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SAMHSA Treatment Drug Courts (NOFO No. TI-23-007) San Joaquin DUI Court Expansion PROJECT ABSTRACT SUMMARY Superior Court of California, County of San Joaquin (SJ-Co), proposes to expand the Driving Under the Influence (DUI) Court. The focus population is defendants with high criminogenic risk factors and high substance abuse treatment needs. This includes co-occurring substance use and mental health disorders and opioid addiction as the geographic catchment area SJ-Co, population 789,410, 1 experiences an opioid epidemic of increased use and related deaths. DUI Court proposes to use its existing coordinated, assessment-based, multi-system approach that integrates the court’s power to hold participants accountable with an array of substance abuse and mental health treatment, and other wrap-around services provided by agency partners. DUI Court also proposes to expand its continuum of services, including HIV and Hepatitis B and C testing access, MAT treatment, recovery housing and a peer mentor recovery support group. Goals and objectives are as follow: GOAL 1: Increase DUI Court capacity in order to effectively treat a greater number of HRHN defendants, including those with co-occurring SUD and mental health disorders. Objectives: Serve 100 unduplicated individuals annually; assess 100% of participants for criminogenic risks and treatment needs using an evidence-based tool. GOAL 2: Expand access to treatment and services in a coordinated, assessment-based, multi-system approach to decrease recidivism among offenders and increase offender success. Objectives: achieve a 12% recidivism rate or lower rate among participants in program; achieve at least a 70% graduation rate or higher rate among participants; provide referral to 100% of at-risk participants for HIV, Hepatitis B and C testing; ensure 100% of participants prescribed medicated assisted treatment (MAT) are provided referrals for the treatment and support to use MAT and mental health services; assess 100% of participants for treatment level with American Society of Addiction Medicine criteria; refer 100% of participants to substance abuse treatment through partner resources; refer 100% of identified participants needing treatment for mental health disorder and co-occurring disorders to partner resources. GOAL 3: Expand recovery support services to improve habilitation and long-term success among participants. Objectives: provide recovery housing in a sober living environment to a minimum of 15 participants using SAMHSA grant funds; distribute 500 1-day bus passes to participants without transportation; distribute 300 $10 gift card incentives for positive progress, 100 $10 gift card graduation incentives, and hold an annual graduation ceremony to celebrate completion of DUI Court; establish a pilot Peer Mentor Group and peer mentor training program; conduct training session for all new peer mentors; link at least 15% of participants to a peer mentor who is trained by ADC; and link 100% of participants to employment development services, such as job searches, training, education, resume-writing or other services. 1 U.S. Census Bureau QuickFacts (Updated 2021)

The Enhanced Bridge to Success Project is the continuation of Clark County Circuit Court #4 Family Recovery Court's dedicated efforts to more effectively reach and help heal families traumatized by drug addiction by assisting parents to become productive citizens as they strengthen their families. Our goal is a reality-based vision: Parents will engage in quality parenting skills to reunite with their children, while becoming clean and sober by addressing addictions, healing from co-morbid mental health diseases, and effectively managing the traumatic influences that have ravaged their lives. We will reach a minimum of 35 additional participants annually (total 175 parents), their children, and extended family members in order to significantly increase the number of children that will be reunified with their clean and sober parents. Measurable objectives focus on this mostly rural, southern Indiana county where outside-of-home placements of children reached 35.2% in 2022. More than 60 service providers collaborate with the Court on our objectives to restore families through respect and keen awareness of needed services, e.g., job training, affordable housing, life skills, educational attainment, healthy alternatives to illegal and misused drugs, and wraparound services that lead this vulnerable population to become responsible, caring citizens of their community.

They City of Dallas is seeking SAMHSA funding to expand the South Dallas Drug Court (SDDC) through providing expanded services for adults and graduates of the program, and by creating a second docket at the primary Municipal Court location in downtown Dallas. The target population for this expansion is persons aged 18 or over, who are diagnosed with substance use disorder (SUD) as their primary condition and who are referred to the SDDC for adjudication and processing to promote treatment, instead of incarceration. The total request for a 5-year period is $1,931,540. Dockets will be located at the Downtown and SDDC locations to provide greater connection to those high-risk, high need individuals. These locations are nearby various shelters, social service agencies and will alleviate transportation barriers. Participants are eligible for the SDDC program if they have a SUD and/or co-occurring disorder and a City of Dallas Class C misdemeanor citation. The goals and objectives for the expanded project are as follows: Goal 1: Increase the capacity of the SDDC to reduce criminal recidivism that may contribute to substance use disorder and other health factors. Goal 2: Increase the number of individuals assessed through the SDDC by 25%. Goal 3: Increase the number of program graduates by providing a continuum of care, including prevention, harm reduction, treatment, and recovery services for individuals with SUD. Goal 4: Ensure graduates are self-sufficient long term by implementing supervised post-graduate case management services. The expanded dockets are designed to identify eligible participants early, and place them in the treatment drug court program the day they are arraigned and enter a plea of guilty or no contest. The program requires intensive supervision based on frequent alcohol and drug testing and court appearances, along with tightly structured regimes of treatment and recovery services, permitting the program to actively support the recovery process and react swiftly to impose appropriate therapeutic sanctions or to reinstate criminal proceedings when clients cannot/will not comply with the program. SDDC will assess 65 clients per year for Year 1 and Year 2, an increase of 25% of current activities, and SDDC will assess 80 clients per year for Years 3 – 5, an increase of 25% from Year 1 and Year 2.

