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The Pennsylvania Parent and Family Alliance (Parent Alliance), a statewide program of Allegheny Family Network, is set to enhance family engagement in the behavioral health system for children. Over the next three years, it will train 30 parents from diverse backgrounds to influence policies and child-serving systems, facilitate the inclusion of these Parent Leaders in decision-making bodies with a target placement rate of 80% post-training, and establish a Parent Advisory Board to review service policies. Collaborative efforts will also develop workshops addressing the challenges faced by parents, aiming for 80% participant satisfaction. A statewide survey will assess respite care needs, leading to the creation of a respite service programs database. Monthly electronic newsletters will share families' lived experiences, with an expected 10% annual increase in recipients. The project will participate in statewide committees to advocate for peer support models, ensuring family input into training and billing standards, and present at conferences and meetings annually, focusing on the needs of underserved communities. Additionally, a chatline will provide referrals for 340 families over three years, and technical assistance will be offered to 10 organizations aiming to improve family engagement and support capabilities, significantly enhancing the support system for children and youth with SED/COD in Pennsylvania.

Building Capacity for Family Support will (i) increase the number of well-trained family peer workforce members serving families with children and youth with mental health needs (SED); (ii) create and support an infrastructure that strengthens the family peer workforce through continuing education, peer support, and exchange of information; (iii) increase the number of effective policy advocates for families with children and youth with SED; and (iv) will increase the numbers of families with children and youth with SED served and supported in Massachusetts. These goals will be achieved by creating a Family Partner Hub consisting of a Family Peer Certification program accessible to diverse underserved populations, and Family Peer Connections to provide continuing education, support, and information exchange among family peer workforce members. Peer to peer support has been proven effective to increase hope, collaboration, self-efficacy, advocacy, and empowerment, and decrease isolation and internalized blame among parents/caregivers of children and youth with SED. The incidences of mental health challenges among children and youth is on the rise with roughly one-third of youth and young adults identifying symptoms of mental health distress in themselves, and visits to emergency depts for mental health reasons increasing by 24-31% recently. The mental health workforce has experienced a significant retraction during and post-COVID. Family peer workers can help fill the service gaps created by the retraction and mitigate the workforce crisis. An increase in available diverse, qualified, and well-trained family peer workforce members will have a direct impact on families with children and youth with SED. This project will emphasize providing career pathways for persons from diverse and underserved or under-resourced communities. Success of this project will be measured by numbers of participants in the Hub, number of participants who attain employment in the family peer workforce, number of participants who advocate at policy levels for improvement in children's mental health access and services, and number of families served as a result of the Hub graduates.

NAMI Missouri's 3-year Statewide Family Network Project, "Family Support and Leadership Project," will benefit parents and caregivers of children and youth with serious emotional disturbance (SED) and/or co-occurring disorders (COD) in Missouri using a combination of proven, peer-led training developed by NAMI and partner organizations, including NAMI Basics, Smarts, Partners in Policy, Holding Hope, Charting the Life Course and WRAP. The project will focus on parents and primary caregivers of youth with SED/COD ("parents/ caregivers") from 3 specific populations of focus: 1.) Military and veteran families; 2.) Families in rural, underserved, and under-resourced parts of the state; 3.) Families living in poverty. Project goals include: Strengthening the leadership of parents/caregivers; Teaching parents/caregivers how to get involved in policy; Helping parents/caregivers access evidence-based and promising practices; Improving understanding, skills, and abilities of Family Support Providers (FSPs) and agencies; Promoting tools to boost connections between families; and Strengthening the statewide family/caregiver network across the state long term. Measurable objectives include the following annual goals: Holding a Partners in Policy Leadership Training to train 10 parents/ caregivers; Holding a Community Advocacy Training on Board and Committee service for 10 parents/ caregivers; Supporting a training program to develop 5 new FSPs; Hosting 3 Provider Seminars and Training 75 Mental Health Providers; Providing CEUs to 30 FSPs; Increasing the favorability rating of mental health professional attitudes toward peer support; Graduating 12 parents/ caregivers from Basics Courses; Earning a rating of “Helpful” or “Extremely helpful” in providing knowledge and support from 90% of parents/ caregivers who attend a Basics Course; Providing respites service for 10 parents/ caregivers; Coordinating FSP mentors to provide in-person advocacy for 10 individuals; Reaching 5,000 Missourians through messaging; Attending 3 conferences as attendees/participants; And 3 partner organization conferences as vendors, reaching 3,000 people; Attending workgroups/ work session meetings with 5 separate partner organizations who represent populations with goals that align with ours. Strategies and interventions include facilitating access to education; promoting skill-building, family peer support, and trauma-informed care; offering access to respite care, encouraging collaboration with mental health professionals, providing access to crisis intervention services and advocacy support, ensuring cultural competence, and implementing a combination of interventions tailored to each family to maximize effectiveness and ensure a holistic approach. Other plans include training 5 parents/caregivers to tell their lived experience stories through the Holding Hope Program, delivering 20 presentations per year, reaching 350 people. We will serve 125 parents/caregivers through our Parent Helpline and email; 15 parents/caregivers through Parent Support Groups; and 25 parents/caregivers annually through CMHW outreach. Through these activities we will serve an estimated 850 people annually, and 2,550 throughout the life of the grant. In addition, we will reach more than 8,000 people annually, and 24,000 throughout the life of the grant.

Kentucky Partnership for Families and Children, Inc.'s (KPFC) mission is to ""empower families with behavioral health challenges to initiate personal and systems change."" Building an infrastructure for a family and youth driven System of Care requires families and youth to have meaningful involvement within the Kentucky System of Care that fosters prevention, personal change in strengthening their advocacy and leadership skills, and opportunities to not only participate, but to have a real voice. Once families and youth understand their power for transforming Kentucky's System of Care, their excitement and energy moves forward to strengthen the movement and toward systems change-the change to create a strong, viable, responsive System of Care in Kentucky. KPFC’s twenty-five-year history includes an active family and youth movement infrastructure. KPFC has a strong partnership with multiple child/family-serving agencies for collaborating with parents and youth as real partners to truly create a statewide System of Care. KPFC’s Peer Support Centers will provide statewide peer support, lived experience consultations, leadership development and create opportunities for meaningful involvement in the Kentucky System of Care. KPFC will address the need for meaningful involvement and leadership opportunity for families and youth across the state through: • Providing six advisory committees across the state to bring voice to embed implementation of family and youth driven practices to agencies working with families raising children with SED/COD. • Building leadership skills of a minimum of 150 participants by year three to share their lived experience perspective regarding family and youth driven within the Kentucky System of Care. • Collaborating with a minimum of 5 Kentucky System of Care partners to identify opportunities for family and youth voice as equal decision makers. • Share a statewide family ran peer support infrastructure and work management system that is replicable in other states. KPFC continues to strengthen the Kentucky System of Care infrastructure through the expansion of regional peer support centers that create opportunities for parents and young people with lived experience to partner with agencies at all levels in their decision-making processes and create system change. KPFC will work with system partners to utilize lived expertise at all levels as ""a way of doing business"" in Kentucky.

