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Project RSPCT

The Delta Opioid Treatment Rural Rapid Response (DOT-R3) collaborative

Recovery Now

Catholic Charities Targeted Capacity Expansion Program

The United Community Center’s (UCC) proposed El Nuevo Comienzo (ENC) (The New Start) project will serve men and women with substance use disorders or co-occurring substance use and mental health disorders who reside in Milwaukee County, WI. ENC will focus on individuals with Opioid Use Disorder, prioritizing admission for people who inject drugs. Participants will receive SUD treatment in a residential level of care including onsite Medication Assisted Treatment (MAT). ENC will Serve 170 (unduplicated) individuals over the 3-year grant period: 50 in Year 1 and 60 in each of Years 2 and 3. Services will be delivered within the context of UCC’s multi-program community center serving Milwaukee’s Hispanic community. The program will employ an integration of two evidence-based approaches to OUD treatment: 1) a behavioral treatment, the Matrix Model, and 2) a pharmacological treatment, Medication Assisted Treatment (MAT). MAT, which is a part of the Matrix Model, will be an important treatment component, given that the drug of choice for about three-quarters of UCC clients is opioids. At admission, participants in ENC will be those who meet ASAM Criteria standards for Level 3 (Residential) level of care. ENC will offer MAT onsite. Project partner CleanSlate is co-located in UCC’s treatment facility. CleanSlate will offer ENC clients buprenorphine or naltrexone, as medically indicated, as part of an individualized treatment plan. This enables opioid users who enter treatment at UCC to begin MAT immediately (within 24 hours) and to be retained in MAT for a sustained period of time, especially if they choose to stay in UCC day/outpatient level of care upon completion of residential. The combination of the impact of substances on the body, the masking of physical problems by the substances, and the reduced access to medical care for low-income individuals ensures that participants served in ENC will be in need of consistent medical attention. Primary health and other medical care will be provided by Federally Qualified Health Center (FQHC) Sixteenth Street Community Health Center (SSCHC). The goal is the full integration of behavior health services, monitored by the UCC nurse (RN), with the full range of medical services available through SSCHC. Given the association between SUD and trauma history/symptoms, all service delivery will be trauma-informed, which helps staff to understand behavior as coping mechanisms rather than pathology; avoid trauma-triggering reactions; adjust their behavior and modify the organizational climate to support the client’s healthy coping capacity; and allow them to manage their trauma symptoms so they are able to benefit from the services. In addition a trauma specific curriculum, Seeking Safety will be provided for all clients. Project goals are 1) Provide treatment & recovery support services to individuals with SUD/COD, primarily those with OUD; 2) Participants will be retained in SUD/COD treatment.; 3) Connect people with OUD to MAT; 4) Participants will decrease substance use; 5) Improve participants' mental health; 6) Participants will have stable housing arrangements; 7) Participants will improve their employment and/or education status; 8) Decrease involvement in criminal justice system; 9) Participants will improve social supports for recovery; 10) Increase access to health services for underserved populations.

