Grants Dashboard

Project Save of Miami Valley provides overdose prevention, education, and overdose reversal medications to first responders in Darke, Montgomery, and Preble Counties in Ohio. This program works by providing naloxone to first responders via Centralized Naloxone Repositories, equipping non-transporting EMS vehicles with naloxone, furnishing naloxone to citizens via EMS agencies, and conducting outreach services to promote linkages to treatment. Montgomery County has the fifth highest overdose death rate in the state while Darke and Preble Counties? deaths rates have more than doubled over the last three years. The highest risk populations to experience an opioid overdose are mostly white (81%) males (64%) between the ages of 20-59 (100%) who have a comorbid physical illness or disability (66%) and a history of substance abuse (95%). Currently, only 16 out of 40 police departments carry naloxone. Annually, Project Save will serve up to 85 law enforcement officers; 400 EMS personnel; 1,920 overdose victims; 67 friends/families of overdose victims; and 800 community members. Throughout the lifetime of the project, that equates to 340 law enforcement officers; 1,600 EMS personnel; 7,680 overdose victims; 268 friends/families of overdose victims; and 3,200 community members. Project Save utilizes six main key activities: (1) equipping law enforcement agencies with naloxone by training on and implementing Centralized Naloxone Repositories; (2) equipping non-transporting EMS vehicles with naloxone; (3) equipping EMS departments to furnish naloxone to citizens directly at the scene of an overdose as well as at fire/EMS stations; (4) outreach services to link individuals to treatment and recovery services after a non-fatal overdose; (5) prevention and education services that focus on how to have a healthy relationship with prescription medications; and (6) trainings to healthcare providers on overdose dangers and encouraging them to provide resources to overdose victims and their families. The project?s goal is to create healthy, drug-free communities in which opiate addiction, and its dangerous consequences, do not diminish the quality of life for our communities? residents nor result in premature death. Measurable objectives include: 15% (485) yearly increase of first responders trained to use naloxone; 15% (10) yearly increase of first responder agencies that have established processes and protocols for carrying and administering naloxone; 10% (2,042) yearly increase in overdose reversals by first responders; 20% (67) yearly increase of family/friends who receive overdose prevention education and a naloxone kit directly following an overdose reversal; 800 community members trained to administer naloxone per year; 20% (14) yearly increase in the number of first responder agencies that have established mechanisms for referring and connecting individuals to treatment and recovery services; 557 individuals will receive referrals to treatment or recovery services per year; and a 5% (28) yearly increase in the number of non-fatal overdose victims that engage in treatment services.

The Mental Health and Anti-Addiction Services Administration (MHAASA) of Puerto Rico, which is the Single State Agency (SSA) for Puerto Rico (PR) for the Substance Abuse Prevention and Treatment Block Grant (SABG) and is submitting this SAMHSA First Responders – Comprehensive Addiction and Recovery Act (PR FR-CARA) application under the Funding Opportunity Announcement (FOA) Number No. SP-17-005 for 2017. The proposed project will finance training to first responders and members of other key community sectors on devices and methods for administering Naloxone for emergency treatment of opioid overdose, and the development of protocols for referral to appropriate treatment and recovery services proposed. Opioid overdose continues to be a major public health threat in Puerto Rico. It has contributed to 45 deaths during 2016 for a rate of 1.3 per 100,000. From 2000 to 2015, nearly 4,300 people died from drug overdoses of which 14.8% were females and 85.2% males. The distribution by age group is as follows: 2.3% ages 0 through 19, 47.5% ages 20 through 39, 42.0% ages 40 through 59 and 8.2% ages 60 and over. The geographic areas that have higher rates of overdose deaths are the metropolitan areas of the island which are: San Juan with 20.0%, Bayamón with 7.1%, Ponce with 6.9%, Caguas with 6.3 and Carolina with 5.0%. In terms of race, 82.0% were identified as whites, 10.6% as African Americans and 7.4% of other race, all being Hispanics. Recent reports from the Drug Enforcement Administration (DEA) highlighted that adulterated fentanyl, which, in its legal form, is used as an analgesic prescribed for severe pain, came to Puerto Rico at the end of the 2016. This opioid-based drug is 50 times more potent than heroin and only 2 mg, which is the equivalent of 3 or 4 grains of a sachet of sugar, is enough to kill a person. The potent narcotic is distributed adulterated in the streets of PR, and nine deaths have been linked to its use in areas of Mayagüez and Manatí. Danger for Puerto Rico increases with the confirmation that the drug is being prepared in clandestine laboratories in the Dominican Republic. This scenario must be closely observed because the criminal organizations on the contiguous island could be using Puerto Rico as a bridge to distribute fentanyl to the US. This current threat is being addressed, and will be reinforced with the proposed project. The purpose of SAMHSA and its Center for Substance Abuse Prevention (CSAP), stated in the First Responders – Comprehensive Addiction and Recovery Act (FOA-p. 4) No. SP-17-005, is to “allow first responders and members of other community sectors to administer a drug or device approved or cleared under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose”. The purpose of the MHAASA, serving as the Single State Agency (SSA) for Puerto Rico under SAMHSA, is to establish and implement a coordinated multi-agency effort to train, administer and empower first responders in the use of Naloxone to prevent opioid overdoses in Puerto Rico.

The Alabama Opioid Assistance (AOA) Project will make training available to 20 emergency medical service providers (EMSPs) and volunteer fire departments for the purpose of increasing access and administration of Naloxone (Narcan) and provide treatment referrals and recovery support services to 1,000 overdose victims and their families in Alabama. The AOA will reach target ten counties with the highest administration of Naloxone and ten rural counties with minimal or no cases of administering the drug in 2016. The goals of the AOA Project are to (1) decrease the number of opioid and heroin overdose deaths in the identified counties of Alabama and (2) increase the number of overdose victims and families who request information and are referred to and/or access treatment and recovery support services. These goals will be accomplished by completing the following objectives: (1) To provide training and education sessions to first responders in Alabama regarding response to overdose; (2) To increase the number of reversed opioid and heroin overdoses using Naloxone by EMSPs and volunteer fire departments; and (3) To establish a protocol, including policies and procedures, to provide information and referral services to overdose victims and families. Scheduled activities to be implemented include developing and implementing a marketing campaign; annual trainings on opioid and heroin use, treatment and recovery to first responders; developing online trainings and resources; purchasing Naloxone to first responders; establishing protocols, policies and procedures, providing peer support to overdose victims and families, and developing pocket referrals to distribute to first responders. The AOA Project will be a collaborative effort involving the leading applicant agency, the Alabama Department of Public Health, Division of Emergency Medical Services, Council on Substance Abuse-National Council on Alcohol and Drug Dependence (NCADD), Alabama Department of Mental Health and other community stakeholders working to address the opioid and heroin epidemic in Alabama.