Expand Substance Use Disorder Treatment Capacity in Adult Drug Court. The intention from this grant request is to serve 94 participants per year and to accomplish four primary objectives: (1) to enhance equity and inclusion within our drug court program, (2) to reduce disproportionate outcomes for historically disadvantaged populations, (3) to enhance the utilization of incentives for successful participant outcomes, and (4) to provide increased access to a full continuum of care for participants. Omaha, Nebraska, located in Douglas County, is the largest urban community in a State that is predominantly rural. Omaha has persistent health and economic disparities, as indicated by disproportionately high poverty and unemployment rates among non-white residents (U.S. Census Bureau, 2018). The Douglas County Adult Drug Court currently serves 130 active participants. Of these participants; 68% identify as White/Caucasian, 23% identify as Black or African American, 4% identify as Hispanic, and 1% identify as either Asian/Pacific Islander, Native American, or Other. Objective 1: One of the primary and most significant barriers to accessing the courts is the language barrier. At this time, the Douglas County Adult Drug Court does not employ bilingual staff to serve this population. Without access to appropriate language or translation services, the Adult Drug Court will be unable to serve a growing population of residents. Upon being awarded the grant, we would like to purchase the Pocketalk translators, which are HIPAA compliant and serve 87 different languages. Objective 2: Since 2018, The Adult Drug Court has unsuccessfully discharged 198 clients from services. These discharges took the form of program termination, voluntary withdrawal, and clients who absconded (and remain in warrant). For the purposes of this grant request, the young (ages 18-31) Black/African American population was examined in comparison to all other ethnic groups. Of those who were unsuccessfully discharged/absconded, 19% fell into this demographic. In comparison, only 5% of successful graduates were members of this demographic. Such disparate outcomes reflect the need to incorporate measures to address the needs of this population to ensure an equitable rate of success. We plan to enhance programming by incorporating the use of the HEAT/HER Curriculum. This curriculum is an evidence-based curriculum, which is supported by the National Association of Drug Court Professionals (NADCP). Objective 3: The Adult Drug Court is seeking to enhance the utilization of tangible incentives in combination with those that are intangible. The barriers to operationalizing this goal have been two-fold: the court currently cannot financially support the purchase of such incentives to provide to participants and does not have the needed infrastructure to accept donations. In response to these barriers, the Court is requesting funding from this grant to purchase tangible incentives. Funding will allow the court to purchase tangible incentives immediately, allowing them to implement these Best Practice Standards in order to promote success for current participants. Secondly, funding will allow the court to explore strategies for sustainability through the development of a 501(c)3 to accept community donations or by requesting such funds as part of the annual budget. Objective 4: The coordinator identified current gaps within the continuum of care. The primary gap identified was in the provision of anger management courses for the participants. It was identified that a significant number of participants have either requested such services or the need for such has been identified during the course of the program. Anger management courses do exist within Douglas County. However, certified courses cost the participant $120, as such services are oftentimes not covered by insurance. The Court is needing to offer a nine-hour anger management course free of charge for all participants.

AADAP’s Drug Court program aims to expand access to care and treatment services for individuals who are within the geographic catchment area of South Los Angeles, Inglewood, and Long Beach (SPA 6 & 8) and eligible under the Inglewood Drug Court, and Long Beach Mental Health/Collaborative Court programs. Over the course of the project, AADAP will aim to serve 400 Court Referred Participants, providing increased access to Substance Use Disorder (SUD) services whilst adding at least one more Drug Court to the program in the final program year. In addition to increased access to SUD services, including mental health, medical services, housing, family therapy, employment/job readiness and training, and other supportive services, the following goals will also be attained: -Increased language access, with culturally specific and culturally competent SUD treatment services. -Improved retention and completion rates in the Drug Court and Mental Health/Collaborative Courts. -A reduction in recidivism into the criminal justice system, with reintegration as productive members of the community. Furthermore, AADAP will increase the number of bilingual and diverse SUD Counselors, training them in culturally and clinically supported evidence-based practices to promote engagement, retention, and sustainable change-behavior in treatment. Using the American Society of Addiction Medicine (ASAM) to assess for SUD DSM Diagnosis and appropriate level of care, upon enrollment, treatment plans and goals will be collaboratively created with clients and their SUD Counselor. The program will also offer additional services such as primary healthcare, Medication-Assisted Treatment (MAT), and psychiatric care. The program's Project Director will oversee and supervise the Court Liaisons and SUD Counselors, strengthen relationships with court officials and treatment providers while representing the project in various networking and planning meetings. Bilingual SUD Counselors will serve as clinical case managers, providing a therapeutic responsibility that promotes continuity in care and engagement, offering concrete outcomes for tangible progress in the recovery process. The program aims to ensure equitable access to drug courts for racial, ethnic, sexual, and gender minority groups.

ABSTRACT Project Name: The Epiphany-FTC Project is a proposed partnership between Mt. St. Joseph-St. Elizabeth (dba Epiphany Center) and San Francisco Superior Court’s Family Treatment Court (FTC) in order to expand and enhance outpatient substance use disorder treatment to parents participating in FTC. The Project will ensure timely access to a high-quality continuum of care to improve abstinence, health, mental health, housing, social connectedness, parent-child relationships, and reduce involvement in the criminal justice and child welfare systems. Population to be Served: The Project will serve underserved families involved in San Francisco’s child welfare/juvenile dependency system who are impacted by parental substance use and co-occurring disorders. These families are estimated to be more than 60% of all FTC / child welfare cases. Eighty-one (81%) of parents enrolled in FTC identify as female; 19% identify as male. The primary race/ethnicity of enrolled parents in both FTC and Epiphany is as follows: 44% White, 25% Black, 19% Hispanic, 9% Asian/Pacific Islander, and 3% Native American. Approximately 98% of families live below the poverty line. Fifty-one percent (51%) of children served by FTC are 0-12 months old, and 79% are 0-5 years old. Thirty-nine percent (39%) of children were placed in home at FTC enrollment, while 61% were placed out of home. Strategies/Interventions: The Project will enhance outpatient services by providing effective, trauma-informed, evidence based recovery groups, and parenting education to improve parent-child relationships. Life skills groups will build skills in the areas of employment, food security, and healthy life styles. Comprehensive case management will work toward an end to behavioral health disparities by increasing access to resources in medical and mental health, and housing. Project Goals and Objectives: Goal #1: Parents participating in the Project will attain a substance free, self-sufficient lifestyle. Objective 1.1: Of parents referred to the Epiphany-FTC Project, 90% will be assessed for treatment needs within 3 days of referral. Objective 1.2: Of parents referred to the Project, 90% assessed to be appropriate for outpatient treatment will begin outpatient services within one week of the initial assessment. Objective 1.3: By the 6th month of treatment, 60% of participants in the outpatient recovery groups will show increased recovery and relapse prevention skills as measured by the Adult Strengths and Needs Assessment (ANSA) domain: Substance Use and Involvement in Recovery. Goal #2: Parents enrolled in the Epiphany-FTC Project will have improved relationships with themselves, their children, their families, and their communities. Objective 2.1: By the 6th month of treatment, parents enrolled in parenting groups will demonstrate improved confidence in understanding of their child’s behavior as measured by ANSA domains: Parental/Caregiving Role, Family Functioning, and Optimism. Goal #3: Parents enrolled in the Project will overcome health disparities and live healthy lives. Objective 3.1: By the 6th month of treatment, 75% of participants will obtain and utilize a high quality primary health care provider for themselves and their children as measured by treatment plan objectives for medical health. Objective 3.2: By the 6th month of treatment, 75% of participants will have reduced risk for homelessness, food insecurity, as measured by treatment plan objectives for housing/basic needs. Numbers to be Served: The Project anticipates serving 40 participants in year 1, 50 per year in the following 4 years for a total of 240 participants.