McDermott Center (dba Haymarket Center), Chicago’s largest provider of SUD and mental health treatment, proposes to expand access to Medication Assisted Treatment (MAT) for 375 individuals with opioid use disorders and co-occurring mental disorders, including serious mental illness. The project will stabilize the patients’ conditions and help sustain recovery by providing education, monitoring, and adherence assistance for all of the patients’ medications. Haymarket Center served more than 9,000 individuals with opioid use disorders in 2017-2018. Yet medication education, monitoring, and administration are not Medicaid reimbursable services for agencies licensed by Illinois’s single state agency. Through grant funding, Haymarket Center has been able to provide MAT to a small portion of its service population. Haymarket has seen a strong demand for MAT services, especially among its residential treatment population with co-occurring opioid use disorders (OUD) and mental disorders, including serious mental illness (SMI). The proposed project will expand access to MAT for this population (Goal 1). All participants will be assessed for a substance use disorder and meet with a psychological services team and psychiatrists as necessary, who may prescribe psychotropic medications. Project nurses will assess patients for appropriateness for MAT medications and work with patients and Haymarket’s board certified medical director, who has a waiver to prescribe or dispense buprenorphine and/or naltrexone under the Drug Addiction Treatment Act (DATA 2000), to identify the appropriate medication. Only 50% of individuals with a chronic condition sustain any medication adherence. Adherence levels are dramatically worsened by OUD and mental disorders. Therefore, funding from this project will provide registered nurses who will assist in stabilizing the patients’ medical conditions; provide education on chronic disease management and medication adherence; administer MAT medications under the direction of a certified physician; and help them to navigate the complex health care systems in a culturally competent manner (Goal 2). Project staff will help patients sustain recovery by ensuring patients’ mental health and MAT medication regimens are included in their transition and recovery plans as they complete SUD treatment (Goal 3). They will ensure patients are linked to support groups that are MAT-positive in the community. Haymarket Center’s federally qualified health center partner, Heartland Alliance Health, as well as other partners, will accept clients for ongoing MAT maintenance in the community once they transition from Haymarket’s residential treatment program. Data collection and performance measurement will be overseen by Lighthouse Institute, a division of Chestnut Health Systems that has extensive experience evaluating CSAT grants, collecting and reporting GPRA data, and following up with patients with OUD and mental disorders, including SMI, following discharge from treatment.

Youth Eastside Services’ (YES) Targeted Capacity Expansion: Special Project proposes to serve youth and young adults ages 12 to 22 with co-occurring substance use and mental disorders (COD) in East King County, Washington. YES’ project will assess 150 young people annually for the presence of COD, to total 450 by the end of the three-year project period. YES will enroll 50 clients with COD annually, to total 150 enrolled over the three-year project. Participants will receive evidence-based, integrated co-occurring treatment from licensed Mental Health Therapists dually certified as Chemical Dependency Professionals, using a treatment team approach. The goals of the project are to increase early identification of COD among youth and young adults ages 12 to 22 in East King County; increase access to evidence-based treatment; and implement strategies to engage youth in care. Adolescents and young adults in behavioral health services have a very high prevalence of COD, higher than in adult populations. If left untreated, young people with COD face serious life challenges, including poor academic performance, school dropout, unemployment, incarceration, self-harming behaviors and suicide. King County’s Department of Department of Community and Human Services, Behavioral Health and Recovery Division has identified adolescents and young adults as the top priority population to focus on reducing substance use and increasing outpatient substance use disorder treatment. YES' project activities include assessing young people for COD; developing client-centered treatment plans; and providing evidence-based individual and group therapies, recovery support, and psychiatric services, as needed and appropriate. The project increases access to outpatient services among young people with COD by providing walk-in services and direct referrals from two school districts participating in this project. A Case Manager is part of the treatment team, to support engagement in treatment among clients. YES is a state-licensed Community Mental Health Center and state-certified Outpatient Chemical Dependency Treatment Program in East King County, WA, providing services for children and youth from birth to age 22, and their families, regardless of the ability to pay.

Recovery Resource Council, a nonprofit, Joint Commission Accredited, State Licensed Outpatient Treatment site, will provide evidence-based therapies for up to 80 parents, grandparents or guardians annually (up to 240 throughout the 3 year grant cycle) involved with the Department of Family and Protective Services. The goal of Recovery Now is to support the stabilization of families facing termination of parental rights, precipitated by Substance Use Disorders, co-occurring mental health disorder, PTSD, and/or trauma. Services will be provided by licensed master's level therapists, Licensed Chemical Dependency Counselors, Peer Support Specialist, and Case Managers. Depending on the client's level of need, Recovery Now will offer up to 10 hours a week of evidence based group services for up to 24 weeks; weekly individual counseling; and parenting classes. Supportive Outpatient Treatment Services will offer up to 6 hours a week for those who require a less intensive treatment plan. The impact of Recovery Now is expected to be reductions in substance use, reduced risk for relapse, decline in trauma related symptoms, and improved family functioning.