Project Name: The Lorain Count?s First Response Applicant Name: Alcohol and Drug Addiction Services Board of Lorain County Target Community: Lorain County, Ohio Adults and families impacted by overdose From opiates, including heroin Lorain County?s First Response (LCFR) is a public/private partnership in Lorain County, Ohio that will save lives due to overdose from opiates, including heroin. The target population is 250 overdose survivors annually, or 1,000 survivors over the four years, and their families who will receive a rapid, community response from police, nurses and treatment and recovery support providers ensuring that these survivors have the best opportunity to continue to live another day. The target population includes overdose survivors and their families who will receive a comprehensive response through a team. This will include rapid response by trained first responders using the life saving device ? Naloxone (aka Narcan). Program services that will be offered through LCFR include: training and distribution of the life-saving device for emergency treatment of known or suspected opioid overdose, training of first responders on addiction, including treatment and recovery supports, and an outreach team that will engage overdose survivors and family members to access supports. Finally we will design and provide comprehensive overdose prevention education and information throughout Lorain County. The goals and objectives for LCFR are: Goal 1: Ensure all first responders, including police personnel and other key community sectors are trained and receive Nasal Naloxone; Goal 2: Increase in the number of opioid and heroin overdoses reversed by first responders and community members; Goal 3: Increase the knowledge of first responders about addiction.; Goal 4: Increase the number of overdose survivors who engage in treatment and/or recovery supports. Partners in the LCRC include: Alcohol and Drug Addiction Services Board of Lorain County, Lorain County General Health District, Avon Police Department, Avon Lake Police Department, Let?s Get Real, The LCADA Way, Mercy Parish Nursing. This effort will be accomplished by the implementation of following efforts over the next four years: train and equip all local police departments and first responders to carry Nasal Narcan, train and distribute Nasal Narcan to community key stakeholders; Train first responders on addiction, including treatment and recovery supports, utilize and Outreach Team through the Quick Response team to engage overdose survivors into treatment and recovery support services; and use data mapping to create impacting Overdose Prevention Education campaigns in Lorain County Communities. We believe that this comprehensive approach will ultimately save lives and help us to achieve our goal of reducing deaths due to overdose from opiates, including heroin in Lorain County.

On June 5, 2017, Arizona Governor Douglas Ducey signed a declaration of emergency and notification of enhanced surveillance advisory in response to the significant deleterious impact the opioid epidemic has had in Arizona. From 2012 to 2016, the number of opioid deaths in Arizona increased by 74%. In 2016, the Arizona Department of Health Services confirmed 790 opioid-related deaths, averaging more than two per day; and during the same year, Arizona?s Emergency Medical Services (EMS) agencies responded to over 64,000 substance-abuse-related 911 calls, (175 calls per day). Governor Ducey?s declaration included a requirement of the ADHS Director to ?develop and provide training to local law enforcement agencies on proper protocols for carrying, handling, and administering naloxone in overdose situations.? To meet this requirement, the ADHS Bureau of Emergency Medical Services and Trauma System are seeking support from the Substance Abuse and Mental Health Administration First Responders ? Comprehensive Addiction and Recovery Act Funding Opportunity Announcement No. SP-17-005 to develop, implement, and assess the following initiatives: ? A statewide naloxone delivery system to provide access to naloxone for first responders ? A statewide acute opioid-overdose recognition and naloxone administration training program for first responders ? A targeted first responder Opioid Screening, Brief Intervention, and Referral to Treatment curriculum to instruct first responders how to recognize actual opioid-related substance abuse or the potential thereof, and to provide appropriate interventions and referrals to care To carry out these initiatives, the Bureau will partner with the University of Arizona Center for Population Science and Discovery, the University of Arizona Center for Rural Health, the Arizona Peace Officer Standards and Training Board, and other key stakeholders. Success will be measured by determining the extent to which the three initiatives contribute to lowering of the number of opioid overdose deaths in Arizona over the course of the 4-year project period. Particular focus will be placed on comparing and contrasting changes in overdose deaths among rural and urban areas disproportionately impacted by the epidemic. Secondary success will be determined by assessing the number of first responders trained to administer naloxone and the number of naloxone kits distributed and employed during the project period. Tertiary success will be measured by successfully piloting the first responder Opioid Screening, Brief Intervention, and Referral to Treatment (SBIRT-EMS) curriculum to train first responders in at least two rural and two non-rural areas of Arizona.

Project Arkansas First Responders Comprehensive Addiction and Recovery Act (Arkansas FR-CARA) will provide immediate intervention to rapidly increasing preventable deaths in Arkansas as a direct result of misuse and abuse of prescription opioid medications. Immediate intervention methods will entail providing Naloxone and training to active volunteer firefighters and all first responders in the highest risk regions of Arkansas. Statewide delivery of resources and training will be performed by moving throughout the state counter clockwise with the implementation beginning primarily in rural regions identified as most at risk. Populations served will be all populations residing in areas identified as rural regions throughout the state of Arkansas. A regionally focused approached will specifically target the highest risk areas first and continue to work throughout the state. This will ensure optimal intervention methods, alleviation of health inequalities as well as overall reduction of overdose mortality rates in these high-risk regions. These rural region improvements will be a direct result of education and increased awareness to this growing drug overdose epidemic. By the end of grant year 1, 80% of all active volunteer firefighters in North Central Arkansas will be provided with Naloxone(NARCAN) for opioid overdose reversal. By the end of grant year 1, 90% of all homeless shelters in North Central Arkansas will be equipped with Naloxone (NARCAN) for opioid overdose reversal. By the 4th year of the grant, 75% of all homeless shelters throughout the state will be equipped with Naloxone (NARCAN) for opioid overdose reversal. By the fourth year of the grant, 50% of opioid overdose victims seen by law enforcement and active volunteer firefighters will be referred to opt into a treatment and recovery centers as an alternative to incarceration. By the fourth year of the grant, 50% of all opioid overdose victims will have conducted a follow-up consultation with the Program Director.

