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This is a study to find out whether a peer-led screening, education, and support program is helpful in improving health-related outcomes including behavioral and physical health of racially minoritized MSM, MSMW, transgender and other higher-risk LGBTQ+ populations. Participation in the study includes taking part in a screening process, HIV/HCV testing as desired, prevention navigation services including linkage to care, and participation in support groups and education sessions facilitated by peer navigators. As part of the study, you will be asked to complete a survey that is approximately 30 minutes in duration before beginning treatment, a brief survey following screening and connection to care, and an additional survey 90 days after treatment engagement if you opt in to prevention navigation services. There is a risk of loss of confidentiality by participating in the study, though we will take steps to protect your confidentiality. If you are interested in reading more about the study continue reading below.

Congreso de Latinos Unidos’ Latino Prevention Navigation project aims to reduce new HIV infections among high-risk Latino and Black adults ages 18-35 in eastern North Philadelphia, such as men who have sex with men (MSM). This project uses navigation and peer education to help participants reduce their risk of contracting HIV. Participants are also screened for substance misuse and provided brief intervention and referrals to treatment. Congreso has over four decades of experience serving Philadelphia’s Latino community, and our Esfuerzo HIV prevention and care program has offered comprehensive linguistically and culturally appropriate services to the community since 1985. The proposed project will provide HIV, STI, and viral hepatitis testing and treatment services through Congreso’s Federally Qualified Health Center, and participants who screen positive for substance misuse receive an immediate referral for substance use treatment with one of our project partners. Congreso will serve 1,200 participants during the life of the project, increasing from 150 participants in Year 1 to 300 participants in Year 5. The goals of the project are to 1) reduce potential HIV infections through substance misuse prevention education and HIV risk reduction education, 2) increase HIV and STI status awareness by testing participants for HIV, STIs, and viral hepatitis, and 3) prevent HIV infection through linkages to relevant services. Measurable objectives for the first year of the project include providing HIV and substance misuse prevention education to provide 150 participants; providing HIV, STI, and viral hepatitis testing and treatment to 150 participants; and assessing 150 participants for healthcare, social service, and substance use treatment needs and providing appropriate linkages to care. A Health Education Specialist will apply the evidence-based Think Twice curriculum. Think Twice is a single-session intervention designed for MSM who are at high risk of contracting HIV and was shown to increase protective behaviors in a randomized controlled trial. The Latino Prevention Navigation project complements HIV sexual behavior prevention services with the Screening, Brief Intervention, and Referral to Treatment (SBIRT) intervention. SBIRT is a secondary prevention strategy that identifies risky substance use behaviors before abuse or dependence occurs and provides early intervention to stop the onset of more hazardous behaviors and symptoms. Participants who screen positive for substance misuse will receive a brief intervention and an immediate referral for substance use treatment with one of our partner organizations—Public Health Management Corporation and COMHAR. Congreso will unify HIV and substance use prevention practices through participant navigation. The Lead Navigator will help participants access healthcare systems, identify and reduce barriers to care, and customize health education to each participant’s needs. Navigation services are designed to support participants with accessing preventative services, such as PrEP, nPEP, and STI testing, which will help participants remain HIV-negative and engaged in their healthcare.

Health Services Center, Inc. (HSC) has provided substance use (SU), HIV, and viral hepatitis (VH) prevention and treatment services in its catchment area for over 30 years. HSC’s service area is a 14 county, largely rural, underserved area of Alabama hit hard by the opioid epidemic, disproportionate experience of HIV by minority and marginalized populations, and poverty. HSC’s Project EPIC (Endless Possibilities in Change) will provide individual SU, HIV, and VH prevention services to young adults (ages 18 – 25) at increased risk, prioritizing minority populations, LGBTQ+ populations, and low-income uninsured populations. The target service area is large, covering over 9,000 square miles (Counties: Blount, Calhoun, Coosa, Cleburne, Chambers, Calhoun, DeKalb, Etowah, Randolph, Shelby, St. Clair, Tallapoosa, Talladega, Clay). In Project EPIC, individual-level prevention service provision will be largely targeted in Calhoun, Etowah, and Talladega Counties, Alabama, the population centers of the area. HSC will partner with Jacksonville State University (a regional university), Talladega College (an HBCU), the local HIV clinic, and other community stakeholders to provide Project EPIC services. HSC will provide the evidence-based individual level intervention, Brief Motivational Interviewing (BMI). BMI is a flexible prevention approach that will allow navigators and community health workers (CHWs) to work with prevention clients to determine prevention goals and strategies. BMI has strong research support with multiple risk factors across populations of young adults. Annually, the program will enroll at least 75 persons (325 over course of project) into individual prevention services. Community prevention capacity development activities will include community awareness activities, providing prevention training to peers and community providers working with young adults, and community coalition building to prevent and decrease SU, HIV, and VH risk. Project EPIC will serve 1,500 community members outreach through brief outreach (7,500 over the course of the project), 300 community members annually with HIV and VH testing (1,500 over the course of the project), and 150 persons annually with psychosocial referrals (750 over the course of the project). Measurable outcomes include: reduction of behavioral health disparities, reduced alcohol and other drug risk, decrease in unsafe behaviors related to SU, decreased HIV and VH risk behaviors, increased HIV/VH knowledge, and improved attitudes toward preventive behaviors. The proposed project staff is highly experienced in providing similar services to the priority populations. Project EPIC will expand and build on these successes.

The Prevention Outreach Substance Use and HIV/HCV (POSH) Project partner organizations in this application are uniquely positioned to address the syndemic conditions of HIV, HCV and substance use disorder. Partnership to End AIDS Status (PEAS) has been providing outreach, HIV prevention, and linkage to care services in Memphis since 2009, with a focus on Black Memphians, men who have sex with men and transgender persons. A Betor Way was founded in 2019 with the mission of reducing the harms of drug use, including HIV, HCV and overdose. Dr. Orisha Bowers, the former president of the National Harm Reduction Coalition, will aid in infrastructure development as well as networking with the Memphis SUD and HIV/HCV providers. Finally, Meharry Medical College, the nations largest historically Black academic medical center, will lead the needs assessment, facilitate the development of a strategic plan, and conduct all evaluation. This partnership will meet the following four goals: (1) Develop a strategic plan to reduce HIV, HCV, and substance use disorder among Black Memphians; (2) Decrease HIV and viral hepatitis infection among residents of Memphis and surrounding counties; (3) Increase linkage to SUD treatment and harm reduction services; and (4) Solidify and augment the system of care for individuals living with or at risk of HIV that also use drugs.