Through the Targeted Capacity Expansion: Special Projects program, Harbor Homes, Inc. (HHI) proposes to create and implement an evidence-based methamphetamine use disorder (MUD) treatment and recovery support services program (MUD Program) for two high-risk, priority populations that misuse methamphetamines: (1) adults who are homeless or at risk of homelessness, and (2) adults who receive Medication Assisted Treatment (MAT) for Opioid Use Disorders (OUD) or alcohol. The geographic service area for this grant includes the cities and towns within Hillsborough County, New Hampshire, with a focus on its Greater Nashua region. The goal is to increase the target area’s capacity to reduce its most vulnerable community members’ use of methamphetamines while facilitating self-sufficiency, through implementation of evidence-based programming and integrated primary/ behavioral health care throughout the public and private sector that addresses the target population’s whole health and wellness, social determinants of health (housing, employment/ income, benefits, nutrition, etc.) and substance use/ CODs. HHI’s long track record of implementing complex and holistic services for homeless/ at-risk individuals, as well as their state of the art federally qualified healthcare for the homeless clinic and evaluation partnership with JSI, Inc. ensures a rapid start-up within four months of grant award and a high quality implementation and evaluation process. Over three years, HHI proposes to: 1) build a comprehensive recovery-oriented system of care that is team-based and coordinated through all stages of recovery by integrating recovery housing, behavioral health, primary and oral health care, and supportive services; 2) provide outreach to 350 (100 in year one; 150 in year two; 100 in year three) homeless/at-risk individuals with MUDs and/or MAT patients with OUDs/alcohol use disorder also using methamphetamines, to connect them with the MUD program; 3) provide integrated primary/ behavioral/ oral health care and SUD treatment, intensive case management, and individualized long-term recovery-oriented supports to 165 (50 in year one; 65 in year two; 50 in year three) individuals who enroll in HHI’s MUD Program; 4) train and/or educate 200 (50 in year one; 50 in year two; 100 in year three) of the Greater Nashua community’s first responders; medical, behavioral, and peer workforce; and health and human service providers to increase their capacity to apply EBPs to reduce the rise in MUDs. Grant-funded staff will utilize evidence-based practices including Housing First/ recovery housing, Matrix Model, Contingency Management, Integrated Dual Diagnosis Treatment, Medication Assisted Treatment, Recovery Support Services, and Critical Time Intervention through a trauma-informed, harm-reduction model to meet the needs of the population of focus. HHI will collaborate with Keystone Hall, NH's premier substance use disorder treatment, prevention, and recovery support services center for the provision of intensive outpatient and residential treatment; Revive Recovery Organization for enhanced RSS; and the City of Nashua.

Center Point, Inc. (CPI) is requesting 375,000 per year for up to three years from SAMHSA CSAT to establish Recovery Residences where people who are transitioning out of CPI's adult residential treatment programs can live with their peers while attending outpatient counseling services and support groups, learning and practicing life skills, and implementing their individual recovery plans with the support of Recovery Coaches. Project activities will take place in Marin County, CA. The population of focus for CPI's ""Targeted Transitional Services: From Treatment to Recovery"" is low-income and indigent CPI clients who lack access to affordable housing, employment and a living wage, recovery supports, and a supportive peer network when they leave the residential treatment environment. The goal of the project is to help people in early recovery not only obtain housing, employment, stability and sobriety, but also develop positive relationships and social networks that offer hope, purpose and community. CPI's project will serve 20 unduplicated individuals per year and 60 unduplicated individuals total. This targeted Special Project will leverage private, state and federal funding to help bridge the gap in supports and services for low-income and indigent people who are in the earliest stages of recovery and at greatest risk of relapse. CPI is participating in California's new Recovery Residence program, which allows counties to use SABG funds to pay room and board for people living in peer-run and/or monitored sober living homes, so long as they are also participating in medically necessary substance use disorder (SUD) treatment services. CPI will lease 5 scattered sites housing units in San Rafael, CA, to provide 10 Recovery Residence beds for clients of the CPI adult residential program who transition into outpatient and IOP programs. SAMHSA Special Projects funding will be utilized to hire one Recovery Support Manager and two Recovery Coaches who will provide case management, job and life skills building, and individualized recovery planning focused on helping Recovery Residence participants gain long-term financial security, stable housing, better health, and a supportive social network. The goals for the project are to provide housing and peer support that helps participants avoid relapse and develop stability in early recovery; provide comprehensive case management and supportive services; and enhance the community's recovery-oriented system of care to improve treatment outcomes, reduce recidivism, and increase participants' physical and emotional well-being. Outcomes for the 60 participants will include increased rates of stable housing, financial literacy, employment, health care access, abstinence from substance use, and participation in IOP, outpatient, or Recovery Support services. CPI is a CARF Accredited DHCS licensed and certified program (DHCS designated ASAM Level of Care 3.1 and 3.5; 1.0 and 2.1 outpatient programs) and is a DMC Certified provider. Special Projects services will be coordinated with psychosocial therapies, case management, and wraparound services, and clients will be directly linked into primary care in partnership with local Federally Qualified Health Centers (FQHCs).