In Baltimore, a city of 614,000 residents, nearly 25,000 people are estimated to misuse opioids, and many of them are not connected to adequate treatment or social support services. Since 2011, the City has experienced a four-fold increase in total overdose deaths from 167 in 2011 to 694 in 2016. According to data from the state of Maryland, 2089 people lost their lives to overdose statewide in 2016. Of these deaths, 33% took place in Baltimore City, though the city comprises only 10% of the state population. Baltimore City carries a heavier burden of overdose fatalities compared to every other jurisdiction in the state, with a per capita overdose death rate of 113 per 100,000. To build on Baltimore’s nationally recognized response to this epidemic and reverse the alarming rise of overdose deaths in Baltimore City, the Baltimore City Health Department (BCHD) and partners the Baltimore City Fire Department (BCFD), the Baltimore Police Department (BPD), and Behavioral Health System Baltimore (BHSB) request $1,993,726 over four years ($498,431.50 per year) to augment the life-saving capabilities of Baltimore City’s Emergency Medical Services (EMS) by developing and implementing an Overdose Survivor Expansion Program (OSEP) designed to improve linkages to recovery services for individuals who experience non-fatal opioid-related overdoses and increase the capacity of first responders to reduce opioid-related fatalities. This will be accomplished by: • Developing and implementing procedures for obtaining consent for outreach services from overdose survivors treated by EMS and BPD in the Central District of Baltimore • Dispatching a real-time targeted overdose outreach team to respond alongside first responders to opioid-related calls in the Central District • Offering case management to people revived from overdose by first responders in the Central District • Implementing a real-time monitoring capacity for tracking SUD treatment system capacity and usage • Developing and distributing culturally and linguistically appropriate public education materials to individuals following non-fatal overdose, with information about SUD treatment options, harm reduction practices and programs, and other Baltimore City recovery services • Developing and providing enhanced “Behavioral Health First Aid” training to BCFD first responders on naloxone administration for the emergency treatment of known or suspected opioid overdose • Ensuring that an adequate supply of naloxone remains available for BCFD first responders to meet the growing number of opioid-related overdoses across the City

As our nation and communities become gripped by the opioid crisis, law enforcement is challenged to be on the front-line of fighting this self-described pandemic. The presence and increased use of fentanyl, and its evil twin carfentanil, goes beyond drug use by a select group of the population into possible terrorist implications. The fentanyl is infused into almost all of the heroin sold locally and can be deadly in very, very small doses. What makes it even more dangerous is that when airborne, the inhalation or touch of the fentanyl can cause critical injuries, including death. Because of its lethality, the drug can be used to make dirty bombs and could kill hundreds of people in a matter of minutes. The individuals who deal this dangerous substances have been known to arm themselves with NARCAN and throw fentanyl in the faces of law enforcement causing them to pass out within seconds. Law Enforcement charged with the responsibility of getting the dealers of this poison off the streets must be armed with the appropriate protective measures, which they currently are not. This gap places officers in a high degree of danger, renders law enforcement unable to abate deadly overdoses and save lives, and gives criminals the ability to avoid apprehension. NARCAN Nasal Spray (NARCAN) is a prescription medicine used for the treatment of an opioid emergency such as an overdose or a possible opioid overdose with signs of depressed respiration and severe sleepiness or non-responsiveness. NARCAN can be both a protective measure for law enforcement to deal with fentanyl or anticipated fentanyl exposures as well as an intervention to individuals who may be in an active overdose. The issuance of NARCAN to individuals pending medical response could save many lives. Administration by law enforcement allows the drug to be administered much earlier than waiting for the arrival of medical personnel to dispense the antidote. The deployment of NARCAN reduces such apprehension and allows the responders to feel protected and equipped to avert loss of life for him/herself and others. The protective measures that NARCAN provides allow safe investigative and intelligence gathering without the fear that comes from interaction with such a dangerous substance. With more robust efforts we can likely experience dramatic decreases in the prevalence of opioid use and distribution. The goals of the project can be achieved through a tandem process. The deployment of the NARCAN to our sworn first responders will allow them to intervene in the case of accidental overdose. This is likely to save many lives as victims will have rapid access to time sensitive medical interventions that can abate death. Additionally, the protective factors that NARCAN provides, will minimize deputy apprehension associated with entering into or interacting in a patrol or investigatory function where these dangerous opioids are present. Certified Peer Recovery Specialists (CPRS) will be hired by BARC to liaise with overdose patients whom BSO EMS has transported to hospital emergency rooms in Broward County. CPRS will be trained by BARC personnel on techniques for communicating with individuals who are just coming out of an opioid overdose, benefits of Medication Assisted Treatment, substance abuse treatment options available, and post meeting follow up with patients. The CPRS will follow the individual through the admissions process at BARC to ensure engagement in treatment. In circumstances where the individual does not show for an appointment at BARC, the Specialist will alert BSO EMS and if appropriate, the CPRS and EMS will complete a team welfare check on the individual at the address provided during enrollment. The CPRS and BSO EMS will attempt to re-engage the individual into care 3 times, with welfare visits, calls, and attempts to reach family.

Our purpose is to create a Restoring Life Network that will train, equip, educate, and intervene in opioid crisis situations. Through the Restoring Life Network, we will 1) provide training on naloxone use; 2) educate on the benefits of naloxone use; 3) provide naloxone kits to our first responder partners; and 4) promote policy changes that are evidenced based at the local, tribal, and state levels that increase the ability of our communities to not only utilize FDA-approved overdose reversal drugs but to build a crisis intervention protocol that ensures higher referral to treatment.