In2Action’s Treatment Court Enhancement Project (TCEP) will increase the long-term success rates for adult men and women diagnosed with a substance use disorder participating in the 13th Judicial Circuit Treatment Court by scaling evidence-based recovery support services in Boone County, MO. An average of 54 people per year with a total of 270 will be served over the life of the project. Participants in the Adult Drug Court, Co-Occurring Track, DWI Track, Mental Health Court, and Veterans Treatment Court will receive enhanced services which fill identified gaps in the Trauma-informed Recovery Oriented System of Care (TI-ROSC) which are sustainable and expected to provide a positive return on investment long after grant funding expires. The goals of the in2Action-TCEP are to (1) mitigate the negative consequences of a recurrence of SUD symptoms among treatment court participants; (2) increase opportunities for long-term recovery for treatment court participants and (3) promote pro-social behaviors among treatment court participants in recovery housing. The measurable objectives are to (1) increase re-engagement in recovery by 80% in respite participants compared to treatment baseline data measured at 5 days post recurrence; (2) reduce positive drug screens to less than 10% for all current Level-1 and Level-2 recovery housing residents and (3) increase Recovery Capital by an average of 50% over two months as measured by BARC-10. The project will utilize multiple evidence-based and promising practices to achieve these goals including: (1) Adult Drug Court best practice standards combined with enhanced recovery support services that focus on increasing (2) Recovery Capital including (3) Accredited Recovery Housing provided by (4) Certified Peer Support Specialists. (5) The Habilitation Empowerment Accountability Therapy (HEAT) program will ensure that special attention is given to populations that are disproportionately represented in the treatment court including black and African American participants. The success and impact of the project will be measured though a formal evaluation conducted by the University of Missouri-Columbia.

Lutheran Family Services proposes to expand substance use disorder (SUD) treatment and recovery support services to adults in existing drug courts in Nebraska’s Douglas and Sarpy counties, including Douglas County Veterans Treatment Court, Sarpy County Drug Court, and Sarpy County Wellness Court. Each court serves individuals assessed as high risk for recidivism and require a high level of need to stabilize and avoid reoffending. Access to healthcare services is a major issue in both counties. Gaps in mental health services, particularly in relation to depression/chronic depression, suicide prevention, social support, obtaining mental health services, housing insecurity, loss of utilities, unhealthy/unsafe housing, and substance abuse. Neither the Douglas County nor Sarpy County court system employees mental health service providers but depend on community-based providers for the court-involved. Court teams will be comprised of a judge, defense attorney, probation staff, and LFS project personnel including a peer recovery support specialist (with lived experience), care and service coordinator, licensed practical nurse, therapist, and psychiatric prescriber. When possible, the court team will also include a member of law enforcement. The project will provide timely access and recommendations to co-occurring assessment. LFS will provide behavioral health services to court participants including outpatient and intensive outpatient substance use treatment, mental health counseling, medication management, and medication assisted treatment (MAT) for opioid use disorder. Following a prescreening process, eligible participants will be identified early and promptly placed in the treatment court program. Abstinence will be monitored by frequent alcohol and other drug testing. The court team will review participant progress on a weekly basis during team meetings and use email to communicate important changes between team meetings. The Veterans Treatment Court will recognize compliance and progress using challenge coins to show transition from one program phase to another, and the drug court will recognize compliance and progress using a phase system which requires completion of specific program tasks and a contingency management system to recognize growth from week to week. Monitoring and evaluation will measure the achievement of program goals and gauge effectiveness and whether the court program was designed in line with best practice standards. Forging partnerships among drug courts, public agencies, and community-based organizations will generate local support and enhance drug court program effectiveness. This will result in a reduction in substance use behaviors and participants’ increased ability to live a balanced and productive life.

The 22nd Judicial District Intervention Court is an established adult drug court in rural Mississippi applying for funding to expand and enhance the continuum of care for substance abuse treatment beyond residential treatment to include more directed aftercare treatment that incorporates increased accountability. This Intervention Court serves three counties: Claiborne, Copiah, and Jefferson. All three of these counties have poverty rates over 35% as some of the highest in the state of Mississippi. The goal of the Intervention Court is to increase access to necessary treatment and support to the participant within this program who have met the Miss. Code Ann. §9-23-1 through §9-23-51 for offenders who are addicted to illicit drugs or alcohol and are at substantial risk for reoffending or failing to complete a less intensive disposition, such as probation or pretrial supervision. The gap in services has a direct impact on the program success level and the implementation of the following objectives will support the program to increase from 26 participants currently to 40 new participants in the first grant year. The objectives read as follows: (1) Internal Clinical Assessments and Recommendations, (2) Relapse Prevention Group Program, (3) Access to Individual Therapy, (4) Update Assessment tools throughout program, (5) Referral and follow up with Medicated Assistance Program, and (5) Increased salaries where applicable for Treatment Counselor/Grant Administrator to meet increased program needs servicing the community. These necessary resources have long been associated with individuals success rate to reduce recidivism and improve the standard of living in the communities being directly supported.

North Suffolk Community Services proposes a five year Treatment Drug Courts initiative aimed at strengthening and expanding existing collaborations with seven eastern Massachusetts Treatment Court, including six Drug Courts in Chelsea, Lynn, East Boston, Charlestown, Malden and Dorchester as well as a Mental Health Court in Chelsea. The NSCS Drug Court Program will increase access to addiction treatment and recovery support services for Treatment Court participants in the identified Courts, ensure regular Clinical and Recovery Coach participation on Treatment Court teams and expand the continuum of treatment and recovery support service availability for participants aimed at fostering long term recovery and reducing recidivism. Recovery Coaches will conduct the GPRA interviews in English or Spanish, making every effort to ensure language concordance between the Coach and participant. The Addictions Division Administrative Assistant enters the GPRA data into SPARS.