The Healthy Moms Healthy Babies project, led by the Alabama Department of Mental Health's Office of Substance Use Treatment Services (ADMH-SU), aims to expand family-based services for pregnant and postpartum women with substance use disorders (SUD), especially those with opioid use disorders (OUD). The project seeks to reduce service gaps and disparities in treatment access for underserved communities, improving outcomes for women with substance use disorders. Healthy Moms Healthy Babies will increase the capacity to provide outpatient family-based treatment and recovery services to pregnant and postpartum women, their minor children, and other family members in a supportive family-friendly, culturally appropriate, trauma-informed environment. The program will be offered at two service sites, serving a total of four counties-Colbert, Franklin, and Lauderdale Counties in northwest Alabama and Etowah County in northeast Alabama. Each of the counties that will be served by this project has been designated by HRSA as a mental health professional shortage area, and a significant portion of the population of focus is living below the poverty line. The project will implement evidence-based practices such as cognitive behavioral therapy, twelve-step facilitation, medication-assisted treatment, gender-responsive and trauma-informed services, case management, and peer recovery support services. These interventions will be provided in a family-centered treatment approach, addressing the needs of women, their minor children, and other family members. Additionally, tobacco/nicotine cessation programs will be offered. The Healthy Moms Healthy Babies project will utilize a steering committee to monitor and guide the program. The committee will be comprised of professionals, individuals with lived experience, and other relevant stakeholders. The committee will promote effective and efficient service coordination and delivery to fill gaps in services and decrease disparities in access to care for underserved women. Project goals include: 1) increase access to family-based services for pregnant and postpartum women with a primary diagnosis of substance use disorder, with at least 60% of the women receiving services for an opioid use disorder; 2) expand Alabama’s continuum of care for pregnant and postpartum women with substance use disorders, especially opioid use disorders, by increasing access to evidence-based outpatient treatment and recovery support services for pregnant and postpartum women with SUD; and 3) improve the coordination, effectiveness, and efficiency of services provided to pregnant and postpartum women with substance use disorders, especially opioid use disorders, by coordinating a steering committee to encourage new approaches and models of service delivery. The project plans to serve 200 unduplicated individuals throughout the three-year program period: 50 in year 1, 75 in year 2, and 75 in year 3.

Funding for the Indiana Pregnancy Promise Program (PROMISE—Promoting Recovery and Opportunity, Maternal Infant Support and Engagement) will expand a successful pilot program addressing opioid use disorder to include pregnant individuals suffering from substance use more broadly. The program’s goals are clear – to save infant and maternal lives, preserve family units, prevent formal involvement with the Department of Child Services, ensure reliable access to appropriate care, and put an end to generational cycles of substance use and trauma. Extending program eligibility beyond opioid use will allow the FSSA to serve approximately 300 additional pregnant individuals with substance use disorder in the target counties of Randolph, Barth, Wayne, Scott, Fayette, Monroe and Jackson within the next 3 years. FSSA anticipates the program will serve a total of 1,000 pregnant individuals during this period. FSSA will formally partner with Centerstone, a community mental health center that will become a Certified Community Behavioral Health Clinic, and VOA Fresh Start to enhance outpatient services. The program is currently limited to Medicaid beneficiaries only; however, SAMHSA funding will allow uninsured and under-insured pregnant individuals necessary access to additional aid. In its current form, the program partners with Indiana Medicaid managed health plans to provide case management and care coordination services to participants. Since the program’s implementation the team of Pregnancy Promise Program case managers have aided hundreds of individuals in securing necessary resources such as safe housing, transportation, childcare etc. The program’s multigeneration approach serves pregnant individuals and infants from the prenatal period through 12 months postpartum, ensuring infants have a pediatric medical home, appropriate referrals to pediatric specialists as needed, and developmental support services. While parents simultaneously continue receiving support from the Pregnancy Promise case manager to sustain recovery, ensure access to comprehensive healthcare, and achieve desired goals such as employment. In under 3 years the program has served nearly 800 mothers across Indiana. Collected data from the program demonstrates promising results for mothers and infants. Success is evidenced by high rates of sustained recovery, relapse prevention, infants with healthy birthweights and family preservation and (re)unification data. The FSSA has published these findings in annual program reports. The Indiana Pregnancy Promise Program is currently reliant on funding through a 5-year award from the Center for Medicaid and Medicare Innovation, which ends December 31, 2024. Supportive funding by SAMHSA will allow Indiana to meaningfully serve additional mother/infant dyads. The Pregnancy Promise Program is reliant on additional state funds to support costs associated with Pregnancy Promise case manager staff at the Medicaid Health Plans.

PPW Heal, Overcome, Persevere, and Empower, HOPE Initiative, a collaborative effort between the Oklahoma Department of Mental Health and Substance Abuse Services, ODMHSAS, Southern Oklahoma Treatment Services (SOTS), and Jim Taliaferro Community Behavioral Health Clinic, JTCBHC, aims to establish a program tailored to address the needs of Comanche County and the surrounding rural areas in the Southwest region of Oklahoma. The initiative goal is to improve outpatient treatment and support services for pregnant and postpartum women with substance use disorder, opioid use disorder. Hope ensures their children under 17 and families receive services as well. Collaboration with designated outpatient treatment providers is essential for HOPE to achieve the following goals: Increase awareness and reduce stigma surrounding pregnant and postpartum women with SUD, Motivate pregnant and postpartum women to seek treatment and supportive services for favorable maternal outcomes, Extend access to prevention, recovery, and family preservation services to mitigate the risk of involvement in child welfare and legal issues for pregnant and postpartum women, Improve culturally sensitive and trauma informed individual and/or family-centered treatment and recovery services, Develop a state and local community action plan emphasizing individual and family centered care across the continuum of pre-pregnancy, pregnancy, neonatal post-natal, birth, and early childhood stages. SOTS and JTCBHC provide services in Comanche County, recognized as a rural mental health shortage area for low income populations, with a HPSA score of 20 and a staffing level of 4.86 FTE to address the shortage and meet the population-to-practitioner target ratio. These established providers have been serving the target population for over twenty years and are well positioned to enhance their family programs to improve treatment outcomes for women, children, and additional family members. Each provider employs a diverse team of peers and treatment professionals with experience, expertise, and a unified philosophy to address the complex needs of families. The HOPE initiative welcomes pregnant or postpartum women with substance use disorder, or opioid use disorder, as well as their children under 17 and family members. A streamlined and integrated system of care over the next three years, incorporates evidence based interventions including Motivational Interviewing, Parent Child Assistance Program, Community Reinforcement Approach, Recovery Monitoring and Support, Seeking Safety, Circle of Security, Contingency Management, Strengthening Families, and Celebrating Families. This comprehensive approach aims to enhance outcomes in individual and family functioning, leading to improved child-parent relationships, family functioning, and overall well-being. HOPE will serve 26 unique individuals each year, totaling 78 over the grant period.