Centerstone REACH Florida (Reach-FL) will develop/implement targeted strategies for substance use disorder (SUD) treatment provision for 200 unduplicated adults (18+) with SUD and/or co-occurring substance use/mental disorders (COD) in the catchment area (Yr 1: 50; Yrs 2-3: 75, annually). Reach-FL will expand/enhance areas of focus to provide comprehensive, evidence-based services, including screening/assessment, outpatient/telehealth treatment, ECHO-based model of care, peer supports, care coordination, wraparound/recovery support services, etc. Reach-FL’s catchment area includes DeSoto, Manatee and Sarasota counties in Central Florida. Reach-FL’s focus population encompasses an anticipated 48,000 catchment area adults (18+) with SUD, including 22,700 with COD. Focus population demographics are expected to mirror those of the catchment area, with 48% male, 52% female, 90% White, 6% African American, 11% Hispanic, and 6% unemployed individuals; 22% are expected to lack health insurance. Reach-FL’s subpopulations include the 12% who are Veterans, 1% with OUD, 11% from racial/ethnic minorities, and/or 8% from rural areas. Of those in the focus population with COD, only 7% will receive both substance use and mental health services. In 2015, the catchment area region had the state’s highest number of opioid-caused deaths (710), and from 2012-2017, heroin related deaths increased by 855% (18 to 172). Reach-FL will deliver evidence-based SUD treatments/interventions according to NIDA’s Principles of Drug Addiction Treatment and SAMHSA’s Treatment Improvement Protocol (TIP) 42: Substance Abuse Treatment for Persons With Co-Occurring Disorders, integrating evidence-based techniques/therapies (e.g., Motivational Interviewing, Cognitive Behavioral Therapy, 12-Step Facilitation), plus relapse prevention, skills development, peer recovery supports, individual/family/group therapy, etc. Clients will be provided/referred to MAT as appropriate according to SAMHSA’s TIP 63: Medications for Opioid Use Disorder. Key Reach-FL strategies/interventions include community collaborations; assembly of Advisory Council; development of program policies/procedures; provision of teleECHO training/resources, enhancement/implementation of telehealth and related technologies; outreach/engagement; screenings/assessments; development of Individual Treatment Plans; provision of outpatient/telehealth SUD/COD treatment, medication delivery/management, care coordination, recovery coaching/peer recovery support services (e.g., housing/employment, benefits enrollment, transportation); monitoring/tracking participant health status; completion/dissemination of comprehensive evaluation; and implementation of a sustainability plan and marketing campaign. Reach-FL goals include: Increase access to SUD/COD treatment to address need among underserved adults; Develop infrastructure/capacity to expand, enhance, and sustain a comprehensive continuum of evidence-based treatment and recovery support services for adults experiencing SUD/COD; Improve clients’ health status and outcomes; and Develop/disseminate a replicable service model. Reach-FL will achieve the following measurable objectives: Conduct outreach/engagement to 1,000 individuals to recruit clients/promote buy-in; Provide training/workforce development (e.g., teleECHO) for 100 staff/community providers; Increase substance use abstinence by 60%; Reduce mental health symptomatology by 50%; Assist 100% in need with recovery support/resources (e.g., employment, housing support); Increased social connectedness by 70%; and Achieve 80% client retention. Reach-FL has secured commitments from partners dedicated to the project’s success, and will collaborate with community providers, law enforcement/courts, coalitions, social service agencies, key stakeholders, etc.