The age-adjusted death rate for poisonings involving opioid analgesics in Oklahoma is significantly higher than the national rate. At present, more Oklahoman adults age 25-64 die of unintentional poisonings than of motor vehicle crashes or suicide. Two counties within the Choctaw Nation of Oklahoma (CNO) service area are designated as the ?Top 5 Counties? in the state of Oklahoma for unintentional poisoning deaths involving at least one prescription opioid. Such tremendous need to address opioid overdose deaths in Southeast Oklahoma spurred the Choctaw Nation, through its Choctaw Nation Health Services Authority (CNHSA), to develop a small program that began supplying and training tribal employee First Responders in the administration of an FDA approved NARCAN? (naloxone HCl) 4mg nasal spray. LT Morgan Greutman, Pharm.D., who implemented this pilot-level naloxone distribution program as a pharmacy resident, is now applying for SAMHSA?s FR-CARA grant opportunity to fund an expanded First Responder naloxone training and distribution program reaching out to rural community-based First Responder organizations. This program entitled, ?Addressing Opioid Overdose Deaths (AOOD)? would have a catchment area that includes: Atoka, Bryan, Choctaw, Coal, Haskell, Latimer, McCurtain, Pittsburg, Pushmataha, and part of Hughes County. If funded, the AOOD team will consist of a pharmacist as Project Director, the Lead Evaluation team of Council Oak Training and Evaluation, Inc. (COTE), and a registered nurse to be hired as the Project Coordinator. By providing naloxone and training on its use to the rural, high-risk counties of Southeastern Oklahoma, the AOOD program is expected to decrease the opioid overdose death rate by 10% over the 4-year grant period. Partnerships with the Oklahoma Department of Mental Health and Substance Abuse services (ODMHSAS) Prevention and Tribal Liaison departments will provide technical and data assistance needed to monitor progress toward grant goals. The CNHSA is well positioned to implement the AOOD program, due to its network of health clinics (1 hospital and 8 clinic locations) and access to tribal community centers (17) positioned throughout the catchment area, along with having already begun a project that trained 34 tribal employee First Responders. Servant Leadership is an important concept to Choctaw Nation and the AOOD project aligns with continuing efforts of the tribe to serve where needed, and to put into practice the philosophy that ?a rising tide lifts all boats?. The long-term impact of the AOOD program is expected to be a complete transformation in the way opioid overdoses are addressed in the rural counties of the CNO service area, boosted by a strong state and tribal partnership. The proposed program is expected to offset costs to rural First Responder Southeastern Oklahoma agencies and to build the capacity of these rural police forces, volunteer fire departments, and tribal First Responders to save the lives of opioid overdose victims.

The purpose of the BFD Recovery Assistance program is to reduce and prevent opioid overdoses. This will be attained by addressing the following goals: 1. Improve access to recovery services and support for affected families; 2. Increase access to naloxone; and 3. Collaborate and coordinate with other first responders and community stakeholders. Goal 1. Improve access to recovery services and support for affected families: Strengthen current mechanisms for connecting individuals receiving opioid overdose reversal drugs to follow-up treatment, recovery and prevention services with achieving the following objectives: 1.1 NRI Coordinator: By Month 4, add a full-time Narcotics Related Incident (NRI) Coordinator position to improve the flow of information and analysis on NRIs to and from all partner agencies and organizations. This will support the rapid identification of individuals and communities that could benefit from post-overdose outreach and coordination services; reduce redundancy and inefficiencies in the outreach system; and identify critical program needs in real-time. 1.2 Post-overdose outreach: In collaboration with BPHC, expand the BFD’s existing in-person, home-based outreach following a 911 call. The targeted outcome will be to conduct home visits within 72 hours of the 911 call for at least 75% of calls from identifiable residential addresses. Goal 2: Increase Access to Naloxone: Through collaboration with other first responder agencies both within the city of Boston and with agencies serving residents of the city of Boston (i.e. local, state, and quasi-municipal agencies), identify gaps in the current system for supplying naloxone on a city-wide basis. 2.1 Conduct an ongoing assessment with Advisory Council members of gaps and shortcomings (including addressing updates to medical directives that all first responder agencies must work under) in the current system for supplying naloxone to first responders and other key sectors, and purchase and distribute naloxone to address at least 75% of these identified gaps. 2.2 Working with BPHC, develop a training program for both first responders and other key sectors such as local community groups. The training will be coordinated by BFD and BPHC, with BFD serving as the lead agencies for first responders. BPHC will conduct training for all community groups, with BFD providing overviews on efforts of first responders during these community-based sessions. Goal 3. Collaborate and coordinate with other first responders and community stakeholders: Improve the City of Boston’s allied approach to combating the opioid crisis through collaborative, data-driven, decision making. 3.1 Hire a Program Manager/Lead Evaluator to provide comprehensive program management, coordinate program services with other agencies, and lead the development of a cross-departmental data collection, monitoring and tracking system 3.2 Convene a city-wide Advisory Council with representatives of key agencies in the effort to address the opioid crisis.

Responding to an extremely high and increasing number of overdose deaths in Chicago, the Chicago Police Department (CPD) proposes: 1) training and equipping patrol officers to carry and administer naloxone to reverse opioid overdoses; 2) improving linkage mechanisms connecting overdose victims to treatment services; and 3) working with other stakeholders to identify issues and implement solutions along the entire opioid overdose response continuum. The primary goal of the CPD Opioid Overdose Reversal Project (COORP) is to save lives by improving first responder response to opioid overdoses across the entire City, but initially within data-driven (e.g. overdose incidents and deaths) pilot program boundaries (estimated to include 6 of Chicago's 22 Police Districts). This will ensure that opioid reversal capabilities and treatment linkage services are quickly delivered where they are most needed, on Chicago's West and South Sides, home to approximately 500,000 residents who are disproportionately: under-employed; under-educated; under-served by social services; and often traumatized by exposure to high rates of violent crime. The following program strategies will be implemented: • All officers "working the street" in six pilot Districts, and eventually across the entire City, will complete an approved Narcan training curriculum and be equipped with FDA-approved Narcan Nasal delivery devices. • Coordinated CPD and CFD policy and standard operating procedures will determine that the first ""first responder"" on the scene will administer naloxone as trained. • CFD EMS personnel will transport overdose victims to emergency rooms (ER); a ""linkage to services"" protocol will be initiated by CFD personnel at the overdose scene or en route to the ER, or by hospital personnel; and everyone receiving naloxone will receive a brochure listing treatment options and contact information. • District police and outreach staff will educate community on topics that include: Illinois Good Samaritan Act; how to prevent an overdose; how to report an overdose; how to access naloxone and respond to an overdose; and how to access treatment services. CPD proposes training and equipping (with an FDA-approved naloxone nasal spray device): 1) 6,300 district officers in all 22 police districts, beginning with a pilot program featuring an intensive linkage effort in 6 districts with extremely high rates of overdose incidents; and 2) 1,800 recruits before they graduate from pre-service training and ""hit the streets"". CPD's COORP is supported by: Chicago Fire Department (co-response partner); University of Chicago Urban Health Lab (Evaluation Partner); Chestnut Health Systems (Outreach & Linkage Partner); Chicago Department of Public Health (Clinical Partner); and the Illinois Department of Alcohol and Substance Abuse (DASA). Objectives include: ensure CPD and CFD consistency and coordination in opioid overdose policy and practice; Narcan training/equipping 8,100 police officers; providing 26,000 overdose victims with linkage information and linking 400 of those individuals per year (1,600 total over four years) to medication assisted treatment (MAT); preparing and using linguistically diverse and culturally sensitive Chicago Opioid Overdose Prevention & Treatment informational brochures for community education; and continuous COORP quality improvement through data collection and analysis, and a vigorous local project evaluation.

