of presentations made, the number of trainings attended, the number of prescribers attending MAT training, and the number of agreements entered into with treatment providers in the Midwest. The mission of MADAC (Meskwaki Alcohol and Drug Abuse Center), ?is to provide alcohol and drug treatment, screening, assessment, intervention and prevention services to tribal youth and adults?. In line with the mission of MADAC are the goals of this project:1) to develop MADAC?s capacity in opioids; 2) to develop and provide opioid misuse prevention, 3) to develop and provide opioid misuse treatment, 4) to develop and provide opioid misuse recovery support services, and 5) increase emergency response on the Meskwaki Settlement for opioid misuse. The strategies of the project (objectives) will be: create a strategic plan focused on opioids within the first 60-days of the project start date; increase in MADAC staff capacity on opioids and associated services; hiring of a Substance Abuse Prevention Specialist, collect and analyze data related to opioids; conduct outreach and prevention activities for tribal operation staff, elders, youth, Meskwaki school staff, and the Meskwaki community; increase the capacity of prescribers; reduce the cost associated with opioid treatment; increase services offered by MADAC; ease the transitioning of Native Americans re-entering their community; and increase the capacity of Meskwaki emergency service personnel and Meskwaki community members on the use of naloxone.


Grantee: SIXTH JUDICIAL DIST DEPT/CORRECT SRVCS
Program: SAMHSA Treatment Drug Courts
City: CEDAR RAPIDS
State: IA
Grant Award Number: 5 H79 TI081053-02
Congressional District: 1
FY 2019 Funding: $374,841
Project Period: 2018/09/30 - 2023/09/29

The Drug Treatment Court Housing First Project will serve 200 unique participants per year, providing access to support and maintain stable housing. The project will serve Drug Treatment Court Programs in Linn County, Iowa, and Johnson County Iowa. The overarching goals of the Housing First Project are to creatively blend the Housing First Model with Drug Treatment Court intervention to substantially reduce the number of days each participant spends in jail and lower overall recidivism. This will be accomplished in part via novel application of the Housing First Model; through new strategic partnerships made possible with this project participants will be able to access appropriate, stable housing from a very early stage of involvement in the Drug Treatment Court. In recognition of housing as a basic human need and a critical stabilizing factor for high risk, high need persons seeking a life of recovery, they will be afforded the opportunity to access appropriate housing regardless of sobriety status. While housing will be regarded and prioritized as a primary need, participants will remain accountable to the Drug Treatment Court Program throughout the project and all behavior will be subject to sanctions and incentives in alignment with evidence based practice. We anticipate this combination of targeted support and clear accountability will have a significant positive impact on program outcomes and is a natural but crucial extension of the successful structure Drug Treatment Courts have long employed to reduce recidivism among chemically dependent individuals in the criminal justice system. We will also reduce recidivism and number of days spent in jail by increasing access to therapeutic interventions such as non-hospital based detoxification services. These services are currently not available in our system of care but are crucial to ensuring appropriate responses to relapse and applying evidence based practices with respect to using jail as a sanction. We expect to serve 40 unique participants per year throughout the life of the project, reducing length of overall jail stays by 20% per year and increasing rates of housing stability (1 year or longer at current residence) by at least 2 percentage points per year.


Grantee: UNIVERSITY OF IOWA
Program: AI/AN Addiction Technology Transfer Center
City: IOWA CITY
State: IA
Grant Award Number: 5 H79 TI080814-02
Congressional District: 2
FY 2019 Funding: $500,000
Project Period: 2017/12/30 - 2022/12/29