The overarching goal of the NARWHAL (Northern Arizona Rural Wellness & Healthcare Access for Mothers with Substance Use) Program is to connect existing prenatal, labor and delivery, postpartum, pediatric, and substance use disorder treatment providers to increase patient engagement, integrated whole-person care, and wraparound services for pregnant and postpartum women with Substance Use Disorders (SUDs), including Opioid Use Disorder (OUD), and their families in Coconino County and surrounding communities in Northern Arizona. The Arizona State Pilot Program for Treatment for Pregnant and Postpartum Women project will address the following goals and objectives: Goal 1: Increase outreach, engagement, screening, assessment, and retention of PPW with a SUD diagnosis, including OUD, in SUD treatment and recovery services, specifically targeting rural and underserved Northern Arizona geographic service area. Goal 2: Develop community partner connections, increase knowledge, and improve coordinated and collaborative care through facilitation of a multi-sector Steering Committee. This committee will bring together primary, obstetric, pediatric and behavioral healthcare providers, substance use treatment service providers, government agencies, managed care organizations, law enforcement, corrections, people with lived experiences, and community programs providing wrap-around supports for PPW and their families. Goal 3: Increase accessibility, effectiveness, and retention in, substance use disorder treatment and recovery services for PPW with a SUD, including OUD. Goal 4: Work with partners to create a sustainability plan beyond the life of the 2024 PPW pilot funds. Objectives include 1: Serving a total of 45 unduplicated women: year 1 (15), year 2 (15), and year 3 (15). 2: Develop and implement partnerships across public, behavioral, substance use disorder treatment, OB/GYN, and pediatric health care partners that will result in improved collaborative care for the priority population. 3: Develop a sustainable and replicable model of comprehensive, patient-and-provider collaboratively developed treatment care plans that meet participants ""where they are, with what they need"", and reflect a family-focused approach targeting rural, underserved geographic service areas of Northern Arizona. 4: Utilize Community Healthcare Workers with lived experience to support connections between OB/GYN, primary care, Labor and Delivery, and substance use disorder treatment.

Abstract Project REACH (Re-Entry Addiction Care & Healing) will expand treatment and related recovery and reentry services to improve abstinence (Goal 1) and social determinants of health/SDOH (Goal 2) and reduce recidivism (Goal 3) among 855 sentenced diverse adults (19-86% Black; 8-80% White and 1-9% of Hispanic ethnicity/varies by jail) over a 5-year period in 3 jails in the rural counties of Franklin, Gadsden, and Wakulla in the Florida Panhandle. Our catchment area has suffered many cumulative adversities: ?One of the largest marine oil spills in history, (BP Oil 2010); ? Hurricane Michael (2018) one of only four Category 5 hurricanes to ever strike the US destroying many behavioral health and social service programs, draining the workforce and exacerbating service gaps; and ? the catastrophic effects of the COVID pandemic. All contributed to significant SDOH disparities, especially related to employment, safe housing, social connectedness, and health/behavioral health. A survey in the Franklin County jail found that 93% of the sentenced adults had a mild, moderate, or severe SUD and 30% had multiple severe SUDs. Moderate to severe stimulant and opioid diagnoses have a strong association with recidivism. The current state of FL rate of incarceration per 1000 population is 2.4% but averages 4.3% in our targeted 3 counties, 79% higher than the state rate (FDC Jan 2023). While stimulant use is more common in the Panhandle than opioids, 8-weeks before we began writing this proposal the FL Panhandle made the national news with a drug bust that netted enough fentanyl to kill 800,000 people (12.19.22 FDLE). As the Project REACH applicant, Northwest Florida (NWF) Health Network will leverage significant staff and funding resources to benefit this project. We are a 501C(3) organization that serves as one of the only Network Management agencies in the country with single and direct responsibility for substance use and mental health services and child protection (child welfare). NWF will leverage 3 existing jail-based Outreach/In-reach Workers to implement the evidence-based CAAPE-5 assessment instrument to identify eligible participants to enroll in Project REACH. After a subsequent warm handoff to the 3 Project REACH Certified Recovery Peer Specialists (CRPS- hereafter called Peers), participants will receive evidence-based Peer Recovery services and the Changing Course Interactive Journaling EBP to identify and mitigate areas that might be problematic and to create person-centered treatment and recovery planning post-release. The Peers will work with a Housing Specialist and Network Coordinator and link participants to a DISC Village, a local SU/COD treatment and recovery organization with 50 years of BH experience with the population of focus. Their comprehensive evidence-based services (MI, CBT, Seeking Safety, MAT, and Tele-behavioral health) across most ASAM levels of care are also leveraged at no cost to this grant to meet the unique needs of each participant. Our project will contract with Solutions Of Substance Associates (SOS), with more than 20 years of federal grant performance assessment experience, to assist with performance measurement.

TITLE: Easterseals Michigan Building Healthy Futures and Resilient Youth an approach to address the needs of students and caregivers who have experienced psychological trauma exacerbated by pandemic and incidents of mass violence. Easterseals Michigan is a leading provider of behavioral health services with a long history of supporting vulnerable children and families in Michigan. Through this project, we are proposing to address the needs of students and caregivers (Preschool-12) who have experienced psychological trauma that has been exacerbated by the COVID-19 pandemic for the past 3 years and recent mass violence incidents that devastated our community in the last 14 months. The program will include outreach, screening, assessment, and evidenced based treatment. In addition, ESM will provide professional development, and trauma informed consultation for school partners. This program will be implemented in three Michigan counties: Genesee (school districts of Grand Blanc Community Schools and Fenton), Wayne (school district of Westland) and Oakland (school districts of Berkley, Birmingham, Clarkston, Holly, Oxford, Lake Orion, Hazel Park, Huron Valley, Novi, West Bloomfield, Walled Lake and Waterford) with 15 school partners representing both urban and rural geographic locations schools to serve students. Decades of research on other incidents of collective trauma suggest many individuals will suffer psychological impacts of the current COVID-19 pandemic, including posttraumatic, somatic, and other mental health disorder symptoms (Itzhaky, Weiss-Dagan, & Taubman-Ben-Ari, 2018; Loeb et al.,). For many students, the COVID-19 pandemic is compounding traumatic experiences for diverse reasons, including potential increased incidents of neglect, abuse, and isolation. Many of our targeted communities are experiencing unprecedented turmoil due to the pandemic and racial injustice. Our community has been impacted by two school shootings in the last 14 months. Our project goals are to improve screening of students in partnering districts who have experienced trauma exacerbated by the pandemic and school violence, provide comprehensive multidisciplinary assessments, and develop a comprehensive array of treatment services increasing capacity for evidenced based practices. ESM plans to serve 1000 students over a five-year period. This is broken down as follows :100 the first year, 170 year two, 210 in year three, 240 year four, and 280 year five. Additionally, we will enhance the workforce by providing training for 6 clinicians on the Intergenerational Trauma Treatment Model, 6 clinicians on the Trauma Focused Cognitive Behavioral Treatment model, 6 clinicians in Solution Focused Brief Therapy and 7 staff in Cognitive Behavior Intervention Trauma Treatment in Schools. ESM will also build on expertise within community agencies by providing mental health consultation and professional development to support students and caregivers in their district that have been impacted by trauma.