The Williamson County Veteran Treatment Court (WCVTC) will expand the services of the Williamson County Veteran Treatment Court (VTC) to provide eligible veterans judicially monitored support and rehabilitation through comprehensive substance use disorder (SUD) and co-occurring mental health disorder (COD) services. Among the 289 individuals in jail in Williamson County in the most recent one day snapshot, 29 are estimated to be Veterans, with 4 (14.7%) expected to have a Substance Use Disorder. Focus population demographics are expected to mirror current WCVTC client demographics with 82% White, 13% African American, and 5% Hispanic. The geographic catchment area of the 21st Judicial District lies south of the state capital of Nashville, and includes the cities of Franklin, Brentwood, and Nolensville, and is characterized by a high cost of living and few resources for those in poverty, including only one temporary homeless shelter and no permanent shelters. SUDs and mental health disorders resulted in more hospitalizations among U.S. troops in 2008 than any other cause (SAMHSA, 2014). Nearly 13% of Veterans are referred to counseling for alcohol use, and 15% report using opioids as compared to 4% of the general population (NIH, 2014). An estimated 82-93% of Veterans with an SUD has a COD and is 3 to 4 times more likely to have a PTSD or depression diagnosis (Teeters et al., 2017). Despite having substantially higher rates of SUD than the general population (9% vs. 6.7%), Veterans accounted for only 3% of SUD treatment admissions in 2016 (TEDS, 2016). While catchment area poverty levels are below state average (4.6% vs. 16.7%), the current WCVTC population far exceeds both at 24% (U.S. Census, 2017; WCVTC, 2020). Homeless Veterans experience SUD (70% vs. 7%) and SMI (45% vs. 41%) at higher rates than their non-homeless peers (Olenick et al., 2015). Nearly 22% of WCVTC participants reported being homeless at some point; the remainder reporting having inefficient or transitional housing. Minorities comprise 17% of the area’s Veteran Drug Court participant population but only 10% of the catchment area. African Americans use behavioral health services at half the rate of whites, leaving 13% of the area’s Veteran Drug Court individuals at risk of not receiving needed treatment (NAMI, 2018). WCVTC will implement program activities in order to expand SUD/COD and other social services to criminal-justice involved Veterans resulting in decreases in negative behavioral outcomes (e.g., recidivism). WCVTC will serve a total of 190 Veterans over the project period; while this is below the minimum expectation, it aligns with the current area focus population size and need and expands the program over the 5 year period. The program has achieved high levels of success and will continue to do so with increased staff capacity, expanded treatment services, and drug testing capabilities. Staff has formed community partnerships that have laid essential ground work to expand needed services to the Veteran population in the geographic catchment area.

The Judiciary of Guam’s FY2023 SAMHSA Guam Family Recovery Program (GFRP) will be implemented in collaboration with the single state agency for mental health and substance use treatment – Guam Behavioral Health and Wellness Center (GBHWC) and the Department of Public Health and Social Services Child Protective Services (CPS). Under the proposed FY2023 SAMHSA GFRP services will be initiated upon identification of substance use by parents in the child welfare system and who are referred to GBHWC for clinical assessment and intervention. The target population is parents involved with Guam’s child welfare system and have a Person In Need of Service (PINS) dependency case filed against them for child abuse and/or neglect. One hundred-thirty (130) unduplicated parents will be served over the project period – 20 served in Year 1 and Year 2, 25 in Year 3, 30 in Year 4, and 35 served in Year 5. Demographic information of participants that engaged with the GFRP, include: 77.1% were female and 22.9% were male; 8.3% were aged 18-24 years; 54.2% were aged 24-32 years; 33.3% were aged 35-44%; 2.1% were between 45-54 years and another 2.1% in the 55-64 age group. In terms of race, 79.2% were Native Hawaiian or Other Pacific Islander; 4.2% were Asian; 4.2% were Multiracial; 2.1% were Caucasian; and 10.5% reported other race. Program eligibility includes voluntary parents whose children are subject to a PINS case where the parent’s substance use disorder is a factor in the neglect or abuse of the children. To provide increased participation in and access to treatment for parents and children, GFRP staff will collaborate with key partners to identify and assess parents and children in need. Validated screening and assessment forms will be used to assess for substance use and addition, mental health disorder, and risk-needs-responsivity. A community-based substance use treatment provider will be contracted to facilitate group and individual treatment sessions for mothers and fathers using evidence-based practices such as the Matrix Model, Moral Reconation Therapy, and Helping Men Recover/Helping Women Recover. The project will also enhance family-centered trauma-informed programs that are critical to serving the needs of the family unit. Recovery supports include peer recovery support services, recreational therapy, wrap-around support services, and implementation of a family drug court alumni support group on Guam. The goal of the FY 2023 SAMHSA GFRP is to strengthen and reunite families by providing collaborative, culturally respectful, family-oriented services and treatment through increased judicial oversight. Objectives to meet this goal are, to commence services immediately upon receipt of the grant and serve a target of 130 parents at the end of the project period; by the end of Year 1, 80% of all families (parents and children) will be enrolled in or avail of at least one substance use treatment, evidence-based program identified as a need in the family service plan agreement; by the end of Year 1, 100% of parents will have access to and avail of wrap-around support services; and increase FDC staff capacity to adhere to fidelity of FDC best practices through evaluation and by providing at least one training opportunity to the FDC team per budget year. Staffing meetings with GBHWC, CPS and treatment providers ensure collaboration and coordination in support of the FDC. All partners have committed to sharing information. Performance measurements and evaluations are done to ensure continuous program improvement.