The proposed program, Project Uplift, seeks to reduce barriers to behavioral health screening and treatment and improve health outcomes and life quality and stability for 80 LGBTQ young in two metropolitan areas in North Carolina, Charlotte and Durham, through provision of intensive case management, evidence-based behavioral health services, and peer support services. Substance use and mental health concerns are highly prevalent among young LGBTQ individuals, exceeding the levels in similarly aged individuals in the general population. Culturally competent treatment options are often lacking for young LGBTQ adults, particularly in the US South where resources for behavioral health are often scarce. Stigma regarding mental health and gender identity and expression is high in the South, which contributes to substance use and mental illness and their resulting negative health outcomes and further complicates obtaining treatment. Through our 20- year experience of providing behavioral health services for LGBTQ individuals, the lack of comprehensive case management and substance use screening and treatment for this population has been clearly evident. This experience and our strong partnerships with organizations working with LGBTQ individuals well-positions our center for implementing this program. The intensive case management services proposed for Project Uplift includes in-depth assessment of goals, resource needs and barriers to goal achievement; provision of services such as financial planning, GED preparation, and obtaining legal documents, and connection to more in-depth services including job training, housing, PrEP, and psychiatric care; and provision of the evidence based Screening, Brief Intervention and Referral to Treatment (SBIRT) services for 80 young adults (18-35; 20 in year 1 and 30 in years 2-3). The case manager, with assistance from the peer specialist, will also facilitate Seeking Safety, an evidence-based group education program addressing trauma among individuals using substances. Counseling services through Project Uplift will involve assessment, trauma-informed care and evidence-based treatment including Motivational Enhancement, Cognitive Behavior Therapy and Dialectical Behavioral Therapy. The two peer support specialists will offer street outreach and outreach to community-based organizations providing services for young adults to recruit for the program and to attempt to reengage clients that have dropped out of care. In addition, the peers will assist in recruiting and training 4-5 additional LGBTQ peers and community knowledge and experience to further enhance recruiting and retention. Project Uplift staff will also create a community advisory group of local organizations working with the LGBTQ population to facilitate a more seamless service system for these individuals. To examine the effectiveness of the comprehensive care model, outcomes including mental health, substance use, housing stability, employment, social support and quality life of will be examined by surveying participants at baseline and at the end of the 6-month program.

ABSTRACT Fulton County Sheriff’s Office FULTON PROJECT 2019 SAMHSA Targeted Capacity Expansion-Special Projects The Fulton County Sherriff’s Office’s (FCSO) FULTON project will treat young adults in the Fulton County Jail with Substance Use Disorder (SUD) followed by community-based treatment after release. Untreated substance abusing offenders are more likely than treated offenders to relapse to substance abuse and return to criminal behavior, which can lead to re-arrest and re-incarceration, jeopardizing public health and public safety. Treatment is the most effective course for interrupting this cycle. FULTON will target individuals in the Fulton County Jail ages 18-26 returning to zip codes 30310, 30314, and 30318 within the City of Atlanta. There was an average daily population of 2,401 inmates in 2018 and the jail’s baseline recidivism rate was 47%. The targeted neighborhoods had an estimated 14,706 residents in 2017 (85% Black, 13% White, 2% Other), of which 20.2% were unemployed (compared to 7% nationally) and 29.0% were living below poverty (compared to 14.6% nationally). FCSO will partner with CHRIS 180 (a mental health community service provider specialized in trauma and substance abuse treatment) to screen Fulton County Jail inmates for SUD; provide evidenced-based, population appropriate treatment approaches such as Thinking for a Change and The Matrix Model; provide recovery support services such as life skills and targeted referrals to community-based service providers; and employ the Transition from Jails to Community model for recruiting, engaging, and treating clients with the greatest criminogenic needs while incarcerated followed by community-based treatment after release. FCSO expects to serve a total of 175 individuals over the three-year grant period. In Year 1, FCSO expects to serve 55 individuals after a four-month start-up phase and 60 individuals each in Years 2 & 3. Project goals and objectives include the following: 1. Increase participants’ abstinence from the use of alcohol and illicit drugs by implementing evidence-based programs in the Fulton County Jail that address behaviors that may lead to substance use:175 jail inmates with SUDs initiate treatment; 50% remain engaged in treatment for at least 6 months from intake; 80% will become abstinent/reduce their use of drugs/alcohol by program exit; and 50% improve anxiety, depression severity, and other underlying causes of SUD 2. Reduce barriers to successful community reentry by addressing inmates’ criminogenic needs: 70% of engaged participants will show reduced criminogenic needs by program discharge; 50% complete Thinking for a Change curriculum; 50% complete the Early Recovery portion of the Matrix Model before program exit; and 30% attend ongoing treatment sessions and care coordination meetings post-release 3. Reduce jail recidivism rates among young adults released from the Fulton County Jail: 40% of participants remain free from criminal justice involvement for three years post release resulting in a 50% reduction in the participants’ recidivism rate