Bright Harbor Healthcare (BHH) intends to provide grief- and trauma-related services to the underserved and under-resourced children, adolescents, and families, in our community, who have experienced trauma and traumatic events. BHH plans to address the unmet behavioral health needs of this vulnerable population by providing timely access to services through our Grief & Trauma Center for at least 150 children, adolescents, and families annually. This will be accomplished by expanding our Children & Families outpatient programming to include the BHH Grief & Trauma Center (GTC). The GTC staff will be comprised of a clinical team who is specialized in treating children and their families who may have or are at risk of experiencing Adverse Childhood Experiences (ACEs). Over the course of 5 years, GTC will provide individual, family and group therapy to youth and families struggling with emerging trauma-related difficulties such as depression, anxiety, inadequate social skills and negative self-esteem. GTC will support their mental health and wellness needs by providing a safe, nurturing environment where they can receive comprehensive assessment, treatment, linkage and, if needed, fulfill the goal of family reunification through therapeutic supervised visitation services. The goal of the GTC is to raise the standard of care by offering effective, evidenced based, trauma- and grief-focused treatment to 750 children, adolescents, and their families, who experience traumatic events over the next 5 years. GTC intends to work in collaboration with Category II, TSA Center to promote awareness and education while improving the treatment outcomes for this underserved population. Thus, reducing the chances of long-term mental, emotional, and physical consequences to children, adolescents, and their families, who experience traumatic events . BHH seeks to identify and implement community strategies to increase awareness of, participation in, and access to trauma and grief treatment and services for at-risk children, adolescents, and their families inclusive of those from diverse racial and ethnic communities. The BHH GTC intends to accomplish this with the development and implementation of specialty clinical positions in the areas of LGBTQIA+, Substance Use Disorder (SUD), as well as Grief & Trauma Community Response. These specialty positions will not only provide clinical services but will provide clinical consultation services, as liaisons to the community, who will consult and provide education on the general space and environment. These services will be open to all requesting assistance to ensure their space is culturally competent, inclusive and inviting to children, adolescents, and their families who have experienced trauma and traumatic events. The BHH GTC specialty clinicians’ role will also include responsibilities of partnering with the community to promote advocacy and decrease stigma by providing education at community-based events and responding to critical evens in our community when requested to provide support and/or debriefing.

Detroit Recovery Project (DRP) is a nonprofit organization with over 20 years of experience providing SUD (substance use disorders) prevention, treatment, and recovery services in Detroit, Michigan. DRP is proposing the RISE Up (Recovery, Integration, Support & Empowerment) Project. The RISE Up Project will expand and enhance substance use disorder (SUD) treatment and related recovery and reentry services to sentenced adults in the criminal justice system with a SUD, MOUD (Medication for Opioid Use Disorder), and/or co-occurring substance use and mental disorders. DRP's primary goal is to support and empower returning citizens and their families following a period of incarceration in state prisons, local jails, and/or detention centers. Building on the strength of existing collaborative relationships with community partners, the Michigan Department of Corrections, Wayne County Jail, Community Corrections, and local drug courts, DRP will provide in-reach and post-release support to include SUD/MOUD treatment, peer recovery coaching, recovery support services, case management, primary and preventative care, employment and housing support, transportation, and prove evidence-based interventions such as Medication Assisted Treatment (MAT), Motivational Interviewing, Cognitive Behavioral Therapy and Strengthening families to further support a positive reentry back to the community and with their families. Over the five years of the project, DRP will address the following goals: (1) Increase access to treatment and recovery support services for individuals with SUD or COD returning to the community after incarceration; (2) Decrease problematic substance use among this group; and (3) Support reentry, reduce recidivism and decrease criminal justice involvement. The RISE Up Project will provide services to 450 individuals with creating innovative pathways to recovery for individuals and families impacted by SUD, MOUD, and/or co-occurring disorders with criminal justice involvement.

This proposal, Project ReConnect, from Virginia Commonwealth University (VCU), is in response to funding opportunity TI-23-006 (FY 2023 Adult Reentry Program) and seeks funding to innovate a high-fidelity Critical Time Intervention (CTI) program enhanced with evidence-based practices to serve 275 individuals with substance use disorders (SUDs) and co-occurring substance use and mental illnesses (CODs) who are incarcerated in the Chesterfield County jail (Chesterfield County, VA), and individuals involved with the criminal justice system who are participating in reentry programs with REAL LIFE, a community-based reentry agency. Our CTI team, will provide comprehensive, trauma-informed evidence-based supports in the Chesterfield County jail, in collaboration with the jail’s residential substance abuse treatment program, and continue services post-release, in collaboration with REAL LIFE (Richmond, VA), a community-based substance abuse treatment and reentry organization, to address the needs of individuals with SUDs and CODs. Our goal is to provide in-jail and community-based services to ensure successful community reentry outcomes for individuals with SUDs/CODs with the following measurable objectives: (1) develop a full-fidelity CTI team to serve individuals with SUDs/CODs incarcerated in the Chesterfield County jail and during reentry; (2) serve 275 individuals over a 5-year project period; (3) track substance use, relapse, drug overdose, health and behavioral health functioning, housing, employment and other outcomes among Project ReConnect participants at baseline, 6- and 12-months; and (4) innovate a multidisciplinary criminal justice/social work internship program and train 20 students to work across criminal justice and social service sectors. Project ReConnect will provide participants: (1) in-jail services for those soon-to-be released individuals with SUDs/CODs; (2) transition services from the jail to community; (3) evidence-based Individual Placement Support and Supported Employment (IPS-SE); (4) peer recovery specialist support; (5) executive functioning skills building; (6) housing assistance/placement using a Housing First model; (7) substance use prevention, recovery and harm reduction services; and (8) comprehensive case management and linkage to long-term clinical services. We will accomplish these aims by creating a full-fidelity CTI team consisting of a team lead, case manager, employment/housing specialist, and peer support workers. Project ReConnect will integrate evidence-based practices (e.g., IPS-SE, Peer Support, and SOAR) to enhance community reentry outcomes for individuals with SUDs and CODs. Also, given our unique academic-criminal justice-community provider collaboration, we will innovate a multi-disciplinary criminal justice – social work student internship program. We will develop a specialized curriculum for our students which prepares them to work across social work, substance abuse treatment and criminal justice disciplines. We plan to train and supervise up to 20 students who will work as part of our Project ReConnect team. We will develop learning modules focused on: (1) evidence-based mental health and substance abuse practices; (2) evidence-based criminal justice practices; and (3) boundary spanning between the criminal justice and social service sectors. Our proposal - to facilitate successful jail-to-community transitions among 275 individuals with SUDs and CODs using an EBP-enhanced CTI model and to develop a multidisciplinary student internship program to equip students with the literacy and knowledge to work across multiple public sectors to best serve justice-involved populations - has the potential to make a high impact in our local community and is well-aligned with SAMHSA’s strategic priorities.