Summary: This project aims to increase access to mental health (MH) support for families/caregivers of LGBTQI+ youth with special emphasis on those who have attempted suicide, are experiencing suicidal ideation, and/or are experiencing behavioral health (BH) issues that place them at risk of suicide. The target population includes LGBTQI+ youth & young adults up to 24 years old & their families living in Queens, New York with focus on BIPOC, migrants, asylum seekers, undocumented youth/families, unhoused youth/families, and all LGBTQI+ youth who are experiencing significant physical, psychological or BH conditions. The project anticipates serving 600 families during its 3-year duration (200 annually). Strategies and Interventions: The project will implement a range of activities such as outreach and engagement, tailored community referrals, family counseling, community MH training, youth & family peer support, and collaboration with youth-serving agencies. Service delivery will be tailored to meet the specific needs of the population, considering cultural, linguistic, and access needs. Project Goals & Measurable Objectives: 1) Increase participation of LGBTQI+ youth & their families/ caregivers in Vibrant’s Family and Youth Peer Support (FYPS) program. Objectives: Engage 200 families of LGBTQI+ youth in FYPS, annually; Establish referral relationships with 24 community organizations, including 6 LGBTQI+-serving organizations; and Complete quarterly public awareness events in high traffic/high need community districts. 2) Decrease the rate of suicide/attempted suicide amongst LGBTQI+ youth & their families/caregivers. Objectives: Provide culturally competent, trauma informed FYPS to 100% of participants; Provide suicide risk assessments to 75% of participants and make warm referrals to clinical BH care providers to 100% of participants in need; Develop suicide safety plans with 100% of participants who screen positive for suicidal ideation; and Conduct quarterly targeted social media campaigns to elevate youth voice and raise awareness about suicide prevention. 3) Decrease the prevalence of health and BH risks amongst LGBTQI+ youth & their families/ caregivers. Objectives: Provide person-centered counseling and support programs to 100% of participants; Conduct basic health screenings for 100% of participants and make warm referrals to care-specific providers for 100% of participants in need; Complete evidence-based BH assessments for 100% of participants upon intake and at least annually and provide warm referrals to BH providers for 100% of participants in need; Conduct SUD screening for 100% of participants and provide warm referrals to SUD treatment providers for 100% of participants in need; and Conduct basic needs assessments for 100% of participants to identify needs related to SDOH and provide warm referrals to support agencies for 100% of participants in need. 4) Increase family/caregiver-specific support for family members/caregivers of LGBTQI+ youth to encourage safe and affirming family/caregiver systems. Objectives: Provide family counseling to 200 families to navigate challenges related to supporting their LGBTQI+ family member/youth; Provide peer support to 200 families to navigate challenges related to supporting their LGBTQI+ family member/youth; Conduct appropriate MH and basic needs screenings for 100% of family members/caregivers to address any unmet needs and provide warm referrals to support agencies and providers to 100% of participants in need; and Provide counseling and support for family reunification/ stabilization for 100% of participants in need. 5) Increase community and cultural support for LGBTQI+ youth & their families/caregivers through provider training on family counseling and support interventions. Objectives: Train to up to 30 providers quarterly on evidence-based family counseling for LGBTQI+ youth & families/ caregivers; and Conduct 6 Queens community outreach events annually.

Out of Home Youth &Family Support Project offers highly specialized services to the LGBTQIA+ community. The mission is to expand access to high quality and low barrier treatment. Staff are passionate advocates for the LGBTQIA+ community and offer a comprehensive wraparound approach to meet the complex and diverse needs of LGBTQIA+ folks by offering services including psychotherapy services, medication management, substance use treatment, case management, mentoring, and intimate partner violence counseling services. Out at Home training and support emphasizes the need for acceptance-based processes and building of community to allow people in the LGBTQIA+ community to thrive and celebrate their individuality. Since the inception in 2018, the need for LGBTQIA+ specialized clinicians has only grown due to anti-LGBTQIA+ legislation and lack of support and education for families, communities, and schools. Our mission is to serve LGBTQIA+ folks of any age, and their families, by providing high quality individual, couples, family, and group therapy as well as parent coaching and external training and support. Values of Out at Home include providing affirming, collaborative, skilled, evidenced-based, and high-quality clinical care, offering low barrier approaches to support clients in accessing gender affirming care, and providing training and consultation to families and our communities within Massachusetts. Clinicians at Out at Home have both training and lived experience in working with LGBTQIA+ populations. 45% of clients at Out at Home are under 18 years of age, and 72% of clients are under 21. Additionally, 55% of Out at Home clients are trans, non-binary, or gender fluid. Out at Home uses evidenced-based strategies to provide high-quality clinical care including Trauma-Focused CBT, Motivational Interviewing, and Intensive Treatment for Complex Trauma. Out at Home’s trainings and psychoeducation are informed by the Trevor Project and the Massachusetts Commission on Gay, Lesbian, Bisexual, Transgender, Queer, and Questioning Youth. During the project, Out at Home will expand group programming and integrate therapeutic mentoring, substance use treatment, case management, and intimate partner violence specialist services. By December of 2023, all current staff will be trained on the Family Acceptance Project. We will evaluate increases to youth’s self-report of sense of parental acceptance, as well as parental self-reports of being accepting of their child’s LGBTQIA+ identity. We will also evaluate change in behavioral health and trauma symptom outcomes. Currently, we serve 71 youth, adults, families, and couples, an increase of 50% from 2021. Intern capacity has tripled for the 2023-2024 academic year. Out at Home has also doubled its staff in the 2023 fiscal year and anticipates being able to serve over 150 LGBTQIA+ clients by the end of the FY23. Over the course of the project, we anticipate serving 310 additional clients throughout Massachusetts. Out at Home will also increase its capacity for external training by 100% in the next three years. Additionally, this funding will allow Out at Home to enhanced recruitment and community outreach efforts through increased staffing to cover a larger catchment area and more diversified services and service delivery to support the program in meeting a broader spectrum of client presentation and needs. Out at Home is also especially aware of the racial disparities experienced by BIPOC folks in accessing effective mental health treatment. Out at Home added language capacities of Mandarin and Spanish to our clinical services in 2023 and focused on hiring BIPOC clinicians to match the needs of our population. Currently, 30% of clients served at Out at Home are BIPOC and through increased physical office locations, the delivery of in-home and community-based services and increased outreach attempts, our goal is to increase enrollment of BIPOC LGBTQIA+ identified clients by the end of 2024.