The Cleveland County Wellness Court is eager and ready to expand our evidence based practices and reduce barriers to accessing co occurring treatment to all individuals and families who need them. Through this project funding, we will serve at least 40 participants annually from Cleveland and McClain Counties, two growing counties located within the Oklahoma MSA with a combined geographic area of 1,138 square miles and a diverse population totaling 290,261 according to the 2010 census. The demographic breakdown of both counties with 81.7 identified as White, 9.2 percent as Native American, 7.3 percent as Black and a 1.7 percent of steadily growing population of Asian and other races, ODMHSAS PICIS FY19. The Cleveland County Wellness Court serves a diverse participant population where 22 percent of current participants are veterans. 52 percent of participants identify as white, 13 percent of participants identify as Native American, 13 percent of participants identify as Hispanic, 13 percent of participants identify as mixed race, and 9 percent of participants identify as black according to COCMHC agency records. The treatment program and multidisciplinary team will ensure the participants served by the Cleveland County Wellness Court receive best practices, competent and quality care. Our multidisciplinary teams are educated in and will continue to provide services using the most up to date best practice standards. The Cleveland County Wellness Court partners with the Judiciary, the District Attorney office, the Oklahoma Department of Mental Health and Substance Abuse Services, ODMHSAS, Central Oklahoma Community Mental Health Center, COCMHC, private defense counsel, Oklahoma Court Services, OCS, and local law enforcement to best address all participants needs. Since 2006 the Cleveland County Mental Health Court has provided co occurring services to participants with co occurring disorders who are involved in the criminal justice system. We seek to reduce barriers, increase the success rate of our participants, and reduce the number of years our participants spend incarcerated. Expanded substance use disorder treatment will also benefit our participants by giving them the tools to reduce relapse and overdose risk, reduce substance use disorder and mental health related hospitalizations, improve mental and physical health outcomes, create expanded support systems, and improve community involvement. COCMHC has served vulnerable adults with mental health and substance use disorder treatment needs of Oklahomans for 52 years. As the first mental health facility built in the United States after the Community Mental Health Act of 1963, COCMHC has progressively embraced evidence-based practices through our adult outpatient, child and family services, Program of Assertive Treatment and Medication Assistance Treatment, adult mobile crisis team, and their CARE for KIDS Mobile Response Team programs. Additionally, COCMHC and the Cleveland County Wellness Court have maintained remarkable partnerships with other service organizations in our community to best remove service gaps as well as avoid duplication of efforts. This funding will allow expansion of our co occurring services while we continue to grow and expand funding opportunities through creative and engaging community events that will create and grow additional funding sources. These services will benefit our court participants, participants immediate and extended families, and the communities of Cleveland and McClain Counties as a whole.

Project summary: The Cass and St. Joseph Counties, MI Adult Treatment Court (Cass/SJC/ATC) Enhancement Project will serve High Risk/High Need Cass/SJC/ATC Participants in rural, diverse, under-resourced and over-burdened communities. Goals are to increase capacity using family-centered, recovery-oriented, trauma-informed, and equity based approaches and strategies including expansion of treatment services to include EMDR, DBT, and HEAT. Project name: Cass and St. Joseph Counties, MI Adult Treatment Court (Cass/SJC/ATC) Enhancement Project Population to be served: High Risk/High Need Cass/SJC/ATC Participants Demographics and clinical characteristics: Predominantly while (approximately 90%). Males 75% served while general populations is 50%. Race/ethnicity includes African American, Native American, Asian, More than two races, and Latino. Underserved non-white participants, higher unsuccessful completion rates for non-white participants. 90% of participants symptoms of PTSD and severe SUD. Strategies/interventions: Family-centered, recovery-oriented, trauma-informed, and equity-based approaches and strategies including expansion of treatment services to include EMDR, DBT, and HEAT. Project goals and measurable objectives: GOAL 1: Increase the capacity of Cass/SJC/ATC providing a coordinated dual-county, multi-systemic, and comprehensive continuum of care that is family-centered, recovery oriented, trauma-informed, and equity based for the population of focus: Adults referred, admitted, participating, and post-participation in Cass/SJC/ATC with a high risk of recidivism (HR) and a high need of treatment (HN) due to a severe substance use disorder (SUD). Objectives: Number of Unduplicated Individuals to be Served with Award Funds per Year (YR) Obj 1.a. YR 1: 90 Obj. 1.b. YR 2: 50 Obj 1.c. YR 3: 50 Obj 1.d. YR 4: 50 Obj 1.e. YR 5: 50 Total Goal: 290 GOAL 2: Increase comprehensive family-centered, recovery oriented, trauma-informed, and equity-based services for Cass/SJC/ATC participants population of focus. (The timeframe for the following objectives is “By December 2023 and ongoing.”). Objectives: 100% of participants will be screened and assessed for SUD and/or co-occurring substance use and mental disorders; assessment info is used to develop appropriate harm reduction, treatment, and/or recovery interventions and treatment plans; screenings and assessments equitable access to drug courts for racial, ethnic, sexual and gender minority groups; participants will be screened for infectious diseases referrals will be made for participants follow-up; referred for vaccination for infectious diseases; evidence-based and population appropriate treatment services including the use of FDA-approved medications in the treatment of opioid use disorder and medication management, and levels of care; recovery support services including: Recovery housing, Peer support services, Childcare, Supported employment, skills training and development, and Transportation services; comprehensive case management; language access services; tobacco cessation programs. GOAL 3. Increase training and enhancement efforts for key partners and team members in areas including family-centered, recovery oriented, trauma-informed, and equity-based services for Cass/SJC/ATC. Objectives: Enhancements to key components of the adult drug court model including training on the expanded treatment for SUDs, co-occurring substance use and mental disorders, harm reduction, and recovery support services; training on behavioral health implementation for the national CLAS standards; address behavioral health disparities and the social determinants of health; to expand diversity equity, inclusion, and accessibility; to utilize data to understand who is served and disproportionately served; develop and implement of outreach and referral pathways that engage/target all demographic groups representative of the community. GOAL 4: Monitor and evaluate the achievement of

The Alabama Drug Court Treatment Expansion Project will expand access to substance use disorder treatment for adult drug court clients in two Alabama counties-Dallas (which includes the City of Selma) and Montgomery (which includes the City of Montgomery). At least 250 individuals charged with drug related felonies who are assessed as needing substance use disorder treatment will receive services over the five-year grant period. The goals of the project, which will serve at least 40 men and women annually, include: 1) increasing access to evidence-based, and population appropriate, substance use disorder treatment services, including the use of FDA-approved medications, in two existing adult drug courts; 2) increasing infectious disease screening, appropriate referrals and follow-up services for individuals with a positive screening test; 3) increasing vaccination for infectious diseases when they are available; 4) improving retention in care by providing recovery support services; and 5) reducing the risks of recidivism by providing validated risk assessments and delivering case management services that reduce these risks. This project is designed to address the disparities in access to substance use disorder treatment for court-involved individuals in these counties and help close the gap in available outpatient counseling and medication assisted treatment. Clients will have access to FDA-approved medications as a component of a comprehensive treatment plan. Client demographics will include: Race: 65% African-American, 34% white; 1% other; Ethnicity:2% Hispanic, 98% non-Hispanic; Federally recognized tribe: less than 1% members of federally recognized tribes, more than 99% not be members of federally recognized tribes; Language: more than 99% English speaking; less than 1% not English speaking; Sex:75% male; 25% female; Gender identity: 74% male ( including trans male); 26% female (including trans female); Sexual orientation: 86% heterosexual, 14% LGBTQ+; Age: 24% ages 18-29, 53% ages 30-49, 23% ages 50 and over; Socioeconomic status: 48% living below the federal poverty line, 52% living above the federal poverty line.