Initially launched as the Prairielands Addiction Technology Transfer Center (PATTC), in 1998, our Center transitioned in 2012 to become the National American Indian and Alaska Natives (AI/AN) ATTC. Our proposed goals (abbreviated) include: 1) Assess/build BH care and primary healthcare workforce capacity e.g., use of technology, continuous quality improvement, etc., to enhance service access; 2) accelerating diffusion of culturally-informed/trauma-informed EBPs; 3) strengthening Tribal data collection systems; and 4) increasing collaboration through systems change. Our overarching implementation strategy will use a systems change approach to improve organizations and systems of care, enhance access, engagement, implementation, and outcomes based in a continuous quality improvement framework. This shift and associated learning curve will require patience and cultural understanding but will be facilitated by our longstanding trusting relationship with our many tribal partners, leaders, tribal members and communities. Our staff has traveled to all 12 IHS regions and met with providers, provider associations and Indian Health Service staff, listening to needs and issues in tribal and urban Indian behavioral health treatment programs. The trusting relationships we have built over the past 5 years and the collective work we have done to expand the effectiveness of the Native and non-Native workforce serving Native populations will provide the foundation for us to shift our focus from a primarily training model to developing, improving, and diffusing the quality of services and interventions provided across the prevention, treatment, maintenance (recovery) continuum. We will utilize more intensive TA models focused more on organizations, localities and systems, create more self-paced online courses and distance learning strategies, promote learning communities that include public health, and create tools for continuous quality improvement. Our Center has had an active Advisory Council (AC) for 5 years, all of whom are members from various tribal communities or members of AI/AN dissent, from across the country. They are tribal leaders, representatives from tribal provider organizations, AI/AN researchers, urban and tribal BH programs and organizations, tribal judge, BH leaders, spiritual leaders, members of the consumer community, and Ex-Officio members from IHS, and Bureau of Indian Education. We also secured three new advisory council members: 1) from Portland Area Health Board, 2) Native LGBT/Two Spirit community, and 3) an Ex-Officio member, SAMHSA RA from Region 6. These well-established and trusted relationships will make it possible to take our proposed accelerated actions to support the ATTC Network, AI/AN Tribes, tribal organizations, urban Indian programs, state and local governments, and other organizations to develop and strengthen the specialized behavioral healthcare and primary healthcare workforce that provides substance use disorder (SUD) treatment and recovery support services to tribal communities. The University of Miami (UM) Miller School of Medicine Department of Epidemiology and Public Health Comprehensive Drug Research Center (CDRC) will serve as an independent evaluator.


Grantee: UNIVERSITY OF IOWA
Program: Medication Assisted Treatment ? Prescription Drug and Opioid Addiction
City: IOWA CITY
State: IA
Grant Award Number: 5 H79 TI081620-02
Congressional District: 2
FY 2019 Funding: $524,670
Project Period: 2018/09/30 - 2021/09/29

Abstract The University of Iowa Hospitals and Clinics (UIHC) proposes to expand medication assisted treatment (MAT) in eastern Iowa, with the project title of Co-MAT-IA. The funds for the project will be used to assist the growing number of adults in eastern Iowa with opioid use disorder (OUD) begin the process of recovery. The goals are to increase the capacity of clinicians affiliated with UIHC to provide and monitor medication assisted treatment for OUD, increase the number of people with OUD in eastern Iowa who get MAT, and decrease illicit opioid drug use and prescription opioid misuse and improve client outcomes. These goals will be accomplished by providing training to increase the number of clinicians in eastern Iowa who offer MAT resulting in expansion of MAT to rural clinics, criminal justice populations, and other communities in Iowa. Partnerships will be formed between UIHC, including Departments of Psychiatry, Emergency Medicine, and Family Medicine, and: River Hills Community Health Center in Ottumwa; Mercy North Iowa Family Medicine Residency Clinic in Mason City; Iowa Department of Corrections & 6th Judicial District Department of Correctional Services; Veterans Affairs (VA) Medical Center in Iowa City and VISN 23; Iowa Harm Reduction Coalition. The objectives of the project are to: ? Build a team of medical professionals to collaboratively deliver MAT services. ? Expand MAT services at UIHC. ? Increase the number of clinicians in eastern Iowa who offer MAT in their practice. ? Construct a patient registry to provide ongoing information about patient treatment and outcomes to assist in guiding treatment modification when patients are not meeting treatment goals. ? Expand to rural clinics. ? Expand to serve criminal justice populations. ? Expand to other communities. ? Decrease heroin and other opioid use by 50% at 6-month post project enrollment. ? Reduce injection opioid drug use by 50% at 6-month post project enrollment. ? Improve quality of life, life satisfaction and social connectedness for people with OUD. The program will create a network for sharing information and expertise to ensure the sustainability of MAT in eastern Iowa beyond the 3 years of grant funding. Services will be provided to 140 unduplicated clients using evidenced based practices as part of the project.


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