Project RENEW aims to support key activities to expand trauma informed substance use disorder (SUD) treatment and related recovery and reentry services to 18-35 year-old Latinx and Black/African American (B/AA), including LGBTQIA2S+ adults with a SUD and/or co-occurring substance use and mental disorders (COD), who are returning to their families and communities in the Metro and South regions of LAC after incarceration from the LAC Men’s Central Jail (MCJ). Project RENEW will expand substance use disorder (SUD) services, SUD recovery and reentry services, and screening for infectious diseases, including HIV and viral Hepatitis (Hepatitis A, B, and C). The goals and objectives will eliminate disparities in SUD treatment and related recovery and reentry services for justice impacted individuals when returning to their communities. Project RENEW will screen 850 individuals for SUD and IDs and will serve 300 unduplicated participants in the 5-years of the Project. Foundational to the implementation of Project RENEW will be a high-quality program, practices, and policies that are evidence based, recovery-oriented, trauma-informed, and equity-based as a means of improving behavioral health.

Center Point, Inc. (CPI) is requesting $399,999 per year for up to five years from the SAMHSA CSAT to expand treatment and related recovery and reentry services for adult men and women with a substance use disorder and/or co-occurring mental health disorder (SUD/MH) who are returning to the community from incarceration in state and local jails. The geographic catchment area where services will be delivered in Marin County, CA. The populations of focus for the project are racial and ethnic minority men and women who have a SUD/MH and who are currently incarcerated and within four months of scheduled release to the community or are parolees or probationers at high risk of recidivism. CPI will provide reentry services to 20 participants transitioning from incarceration and/or who are an at-risk probationer or parolee in each project year, for a total of 100 unduplicated individuals served over five years. CPI has established a collaborative partnership with the Marin County Sheriff's Office (MCSO) to provide services in Marin County Jail including screening, assessment, and recruitment of individuals into reentry program services. CPI will directly provide outpatient and residential SUD/MH treatment to all participants, depending on their assessed level of need and treatment goals, along with comprehensive case management and recovery support services (RSS) to reduce participants' criminal justice involvement and improve abstinence from substance use, housing stability, employment status, social connectedness, and overall physical and behavioral health. All participants will have access to CPI's comprehensive, integrated SUD treatment and recovery support system that include residential, outpatient, continuing and aftercare, recovery residence transitional housing, RSS, and vocational and employment services. Project services will be coordinated with psychosocial therapies and RSS, and clients will be directly linked into ongoing primary care and supportive services in partnership with local Federally Qualified Health Centers (FQHCs) and community-based agency partners. Over the five-year grant period, CPI's project will expand in-reach screenings, assessments, and pre-release transition planning to increase 100 participants' access to and engagement in community-based SUD/MH treatment; expand transitional services and RSS that provide emotional and practical support to maintain participant remission and reduce recidivism; and expand and enhance CPI's service delivery model to provide evidence-based and population-appropriate harm reduction and treatment services to meet the unique needs of diverse populations at risk. Outcomes for participants will include increased SUD/MH treatment access and participation, decreased substance use, decreased criminal justice involvement, and overall improvements in physical, emotional, and mental health.

The Supporting Purposeful Interventions & Resilience In Trauma (SPIRIT) program will implement trauma-specific screening and stratified intervention by triaging youth with chronic medical conditions. SPIRIT will use the Pediatric Traumatic Stress Care Process Model (CPM) to assess youth and families for trauma-related psychological distress and match them with an appropriate intervention. Care coordination will be embedded within each service. Youth enrolled will be aged 8-18 years. It is anticipated that youth most youth will have Medicaid as their insurance payor, the majority will be from racially minoritized populations, and presenting with an array of trauma exposures based on historical demographics of youth served by SPIRIT providers. SPIRIT staff will work directly with medical providers to provide education and training on trauma-specific screening within the CPM framework. Each intervention pathway provides stratified care based on the needs of the youth and include online modules, group psychotherapy, and individual/family therapy. SPIRIT patient navigator will assist all families with case coordination and patient advocacy. SPIRIT will serve 150 youth and families in Year 1 and 1,250 youth and families throughout the life of the project. Goal 1: Increase pediatric healthcare provider ability to identify trauma exposure and distress and link with appropriate matched interventions. SPIRIT will recruit clinics to provide trauma screening and referrals, will tailor workflows specific to clinic needs and policies, and use the CPM to match to appropriate treatment. Goal 2: Decrease trauma symptoms and impairment via evidence-based, trauma-focused treatment services. SPIRIT will use patient care navigation to problem-solve barriers to treatment engagement with goal of ? 75% session attendance. 70% of participants will demonstrate a clinically reliable improvement in functional impairment and posttraumatic stress symptom severity at program discharge. Goal 3: Elicit stakeholder feedback on stratified intervention processes and incorporate feedback. SPIRIT staff will complete independent focus groups to adapt interventions. An advisory board with patient, parent, and medical providers will meet quarterly and consult on project implementation. All intervention materials will be tailored for youth living with a chronic medical condition. Goal 4: Deliver training related to the intersection of trauma exposure and chronic medical conditions on youth development and functioning. SPIRIT staff will implement professional education on trauma exposure and chronic medical conditions. SPIRIT will develop a brief web-based curriculum for medical providers, on-demand training for school nurses, and provide live trainings within the hospital and within the community as requested. Goal 5: Use programmatic outcome evaluation to justify institutional and state support for expanding the developed screening and stratified intervention model. SPIRIT staff will analyze outcome data, provide statistics on program impact on trauma symptoms and impairment, measure program acceptability and satisfaction, and present results at state and national forums and conferences.

Project Building Resilience and Accessibility for Vulnerable Populations Ensuring Equity (BRAVE) will address the unmet mental/behavioral and social services needs of BIPOC children, adolescents, and families who have experienced trauma, including child abuse and neglect; violence at home or in the community; serious illness, accident, or injury; natural or man-made disaster; death of a primary caregiver; serious military-related, war-related, or refugee-related stressors; multi-generational, historical, and race-related trauma. The project will build community capacity to provide trauma-informed care in child-serving systems through training and consultation for system providers, professionals, ad caregivers. The project focuses on under-served and under-resourced communities in Palm Beach County (Riviera Beach, Lake Worth, West Palm Beach, and Pahokee) where there are significant numbers of BIPOC (including immigrants, refugees, and asylees) who have experienced high rates of adversity and trauma and where there are critical gaps in resources, including trauma-informed care and treatment. The target population experiences persistent challenges and disparities related to poverty or economic stress, high crime rate, housing instability, physical and/or emotional stress, lack of preventative care to address the impact of multi-generational and ongoing, complex trauma, and lack of access to effective trauma treatment. The project will deliver Trauma Treatment services for 350 children and adolescents, Care Coordination services for 350 families, Caregiver Support Groups and Workshops for 700 parents and caregivers, and Trauma-Informed Training for 7,466 professionals and paraprofessionals throughout the lifetime of the project. (Trauma Treatment - Yr 1: 50; Yrs 2-5 average 75/year. Care Coordination - Yr 1: 50; Yrs 2-5: average 75/year. Caregiver Support Groups/Workshops - Yr 1: 100; Yr 2-5: average 150/year. Training - Yr 1: 1,066; Yrs 2-5: average 1,600/year.) Goal 1: Increase capacity and access to quality culturally and linguistically appropriate trauma-informed and trauma-specific services for BIPOC children, adolescents, and families (including refugees, immigrants, and asylees) through strategic staffing and partnerships. Goal 2: Reduce the impact of trauma and trauma-related symptoms in BIPOC children, adolescents, and families through the delivery of EBPs for child traumatic stress provided within the target communities. Goal 3: Improve BIPOC family functioning and access to helpful services and supports through the provision of Care Coordination services and Parent Support Groups and Workshops provided in a culturally and linguistically sensitive manner within the target neighborhoods. Goal 4: Increase access to trauma-informed and culturally sensitive care in child serving systems to build community capacity to effectively address adversity and trauma through training and consultation for case workers, attorneys and judges, dependency workers, faith-based entities, pediatric professionals, adult caregivers, and other child-serving individuals who work with children, ages birth to 18, and their families.