The proposed project, Family Recovery Court, will enhance and improve drug court operations for 175 participants over five years by providing extensive behavioral health treatment. The Tarrant County Family Recovery Court (FRC) is a specialty family court docket that oversees cases of child abuse or neglect, in which parental substance abuse is a contributing factor. To participate in the Drug Court, individuals must have a substance use disorder (SUD) or may be presently struggling with significant substance use issues which has resulted in the removal of their child from the home. Therefore, the population of focus consists of those with SUD and people with co-occurring mental and substance use disorders (COD) who are involved with the Department of Family and Protective Services (DFPS) and the criminal justice system. The proposed plan will integrate the evidence-based practices (EBP) of Seeking Safety, Eye Movement Desensitization and Reprocessing (EMDR), and Celebrating Families into the current service array, which involves detox, a residential and outpatient treatment service that utilizes the evidence-based practice, Seeking Safety, and hosts a family-based recovery program, Celebrating Families. This project seeks to expand services to address the increase in referred individuals, implement intensive treatment and recovery services to address trauma related symptoms arising from substance use, increase the possibility of family reunification and reduce drug court failure rates. My Health My Resources of Tarrant County (MHMR) will partner with the FRC, Challenge of Tarrant County, and JPS Health Network, to support the stabilization and reunification of families facing termination of parental rights precipitated by parental SUD and other related concerns.

Public Health Management Corporation proposes to partner with the Philadelphia Treatment Court on the Philadelphia Treatment Court Expansion Project (PTCEP). PTCEP will integrate the use of specialized case management and recovery support services for 40 individuals who have opioid use disorder and/or co-occurring disorders. PTCEP will enhance alternative and supplemental supportive case management with intensive recovery services to achieve sobriety and reduce criminal recidivism for defendants in active substance use.

The Rockdale County Treatment Court Capacity Enhancement Project is focused on elevating the integrity of the treatment services and drug testing abilities of the Rockdale Accountability Courts (RCA). The project will also provide the required abilities to meet the demands being place on the courts by newly implemented criminal justice initiatives with co-responder units, Mental Health Ward within the jail, and pursuit to increase the pre-trail services to reduce the number of individuals entering the system. The project will serve Rockdale County, Georgia with a population of 90,896. Of 1200 unclassified individuals contains those 48% or 576 individuals were drug, alcohol, and mental health related. Of the population 64% presented with primarily mental health concerns, 19% presented with primary alcohol and other drug issues, and 16% presented with co-occurring disorders. These concerns have caused the Rockdale Accountability Courts (RCA) to experience a 72% increase over the last three years. The overall goal to provide the required levels of expanded service to participants that will reduce recidivism rates and the school-to-prison pipeline and increase participants’ abilities for long-term recovery. Objective 1: Conduct review and confirm court deficiencies, case data, evidence-based programs, training requirements, and opportunities for awareness initiatives. Objective 2: By November 2023, hire a Case Manager to assist RAC Coordinators on tracking, follow-up, and coordination with additional services. Objective 3: By February 2024, enhance recovery for support services by increasing the number of treatment hours for participants each week to address co-occurring disorders. Objective 4: By February 2024, expand drug testing from the recommended eight panels to 10 panels with variable options and increasing the frequency and randomization of testing to identify needs. Objective 5: By February 2024, reduce obstacles and enhance support services by implementing gender-based trauma treatment and prevention for opioid overdosing programs. Objective 6: By February 2024, reduce obstacles and enhance support services by providing housing solutions on a needs-based criterion to enhance long-term recovery. It is expected for the project to serve approximately 175 participants a year with a five-year total of 875 participants.

The Ashland Wellness & Recovery Court (WRC) Enhancement and Bad River Tribal Judicial Partnership in rural Ashland WI proposes to enhance and expand existing treatment court services. The proposed enhancements include addressing historical disparities in Native American access to treatment (Goal #1), expanding access to opioid harm reduction strategies (Goal #2), and expanding program services (Goal #3). These goals will be accomplished by adding a Bad River Ojibwe Tribal Judge to our Team, embedding program-specific peer specialists, expanding access to opioid overdose reversal training, and expanded evidence-based resilience-based treatment approaches. The proposed system-level, program-level, and client-level goals are in alignment with both Wisconsin and federal harm reduction, opioid treatment, peer support, and disparity reduction strategies, as well as in alignment with our local needs. The WRC has been operational for more than a decade, transitioning to a hybrid Healing to Wellness Court approach during the past four years in partnership with the Bad River Tribe. Native Americans consistently comprise two-thirds of current WRC program admissions. WRC participants during the past four years have been 40% female, 48% with co-occurring disorders, 65% opioid or methamphetamine dependent, and 46% have been charged/convicted of drug possession. Nearly one-half (48%) accessed MAT during their WRC participation and 50% graduated from the program. Fall 2022 six-month GPRA data indicated that 90% of WRC participants were abstinent from alcohol, 78% were abstinent from illegal drugs, and only one person reported IV drug injection; three-quarters of participants had stable housing and 100% of graduates had a permanent place to stay in the community. We propose to admit 100 new participants over the five-year project period (20 per year) to WRC services that are more culturally responsive with a Tribal Judge co-presiding during court hearings, offer opioid overdose reversal training/Narcan, focus on MAT to support recovery and work with the Ashland Jail to allow in-custody MAT, provide in-house Moral Reconation Therapy (MRT), and add nicotine cessation services to our comprehensive treatment strategy. In addition, WRC will expend significant effort to make the system-level and program-level improvements detailed in our objectives and will sponsor/co-sponsor at least eight cultural and wellness activities in the community each year to support participant recovery.

