Sponsor: Public Health
Title
title
Grant Award from Minnesota Department of Human Services to Provide Opiate Treatment and Care Coordination for African American and American Indian Residents
end
Recommendation
recommendation
1. Ratify the submittal of the grant application to the Minnesota Department of Human Services in the amount of $446,995 to provide opiate treatment and care coordination for African American and American Indian residents.
2. Accept a grant award and approve a grant agreement with the Minnesota Department of Human Services to provide opiate treatment and care coordination for African American and American Indian residents for the period of October 1, 2021 through September 29, 2022, in the amount of $446,995.
3. Authorize the Chair and Chief Clerk to execute the grant agreement.
4. Authorize the County Manager to enter into agreements and execute amendments to agreements in accordance with the county’s procurement policies and procedures, provided the amounts are within the limits of the grant funding.
end
Background and Rationale
body
Public Health took the lead in a grant application to work in collaboration within the Health and Wellness Service Team to apply for a Minnesota Department of Human Services (DHS) grant to continue the work of providing a culturally responsive Medicated Assisted Treatment (MAT) for African American and American Indian residents with opioid use disorder. Public Health was awarded the grant, in the amount of $446,995, for the period of October 1, 2021 through September 29, 2022.
The goal of this funding is to continue work to initiate culturally responsive MAT for African American and American Indian residents with opioid use disorder. In Ramsey County between 2007 and 2017, opioid-related deaths increased more than 80%. From 2016-2018, the opioid mortality rate was 6.2 per 100,000 county residents, and there were 23 opioid overdose deaths in 2018. While there was a decline in opioid overdose mortality in 2018, the emergency room visit remained relatively steady with 406 visits in 2017 and 380 in 2018.
Funding received from DHS in 2020 allowed for building infrastructure and relationships to provide services to county residents who suffer from opioid use disorder in the community and in our correctional system. Ramsey County connected residents to culturally responsive MAT service. Within the Health and Wellness Service Team, Corrections, Social Services and Public Health departments collaborated and worked in partnership with My Home, Inc. to provide comprehensive MAT services and support for residents undergoing treatment for opioid use disorder. The focused population continues to be the African American community. In addition, this team plans to build relationships with the American Indian community to determine the opportunities for expansion of MAT services to include targeted interventions in partnership with this community.
Opioid addiction is a challenge for people entering the county’s correctional facilities. In 2020, the ADC conducted 925 Clinical Opiate Withdrawal Scale assessments. The RCCF conducted 60 Clinical Opiate Withdrawal Scale assessments during 2020. In terms of substance use in Detox, 81% report using alcohol, in addition to other substances. Four percent report using opiates. Only 2% of Detox clients report that they are actively in MAT. These data support the approach to serve people while incarcerated.
The service design includes three components: Corrections-based treatment, community-based treatment, and care coordination. Corrections-based treatment will be available to people with substance use disorder who enter the Adult Detention Center and the Ramsey County Correctional Facility while they are going through withdrawal. Community-based treatment will be provided to those referred from community partners, correctional facilities, Ramsey County mental health services, Ramsey County syringe exchange services and Detox. Our partner, My Home Inc., will provide robust and culturally responsive to African American history and culture counseling and support case management using experienced social workers and chemical dependency counselors, and an additional 12-week curriculum that will support clients on their road to recovery. In addition, My Home, Inc., provides the use of reSET-O PDT, a phone-based prescription digital therapeutic technology that provides around-the-clock access to video, audio and reading that supports in-person cognitive behavioral therapy and that aids in retention in the program. Ramsey County, in collaboration with My Home, Inc., will provide continued care coordination and community follow up to improve treatment continuity outcomes and prevent recidivism.
end
County Goals (Check those advanced by Action)
☒ Well-being ☐ Prosperity ☐ Opportunity ☐ Accountability
Racial Equity Impact
The African American and American Indian populations are disproportionately affected by this issue - in Minnesota, American Indians are seven times more likely to die from a drug overdose as Whites, and African Americans are twice as likely to die from a drug overdose as Whites. Opioids are used for self-medicating for pain caused by trauma and mental health or physical ailments. This funding will assist the Health and Wellness Service Team create a culturally responsive and supportive program that is effective in reaching individuals who suffer from opioid addiction, with special attention to the African American population and discovery with the American Indian community, reducing the unmet opiate treatment needs of these communities
Community Participation Level and Impact
We continue to work in partnership with My Home, Inc., who leads the community-based component of care coordination and counseling support in the African American community and is engaged with community to advise the direction of this work. The evaluation team plans to also engage participants who have received services to provide feedback and offer input in the delivery of services so that we may improve upon the work that has been done thus far. In addition, this team has already begun to engage the American Indian community to determine how the county may play a role to uplift and partner with organizations that are leaders doing opioid related work within the American Indian community. The team is seeking guidance and direction from community leaders and experts. The goal is to improve treatment engagement and reduce the number of deaths related to opioid use through the process of engaging and enrolling individuals who are suffering from opioid addition to medication assisted therapy and long-term addiction therapy. Successful treatment and recovery have an impact on the individual, family, and community in terms of preserving/healing of relationships, community healing, prevention of crime and victimization, involvement in criminal justice system, productivity loss, and additional medical and prescription costs.
☒ Inform ☒ Consult ☒ Involve ☒ Collaborate ☐ Empower
Fiscal Impact
The program costs will be covered by grant funding through the Minnesota Department of Human Services in the amount of $446,995. At the end of this grant period, third party billing and coverage by Certified Community Behavioral Health Clinic to cover program costs will be set up. Additional funding may be applied for to continue services.
County Manager Comments
No additional comments.
Last Previous Action
On April 28, 2020, the Board of Commissioners accepted a grant award and approved a grant agreement with the Minnesota Department of Human Services in the amount of $200,000 to reduce the unmet opiate treatment needs of the African American community in Ramsey County for the period of May 13, 2020 through September 29, 2020 (Resolution B2020-089).
Attachments
1. Grant Agreement with the Minnesota Department of Human Services