In response to the rise in youth behavioral health acuity since the pandemic, increasing strains on the behavioral health workforce, and the distinctive needs of Special Education students, BHcare's Build Child Resilience initiative will work with the Child Health Development Institute and local high-need public and special education schools to bring trauma-focused school-based behavioral health services and training of school support staff to six area schools. The population of focus consists of the students in 4 high-need public schools and two Special Education schools. The Special Education schools are part of Area Cooperative Education Services (ACES), a Regional Educational Service Center which operates 6 schools in southern CT. The school populations are predominantly Black and Hispanic and low income. Indicators of trauma frequency in Derby and the Derby schools demonstrate that rates of substantiated child abuse reports and suspensions or expulsions are more than double the state rate, and 30% of 7-12 graders surveyed having "directly seen, heard, or been a victim of violence in neighborhood, community, or school." As for the ACES schools, studies show that children who experience 3 or more adverse childhood experiences in early life have double the odds of entering a Special Education program than children without such exposure. They also show that children with disabilities are more than three times as likely to be maltreated than nondisabled peers. Finally, the difficulty of differentiating features of trauma-related disorders from those of other neurodevelopmental disorders make it more difficult for Special Ed teachers to respond appropriately to trauma without special training. BHcare will hire 4 full-time school-based clinicians, supported by an APRN, who will provide school-based services in the target schools. The principal Category II TSA Center supporting the program will be Connecticut's Child Health Development Institute (CHDI), the state-designated Performance Improvement Center, supplying staff training and support. The foundation of trauma-informed care in schools is the capacity of teachers/support personnel to understand and recognize trauma and refer for treatment. The program includes 3 components for school staff: Training in Trauma ScreenTIME, a CHDI training on understanding/recognizing trauma; adoption of ""Handle with Care,"" under which the school receives a notification (a "Handle [student] with care" note) from police when a child has been identified at the scene of a traumatic event; a training on trauma-informed care for early childhood targeting elementary school teachers, by Child First, a Category II TSA. Clinicians will be trained in 5 trauma-informed evidence-based practices: The Attachment, Regulation and Competency (ARC) Framework for multiple and/or prolonged traumatic stress; the Cognitive Behavioral Intervention for Trauma in Schools (CBITS) group intervention for 5th-12th graders who have experienced trauma; Bounce Back, a version of CBITS for younger children; Trauma Focused Cognitive Behavioral Therapy, a child/parent treatment for youth; and Dialectical Behavioral Therapy is a treatment adapted specifically for adolescents with extreme emotional instability, including self-harm and suicidal ideation. Goals are: (1) to build knowledge/collaboration on evidence-based trauma treatment, with objectives targeting clinician education, school personnel education, and engagement of community partners; (2) to provide evidence-based, trauma-informed clinical services in 6 schools, with objectives targeting students referred for treatment, students screened, and students receiving treatment, including appropriate percentages of Black/Hispanic and LGBTQ+ students; and (3) to improve outcomes among youth engaged in school-based care, with objectives measured by NOMs and OHIO Scales interviews. Projected numbers served with grant funds: Year 1, 95; Year 2, 125; Years 3-5, 150; total of 670.

Summary: This project will expand Sinai Health System’s capacity to provide effective trauma- and grief-focused treatment for children, adolescents, and their families, who experience traumatic events on the Southwest side of Chicago, with a focus on individuals who identify as lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual, or any other gender expression/identity (LGBTQIA+). Sinai’s Behavioral Health (BH) Department will work with child-serving institutions to provide direct evidence-based mental health treatment and services including screening, diagnostic assessment, care management, therapy, and prevention for at-risk children and adolescents in Holy Cross Hospital’s Casimir Clinic, an outpatient assessment and treatment program which treats children, adolescents, and their families. Title: Expanding Access to Trauma and Grief Services for Southwest Side Chicago Youth Population & Demographics: The geographic catchment area will be the service area for Holy Cross Hospital (HCH) which includes 14 community areas across seven zip codes on the Southwest side of Chicago. This service area has a Hardship Index Score of 86 (out of 100), indicating that the communities face increased hardship in terms of employment, housing, education, and poverty; factors that are highly correlated with poor mental and physical health. The population of focus will be underserved and under-resourced children, adolescents, and their families who have experienced trauma and traumatic events. Within our service areas, this population is predominantly Black/African American (53%) and between 18 and 40 years old (46%). Goals & Objectives: Goal 1: Increase capacity of Sinai’s Behavioral Health (BH) outpatient clinic to provide effective trauma- and grief-focused treatment and service systems for children, adolescents, and their families who experience traumatic events. 1.1. By September 29, 2028, Sinai’s BH Department will enroll 540 new youth patients into their BH outpatient clinic. 1.2 By September 29, 2028, 25% of patients at Holy Cross’s BH outpatient clinic will experience an increase in strengths one year after their initial assessment. 1.3 By September 29, 2028, 40% of patients at Holy Cross’s BH outpatient clinic will experience a decrease in trauma-related symptoms one year after their initial assessment. Goal 2: Increase access to evidence-based trauma- and grief-focused treatment and service systems for LGBTQIA+ youth through additional training opportunities that focus on treating LGBTQIA+ populations. 2.1 By September 29, 2025, Sinai’s BH Department will have trained 90% of psychotherapists on evidence-based practices for treating LGBTQIA+ populations. Number of Unduplicated Individuals to be Served with Award Funds Year 1 Year 2 Year 3 Year 4 Year 5 Total 80 100 120 120 120 540

