Sponsor: Public Health
Title
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Amendment to the Agreement with the Minnesota Department of Human Services for the Expansion and Enhancement of a Continuum of Care for Opioid-related Substance Use Disorders
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Recommendation
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1. Approve an amendment to the agreement with the Minnesota Department of Human Services for the expansion and enhancement of a continuum of care for opioid-related substance use disorders for the period upon execution through June 30, 2024 in the amount, as amended, of $774,712.
2. Authorize the Chair and Chief Clerk to execute the amendment.
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Background and Rationale
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In 2022, Public Health, in collaboration with Community Corrections and Social Services Mental Health Division, applied for and was awarded a grant from the Minnesota Department of Human Services (DHS) to increase substance use disorder/mental health (SUD/MH) care coordination through a variety of initiatives for individuals both entering and leaving the correctional system. The program identifies and works from first point of contact through the judicial system, detox and probation. The goal is to continue to decrease involvement in the criminal justice system for offenses related to opioid use disorder (OUD) or other SUD concerns and probation violations that are also related to lack of compliance with treatment-based services. DHS wishes to extend the original term of the grant for an additional one-year period through June 30, 2024, and award additional funding in the amount of $265,028. The new grant amount, as amended, is $774,712.
This funding will allow the county to continue to offer mental illness and chemical dependency assessments for individuals who are both pre- and post- sentence and offer care coordination from peer support specialists or other chemical dependency case managers for persons that are seeking to get connected to services. Between 2019 and 2020, there was a 54% increase in opioid-related fatalities among Ramsey County residents resulting in 69 deaths in 2020. Many opioid-related overdoses result in either a hospital admission or a visit to an emergency department. There were 708 opioid-related visits made to hospitals among Ramsey County residents in 2020. The rate of hospital and emergency department visits continues to rise in the county from 0.6 visits per 1,000 population in 2016 to 1.3 visits per 1,000 in 2020, the second highest rate in the metro area.
The program’s goal is to ensure that pre-sentence clients are offered assessment, access to culturally appropriate and responsive care and information about community services to navigate through treatment options regardless of health insurance status. This entails offering assessments that are easily accessible at any correctional facility in Ramsey County (Adult Detention Center, Ramsey County Correctional Facility and Juvenile Detention Center) and are inclusive of mental health considerations that might impact chemical use concerns. Ensuring access to the correct level of care follows Minnesota’s movement toward direct access to treatment.
Corrections-based treatment will be available to people pre- and post-sentence, those incarcerated, and/or on probation with substance concerns who enter the Adult Detention Center, Ramsey County Correctional Facility, juvenile probation or the Juvenile Detention Center. Individuals living in the community will be offered care coordination. Correctional facility-based individuals will be offered mental health care through corrections-based services, social services (1919 University Ave) including dual diagnosis programing, services through Public Health such as naloxone at time of release and information from the syringe services program and Detox. The county will continue to provide care coordination and community follow up that improves treatment outcomes and prevents recidivism with community-based, culturally responsive counseling and support services as are currently offered through the Medicated Assisted Therapy initiative.
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County Goals (Check those advanced by Action)
☒ Well-being ☐ Prosperity ☐ Opportunity ☐ Accountability
Racial Equity Impact
More than 5,400 Minnesotans have died of opioid overdoses since 2000. The epidemic has torn families apart and ravaged communities, particularly the American Indian and African American population and other racially and ethnically diverse communities. Individuals, families and communities continue to suffer, as the COVID-19 pandemic has caused a surge in both fatal and nonfatal overdose deaths. Minnesotans have suffered tremendously from the opioid epidemic. Opioid overdose deaths have increased dramatically during the COVID-19 pandemic.
Community Participation Level and Impact
The community has been engaged during this grant application there have been two community partners meetings. Public Health also had a Saint Paul City Council Policy update and met with Ramsey County municipalities as well as the East Metro Mental Health Roundtable.
Public Health also publishes a Community Health Assessment (CHA) every five years with ongoing evaluations and updates. The CHA identifies key health conditions and needs among county residents. The CHA process includes community engagement about health experiences and concerns as well as data and trend analysis from a variety of sources. One of the key health conditions that was identified by community is Tobacco, Alcohol & Substance Abuse Opioid Misuse and Death <https://www.ramseycounty.us/sites/default/files/Departments/Public%20Health/CHA/Opiod%20Misuse%20and%20Death_final.pdf>.
☒ Inform ☒ Consult ☒ Involve ☒ Collaborate ☒ Empower
Fiscal Impact
This amendment to the agreement with the Minnesota Department of Human Services extends the original term of the grant for an additional one-year period through June 30, 2024, and awards additional funding in the amount of $265,028. The new grant amount, as amended, is $774,712. The program costs will be covered by this grant funding through June 30, 2024.
Last Previous Action
On April 26, 2022, the Ramsey County Board of Commissioners approved a grant agreement with the Minnesota Department of Human Services for the expansion and enhancement of a continuum of care for opioid-related substance use disorders for the period upon execution through June 30, 2023 in the amount of $509,684 (Resolution B2022-105).
Attachments
1. Amendment to Grant Agreement with DHS