Jacksonville Fire and Rescue Department will use the awarded resources to purchase life-saving naloxone for the Safe and Healthy Neighborhoods Project. The naloxone is a vital piece in the city’s ongoing, comprehensive plan for prevention, interdiction, rescue, and recovery of overdoses related to heroin and opioids. The city’s size, high rates of abuse, and existing recovery infrastructure will result in substantial returns on this investment. As part of Mayor Curry’s citywide initiatives for safe and healthy neighborhoods to be supported by data-driven, successful programs, the Jacksonville City Council has enacted a pilot program to connect patients and families with treatment and recovery services while reducing recidivism rates and deaths. Through an emergency investment of over $1.4 million, the City of Jacksonville is partnering with local emergency departments and treatment facilities to provide inpatient and outpatient services for overdose victims. The naloxone requested in this funding opportunity is necessary for our first responders to keep these victims alive for recovery. Community members are also contributing as local non-profit, Drug-Free Duval’s North Florida Opioid and Heroin Task Force launched its campaigns earlier this year to begin to provide communitywide collaboration for prevention and education. JFRD has the overwhelming task of providing rescue services to the largest city in the contiguous forty-eight states. Covering 841 square miles of urban, suburban, rural, river and beach, the JFRD service area is just as diverse as the population. To ensure the best service to all parts of Duval County, the city and JFRD have transformed all of their response vehicles to Advanced Life Support status. The majority of funds in this grant opportunity will be used to secure 2mg/mL syringes of naloxone for distribution to JRFD rescue teams. As this program proceeds, recidivism and death rates will fall while rescuers improve effectiveness and efficiency in delivering naloxone. The devastating effects of this epidemic on the Jacksonville community are comparable to the worst in the nation. With our rescue teams responding to an average of two calls per hour for suspected overdoses, Duval County’s rates of abuse are among the highest in the country. JFRD estimates over 4,000 incidents of suspected overdose per year, and, over the next four years, administering almost 17,000 doses of naloxone for incidents across the Duval County service area. The community requires a significant investment in naloxone to reverse these overdoses so that victims can participate in recovery. Jacksonville is resolved to overcome this health crisis. The people are in place; the foundation is set. The funding from this project will provide the resources to activate the city’s comprehensive plan to combat this epidemic.

Hampshire County, located in Western Massachusetts, has been hard hit by the opioid crisis sweeping the nation. Since 2011, there has been a 240% spike in the number of opioid overdose (OD) fatalities. In response, the City of Northampton will take a county-wide two-pronged approach to reduce the overdose death rate. First, this project will increase the capacity to reverse opioid overdoses by ensuring all first responders are equipped with Naloxone. Secondly, the project will implement a comprehensive overdose response team consisting of first responders, emergency departments, recovery coaches, and addiction treatment centers. This proposed project will leverage relationships and build off the progress made to date by Hampshire HOPE, a multi-sector coalition addressing the rise in prescription opioid misuse, heroin use, addiction, and overdose death in Hampshire County. This project will engage at least 300 residents per year by administering Naloxone to overdose victims and by engaging victims of overdose and their family members through an overdose response team. Measureable objectives will include the number of: First responders and other key community members equipped to carry Naloxone; Opioid overdoses reversed by first responders or other key community members; Fatal opioid overdose; Overdose victims who are screened for program eligibility and sign waiver to participate; Participants engaged in an intervention by the overdose response team. This comprehensive overdose response team will bridge gaps in our current systems of emergency response, intervention, and treatment in order to improve the outcomes for people struggling with opioid addiction.

The Opioid Overdose Prevention: Medical Outreach and Education Project will provide increased overdose prevention education, including naloxone training and distribution, to Portland’s at-risk residents. This medical outreach will be conducted by skilled paramedics who are currently employed by the Portland Fire Department. Paramedics will spend fifteen hours each week at the Oxford Street Shelter, Maine’s largest emergency shelter. The Oxford Street Shelter is located in an area of Portland, the Bayside Neighborhood, which has been disproportionately impacted by the opioid epidemic. In addition to providing overdose prevention education, the paramedics will have the ability to make referrals to primary care, substance use and mental health treatment services and recovery services. Partnerships with the Oxford Street Shelter, the Preble Street Resource Center, Greater Portland Health and the Portland Recovery Community Center will enhance the continuum of care Portland is seeking. Further, overdose prevention education and naloxone distribution will be available to other key community members. These members include social service agencies serving Portland as well as the friends and family members of our high-risk community members. Through this project, we intend to serve approximately 400-500 unique individuals, annually, with a total of 1600-2000 over the life of the project. Throughout the implementation of the project, demographic data will be collected on all participants. Additionally, the number of referrals to primary care, substance use or mental health treatment and recovery services will be collected and reported. For the naloxone distribution portion of the project, number of naloxone trainings and kits, reported reversals and kit refills will be collected and reported.