The Mariposa County Drug Court Expansion Project will focus on Drug Court Participants in Mariposa County; all Drug Court participants struggle with SUDs and some with co-occurring mental illness. This project seeks to address health disparities and close gaps in our current Drug Court model to see an increase in graduation rates, a decrease in substance use, and improve recovery outcomes through Recovery Coaching, case management, career education, and transportation. The project will work with 30 people annually; 150 people over the course of the project. The budget reflects a reduced funding request due to the small population in our county, thus a smaller Drug Court population. Goals and Objectives are as follows: Goal 1: Provide access to services throughout Mariposa County to decrease substance use and improve recovery outcomes. Objective 1.1: Provide Case Management (CM)/Recovery Coaching (RC) services two times per week in North County beginning January 2024. Objective 1.2: Provide Mariposa County Probation access to office space for drug testing as needed beginning January 2024. Objective 1.3: 60% of North County residents in DC will access six or more services in their community annually. Objective 1.4: 70% of DC participants will report a lessened burden of completing required tasks due to increased access to services. Objective 1.5: Provide transportation for DC participants to access needed services; 90% of participants that use transportation services will report that transportation increased their ability to meet DC requirements. Goal 2: Increase the graduation rates for DC participants by 10% through supportive case management, care coordination, and recovery coaching. Objective 2.1: Hire a DC Case Manager by November 15, 2023. Objective 2.2: Introduce CM/care coordination into DC Model by January 1, 2024. Objective 2.3: 60% of DC graduates will report improved engagement and reduced barriers due to services. Objective 2.4: Provide CM to no less than 30 DC participants (90%) annually and 150 individuals over the course of the project. Objective 2.5: 10 DC participants will engage with Recovery Coaches annually, 50 over the course of the project. Objective 2.6: 65% of DC Participants that engage with Recovery Coaches will report improvement in one of the four dimensions of recovery. Goal 3: Increase employment opportunities for Drug Court participants by building professional skills and experience. Objective 3.1: Hire a Recovery Coach Mentor by November 15, 2023. Objective 3.2: Provide a bi-annual Recovery Coach Academy beginning in January 2024. Objective 3.3: Train 5 Drug Court participants as Recovery Coaches annually. Objective 3.4: Employee 4 Drug Court participants as Recovery Coaches annually. Objective 3.5: 75% of Recovery Coaches will report increased confidence in their ability to obtain and retain employment. Goal 4: Increase the social connectedness of Drug Court participants. Objective 4.1: Host monthly sober social support activities beginning January 2024. Objective 4.2: 50% of drug court participants will report an increase in their access to a sober community of support and that this support is central to their recovery.

Abstract Project Summary: This proposed project is submitted by the Cleveland Municipal Court (CMC) to expand access to evidence-based supervision and treatment services for defendants of the CMC's four specialized dockets. These include: The Greater Cleveland Drug Court, Mental Health (Co-Occurring) Docket, Veterans Treatment Docket and the Human Trafficking Docket. Project Name: Recovery Project V Population of Focus: The population targeted for this project include offenders who are addicted to alcohol and other drugs and are at risk for failing in ess intensive or traditional models of supervision, such as standard probation. This project will focus its efforts on non-violent offenders who are determined high-risk for recidivism and high-need for substance use disorder treatment. Special conditions will be given to those individuals who are retired or active military service members, victims of human trafficking, addicted to opiates and those diagnosed with co-occurring disorders. Project Goals, Objectives, Strategies and Interventions: The overarching goal of this project is to establish a coordinated, multi-system approach designed to combine the sanctioning power of the Cleveland Municipal Court's four problem solving treatment courts with evidence-based treatment approaches to reduce recidivism and the abuse of alcohol and other drugs. Objectives include: #1 Convene a project management team to oversee implementation, evaluation, continuous quality improvement and sustainability of the project; #2 Address the gaps in the continuum of treatment for defendants; #3 Develop a "participant flow chart" illustrating the pathway participants will move through as they are identified, screened, assessed and transferred from the suburban municipal courts; #4 Refine the treatment and recovery support continuum for participants consistent with evidence-based practices; #5 Begin service delivery by screening, assessing and transferring a total of 200 defendants into the Cleveland Municipal Court and #6 Address behavioral health disparities among racial and ethnic minorities by facilitating access to evidence-based treatment services. Number of Participants to be Served: This project proposes to serve 40 participants in Year 01, and 40 in Year 02, 40 in Year 03, 40 in Year 04 and 40 in Year 5 for a total of 200 participants over the grant period.

Onslow County, North Carolina is requesting $1,999,277.00 over five years to expand the treatment capacity of the Onslow County Veterans Treatment Court (OCVTC). The North Carolina Office of State Budget and Management estimates the 2022 population of Onslow County to be 209,491. In addition, there are approximately 45,079 active-duty marines and sailors stationed at Camp Lejeune and New River Air Station, both located in the county. Camp Lejeune with its various satellite camps, housing, training areas and New River Air Station is the largest concentration of marines and sailors in the world. The National Center for Veterans Analysis and Statistics (NCVAS) estimates that in 2022 there were 33,766 military veterans (16% of the population) living in Onslow County. We are a young Veterans Treatment Court (VTC) and have not requested any Federal funding up to this point, but we know that we need to expand support services and access to treatment to meet the needs of our veterans. It is estimated that 30% of crimes responded to by the Onslow County Sheriff’s Office involve a veteran as perpetrator and of the 5,092 individuals booked into the Onslow County Detention Center in 2022, approximately 1,527 were veterans. The OCVTC is established as both a pre-conviction, post-conviction court, with primarily voluntary participation and required informed consent. This proposal seeks to expand access for veterans who are uninsured, underinsured, and those who refuse VA treatment. The NCVAS reports in 2022 only 39% of the 687,364 veterans in NC have registered for VA services. The uninsured can utilize providers who contract with the State’s Integrated Payment and Reporting System (IPRS). IPRS providers are reimbursed at Medicaid rates through the managed care organizations (MCOs), which monitor them for quality assurance and licensure. PORTHealth is such a provider and is partnering with the OCVTC, providing a dedicated Community Supervisor Coordinator to provide and connect participants with assessments, treatment and MAT when appropriate. Another enhancement to the program is a certified peer support specialist – Recovery Coach - to help navigate the journey of treatment, services and life in recovery. The Recovery Coach will support the work of the volunteer mentors, and ensure that participants always have that ‘go-to’ person. In an effort to increase utilization of VA services, we are also including a Veteran Services Assistant to help veterans in obtaining benefits, filing claims, filing claims appeals, and serving as a liaison to VA services. The OCVTC is projected to serve 320 unduplicated individuals over the next five years, increasing from fifty to seventy-five per year during the life of this grant. Our goals are to: • Increase capacity to assess veteran’s risk and responsivity to treatment. • Connect veterans to effective evidence-based treatment and recovery supports. • Connect all eligible veterans with benefits and treatment earned through military service. • Decrease stressors related to daily living (e.g., addiction, financial management, housing, employment). • Reduce re-entry into the criminal justice system. We appreciate this opportunity to apply for funding to aid the men and women who have served our country.