The Center for Resilience and Well-Being (CRW) will partner with family-serving agencies and schools to increase access to trauma-informed, evidence-based prevention practices and treatment services (TI-EBPs) in our local Boulder County and in two rural, underserved regions of Colorado. This project will reduce behavioral health disparities for Latina/o/x families and families living in low-resource rural areas. A unique aspect of this project is the focus on prevention efforts which will expand our reach to all youth and address many of the barriers associated with accessing effective behavioral health supports. Evidence-based prevention is one of the most powerful and cost-effective strategies for promoting health and reducing risk and behavioral health challenges for youth across racial and ethnic identities and low-income status. Populations to be served. Our target areas include our local Boulder County and two rural counties (Garfield, Montrose) and surrounding areas on the Western Slope of Colorado that serve many high needs, underserved communities. Our eight partner agencies for this grant serve large numbers of youth and families who have experienced complex trauma and other adverse life events (e.g., poverty, housing/food insecurity), including a significant number of Latina/o/x families. The number of unduplicated individuals served will total 36,000 families in family service settings (Y1: 2,400; Y2: 4,800; Y3: 7,200; Y4: 9,600; Y5: 12,000), and 45,000 educators and youth in schools (Y1: 3,000; Y2: 6,000; Y3: 9,000; Y4: 12,000; Y5: 15,000). Strategies/Interventions. (1) Let's Connect® is a parent-child intervention with demonstrated efficacy at building parents' social emotional competence (SEC) and teaching parenting skills that promote healthy communication, supportive relationships, and youth SEC and behavioral health; (2) Supporting Caregivers is a group-based adaptation of Let's Connect® for parents impacted by trauma or disaster, (3) Resilience in Schools and Educators is a K-12 school prevention program that builds educators' wellbeing and SEC and teaches skills that promote supportive relationships, youth SEC and mental health, and safe supportive environments, (4) Calm and Connected Toolkit is a prevention program that teaches adults skills to destigmatize and support youth mental health challenges; (5) Trauma-Focused Cognitive Behavioral Therapy® is the best supported treatment for youth and caregivers for reducing trauma-related difficulties and enhances parental support and youth resilience; (6) Alternatives for Families: Cognitive Behavioral Therapy® is a treatment for families involved in high conflict violence, and abuse with demonstrated efficacy for increasing positive parenting, youth coping and social skills and reducing family violence, behavior problems, and abuse recidivism. Goals/Objectives. Goal 1. Develop the collaborative infrastructure for a community-based prevention hub to provide trauma-informed, prevention services for families and schools in our local community. Objectives: Convene communities of practice (CoP), consumer advisory groups (CAG), and a diversity, equity, inclusion, and belonging consultation team to conduct strengths-needs-gaps (SNG) assessment and action plan; partner agencies will establish systems for implementing services with fidelity and outcomes tracking. Goal 2. Improve behavioral health outcomes and reduce health disparities by implementing and sustaining culturally-responsive TI-EBPs in our local and rural communities. Objectives: Convene CoPs and CAGs, conduct SNG in rural regions; 85% of providers at partners will implement one TI-EBP and 70% will implement two; 5 school districts will implement TI-EBPs; 75% increase in referrals to TI-EBPs; local housing authority will offer TI-EBP. Goal 3. Promote long-term sustainability of TI-EBPs. Objectives: 80% of supervisors show TI-EBP supervision skills; 5 family/5 school staff complete Trainer programs.

Jewish Family Services (JFS) of Washtenaw County Michigan Caring for our Kids: Expanding Delivery of Trauma-Informed Care for Washtenaw County Youth Jewish Family Services (JFS) of Washtenaw County Michigan, an impactful non-profit behavioral mental health and supportive services agency, will deliver enhanced access to effective trauma- and grief-focused treatment and service systems for youth and their families, who are now or who have previously experienced traumatic events. Through the SAMHSA NO. SM-23-010 project--Caring for our Kids: Expanding Delivery of Trauma-Informed Care for Washtenaw County Youth-- JFS will increase capacity, raise the standard of care, and improve access to evidence-based services for Washtenaw County youth experiencing trauma. JFS also will raise awareness and experience with evidence based, trauma informed practices for youth serving behavioral therapists and school-based educators and increase awareness of, participation in, and access to, trauma and grief treatment and services for at-risk children, adolescents, and their families and those from diverse racial and ethnic communities. Currently reaching over 20,000 clients each year, JFS will support a minimum of 700 additional unduplicated youth and their families over five years including low-income individuals from diverse racial, ethnic, sexual and gender minority communities; and refugee and immigrant youth and families living with the trauma of forced migration. Approximately 60% of JFS’ current client population meets these criteria. JFS will increase capacity, raise the standard of care, and improve access to evidence-based services for Washtenaw County youth experiencing trauma. Trauma-Focused Cognitive Behavioral Therapy, Eye Moment Desensitization and Reprocessing for Children and Adolescents, Dialectical Behavioral Therapy for Children, Child Centered Play Therapy, and Trauma Systems Therapy for Refugees (TST-R) will be delivered. It is expected that participants will experience improved symptoms of mental illness and an improvement in functioning as outlined in the GAD-7 with the adolescent PHQ-9, DSM-5 Parent/Guardian-Rated Level 1 Cross-Cutting Symptom Measure—Child Age 6–17, Screen for Child Anxiety Related Disorders (SCARED) CHILD Version, Child and Adolescent Trauma Screen (CATS). Outcomes also include increased use of mental health support through JFS and their local schools and finally, improved feelings of connectedness and sense of belonging to schools among low-income individuals from diverse backgrounds, including recent refugees, immigrant youth and families.

Federation of Organizations (Federation), a nonprofit, 501(c)(3) multiservice health and social service organization, is proposing the Suffolk County Community Treatment and Service (SCCTS) Center in response to the Substance Abuse and Mental Health Services Administration (SAMHSA) FY2023 National Child Traumatic Stress Initiative – Category III Notice of Funding Opportunity SM-23-010. The goal of the SCCTS is to increase access to effective trauma- and grief-focused treatment and service systems for children and adolescents in Suffolk County that have been impacted by traumatic events. Through this program, SAMHSA aims to raise the standard of care and improve access to evidence- based services for children experiencing trauma across the nation. Childhood traumatic stress occurs when violent or dangerous events overwhelm a child’s or adolescent’s ability to cope. Trauma experienced during childhood can have long-term mental, emotional, and physical consequences, increasing risk for depression, anxiety, suicide, substance use disorder (SUD) and physical health issues, such as heart disease and dementia, later in life. In most cases, the underlying risk factors, like poverty, residing in high crime communities, family members with substance use disorder (SUD) or co-occurring mental illness and SUD (COD), or family history of incarceration, violence, or trauma, significantly increases the likelihood that a young person will experience multiple and repeated traumatic events. Traumatic stress can adversely impact a young person’s academic performance, mental health, physical health, behavior, and relationships with peers and family members. This impact can also be long lasting, increasing a person’s risk for substance use, violence, crime, sexual promiscuity, and other high-risk behaviors later in life. Given Suffolk County’s disproportionately high rates of SUD, pockets of high child poverty and homelessness, along with its large military and veteran population, and geographic isolation of impoverished communities, there is a large need for programs to address child traumatic stress. There are, however, few existing programs that address the comprehensive needs of youth impacted by trauma, presenting a crucial need for our proposed SCCTS Program. Given the geographic dispersion of the county, existing programs are not located in (and therefore, are not accessible to) the communities most in need of services. Federation’s mental health, SUD treatment, and outreach services are located in communities with the highest rates of poverty, diversity, homelessness, crime, violence, and social service needs. Federation, working in coordination with schools, youth-serving agencies, and providers throughout Suffolk County, will provide specialized mental health and support services to children, adolescents, and families, who have been impacted by adverse events resulting in trauma. The SCCTS will also provide substance use disorder (SUD) treatment to family members, if needed, housing support, as well as other wraparound services, such as education support, employment, and benefits/entitlement advisement. Federation will use Case Management and Peers to provide daily support and coordination of services and care.