The Columbus Consolidated Government is seeking funding to equip first responders in our area with life-saving Naloxone. Currently, no first responders in the area have the medication nor are they trained to use it. The Columbus Consolidated Government seeks to serve over 300 individuals with this program and save at least one hundred lives. The population of focus will be first responders and families of opioid addicts. The project will first train and ensure first responders have Naloxone on hand. At the same time, the program will conduct community outreach to families and friends of opioid addicts to provide education, referrals and life-saving kits. The project will work to train all first responders in the area to include: the Columbus Police Department, the Muscogee County Sheriff’s Office, the Muscogee County Marshall’s office and the Columbus Fire and EMS Department. Once in initial trainings are complete, the Coordinator and the Trainer will work to establish this training as an annual ongoing in service required by local first responders. In addition to the training, statistical analysis will report the continued need for the program and will work towards sustainability through departmental budgeting. If used, first responders will be able to provide referral information on the spot to overdose victims and their families or significant others. This information will include linkages to evidence based treatment facilities in the area, Medication Assisted Treatment facilities in the area and programs like our local Drug Court. As a part of the community outreach program, informational gatherings will be held in the areas of highest need in Muscogee County. Local media outlets and 12-step meeting houses will be used to advertise local events. At said events referral information to treatment centers, education about addiction and recovery and linkages to family resources will be available. Also at these community meetings life-saving kits also containing Naloxone will be made available to addicts and family members of addicts. The goals of the project are: Goal 1.1 : Increase the number of First Responders in Muscogee County with access to naloxone from zero to 75 persons in year 1. Goal 1.2: Increase the number of first responders with access to naloxone from zero to (75) individuals in Year 1, (150) individuals in Year 2, and (225) individuals in Year 3 and 4. Goal 1. 3: Increase the number of first responders trained to identify an overdose and administer naloxone from zero to (75) individuals in Year 1, (150) individuals in Year 2, and (225) individuals in Year 3 and 4. Goal 1.4: Increase the number of community advocates and family members of addicts who have access to naloxone to 50 persons per year. Goal 1.5: Reduce opioid overdose deaths in Columbus, Georgia by 20% annually.

The goal of the project, “A Comprehensive Response to the Opioid Epidemic” is to reduce opiate-related overdoses and deaths in Allegheny County, Pennsylvania. Its strategies for accomplishing this goal are to make naloxone consistently available to trained first responders and other individuals who are most likely to encounter people with opioid use disorder; and strengthen the infrastructure that supports this targeted naloxone distribution and that directly connects people who have suffered overdose to treatment and recovery supports. The project will serve an estimated 12,000 individuals over four years (2,000 per year, through reversals and 1,000 per year through outreach, education and training). The Allegheny County Health Department (applicant) will target high-risk areas of the county and people who have had an opiate-related overdose. It is therefore expected that the demographic profile of the overdose victims the project serves will mirror that of overdoses in the county to date (male, between the ages of 24 and 34, living in neighborhoods with higher rates of poverty). In addition to these characteristics, close to 40% of the population will have been detained in the county jail and used publicly-funded behavioral health services. To achieve its goal, the project relies upon the close collaboration that exists in Allegheny County among local governments, first responders, peers, members of community organizations, county-based Centers of Excellence (COEs), and university researchers. With this network of partners, the county will achieve these measurable objectives: • Reliably distribute naloxone to the current 71 municipal police departments who are part of the county’s network and an additional 35 police departments. • Reliably distribute naloxone to an additional 15 of the county’s EMS departments, located in hot spot communities, for their “leave-behind” use with overdose victims and family members/friends. • Reliably distribute naloxone to at least 50% of the county’s fire departments. • Reliably distribute naloxone to at least 20 community organizations to outfit outreach staff in hot spot communities. • Train community members in targeted areas who will be using naloxone in the value and use of naloxone, how to track and report to ACHD on its use, and in the referral system that links individuals and families with COEs and other recovery resources. • Ensure that the Centers of Excellence or other treatment and recovery resources are serving the individuals who have had a reversal of overdose due to opioids. • Complete the development of the county’s infrastructure needed to support these objectives.

The grant is collaboration between three hospitals, two governmental agencies, a behavioral health treatment agency, law enforcement and emergency responders across Huron County Ohio. The grant provides Narcan and training to support the first-line responders. Each hospital will act as a Narcan repository along with the Huron County Sheriff, Huron County Public Health and the Norwalk Police Department. The Norwalk Police Department, the Huron County Sheriff, and Firelands Counseling & Recovery Services will participate in a Quick Response Team for Norwalk residents who experience overdoses. The objective is to reach out to the individual and family and provide information on treatment and support services. A resource packet will also be used by the emergency departments and the Quick Response Team to provide educational and support materials to individuals at risk. Trainings to be provided include: Mental Health First Aid which promotes empowerment and strength when discussing mental health or substance use disease. After completing the eight-hour course, participants receive a certificate of completion, highlighting their new knowledge on mental health first aid, which may help them save a life. The training provide individuals with a greater understanding of suitable language to use when discussing mental health and substance use challenges Crisis Intervention Training for law enforcement. This 40-hour training should work to improve the quality of services for persons who are vulnerable to crisis. The methods reflect generally accepted approaches to working with individuals who have mental, addiction and emotional problems, whether or not they are in crisis. CIT methods provide for a forward-thinking approach, rather than a reactive approach, to stabilizing individuals in our community. The added training would create a stronger and more emphatic approach to dealing with mental health and addicted individuals in our community. Sensitivity Training for Fisher Titus Hospital Staff. These two-hour trainings will promote the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care. The trainings will offer a user-friendly format for providing comprehensive — but by no means exhaustive — information on advancing and sustaining culturally and linguistically appropriate services within health and health care organizations. This training will be mandatory for all employees and optional for partner employees.

The Lancaster County Drug and Alcohol Commission proposes to implement the First Responders – Comprehensive Naloxone Distribution and Recovery Service Initiative in Lancaster County, Pennsylvania. The project will save lives by reducing opioid overdoses and overdose deaths by increasing access to naloxone; training first responders on the use of overdose reversal drugs; and establishing and standardizing processes, protocols, and mechanisms to better ensure effective referral to treatment and recovery. The project will serve the population of Lancaster County, located in South Central Pennsylvania, with a population of over 550,000 residents. There are 60 municipalities in the county, including Lancaster City- the county seat. While approximately 88% of the county’s population is white, the Latino population in Lancaster County has grown by 68% in the last 10 years. The opioid epidemic is disproportionately impacting the county as evidenced by a 33% increase in the number of drug related overdose deaths in the County between 2014 and 2015, and a 37% increase in the number of overdose/poisoning related EMS calls. Three goals have been identified for the project: 1) Increase access to naloxone in Lancaster County to reduce the number of deaths due to opioid overdose; 2) Enhance connectivity of services to benefit local opioid abusers and their families at all points of entry into the system, and 3) Facilitate train the trainer programs in both English and Spanish to first responders, treatment facilities, and recovery support providers to provide hands-on experience administering naloxone. To accomplish this, the project team will work toward several measurable objectives including the distribution and track the use of 2000 naloxone kits; work with first responders, treatment facilities, emergency departments, and recovery houses/emergency housing to standardize processes and mechanisms for referrals and “warm handoffs.” The project team will also develop a hands-on train the trainer program for first responders, treatment providers, and recovery support service providers to augment the Pennsylvania DDAP online training module. The project will be advised by the Joining Forces Coalition, a community collaborative comprised of leaders of key organizations and other coalitions who are committed to coordinate efforts to reduce deaths from opioid and heroin overdose throughout Lancaster County. The Advisory Council will function as a public-private partnership to collaborate with the community to reduce deaths from opioid and heroin overdose in Lancaster County. Combined, these efforts will result in improved outcomes in the community, including improved access to life-saving naloxone through distribution and training, and a coordinated approach to referral and connection to information and resources. An anticipated 275 first responders will be impacted per year, along with 5,000 substance misusers/abusers per year, for a total of 1,100 first responders and 20,000 substance misusers/abusers impacted over the project period.