As an adult problem-solving court, this evidence-based court provides Kankakee County, Illinois defendants with accountability, structure, and distributive justice. Assessed and diagnosed with a substance abuse and/or co-occurring disorder, participants are at high risk for recidivism. They progress through a four-phase structured (700 day) residential, outpatient, medically assisted and/or aftercare treatment continuum, enhanced by case management, self-help, and support. The overarching goal is to intervene in the drug/crime cycle as early as possible while minimizing recidivism. Serving a minimum of 40 people annually, Drug Court’s five 2023-2028 goals focus on reducing drug use in first 100 days from 81% to 25%, decreasing missed toxicology testing from 56% to 35%, improve low employment at entry of 12% to 50% by Phase II, enhancing structure to decrease early disciplinary exits from 49% to 30% and rewarding achievements, specifically volunteerism, task accomplishments, skill development and treatment. 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 14.4%. In 2019-2022, 54% (79/146) of Kankakee County Drug Court (KCDC) participants resided in the city of Kankakee where poverty was double (28.6) the county rate. As a primarily rural county, the landscape serves haven to narcotics dealers, users and is increasingly drawing addicts from neighboring Indiana and the Chicago-metropolitan area.

Muscogee County Family Drug Court is seeking a grant to expand services and increase capacity in the Court to address the recurring issue of substance abuse in dependency cases and increase family reunifications by providing Semi-Residential Housing, Recovery Support Services, HIV Rapid Testing, funding for Medication-Assisted Treatment (MAT) and General Education Diploma (GED) testing. All of these program expansions and enhancements work to create a more well-rounded program targeted at the treatment of moderate to high-risk/need participants and their families, including those with opioid dependence. The population of focus will be adults age 18 and older who are residents of Muscogee County and must be the legal and primary caretaker of a child who has been placed, or is in danger of being placed into DFCS' care outside of the parental home. The parent must have dependency allegations arising from substance abuse or dependence, and must voluntarily enter the program and show a willingness to live a drug-free lifestyle. Goal 1 Increase the number of Family Drug Court Participants by 35 individuals per year through the addition of one full-time case manager, serving a total of 175 participants over the 5 year grant period. Goal 2 Increase the number of individuals receiving MAT from zero to up to 5 individuals per year. Goal 3 Obtain a successful completion rate of 50% of participants in year one with a 10% incremental increase in each year thereafter through improved staff training and enhanced program services such as wrap-around services, MAT, and Recovery Support Services. Goal 4 Have reactivations rates among Family Drug Court Program successful completions to under 20% annually. Goal 5 Reunify families at a rate of 50% of participants in year one with a 10% incremental increase by providing wraparound recovery support services. Goal 6 Increase the number of individuals receiving wraparound recovery support services from zero to 35 families per year.

The Family Recovery Program, Inc. (FRP) is a 501c3 nonprofit in Baltimore, Maryland. FRP primarily serves Baltimore City parents; age 18 and older, with a child or children under the age of 13 who have been removed from their parents’ care for reasons related to substance use disorder (SUD). The purpose of FRP is to reduce a child’s exposure to out-of-home placements when that child is removed from their parent’s or legal guardian’s (here-in-after “parent”) care due to the parent’s substance use disorder. This new funding will allow FRP to implement the Family Matters Initiative to expand service to additional families and to expand its overall service delivery model. This expansion will enable us to include additional evidence-based interventions (EBI) and to proactively layer more support and engage extended family and support systems in our work with each family. FRP’s comprehensive framework will ensure the best modalities to serve our parent participants. FRP will employ the following EBIs for our programs:(1) Medication for Opioid Use Disorder (MOUD; (2) Motivational Interviewing; (3) Intensive Case Management; and (4) Peer Support. FRP is a Family Drug Treatment Court working with Baltimore City lawyers, judges, and other direct service providers. We serve families who are eligible for family treatment court. On average, most of our parents enrolled in FRP identified as Black/African American. They may also be low-income and experiencing homelessness. These are typically individuals who have either lost custody of their children or are at risk of losing custody. Our Programs are designed to promote positive changes among parents and promote the positive development of children by employing key characteristics of trauma-informed approaches and protective factors. To assist parents, families, and children engaged in Family Drug Treatment Court to make healthy personal choices regarding the impact of substance use, FRP employs an approach embedded with trauma-informed services designed to be culturally appropriate for our parent participants. The overarching goal of our Family Matters Initiative is to serve an additional 195 families over a five-year period by implementing culturally appropriate, evidence-based, emerging, and community-defined best practices, interventions, and frameworks to address substance use disorder, tackle mental health concerns, help our families secure affordable housing, and successfully reunify children with their biological parent (s). FRP uses a strengthening families approach to help parents and families develop healthy communication skills and improve parents’ decision-making skills and overall family connection. Specific Goals Include: Goal 1 - By month 12, a minimum of 70% of parents’ drug and alcohol tests will be negative or excused positives due to prescribed medications. Goal 2 - By month 12, a minimum of 60% of program participants will be referred to treatment as a means of assisting parents, families, and children engaged in Family Drug Treatment Court. Goal 3 - By month 12, a minimum of 75% of parents identified needing mental health services will be referred to or confirmed as currently enrolled with a mental health provider (within 30 days of FRP enrollment). Goal 4 - By month 12, a minimum of 45% of FRP children will be on track for reunification with a biological parent, FRP or non-FRP, within 22 months of the parent’s enrollment. (Note that based on FRP’s experience, the average full reunification time is approximately 22 months) Goal 5 - By month 12, 100% of FRP parent participants will be referred to housing opportunities that may include in one of our facilities and make housing referrals as needed. Goal 6 - By month 12, 80% of FRP parent participants' extended families participate in monthly family meetings to develop a plan for healthy communication skills, develop problem-solving skills, and explore how to support and empower birth parents and their children.