The Integrated Outreach and Care (IOC) program is a partnership between several clinics that all operate within the Meharry Medical College Academic Medical Center, the largest HBCU medical center in the country. It brings together the Meharry Addiction Clinic, the Nashville Alliance for Drug User Safety (NADUS) and the Patient Navigation for Addiction Treatment and HIV/HCV Treatment and Care (PATH) from the Department of Family and Community Medicine. We are also partnering with the Meharry Community Wellness Center, the Department of Internal Medicine's infectious disease clinic and largest Ryan White HIV provider in Nashville. Finally, the Elam Mental Health Center, a clinic of the Department of Psychiatry and Behavioral Sciences, the city's safety net mental health and substance use provider clinic. We will integrate our outreach efforts with the clinic services to provide a one stop shop for HIV, viral hepatitis, substance use disorder treatment, mental health, and harm reduction services. We will focus on underserved African American communities as well as the burgeoning homeless population in Nashville. The combination of expertise within the three partner departments will allow us to meet the goals of (1) identifying, engaging, and supporting individuals who are racial and ethnic minorities, use substances and are at risk for, or living with HIV and other blood borne pathogens access the services they need to successfully transition to health and wellness; and (2) solidify and augment the system of care to provide a welcoming, culturally appropriate, and trauma informed community-based continuum of substance use and health services. The timing of these funds is very critical for our county as the state returned nearly $12 million dollars in CDC funding ear marked for HIV testing and surveillance. Receipt of these funds will allow us to begin to fill the gaps left by the loss of CDC funding in this area.

The purpose of our proposed project, "Community-and clinic-based substance use treatment and HIV prevention for African American and Hispanic/Latino men who have sex with men" is to increase status neutral access to and engagement in care for racial and ethnic medically underserved individuals at risk for or living with syndemic conditions including substance use, mental illness, HIV, viral hepatitis, and minority stress. With nearly 1.1 million residents, Rhode Island has one of the highest percentages of LGBTQ+ residents of any state in the country and the majority reside in Providence, the capital city. Providence is the epicenter of substance use in Rhode Island and has among the highest rates of illicit drug use in the United States. Disparities exist between the general population and the LGBTQ+ community with higher rates and severity of substance use disorders (SUDs) and co-occurring mental health disorders (CODs) and lower rates of access to- and engagement in- substance use treatment among racial and ethnic minorities with intersectional LGBTQ+ identities. Despite the large percentage of underserved individuals and the knowledge of these disparities, Rhode Island does not have a dedicated treatment program that addresses the important and unique needs of racial and ethnic medically underserved individuals with intersectional LGBTQ+ identities who suffer disproportionate rates of syndemic substance use, co-occurring mental health, medical, and social concerns. . Our proposed community- and clinic-based project will aim to address these unmet needs by providing affirming, evidence-based, status neutral, and inclusive outreach and treatment for SUD and CODs for 225 individuals from this underserved community in Rhode Island. Aligned with our purpose, the goals for our project include: 1) Increasing access to and engagement in culturally congruent SUD care, 2) Decreasing substance use and mental health symptoms among clients who engage in and complete our project services, 3) Increasing knowledge of medical statuses of HIV, viral hepatitis, and STDs, 4) Decreasing HIV infections, and 5) Promoting personal and organizational health literacy to prevent the perpetuation of minority stress, stigma, and discrimination which contribute to SUDs and CODs. Our program goals and design are derived from our process of centering the voices of those with lived experiences. We plan to use a status neutral approach by braiding together existing resources with the new program services across sites to decrease disparities in health and attend to ""whole person"" health care. To meet the needs of our community and accomplish our goals, the objectives of our project include:) Screening at least 800 racial and ethnic medically underserved individuals with intersectional LGBTQ+ identities in community and clinic settings; 2) Providing collaborative, culturally congruent, status neutral multidisciplinary care to 225 individuals to address the syndemic of SUD, CODs, medical concerns, and social determinants of health needs, 3) Testing for HIV, viral hepatitis, and STDs in the community and clinics, 4) Providing education about Undetectable = Untransmissible and support for adherence and PrEP care, and 5) Collaboratively creating and engaging in a dynamic educational curriculum to support diversity, equity, inclusion, belonging, and anti-racism across the three program sites. In summary, the project will provide critical services for the screening and treatment of substance use and other co-occurring disorders among racial and ethnic underserved individuals with intersectional LGBTQ+ identities in the state of Rhode Island which has among the highest rates of illicit drug use in the country.

Organization: Erise Williams & Associates, Inc. Erise Williams, Jr., MPH, President/CEO 3737 North Kings highway Blvd. Suite 204-206 St. Louis, MO. 63115-1736 314-385-1935 (Phone) www.minorityhealthstl.org erisejr@minorityhealthstl.org 314-385-3011 (Fax) Summary: With funding through SAMHSA's Minority AIDS Initiative: High-Risk Populations, Williams and Associates will extend an existing program initially developed with CSAT funding into a more comprehensive and robust network of partners to increase engagement in care for racial and ethnic medically underserved individuals with substance use disorder (SUDs) and/or co-occurring SUDs and mental health conditions (COD) who are at risk for or living with HIV/AIDS. Project Name: STL MADE: Substance Use Disorder Treatment for Racial/Ethnic Minority Populations at Risk For HIV/AIDS Population(s) to be served: The population of focus for this initiative is Black/African American individuals 18 years and older with substance use disorders (SUD) and/or Co-Occurring Disorders (COD) who are at high risk for or living with HIV/AIDS, with particular regard to Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, Intersex and Asexual persons, and those with other gender identities (LGBTQIA+) of any race/ethnicity. Strategies/Interventions: The project will use the following Evidence-Based Practices: Motivational Interviewing (MI); Self-Management and Recovery Training (SMART Recovery), Cognitive Behavioral Therapy (CBT)), Community Engagement, and the SAMHSA Opioid Overdose Prevention Toolkit. Goals and Objectives: Increase engagement in care for Black/African American medically underserved individuals, including Black/African American LGBTQ+ individuals with substance use disorders (SUDS) and/or co-occurring SUDs and mental health conditions (COD) who are at risk for or living with HIV/AIDS. Objectives include 1) Deliver 5,785 educational, screening, and recovery support encounters; 2) Deliver case management to 525 people; 3) Link 236 people to essential and support services; 4) Provide SUD/COD treatment and recovery services to 150 people; 5) Provide 500 people with HIV testing; 6) Provide case management and referral to care for persons with a positive HIV test; 7) Provide PrEP services to 500 people; 8) Provide PEP to 200 HIV-exposed people; 9) Test 150 people for Hepatitis B and C; 10) Developing MOAs with two primary HIV treatment and care providers; 11) Screen and assess 625 people at risk for HIV for CODs; 12) Develop an outreach strategy; 13) Provide SUD services to 75% of people affected by HIV/AIDS;14) Implement Peer Recovery Support Services. Number of People to be Served: The project will serve 578 annually, 2,890 throughout the life of the project.