Centerstone’s LGBTQI+ Family Support Program (Family+) will prevent health/behavioral health risks and promote well-being through staff and community trainings on LGBTQI+ competent treatment, outreach/engagement, and non-traditional holistic support activities for an unduplicated total of 230 LGBTQI+ youth and their families residing in Bladen, Cumberland, Hoke, Robeson, Harnett, Lee, Mecklenburg, and Sampson counties, North Carolina (i.e., Y1:60; Y2-3: 85/yr.). Services will be delivered at Centerstone’s Steven A. Cohen Military Family Clinic in Fayetteville, North Carolina, home to Fort Liberty Army Base (formerly Ft. Bragg), the largest US Army installation, and Pope Air Force Base. Family+ will place a key emphasis on serving focus population youth from among the area's estimated 37,800 children of active duty military members and 82,475 Veteran households with children. Focus population demographics are expected to mirror those of the catchment area: 49% male, 51% female, 46% White, 30% Black/African American, and 15% Hispanic/Latino individuals. An estimated 275,260 area individuals live in poverty, 210,840 did not graduate high school, 230,360 are uninsured, and 220,600 have a disability. Compared to their heterosexual peers, 23% of North Carolina’s LGBT youth report electronic bullying (vs. 10%); 29% don’t go to school/feel unsafe there (vs. 13%); 25% experienced sexual violence (vs. 11%); 68% felt sad/hopeless (vs. 35%); and 48% considered suicide (vs. 15%). Family+ will implement evidence-based strategies/interventions, including screening/ referral protocols (e.g., SDQ, PHQ, C-SSRS for those under 18; PHQ, GAD, Primary Care Post-Traumatic Stress Disorder [PC PTSD], Quality of Life Enjoyment and Satisfaction Questionnaire [QLES], C-SSRS Recent for 18+; and CRAFFT for ages 12-21) and family counseling interventions (i.e., AFFIRM Cognitive Behavioral Therapy [AFFIRM CBT], Trauma-Focused Cognitive Behavioral Therapy [TF- CBT], Emotionally Focused Therapy [EFST], AFFIRM caregiver, Youth Mental Health First Aid [YMHFA]). Family+ goals include: (1) Develop/implement an outreach/engagement plan to connect LGBTQI+ youth and their families with counseling and supports; (2) Develop/implement a public awareness communications plan to engage families of LGBTQI+ youth; (3) Develop/implement screening and referral protocols to identify LGBTQI+ youth and their families needing supports; (4) Identify/coordinate referral pathways with community-based service providers for LGBTQI+ youth referred to the family counseling program; (5) Develop/implement a training and workforce development plan on evidence-based family counseling intervention(s); (6) Implement evidence-based family counseling interventions; (7) Coordinate efforts and access relevant technical assistance (TA) and resources; and (8) Develop/disseminate a thoroughly documented model for replication/adoption. As a result of these goals, Family+ will achieve the following measurable workforce and participant-related objectives: ensure 100% of Family+ staff are culturally competent and trained in EBPs; provide outreach/engagement, non-traditional/holistic supports, and LGBTQI+ affirming interventions for 230 youth and their families; screen/assess 100% of participants and caregivers for behavioral health and/or social determinants of health concerns; triage 100% into appropriate interventions; offer 100% peer/family supports; develop individual treatment/safety plans for 100%; coordinate referrals and/or emergency services for 100% in need; provide case management for 100% in need; train 100 staff/providers in evidence-based interventions and deliver 15 trainings on the impact of trauma; reduce trauma-related mental health symptoms among 60%; increase wellbeing and life quality among 80%; improve family functioning among 50%; achieve 80% retention rate; and achieve care satisfaction among 80%.

Family Pride Initiative is a collaboration between the University of Arizona Southwest Institute on Women (SIROW-applicant agency), the Southern Arizona AIDS Foundation (SAAF), Charlie Health, Palo Verde Behavioral Health and University of Arizona Professor of Family Studies and Human Development, Russ Toomey. The Family Pride Initiative is a SAMSHA funded grant for Family Counseling and Support for Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, and Intersex+(LGBTQI+) Youth and their Families. (Short Title: LGBTQI+ Family Support). The proposed Family Pride Initiative aims to reduce disparities and improve outcomes for LGBTQI+ youth in Tucson and southern Arizona by strengthening supports for caregivers, families, and providers. The program will educate caregivers using evidence-based practices AFFIRM or the Family Acceptance Project. Counselors and their supervisors will obtain training on LGBTQI+ best practices and resources including the previously mentioned evidence-based practices. The community as a whole will receive education and support through media campaigns including media outlets, social media, and online resources. Our behavioral health collaborators will provide individual and family counseling to youth and families needed access to behavioral health or help supporting LGBTQI+ youth.

Casa Esperanza's Proyecto Redes (Networks): Recovery & Early Diversion Engagement Services program will serve Latinos with substance use or co-occurring mental health disorders at risk of incarceration within Middlesex and Essex County. Through this diversion grant opportunity, the most vulnerable individuals with COD and SMI will experience increased access to behavioral health services, leading to reduced symptomatology and improved health outcomes, and avoid long-term socioeconomic issues resulting from justice involvement and incarceration. Connecting individuals with appropriate programming in lieu of arrest and incarceration reduces the burden on the court system to process new arrests and reduces the jail population with SMI and COD. Casa expects over 40% of clients to be monolingual Spanish speakers and all to be below the national poverty line. Casa anticipates serving 40 individuals in Year 1 and 50 individuals per year thereafter for a total of 240 individuals served throughout the project's lifespan. Latinos receiving diversion services through Proyecto Redes will have access to mental health services, residential treatment, medication-assisted therapy, clinical stabilization services, and recovery support services. Additionally, a Behavioral Health Partnership Workgroup will provide project oversight and case conferencing. Proyecto Redes proposes to accomplish the following goals: Strengthen the existing infrastructure responsible for coordinating, developing, planning, supporting, and providing effective early intervention services for Latine with SMI or COD who are at risk of detention due to behavioral health disorders. Reduce the number of arrests for Latine with MI/COD by diverting them from justice systems to community-based behavioral health treatment and recovery supports that reduce risk, improve health outcomes, and sustain recovery. Address the stigma, health disparities, and barriers to culturally and linguistically appropriate treatment and support services for Latine through education and training that reinforces existing competencies and develops new skills. Proyecto Redes' success will be measured through the number of assessments completed, case management services provided, training staff on CLAS standards, training law enforcement and community partners, completing Sequential Intercept Mapping, and the number of referrals to crisis intervention and psychiatric rehabilitation services. Casa's Proyecto Redes team will ride along with law enforcement officers to directly intercept and assess individuals. Additionally, highly trained clinical staff will utilize evidence-based practices to administer mental health treatment, such as Integrated Dual Disorder Treatment, Motivational Interviewing, Cognitive Behavioral Therapy, Medication-Assisted Treatment, Intensive Case Management, and Assertive Outreach. Proyecto Redes staff receives ongoing training to reinforce existing competencies and develop new skills. Our proposed Proyecto Redes will address the interconnected problems Latinos face working with current diversion models, offer clients a resource for individual/family recovery management, emphasize long-term recovery, address stigma, and build community connection before arrest and booking.

The GBMH Early Diversion Grant Program will serve adults and youth with SMI, SUD, SED, and COD in Grant and Blackford Counties in northern Indiana. Grant Blackford Mental Health (dba Radiant Health) will implement the follow strategies for early diversion: (1) Employ three Early Diversion Coordinators (one for Blackford County, one for Grant County youth, and one for Grant County Mental Health court) to provide case coordination and legal advocacy for clients with mental health and substance use disorders; (2) Collaborate with the local JRAC to create a Behavioral Health Partnership Workgroup to coordinate early diversion services; (3) Expand crisis services through the addition of a 24/7 mobile crisis team and a new crisis stabilization unit where individuals in crisis can be diverted; and (4) Train local law enforcement and court personnel on Mental Health First Aid, QPR, and CIT to ensure a trauma-informed and culturally-responsive approach to justice-involved individuals with mental health disorders. Project goals include increasing the number of justice-involved clients who are diverted from jail, increasing the number of clients who encounter mental health professionals alongside law enforcement; and increasing awareness and capacity of law enforcement and court officials to provide services to the target populations. The number of individuals served will begin with 50 in the first year and reach 200 by year 5.