Care Plus NJ's Northeastern NJ Recovery and Individualized Support Expansion (RISE) will enhance and expand comprehensive treatment, care coordination, community outreach, and recovery support services for high school adolescents and young adults (ages 14-30) who are struggling with substance use disorders (SUD's) and/or co-occurring substance use and mental health disorders in Bergen County, NJ. The target population includes adolescents and young adults who have the highest prevalence and fastest growing rates of substance use, major depression, serious mental illness, and suicidality. Rising overdose rates related to the burgeoning opioid crisis have given a specific urgency to addressing these needs, particularly in NJ where the drug overdose rate increased 29.3% from 2016 to 2017, higher than the national average. Bergen County's overdose rate has nearly doubled from 2016-2018, and 52% of opioid overdoses were for individuals ages 18-31. Bergen County is assessed to have the highest percentage of unmet demand for substance use treatment in the state at 58.4%. Access to services and retention in treatment is often poor due to cost, inadequate insurance, lack of transportation, fractured continuity of care for adolescents graduating into the adult system of care, and a dearth of developmentally appropriate treatment options. there are currently not enough specialized services in Bergen County for the population of focus that support their recovery based on age, drug of choice, and level of support needed to complement clinical interventions. The RISE program will provide evidence-based screening, assessment, treatment, and recovery support to 700 unduplicated adolescents and young adults throughout the grant lifecycle. Medication Assisted Treatment, ambulatory withdrawal management, outpatient and intensive outpatient individual, group, and family therapy, transportation assistance, and wraparound case management services will be offered to engage this population with the highest need but the least engagement. The goals are to provide care coordination and linkage to services to high risk high school youth to prevent or reduce the progression of a SUD, and to provide evidence-based, developmentally appropriate treatment services to young adults to increase retention in treatment and improve recovery outcomes. Care Plus NJ's extensive network of intersystem relationships and acute insight into the population of focus will ensure that services are fully integrated, developmentally appropriate, and seamlessly coordinated between the children's and adult's systems of care. The RISE program will increase access to lifesaving services for the adolescents and young adults at highest risk of overdose, first episodes of psychosis, and escalating rates of substance use establish meaningful recovery.

St. John’s Well Child and Family Center’s TransYouthConnect program (TYC) will integrate, enhance, and expand screening, assessment, evidence-based clinical and nonclinical treatment services, and recovery support services for substance use disorder and co-occurring mental disorders (SU/coMD) among transgender/gender non-conforming (TGNC) young adults ages 18-25 (TGNCY) in South Los Angeles. This program will be the youth-specific offshoot of St. John’s Trans Health Program which has been in operation for more than 6 years. More than 75% of TYP will be people of color; approximately 15% are homeless and 27% are immigrants; 47% are transmen, 47% transwomen and 6% nonbinary. All are low-income. TGNCY experience SU/coMD at disproportionately high rates compared to the general population, with extremely high rates of posttraumatic stress, as a result of experiences of poly-victimization, discrimination, and depression and anxiety due to struggles with gender dysphoria. Serving younger TGNC people provides an opportunity to interrupt SUD and support them to improve their health, functioning and stability through collaborative, comprehensive, trauma-informed and recovery-based treatment and peer-driven wraparound services. Strategies include incorporating SU/coMD treatment into a menu of trans-specific services that TCNGY actively seek, such as name/gender change services and surgery referrals, providing services in a safe, welcoming ‘medical home’ setting, coordinating and systematizing care in ways that support retention, providing incentives and assistance with transportation, and incorporating economic/professional development services. St. John’s will continue its success of implementing the EBP Seeking Safety with the TGNC community. Objectives include: ensuring that staff have all training they need to conduct services in a way that is trans-affirming and culturally competent; linking positive screens immediately into care coordination services, where TGNCY will work with a provider on a treatment and recovery plan; ensuring high rates of retention in Seeking Safety and clinical services; and increasing a sense of hope, functioning, self-efficacy, social connection/inclusion among participants. A total of 1,000 unduplicated TGNCY will be served by TYC. Annually, TYC will screen 875 unduplicated patients, and 350 will access one or more SU/coMD services.