The Orange County First Responders CARA grant funding will serve the citizens of Orange County, Florida. The purpose of the grant is to work with local law enforcement agencies, EMS and key community sectors and provide naloxone and training on the reversal medication for a suspected opioid/heroin overdose. We will work with non-profit hospitals busiest emergency departments to establish processes and protocols to provide appropriate referral to treatment for opioid/heroin dependence or addiction. Orange County includes 13 municipalities and will work with law enforcement agencies serving unincorporated Orange County, city police departments and the university police department on the purchase of naloxone, the reversal medication for a suspected opioid/heroin overdose. We will also work in partnership with Orange County Fire Rescue to equip Asst./Deputy Chiefs with naloxone when needed. The first responder agencies will receive training from the Medical Director of Orange County Emergency Medical Services on the administration of naloxone and the latest information on opioids, heroin and illicit fentanyl sold on our streets and the safety precautions necessary for first responders. We will also work with key community sectors to include our federally qualified health centers and hospitals on the purchase of naloxone kits for their agencies and training for staff. In addition, we will provide local substance abuse treatment providers, healthcare providers, county jail and public school system with naloxone training materials for staff and dissemination of treatment resource packets to the public. The goal of the project is to increase the number of first responders/key community sectors equipped and trained to carry naloxone and increase the number of referrals for substance abuse treatment services for opioid/heroin dependence and addiction. The population focus will be individuals who have received naloxone to reverse an opioid overdose by first responders and key community sectors admitted to Orlando Health and Florida Hospital busiest emergency departments for suspected opioid/heroin overdose. The estimated population to be served by the project is 350-400 patients annually based on current data sources and 1400-1600 during the life of the grant. Project data will be collected by the epidemiologist/evaluator and the measurable outcomes will include the number of first responders and key community sectors equipped with naloxone, number of suspected opioid/heroin overdoses reversed by first responders/key community sectors, number of first responders/key community sectors who received training on naloxone administration, the number of responses to requests for services to opioid and heroin overdoses and the number of overdose victims and families that have received treatment referral services and resources and available data on treatment admissions. Orange County is an urban county with a population estimate of 1.3 million people. Approximately 22% of the population is under 18 years, 66% between 18 and 64 years, and 11% are 65 years and older. 51% of the population is female and 49% male. 68% of the population is White, 22% Black or African-American 30% is Hispanic is Latino and 6% Asian and 3% other.

The First Responders-Comprehensive Addiction and Recovery Act Cooperative Agreement Grant aims to take a systems of care approach to combat opioid overdose deaths in the state of Delaware. The goal of this project is to decrease mortality and morbidity form suspected opioid overdoses. Measurable objectives used to meet this goal include enhancing the acute response (EMS and Law Enforcement and Emergency Departments) to opioid overdoses by improving statewide planning and preparedness efforts within the healthcare community through Coalition development, providing ongoing training and technical assistance support to the first responder community, increasing the availability of naloxone to the first responder community, and reviewing best practices and lessons to implement overdose prevention strategies through the first responder (EMS and Law Enforcement) communities. Grant funds will be used to advance and evaluate state level interventions and education for preventing opioid overdoses. Grantees will train and provide resources to first responders and members of other key community sectors at local governmental levels to carry and administer a drug or device approved or cleared under the Federal Food, Drug and Cosmetic Act for emergency treatment of known or suspected opioid overdose. Grantees will also establish processed, protocols, and mechanisms for referral to appropriate treatment and recovery communities.

The purpose of the Virginia First Responders Project for Opioid Overdose is to train first responders and other community sectors about opioid overdose, the use of naloxone for overdose reversal and available treatment resources in communities that can assist people in addressing opioid addiction. It will also ensure that first responders can carry temperature controlled naloxone kits to have it available while on duty. Approximately 3,500 people will participate in training and 7,000 people will be provided with naloxone. Project goals and objectives include: Goal 1- Equip more first responders and community sectors with naloxone for emergency treatment of known or suspected opioid overdose. Objectives: 1) Increase amount of naloxone (Narcan) available for use by first responders 2) Increase numbers of first responders and members of other key community sectors equipped with naloxone. 3) Increase the number of opioid overdose reversals by first responders in order to decrease death rates. Increase the number of First Responders and members of other key community sectors trained in OONE. Goal 2 - Train and provide resources for first responders and members of other key community sectors to carry and administer naloxone for emergency treatment of known or suspected opioid overdose. Objectives: 1) Include education on opioid use disorders, evidence based practices, and benefits of incorporating use of naloxone among first responders in all trainings. 2) Increase training capacity by adding a Project Coordinator at DBHDS. 3) Train a minimum of one OONE Master Trainer in each targeted area of the state. 4) Increase the number of First Responders and members of other key community sectors trained in OONE. 5) Increase the availability of resources to support first responders carrying and administering naloxone by providing items such as temperature controlled storage units and appropriate personal protective gear. 6) Improve and expand data collection methods used for planning, resource allocation, and tracking to gather comprehensive data on training and naloxone use in targeted areas. 7) Establish a system of support and technical assistance for implementation, maintenance of program initiatives by the end of year one. Goal 3-Establish processes, protocols, and mechanisms for referral to appropriate treatment and recovery communities, which may include an outreach coordinator or team to connect individuals receiving opioid overdose reversal drugs to follow-up services. Objectives: 1) Establish an outreach team to identify treatment services in the targeted areas and develop a comprehensive referral guide to include public providers (CSBs), community providers, private providers, and peer resources for use by first responders. 2) Develop procedures for referrals that can be used statewide. 3) Distribute the resource guide at 100% of trainings providing enough for further distribution at participants’ respective organizations. 4) Increase the number of individuals referred to treatment by first responders by 10% each year. 5) In the targeted area CSBs collect and review data quarterly related to referral from first responders and follow-up to treatment.