Abstract SAMHSA Early Diversion Grants, SM-23-012 Hennepin County Behavioral Health Center Expansion The Hennepin County Behavioral Health Center Expansion Project will expand hours at the Behavioral Health Center in Minneapolis, Minnesota to be open 7 days a week from 9 am - 9 pm. The BHC is a walk-in / drop-off center where residents with mental illness and co-occurring disorders who are at risk for committing minor, nonviolent and nuisance offenses can access stabilizing behavioral health and related services instead of receiving a criminal justice response. Hennepin Count's Behavioral Health Center (BHC) is designed to provide an early diversion response for residents with MI/COD who are symptomatic and struggling with community functioning, elevating their risk for criminal justice involvement on minor, nonviolent and nuisance offenses. Almost all BHC participants are Medicaid-eligible and 71% identify as BIPOC, most commonly as Black, Hispanic or American Indian. In 2021, at intake, 27% of BHC participants who were assessed had been booked into the Public Safety Facility within the past six months, 91 % had an inpatient hospitalization, AND 86% utilized the emergency department (average of 5.8 ED visits per person). The BHC provides a low-barrier alternative to jail or hospitalization for residents in behavioral health crisis. Law enforcement and other first responders can quickly transfer qualifying individuals to the BHC's care on a voluntary basis and return to calls for service. Residents can also walk in for services as self-referrals or with the support of trusted family and peers. The three-story BHC offers a comprehensive array of on-site resources including opioid-responsive Withdrawal Management, Mental Health Crisis residence, primary care including medication management and medicated assisted treatment, and county social service intakes. BHC case managers assess needs and connect residents to behavioral health supports of their choice (e.g., MI/COD treatment, rehabilitative services, targeted case management, ACT, permanent supportive housing, supported employment) over an average 60-day intervention. Peer support specialists, person-centered practices, and a Resident Advisory Group of BHC participants create a low-barrier and responsive environment for residents in behavioral health crisis. By the end of the five-year grant period, the BHC project will service 9,000 unique individuals with 20,000 connections to community-based behavioral health services and supports. The targeted benefits are a 10% reduction in jail bookings, a 15% reduction in emergency department visits, a 20% reduction in inpatient hospitalizations, and a 30% increase in the total number of claims for community-based mental health services. The lead applicant is Hennepin County's Behavioral health Division in partnership with justice system partners including the Hennepin County Sheriff's Office, the Minneapolis Police Department, and additional stakeholders within the Hennepin County Criminal Justice and Behavioral Health Initiative. By expanding access to low-barrier, comprehensive supports available at the Behavioral Health Center, Hennepin County will decrease racial disparities and further increase early diversion of residents with MI/COD, connecting them to stabilizing behavioral health and related resources that improve their community functioning.

Breathitt, Wolfe, Lee, Owsley, Leslie, Letcher, Knott and Perry County are remote rural counties located in the Appalachian region of eastern Kentucky. The counties comprise the Kentucky River Region, 5th U.S. Congressional District. Four are designated Promise Zone and Opportunity Zone counties. Kentucky has the highest incarceration rate of adults in the country. Despite the lack of population density, the KYHealthFacts data supports that this Eastern KY Region keeps pace with the more urban parts of the State, especially with drug arrests per 100,000 (Region 2261 vs State 2301). According to Measure of America (2021), the district ranks next to last in the nation with 23.5% of youth 16-24 not in school nor employed. Breathitt County was named among the top 50 counties in the nation as priority for intervention with 31.6%. Status offense rates were equally high, 94/1000 for the state with 151/1000 for Perry County. The KY Dept of Education reports the homeless rate for students are the worst in the state, with homeless rate for students in Perry (9.2%) more than triple the State 3% average. Three of our target counties continue to have juvenile incarceration rates above State norms, and five have rates of 10/1000 or worse. These eastern Kentucky counties chosen for intervention have an estimated 2,296 court involved/re-entry population, ages 18-35. The number of Kentucky children being raised by foster/kinship is trending upward; having increased 75% between 2012- 2014 and 2016-2018. Youth aging out of care are in the extreme risk category for unemployment, addiction, suicide, school dropout, incarceration, and exploitation. Guided by a consortium of safety net providers, implementation of diversion efforts is bearing fruit. KRCC is piloting a TAY grant offering services and supports via Drop-in Centers. These Centers are beginning to be used as check in points for DJJ involved youth who are fulfilling diversion plans or post release plans. KRCC is also a treatment partner with local Drug Courts, and with KY Senate bill 90 prioritizing adult nonviolent crime offender diversion, the partners are planning how to extend this partnership with Commonwealth Attorney/Judicial and Law Enforcement to offer adult treatment diversion options to prevent arrests or incarceration. The Region’s SAMHSA Early Diversion grant application, Restore HOPE, will provide the resources to enable partner members in the KY River Region to build an outreach and assessment process whereby behavioral health, law enforcement and other safety net providers will participate earlier in the legal process, minimizing client contact with criminal justice, and offering a seamless referral link to appropriate treatment interventions and social supports in lieu of incarceration. Specifically, Restore HOPE will hire outreach coordinators to lead a team that will 1) complete mapping the DJJ/Justice system and behavioral health system to identify multiple points of intervention and establish a protocol to utilize these points to improve effectiveness and efficiency in diversions 2) establish a screening and assessment protocol to use for diversion planning with benchmarks for fidelity that includes early intervention, clinician participation in the early detention/diversion process and 3) develop additional evidence based treatment options as determined by gaps and identified need. We project serving 125 referrals in year 1.

Siouxland Human Investment Partnership (SHIP) with Sky Ranch Behavioral Services (SRBS) will deliver SHIELD, a culturally affirming evidence-based diversion initiative to divert 500 youth prior to arrest and booking and impact 2500 beneficiaries of youth, parents/caregivers, and providers over five years. This is in response to a crisis of tobacco and THC vaping with related substance use and mental health in the Sioux City Community School District (SCCSD) with a goal to reduce the number of youth with mental illness or co-occurring disorders (COD) in the juvenile justice system, increase resiliency skills, enhance school engagement, and improve overall well-being. SHIELD will prioritize and serve Woodbury County, Iowa located in the tri-state (Iowa, Nebraska, South Dakota) region of the Sioux City Metropolitan Statistical Area (MSA), known as Siouxland. While this evidence-based early diversion initiative will be open to all youth ages 11 to 18 in grades 5 to 12, a priority focus will be on SCCSD, the largest District in the region, including youth impacted by poverty, low academic performance, and other identified barriers. Minority youth who have been disproportionately impacted by racial and equity barriers will also be prioritized to include the Indigenous, African American, Latino, and LGBTQIA+ youth. SHIELD will be delivered in partnership with SCCSD, Sioux City Police Department (SCPD), Iowa Third Judicial District Juvenile Court Services (JCS) and the network of community-based providers. Grounded in the Interconnected System Framework (ISF)- Positive Behavioral Interventions and Supports (PBIS) and Stages of Change Theory, evidence-based practices will include Screening, Brief Intervention, Referral, and Treatment (SBIRT), motivational interviewing, and INDEPTH diversion. Substance use and mental health screening tools will include CRAFFT+N and Pediatric Symptoms Checklist. Practices will be delivered in individual, group, family, and community-level interventions by diversion specialists and interventionists with core partners. Deliverables for SHIELD will include the quarterly Advisory Behavioral Health Workgroup composed of the current SCCSD workgroup, youth, core partners and community-based providers for this initiative, Early Diversion System Mapping using the Sequential Intercept Mapping (SIM) Model in months 1-3, development of the SHIELD Blueprint™, a comprehensive plan of evidence-based and community-based services to divert youth in the population of focus by month 6, a culturally affirming Early Diversion Continuum of Interventions, to include: 1. Vaping prevention education for all 5th and/or 6th graders to divert future use; 2. Group Diversion education for middle and high school students identified vaping, substance use, or other risk behaviors as a part of in-school suspension as an alternative to law enforcement intervention; 3. Family and Group intervention for youth identified with first-time THC or other substance use as an alternative to Juvenile Court intervention. 4. Engagement in community-based SUD, mental health, cultural, and/or supportive services to support youth with resources to divert from future high-risk behaviors. Annual Training of core and community partners on culturally affirming mental health and substance use awareness and identification, de-escalation, diversion, and crisis intervention will build capacity and Sustainability Planning grounded in Capacity-Building by year 3. SHIELD will serve 2500 unduplicated youth, family members, and multidisciplinary professionals/paraprofessionals with 500 youth diverted from arrest and/or booking. 1) Diversion, Resiliency, Well-being. Reduce the number of youth with mental illness or COD involved in the juvenile justice system, through early diversion and increase resiliency of youth 2) Capacity Building and Sustainability. Provide resources, training, and capacity building to sustain the impact of SHIELD.