CADA Prevention and Recovery Center, a substance use treatment, mental health and HIV provider with 59 years of experience and a 13-year proven track record of serving the population of focus, respectfully submits this proposal to implement Reconnect & Recover to expand trauma informed, culturally and linguistically appropriate substance abuse and/or related co-occurring mental health disorder treatment services and related peer recovery support services for 150 adult males over the 3-year grant period, doubling existing treatment capacity. Reconnect & Recover addresses a statewide and parish need to strengthen criminal justice coordination in partnership with the New Orleans Reentry Task Force, the La. Dept. of Public Safety & Corrections, New Orleans District Probation/Parole and the La. Council of Resources (LACOR). Project Name: Reconnect & Recover. Population to be served: Male adults (ages 18+) who have SUD and/or COD treatment needs based on ASAM criteria; 100% trauma-involved and who are at risk for HIV and hepatitis; 40% COD; 50% Black; 5% Hispanic; 10% Multi-racial; 100% criminal justice involved. Strategies: The underserved adult male criminal justice involved population will be served through expanded treatment and community-based criminal justice systems coordination: 1) Behavioral Health Disparities Impact Statement/Targeted Outreach Plan/Strategic Plan within first 60 days; 2) Expanded formal agreements with MAT, housing and employment providers, as prioritized in the New Orleans Reentry Task Force Strategic Plan. Provide SUD and/or COD evidence-based treatment and recovery support services; HIV/AIDS testing, case management, linkage, care and treatment; housing supports; outreach; and capacity enhancements ensuring treatment retention. Evidence based practices: Trauma-informed SUD/MH standardized screening/assessment (PCL-CV, COJAC, ASI); Strengths-based Case Management; MI; Seeking Safety; MATRIX; and SMART Recovery. Goals: Aligned with the New Orleans Reentry Task Force Strategic Plan: 1) ensure criminal justice systems coordination and SUD screening/assessment diagnosis for COD, trauma and HIV; 2) increase substance use abstinence; 3) increase recruitment/access/engagement/retention in treatment; 4) improve employment status; 5) improve housing stability; 6) decrease criminal justice involvement; 7) improve social connectedness through recovery support services; and 8) improve access/availability, reducing disparities. Objectives: Years 1-3 to 6/30/2022: 1) 100% of 150 participants will receive SUD screening/assessments diagnosis for COD, trauma, HIV and hepatitis; 2) 80% will achieve abstinence; 3) 80% will increase recruitment/access/engagement/retention in treatment; 4) 80% will improve employment status; 5) 80% will improve housing stability; 6) 80% will decrease criminal justice; 7) 80% will improve social connectedness; and 8) 65% of participants are racial and/or ethnic underserved adult male, criminal justice involved special populations. # served: 50 Year(s) 1-3, totaling 150 in three years.