Detroit Community Opioid Response Initiative (DCORI) seeks to reduce the rate of opioid overdose fatalities in Detroit by 10% by September of 2021. This initiative empowers community members closest to a potential overdose episode with saving opioid reversal and treatment resources. It relies on the strength of community leaders to intervene in the most hard to reach cases, and provides them the knowledge to bring loved ones and neighbors into care. This initiative focuses on populations of highest risk, including re-entering citizens, IV drug users, and people experiencing homelessness. Between 2011 and 2015, the number of opioid-related fatalities in Detroit tripled, from 40 in 2011 to 127 in 2015. Detroit’s current population of 672,795 residents is spread thinly across a city that has a carrying capacity of 1.8 million people. The sheer size of the city and varying levels of population density pose unique challenges for municipal service provision, including emergency response. Over 40% of residents live below the poverty line. Educational attainment in the city is low--only 12.7% of residents hold a bachelor’s degree or higher – and unemployment is high, ranging from 10-15%. DCORI strives to: 1. Increase the number of community access points for naloxone, including community pharmacies participating in a statewide standing order for naloxone distribution. 2. Train members of block clubs, neighborhood patrols, and family members of known or suspected opioid misusers on the use of narcan. 3. Establish referral pathways for first responders to connect opioid misusers to treatment. DCORI expects to train 4,000 community members over the course of the project, and will distribute up to 1,500 doses of naloxone per year through trained community first responders. Success will be measured by a reduction in rate of fatal opioid overdoses. The team will track outcome metrics, including total number of overdose responses and number of overdoses successfully reversed through the use of naloxone. It will monitor the number of community members trained as first responders and assess retained knowledge. Partners in this collaboration include the Detroit Health Department and Emergency Medical Services, Wayne State University Center for Urban Studies, University of Michigan Injury Prevention Center, and the Detroit Police Department, and the Detroit Wayne Mental Health Authority.

DuPage County Health Department (DCHD) is requesting $1,565,795 for the four year project to deliver the DuPage Narcan Program under the First Responders ? Comprehensive Addiction and Recovery Act Cooperative Agreement. Funds will be used to expand and promote the DuPage Narcan Program (DNP), which equips law enforcement officers and other first responders in DuPage County and the surrounding areas with naloxone, an opioid overdose reversal agent. The DNP serves any individual, encountered by a DNP first responder, who is exhibiting signs of an opioid overdose. The DNP trains first responders to recognize signs of an opioid overdose and administer life-saving naloxone. In addition, this project supports a pilot to equip local police department social workers with resources to offer follow-up and referrals to substance abuse treatment to opioid overdose survivors. The project goals are to 1) increase the number of first responders equipped with and trained in the use of naloxone, 2) develop and implement a program with DNP police department social workers to provide information on wrap-around services to opioid overdose survivors, 3) increase public access to the drug disposal program RxBOX, 4) increase public awareness of opioid overdose prevention resources including: Good Samaritan 911 law, signs of overdose, RxBOX, and DNP, and 5) improve evaluation of DNP impact on opioid crisis in DuPage County.

The Erie County Health Department (ECHD), located in Sandusky, Ohio, is serving as the lead applicant for this proposed project. ECHD has secured partnerships with First Responder agencies throughout Erie, Huron, and Ottawa Counties to train and equip First Responders to administer Naloxone to suspected drug overdose victims. After a person has been saved, they will be referred to the Circle of Care. Locally, ECHD championed this model of recovery utilizing key partnerships in the community. The Circle of Care begins with medically supervised detoxification at ECHD, then refers persons to the appropriate post-detox treatment (inpatient, intensive outpatient, etc.), secures housing in sober living communities or recovery housing in Erie County, and finally, the model ends with long-term recovery support services provided by Recover Community Organizations. The project is titled “Saving Lives: Erie, Huron, and Ottawa Counties.” The populations to be served include Erie, Huron and Ottawa Counties. The US Department of Commerce, Economics & Statistics Administration & the US Census Bureau, has designated the counties as Micropolitan Statistical Areas, therefore, our project shall be considered to be a rural community. We anticipate our project expanding to other rural Counties in years 2 – 4. ECHD has trained and equipped 466 First Responders and 168 community members with Naloxone since 2015. Combined, the First Responders have reported over 300 overdose reversals using Naloxone. Even with these 300 confirmed reversals, Erie County’s drug overdose death rates have nearly doubled since 2015. And, the number of Emergency Department visits due to drug overdoses has more than tripled since 2015! This fact serves as justification that ECHD’s current efforts and capacity need to be enhanced and expanded upon in order to reverse the current drug epidemic. Huron and Ottawa Counties have seen similar trends as well as their drug overdose death rates and Emergency Department visits due to drug overdoses have increased since 2015 as well. ECHD operates a fully-funded Federally Qualified Health Center (FQHC) on its main campus in Sandusky, Ohio. Sandusky is a designated Medically Underserved Population and is designated as both Mental Health and Dental Health Professional Shortage Areas. The FQHC serves over 4,100 unduplicated patients per year. There are no private providers accepting new Medicaid or self-pay patients within Erie County. ECHD’s FQHC provides a broad range of primary care, oral health care, and behavioral health care services. Because ECHD operates an FQHC, we have the ability to integrate primary care and oral health care into the drug overdose survivor’s treatment regimens. A plethora of research indicates that people with access to preventative and diagnostic health care are more likely to be in control of their health, which, in turn, grants them a greater opportunity to effectively manage their recovery. People with access to quality health care, face fewer health challenges compared to people who have limited ability to access or afford health care. We believe healthy people have a superior quality of life, and healthy people in recovery have fewer challenges to live a prosperous life. ECHD has a strong track record of training and equipping First Responders with Naloxone. In addition, we have built a medically supervised detoxification facility, secured affiliation agreements for post-detox treatment, and we are in the process of acquiring property to renovate into recovery housing and sober living communities, finally, we have strong existing partnerships with RCO's in Northwest Ohio. Our project will save thousands of lives, improve quality of life, and improve virtually every sector of society through this project.