The Mississippi Early Diversion Project (MS-EDP) will integrate the CMHC’s existing continuum of care with Crisis Intervention Team (CIT) diversion efforts to build a trauma-informed, systematic response to crisis intervention and diversion from the justice system to the behavioral health system. In areas lacking CIT, Sequential Intercept Mapping workshops will localize gaps and resources in Intercepts 1 and 0. Behavioral Health Partnership Workgroups will be formed organically from this meeting Trained CIT officers will serve as the main source of interception from arrest and detention to services and support. MS-EDP will train and certify law enforcement officers to serve as the main source of interception from arrest and detention to trauma-informed services and support at each local community mental health center. MS-EDP will target individuals living with mental health or co-occurring disorders encountered by law enforcement officers throughout the state of Mississippi. In addition, specialized CIT partnerships will be developed that target unhoused individuals and veterans at four of the state’s military bases. The project’s goals and objectives are: Goal 1 is to build collaborative partnerships among relevant agencies to divert individuals with MI or COD from the justice system to services and support. By the end of the project period interagency Behavioral Health Partnership Workgroups will be convened in every CMHC catchment area (Objective 1:1). Goal 2 is to build community capacity to divert individuals with MI or COD from the justice system. A minimum of 22 CIT training classes will be held by the end of the project. (Objective 2:1) A minimum of four Train the Trainers will be held across the life of the project (Objective 2:2). By the end of the project period, four military bases will have operational CIT programs (Objective 2:3). By the end of the project period stakeholders working with individuals without housing in the Hattiesburg, Gulfport/Biloxi, and Jackson MSAs will participate in CIT training (Objective 2:5). Goal 3 is to divert individuals from the justice system to community-based support and services in a culturally appropriate manner. By the end of the project, 90% of all CIT contacts will be diverted from jail (Objective 3:1). Number of Unduplicated Individuals to be Served with Program Funds: Year 1: 15; Year 2: 35; Year 3: 60; Year 4: 90; and Year 5: 120; for a total of 320.

Executive Summary Recovery Network of Programs (RNP), in partnership with the Stamford Police Department (SPD), proposes an expansion of their Community Response Initiative (CRI). Its goal is to deliver a comprehensive, multi-agency, culturally responsive, trauma-informed, evidence-based earliest point of diversion service for adults and juveniles with substance use and behavioral health disorders at risk for criminal justice involvement. The population of focus (POF) is adults and juveniles with mental illness and/or co-occurring disorders (COD) from the City of Stamford Connecticut, located in Fairfield County, who are in crisis and will benefit from a referral to community-based services prior to any arrest or booking. RNP is a behavioral health nonprofit that has operated in Fairfield County for over fifty years which, through an extensive care continuum, serves the needs of adult individuals with substance use and co-occurring disorders. The agency serves over 6,000 individuals annually and nearly 3,000 individuals daily among all programs. According to the 2020 Census, 40.7 percent of the population of Stamford are individuals of color. 19 percent of the population age 5 and older, are linguistically isolated meaning they speak English “less than very well.” Latinos and Asian Americans are more likely to be linguistically isolated than other racial/ethnic groups. The socioeconomic disparities prevalent among poorer residents include access to medical care and stable housing, employment, literacy and linguistic fluency, environmental hazards, and transportation all of which impact access to care, physical and mental health outcomes, and overall quality of life. There is a shortage of mental health professionals/facilities in Stamford represented by its Health Services and Resources (HRSA) rating of 15 (out of 26) as a Mental Health Professional Shortage Area (HPSA). Police officers routinely express concern about the amount of time spent waiting in hospital emergency rooms in combination with the prospect that individuals with mental disorders may not be admitted to inpatient care. Much of the increased time is due to an inability to refer people to needed service providers. Moreover, police arrest a substantial number of people with behavioral health and substance use conditions, further criminalizing what are illnesses. According to SPD statistical data for 2020, officers responded to 54,245 calls for service that were not informational, test calls, or program patrols. The SPD estimates that approximately 30 - 40% of these calls involved a person with mental illness and/or substance use disorder (SUD) to varying degrees, which is somewhat higher than national trends. For these reasons, the SPD created the specialized Behavioral Health Unit (BHU), which employs a cross-system approach. RNP and the Stamford Police Department were the first to establish a law enforcement and behavioral health partnership in Connecticut, the Community Response Initiative (CRI). RNP employs a licensed, clinical Social Worker (SW) from RNP who is embedded within the Stamford Police Department and is available to go to mental health/substance use calls freeing up police officers to attend to other, more typical situations. The SW engages with the individual in crisis or at risk of crisis and seeks to redirect them to treatment. The CRI expansion responds to a significant increase in calls involving juveniles. The CRI expansion will employ a bilingual Licensed Clinical Social Worker (LCSW) and enhance collaboration with local providers that serve juveniles. The projected results of the expansion are: Additional Adult Diversions (Includes Veterans) Year 1 Year 2 Year 3 Year 4 Year 5 Total 70 80 100 110 125 485 Juvenile Diversions Year 1 Year 2 Year 3 Year 4 Year 5 Total 25 45 60 75 90 295