In response to the Substance Abuse and Mental Health Services Administration’s request for applications under FOA No. TI-19-007--Targeted Capacity Expansion- Special Projects, PROCEED, Inc., proposes to implement Juntas/Together (English/Spanish)—a comprehensive, woman-centered and trauma-informed substance use disorder/ co-occurring disorder (SUD/COD) treatment program for Latina and African-American women experiencing intimate partner violence (IPV) and their children, in the City of Elizabeth and broader Union County, NJ. Juntas/Together integrates best evidence supported SUD/COD treatment practices, with IPV safety planning, case management and navigation services, peer support, and age-appropriate counseling and referrals for the children of women enrolled in the program. Research has shown that survivors of IPV may use substances at higher rates than people who have never been abused; it has also been suggested that people accessing SUD treatment experience high rates of IPV. PROCEED has also seen an increase in IPV among our mostly Latina clientele who are especially vulnerable due to language barriers, immigration status and racial discrimination. Addressing IPV and providing substance use treatment are priority areas for Union County, NJ. The strength of Juntas/Together is that it addresses the interaction and duality of IPV and SUD/COD in the misuse, treatment and long-term recovery of substances in a supportive, trauma and woman-centered manner, inclusive of children. Program strategies are multi-pronged and will include: 1. SUD/COD treatment using a) Seeking Safety – an evidence-based, present-focused, intervention to help people address and overcome trauma and addiction; combined with b) Motivational Interviewing- a client-centered, clinical method of counseling and communication used to help motivate and elicit behavior change by helping clients to explore and resolve ambivalence. 2. IPV Safety Planning: universal IPV screening, resource identification, safety planning 3. Psychiatric/Mental Health Services: to address clients’ multiple traumas and substance use 4. Case Management/Navigation services: includes legal, health, education and human services 5. Referral/Provision of age-appropriate counseling services for the children of enrolled women 6. Peer support: cohort of women in recovery trained to provide emotional support to their peers 7. Universal HIV testing and Viral Hepatitis (VH) screening; VH testing offered based on risk It is anticipated that up to 75 women and 20 children will be served in year 1 of Juntas/Together, and 100 women and 30 children in years 2 and 3, for a lifetime project total of 275 women and 80 children.

Summary of your project: TCE-Special Projects will provide behavioral health services and the T-SISTA and Seeking Safety interventions to LGBT adults, with a focus on Black and Latino men who have sex with men (MSM) and transgender populations who gather in Midtown Manhattan in New York City (NYC), often hailing from Harlem and Washington Heights in Manhattan, and Northern Queens. The proposed project recruit clients through the peer-led Social Network Strategy (SNS) and will be implemented at Housing Works’ 37th Street (designated Federally Qualified Health Center (FQHC)) which also houses Positive Health Project (PHP), a subsidiary of Housing Works, located in Midtown Manhattan. Population(s) to be served: LGBT adults who reside or visit the proposed service area who contend with disproportionately high rates of substance use and mental health issues, poverty, unemployment, and incarceration. LGBT individuals used illegal drugs in the past year at double the rate of heterosexual individuals (39% compared to 17%), including prescription pain medication misuse (10% compared to 5%). LBGT individuals are also more likely to have mental health issues, especially depression, than heterosexual adults. Transgender individuals experience higher rates of depression, suicide ideation, and self-harm than those who identify as cis-gender. Strategies/interventions: The proposed project will implement three evidence based practices: 1) SNS, a peer-led outreach strategy; 2) Seeking Safety, a 25-session evidence-based counseling model to help people attain safety from trauma and/or substance use; and 3) T-SISTA, a 5-session peer-led , to prevent HIV infection among transgender women, with the goal of increasing access, engagement, and retention in behavioral health services for the target population. Project goals and measurable objectives: The proposed project will: 1) enhance the continuum of care for substance use disorder services; 2) reduce alcohol and other drug consumption and its negative health impact; 3) increase rates of retention in behavioral healthcare Objective 1: By the end of the program, 85% of enrolled clients (from baseline) will have increased knowledge on how to manage their behavioral health conditions; Objective 2: 75% of enrolled clients (from baseline) will report increased confidence in their ability to manage their behavioral health conditions.; Objective 3: 75% of enrolled clients (from baseline) will report increased retention in behavioral health care as applicable; and Objective 4: Substance use among enrolled clients will be reduced by 10% each program year (from baseline). The number of people to be served: Project Link will enroll a total of 525 clients over the course of the project. 50 clients will participate in Seeking Safety and 80 clients will participate in T-SISTA, over the life of the project.