As an evidence-based diversion program, Building Blocks provides participants in Kankakee County, Illinois with accountability, structure and access to treatment. Assessed and diagnosed with a mental health or co-occurring disorders, participants are high risk for arrest. They progress in a voluntary continuum of residential, outpatient, medically assisted and/or aftercare treatment, enhanced by case management, self-help, education, and community support (up to 750 days). The overarching goal is to divert individuals with mental health needs from arrest and the criminal justice system, while minimizing recidivism amongst participants. Building capacity annually, the program will serve 15 participants in year one and expand to 60 participants by year five. Building Block’s goals in year one focuses on capacity building by identifying resources, hiring staff, completing a Sequential Intercept Map and creating a no-wrong-door point of entry plan. Year two through five goals become qualitative in nature, informed by the year one Sequential Intercept Map resources identification and developed recovery-oriented, trauma-informed, and equity-based baseline measures. In partnership with Kankakee County dispatch, Building Blocks will deploy a cross-trained law enforcement team with behavioral health experts to meet with individuals during a crisis. Using the Columbia scale for assessment and IRIS referral system management, the team deescalate situations and create warm hand-offs with community treatment providers. The Building Blocks’ social worker will provide wrap-around life skills, vocational, education and follow-up support. Building Blocks first admissions will focus on population health frequent fliers whom regularly present to law enforcement, social service agencies and area hospitals. Located in northeastern Illinois, Kankakee County is a 677 square mile area with a 110,024 population (70% Caucasian, 15% Black, and 11% Hispanic), a 50/50 male/female split and English/Spanish as the primary/secondary language. The county median income is $61,664 (U.S. Census, 2022) with a poverty rate of 13.4%. In 2022, Riverside Medical Center provided 1,551 adult mental health hospitalizations and 3,135 adult intensive outpatient treatment sessions (Riverside Medical Center Stat Report, 2023).

The Mobile County Partnership for Early Criminal Justice Diversion will expand existing efforts to provide diversion from arrest into immediate treatment. The program is a collaboration between criminal justice and mental health targeting four key areas that enhance law enforcement training, clinical co-response, recidivism prevention, and treatment adherence. Addressing critical gaps in the comprehensive crisis continuum promotes decriminalization of behavioral health crises. The program will enhance law enforcement training on behavioral health issues and crisis de-escalation using virtual reality technology and mental health clinical co-response. Evaluations will be both in person and through the use of clinician remote evaluation, officers carrying iPads in their patrol vehicles that connect directly to a clinician for evaluation and disposition. The expansion of the Forensic Assertive Community Treatment (FACT) Team will provide comprehensive in-home services to justice-involved individuals at high risk for recidivism by using evidence-based practices and programs to create meaningful change in the lives of participants. The program will work to ensure that participants are attending treatment regularly and remaining compliant with medication, are linked to housing, education, and employment programs to address racial, economic, and other barriers that contribute to high rates of recidivism in disparate populations. This program also creates a Homeless Outreach Team consisting of a CIT trained officer and a clinician to address the growing number of homeless individuals who need, not only housing, but also mental health and substance use services. This program will focus on adults, aged 19 and older, living with mental health and/or substance use disorders who have a criminal justice nexus within Mobile County, Alabama, regardless of ethnicity, sex, sexual orientation, or socioeconomic status. The program serves over 3,000 individuals annually and 17,000 over the course of five years, by diverting at least 50% of all law enforcement calls for behavioral health issues to immediate and appropriate treatment options rather than incarceration. It will increase training with new technology by 100% and increase access to those individuals who have contact with law enforcement, due to behavioral health issues, who have never sought or engaged in treatment, by 100% with immediate connection through the use of remote clinical response. The Mobile County Partnership for Early Criminal Justice Diversion will build on an existing collaborative relationship that started in 2019 with a multi-agency planning committee initiated during the development of the Stepping Up Initiative. Mental health, law enforcement, court personnel, attorneys, community corrections, and many other agencies began working together to address the number of individuals with mental health and substance use disorders incarcerated in Mobile County. This planning committee engaged in a recent Sequential Intercept Mapping and have been dedicated to addressing all points of intercept, particularly zero and one, in order to decriminalize mental illness and provide front-end diversion that helps individuals get the right treatment, at the right place, at the right time.

Early Diversion Worcester (EDW), a comprehensive early diversion program for adolescents, ages 14-21 who reside within 10 miles of our new state-of-the-art, secure facility. Our overarching aim is the reduction of the number of adolescents with mental illness or COD and SUD that are involved in the criminal justice system that reside in Central Worcester County. We will accomplish this through the application of a high-quality, responsive program using holistic, evidence-based practices centered on community-based solutions aligned with education support services and instituting policies that are recovery-oriented, trauma-informed, and equity-based as a means of improving behavioral health.

The Staten Island - Partnership for Early Diversion (SI-PED) is a coalition of direct service providers and representatives of the criminal justice system expanding early diversion on Staten Island for people with a mental illness of co-occurring disorder (COD). SI-PED targets inflection points that commonly lead to arrest and institutes a quicker response and assessment system, which leads to referrals into evidence-based practice early diversion programs through partners. Led by the Staten Island Performing Provider System (SI PPS), the project establishes a Behavioral Health Partnership working group among the stakeholders on Staten Island and offers multiple routes to diversion, ensuring access to early diversion services before arrest and booking, and through collaborations that ensure first contact with criminal justice systems do not lead to a permanent record. The target population will be adults with a mental illness or co-occurring disorder (COD). Staten Island is at the epicenter of the opioid crisis in New York, and expanded early diversion efforts can make a significant impact. The SI-PED strategy is to: Provide quick, effective assessments in critical points of inflection that often lead to an arrest, booking, and criminal record. Inflection points include the emergency room (which often engages with those experiencing homelessness), through emotionally disturbed persons calls, through first contact with a NYPD precinct, and through those engaging with community-based direct service providers who may be a good fit for the program. Assessments will include in-person clinical interviews and responses as well as telehealth options to ensure quick responses at all times. Make referrals into community-based, evidence-based practice (EBP) early diversion services coordinated and led by partners. Follow up with all engaged participants and ensure strategies are effective through weekly case conference meetings. Build community capacity by expanding the Behavioral Health Partnership working group. This work expands on projects that SI PPS and collaborators are already working on, including HOPE (Heroin Overdose Prevention and Education), a pre-arraignment diversion program designed to redirect low-level drug offenders with substance use disorder to community-based health services, instead of jail and prosecution, and the Hotspotting the Opioid Overdose Epidemic (Hotspotting Program), which uses data to identify at-risk individuals for an overdose and institutes preventative care. Because of these complementary, ongoing efforts, SI-PED will be able to launch quickly and effectively, expanding the scope of early diversion on Staten Island. The program’s objectives are aligned under three goals: Goal 1 - Increase the capacity of Staten Island organizations and agencies to divert and connect more adults prior to booking and criminalization by connecting agencies, nonprofits, and hospital systems across the community; Goal 2 - Increase diversion for adults from first contact with the criminal justice systems to community-based mental health and substance use disorder (SUD) services; and Goal 3 - Decrease criminalization rate leading to a criminal record in Richmond County. Project name: Staten Island - Partnership for Early Diversion (SI-PED) Project geography: Staten Island, New York; Richmond County Number served: 475 onboarded into the program, progressing by respective year from 75, to 85, to 95, to 105, to 115.

"Early Diversion through Youth Crisis Care" ("EDYCC") is a project by Oaklawn Psychiatric Center to expand its programming and collaborations to divert youth ages 8-22 with, or at risk for, serious mental illnesses or a co-occurring disorder from the formal juvenile justice system. "EDYCC's" mission is to implement and strengthen crisis response and stabilization services in Elkhart and St. Joseph counties Indiana. We will do this to keep youth from formal juvenile justice interventions and divert them to appropriate community-based mental health and substance use disorder services and other supports. Specifically, this project will address a gap in our current crisis continuum for youth by implementing a mobile crisis team who is able to dispatch into the community to meet with a youth to deescalate and stabilize the current crisis and link to ongoing care. This project will also expand upon current collaborative partnerships to enhance existing crisis services of a 24/7 phone line and emergency shelters to create a robust crisis continuum of care grounded in system of care values and principles. It is based on the youth crisis intervention framework of: "someone to call, someone to respond, and a safe place to be." Across the project, we propose to serve 510 youth averaging 102 annually. Our goals and objectives include: (1) Building collaborative partnerships among community agencies by the development of a Behavioral Health Partnership Workgroup (BHPW) through integration of the "EDYCC" program into the existing systems of care. We will do this by: (a) Developing and implementing an annual plan to divert youth away from juvenile justice (JJ) system, and (b) Adding community partners to share resources to further the goals of "EDYCC." (2) Expanding community capacity to support its ability to implement the youth crisis intervention framework of "someone to call, someone to respond, and a safe place to be." We will do this by: (a) Training community partners in an understanding of the "EDYCC"; (b) Increasing contacts with youth at risk for crisis through the Street Outreach Program; (c) Working with law enforcement and 911 dispatch to appropriately route referrals to Oaklawn's mental health Crisis Line; (d) Providing outreach to Veteran's support service organizations to promote services to young veterans in crisis as well as veterans' children experiencing crisis that will put them at risk. (3) Diverting youth from juvenile justice system to community-based culturally relevant mental health and SUD services and other support services. We will do this by: (a) Expanding awareness and utilization of the current operational 24/7 crisis lines; (b) Engaging key partners from the mental health, law enforcement and social services sectors to collaboratively implement a mobile crisis response program for youth with behavioral health needs that will result in a reduction in law enforcement calls and increase timely access to appropriate care; (c) Implementing an evidenced based screening process (CAT) for identifying youth in crisis with behavioral health needs, so identified individuals (especially from groups disproportionately over-represented in JJ referrals) will have access to timely and appropriate mental health interventions/support; (d) Coordinating with partners to maintain dedicated safe space "facilities" for youth with behavioral health needs, ensuring participants feel safe and supported during their time in the program; (e) Implementing a crisis continuum of care for youth with behavioral health needs in crisis, that links individuals to ongoing therapeutic interventions; and (f) Establishing and implementing a comprehensive follow-up care program following a crisis incident.

The New York City Department of Health and Mental Hygiene, in collaboration with well-established community organizations and agencies such as RiseBoro, Christopher Rose Community Empowerment Campaign (CRCEC), Maimonides Medical Center, Interborough Developmental and Consultation Center, and an Early Diversion Partner, seeks funding under NOFO # SM-23-012 for the Partnerships for Early Diversion of Youth (PEDY) program. PEDY aims to build equity-informed community capacity in Brooklyn neighborhoods that have been identified by the NYC Taskforce on Racial Inclusion & Equity (TRIE) as among the hardest-hit communities post-COVID, with significant health and social disparities. PEDY is designed to divert diverse youth, aged 13-21 years, from the juvenile justice system to community-based mental health, substance use disorder (SUD), and other support services. Studies indicate that a substantial number of youths in detention or correctional settings have diagnosable mental health problems. Central Brooklyn youth face a higher risk of involvement in the criminal justice system and encounter significant barriers to accessing mental health and social support. Collaborative partnerships and community capacity-building are crucial for supporting youth and reducing health and social disparities. The NYC Department of Health and Mental Hygiene, in coordination with its partners, is well-positioned to lead efforts in enhancing cooperation and coordination of care for justice-involved youth in Central Brooklyn. Premised on evidence that diversion programs are more effective than traditional judicial interventions in reducing recidivism rates; the PEDY program aims to reduce the number of youths with behavioral health challenges or COD that are involved in the juvenile justice system in Central Brooklyn neighborhoods. The PEDY program aims to serve a total of 225 youths with mental health concerns or co-occurring disorders (COD) who are at risk for or already involved with the juvenile justice system in Central Brooklyn neighborhoods such as Bushwick, East Flatbush, Bedford Stuyvesant, Brownsville, and East New York. . The specific goals of the PEDY program are as follows: 1. Connect up to 225 at-risk youth to evidence-based and community-based mental health and substance use disorder services by September 2028. 2. Develop a comprehensive plan of evidence-based and community-based mental health services using a multi-agency approach to divert youth prior to arrest or booking. 3. Reduce the number of contacts youth have with the juvenile justice system by September 2028. 4. Conduct juvenile justice early diversion community system mapping to identify diversion opportunities, potential partners, and desired outcomes. 5. Expand and integrate existing mental health, substance use treatment, and recovery support services into the Early Diversion program. 6. Increase cross-system collaboration, coordination, and sustainability among New York City agencies and five community-based organizations by September 2028. Through the PEDY program, the New York City Department of Health and Mental Hygiene aims to make a significant impact on diverting at-risk youth from the juvenile justice system and improving their access to essential mental health and support services. The collaboration between the lead agency, community organizations, and agencies will enhance coordination, increase equity, and reduce health and social disparities in Central Brooklyn neighborhoods.

The West Virginia Youth Early Diversion Behavioral Health Partnership will foster collaboration among state partners to develop or enhance processes to divert youth and young adults up to age 25 with mental illness or co-occurring disorders from the juvenile justice and criminal justice systems to expanded, culturally responsive community-based behavioral health services. This work will build upon state efforts to effect youth behavioral health threat assessments, school discipline reform, and improved access to behavioral health services. It is estimated that 100 youth and young adults will be served per year for a total of 500 individuals over the course of the five-year grant.

During the five-year grant period, Bluebonnet Trails Community Services (BTCS) seeks to serve at least 1,125 adults and youths who are at risk of criminal justice system involvement due to mental illness or co-occurring disorders. In our Central Texas service area of Caldwell, Gonzales, and Guadalupe Counties, the award will fund multi-disciplinary crisis response teams to assess an average of 225 persons annually and divert them from arrest into behavioral health care when appropriate. We aim to achieve two project goals: 1) increasing pre-booking jail diversions for persons experiencing a mental illness or co-occurring disorder to reduce preventable arrests and unnecessarily lengthy incarcerations, and 2) increasing access to evidence-based behavioral health services to reduce the risk of crisis relapse or future offending. To fulfill goal 1, BTCS has identified three coinciding measurable objectives: 1) establish an Interagency Behavioral Health Workgroup (comprised of law enforcement, local emergency departments, psychiatric hospitals, health care providers, specialty courts, juvenile justice and child advocacy agencies, community shelters, Veteran-serving organizations, and first responders) to meet on a quarterly basis to advance early diversion strategies in the service area; 2) train 75 law enforcement officers/deputies, dispatchers, attorneys, civilian first responders, paraprofessionals, Veteran-serving organization personnel, and other professionals each project year on the signs and symptoms of mental illness and substance use, culturally appropriate de-escalation and crisis resolution techniques, and diversion resources; and 3) track the number of persons diverted from arrest due to this project and ensure a five percent increase in diversions each year. To fulfill goal 2, BTCS has identified two coinciding measurable objectives: 1) coordinate a regional Sequential Intercept Mapping (SIM) exercise for Caldwell, Gonzales and Guadalupe County stakeholders to map existing and future early diversion resources; and 2) build a data report in our electronic health record to track and report the number of persons assessed and connected to treatment, along with demographic information to ascertain local disparities and targeted diversion strategies. Based on assessed needs, multi-disciplinary response teams will connect persons with a variety of trauma-informed and evidence-based services, including case management; assertive community treatment; medication management, peer recovery support; supported housing, vocational training, supported employment; care coordination; primary and dental care; substance use treatment (including medication assisted treatment); Multisystemic Therapy (MST) for at-risk youth, and 24-hour respite programs for adults or youth. Bluebonnet Trails Community Services will also provide psychiatric rehabilitation and life skills training using evidence-based curricula such as Illness Management Recovery (IMR), Assertive Community Treatment (ACT), and Seeking Safety. Case managers serving youth will receive training in Skillstreaming, Seeking Safety, Wraparound, Nurturing Parenting, and Preparing Adolescents for Young Adulthood (PAYA).

The Behavioral Health Partnerships for Early Diversion of Youth and Adults Program will serve people ages 10 and older who experience behavioral health crises in Southwest Idaho. Southwest District Health (SWDH), Pathways of Idaho, and Washington County will partner to reduce law enforcement and justice system involvement, increase access to crisis care and promote healing and recovery and improve first responder's response to behavioral health crises in SW Idaho. Southwest (SW) Idaho is rich in agriculture, rural living, and cultural heritage. Despite the strengths of SW Idaho communities, behavioral health crises and access to proper crisis care remains a challenge. In Idaho, people experiencing a major behavioral health crises can be housed in a state prison, even if they have not committed a crime. Many more people spend time in county jails for behavior exhibited during a mental health crisis, often being asked to choose between jail or community service, which is not always feasible when in crisis. To divert people experiencing a behavioral health crisis from the justice system to appropriate levels of care, it is imperative to involve law enforcement in the solution and build partnerships where crisis intervention services are the easy and default choice for community members and first responders. Pathways of Idaho, the operating provider for SW Idaho's youth and adult crisis centers, will implement early diversion programming into crisis stabilization services and integrate into after-care planning. SWDH will partner with the Idaho Department of Health and Welfare and other SWDH programs to train law enforcement and other first responders on how to respond effectively to behavioral health crises, when awaiting or transitioning to a different level of care. These training courses include Crisis Intervention Training, QPR (Question, Persuade, Refer), and Mental Health First Aid. SWDH will also promote early diversion programming and crisis center services via a digital and social marketing campaign to increase awareness of services that can be chosen before involving law enforcement for behavioral health crises. Additionally, to reduce the burden of behavioral health crises on traditional first responders and promote appropriate access to behavioral healthcare, SWDH proposes working with Washington County to develop a Psychiatric Evaluation Team community paramedic program. It is anticipated that the activities of this early diversion program will reach almost 8,000 youth and adults over the five-year project period. Pathways of Idaho and Washington County are committed to the success of these efforts and Region 3's Mobile Response Teams are eager to support the proposed activities in this grant application. Throughout the duration of this project period, we expect to see increased referrals from established community partnerships and the general community to the community crisis centers, increased confidence from first responders to effectively respond to behavioral health crises, prevent future crises, and sustainability of long-term diversion from law enforcement and justice system involvement. Collaboration between the Project Director, Project Evaluator, Pathways of Idaho, justice-involved partners, and non-justice-involved partners will support the accurate and timely reporting of data that showcases diversion from costly and ineffective resources towards appropriate and effective behavioral health crisis services.

The Fulton County Department of Behavioral Health and Developmental Disabilities (DBHDD), in partnership with the Fulton County Juvenile Court (FCJC) and Fulton County Schools (FCS), proposes this Youth Diversion Program (YDP) to provide early diversion services to 1,080 youth with a mental illness or co-occurring disorder (COD) who are involved with, or at risk of being involved with, the justice system. YPD will target middle/high school children aged 13-18 attending schools in South Fulton County, Georgia. DBHDD and its partners propose this YRD program to provide adolescents in the service area with an evidence-based intervention to receive support for mental health concerns, reduce or prevent involvement with the justice system, stop the escalation of community violence, and restore peace within schools to promote a safe learning environment for all students. YDP will serve 900 unduplicated youth through the Risk Reduction program and 180 unduplicated youth through the Diversion program for a total of 1,080 youth. YDP’s goals and objectives are as follows. Goal 1: Increase the number of moderate-high risk youth with a mental illness/COD, ages 13-18, successfully diverted from justice systems into the Diversion program. Objectives: (1a) Enroll 180 moderate-high risk youth in the Diversion program; (1b) 65% of youth will successfully complete the program and meet goals identified in Individualized Service Plans (ISPs); (1c) 60% of youth will not recidivate back into the program; (1d) 60% of youth will be connected to community resources. Goal 2: Increase the number of moderate-high risk youth with a mental illness/COD, ages 13-18, diverted from justice systems into the Risk Reduction program. Objectives: (2a) Enroll 900 youth in the Risk Reduction program; (2b) 80% of youth will successfully complete the program and meet goals identified in ISPs; (2c) 60% of youth will not recidivate back into the program; (2d) 70% of youth will improve school attendance. Goal 3: Assess/address the mental health, substance use, and/or treatment needs of enrolled youth. Objectives: (3a) Develop a comprehensive plan of services to be provided/referred to enrolled youth; (3b) Each youth provided a customized ISP; (3c) Provide mental health/case management services to 1,080 youth based on ISPs; (3d) 90% of youth will demonstrate a 30% increase in positive social functioning, family involvement, school attendance/engagement/performance, and community connection. Goal 4: Improve the community’s capacity to support the early diversion of youth with a mental illness/COD from justice systems to community-based services. Objectives: (4a) Integrate YDP into existing system of care by establishing/facilitating a new Behavioral Health Partnership Workgroup (BHPW); (4b) Recruit 8-10 partners to serve on BHPW; (4c) Conduct community system mapping; (4d) Develop, implement, and oversee a comprehensive strategic plan to divert youth with a mental illness/COD to community-based services. Goal 5: Increase the capacity of professionals to effectively respond to youth experiencing mental/behavioral health challenges. Objectives: (5a) 475 professionals trained on mental health/substance use challenges among youth; (5b) 75% of professionals report increased knowledge of how to identify/address mental health/substance use challenges among youth; (5c) 75% of professionals identify applied skills including de-escalation, diversion, and crisis resolution practices; (5d) 75% of professionals exhibit confidence in their ability to assist youth experiencing behavioral health challenges. Goal 6: Expand the availability/quality of diversion services for youth. Objectives: (6a) Expand YDP by engaging additional partners and integrating existing services into referral network; (6b) Develop a sustainability plan to continue/expand YDP.