Sponsor: Public Health
Title
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Grant Award from the Minnesota Department of Human Services for Harm Reduction Services and Treatment Referrals
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Recommendation
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1. Ratify the submittal of the grant application to the Minnesota Department of Human Services for harm reduction services and treatment referrals, in the amount of $1,038,351.
2. Accept a grant award from and approve a grant agreement with the Minnesota Department of Human Services for harm reduction services and treatment referrals for the period upon execution through June 30, 2026 in the amount of $1,038,351.
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.
5. Approve an increase in the personnel complement of the Public Health Department by 2.0 Full Time Equivalent.
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Background and Rationale
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Public Health applied for a grant from the Minnesota Department of Human Services to provide harm reduction services and treatment referrals to people who use drugs (PWUD) in Ramsey County and surrounding communities. Between 2018 to 2021, Ramsey County experienced a 169% increase in drug overdose deaths, the largest increase among the Twin Cities metro area. During the same time, opioid-involved deaths among Ramsey County residents increased 438% with 48% of deaths among 35-54-year-old residents. Unsheltered people in Minnesota experience significant disparities related to substance use disorder (SUD). Compared to the total Minnesota population, unsheltered people had an 11 times higher risk of a fatal opioid-involved overdoses, and a 16 times higher risk of a fatal overdose involving methamphetamines and opioids.
Public Health was awarded $1,038,351 in grant funds for the period upon execution through June 30, 2026. The program’s goals are to:
1. Reduce harms associated with drug use among justice-involved individuals and people experiencing homelessness.
2. Reduce the unmet drug treatment needs among justice-involved individuals and people experiencing homelessness.
This work builds on and sustains the existing harm reduction work facilitated by Public Health’s Clinic 555 Syringe Service Program (SSP). The SSP began providing harm reduction services including syringe exchange, education, and naloxone distribution to PWUD in July 2018. In 2023, the SSP provided syringe exchange and harm reduction services to 1,646 individuals, distributing 377,722 syringes through 4,994 client encounters. The funding will allow the county to offer harm reduction services including naloxone kits, wound care, harm reduction education, and syringe exchange to people experiencing homelessness through the SSP and mobile medical unit or Care Van. The program also includes the identification of people experiencing homelessness in need of drug treatment services and providing treatment and support services referral to those individuals. The Care Van allows staff to reach people experiencing homelessness in need of harm reduction services and treatment referrals in community, reducing barriers to care.
For this project, the Public Health staff will provide harm reduction services including wound care and harm reduction services to people experiencing homelessness, that are justice involved, and communities most impacted by opioids and substance use. The grant award will fully fund the 2.0 Full Time Equivalent increase in the personnel complement for clinical services in SSP.
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County Goals (Check those advanced by Action)
☒ Well-being ☐ Prosperity ☐ Opportunity ☐ Accountability
Racial Equity Impact
According to preliminary data from the Minnesota Department of Health, opioid-involved overdose deaths among Minnesotans increased 44% from 2020 to 2021, and the number of deaths has more than doubled since 2019 with significant racial and ethnic health disparities. In 2021, American Indian Minnesotans were 10 times as likely to die from a drug overdose than white Minnesotans. Black/African American Minnesotans were more than three times as likely to die from drug overdose than white Minnesotans. Between 2018 and 2021, American Indians in Ramsey County had the highest rate of drug-induced death at 306.5 per 100,000 followed by White residents (196.8 per 100,000) and Black/African American residents (164.6 per 100,000) (Centers for Disease Control and Prevention, 2023).
Community Participation Level and Impact
The community was not specifically engaged during this grant application process due to the short turnaround time between notification of the opportunity and application due date. However, Public Health did notify the Substance Abuse and Recovery community advisory group, the Community Health Services Advisory Committee and Opioid Community Partnership about the plan to build capacity and to seek funding to enhance the opioid prevention and harm-reduction work in Ramsey County. As part of Public Health’s 2022 opioid response engagement survey respondents ranked supports for people in recovery as extremely important or very important (90%), along with connecting people to services (87%) and helping people in the justice system (86%) as extremely important or very important. Making overdose prevention, medications for opioid use disorder and SUD treatment services affordable and accessible was part of the feedback received.
Public Health also publishes a Community Health Assessment (CHA) and a Community Health Improvement Plan (CHIP) once 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>as an issue. Based on the results of the CHA, Public Health develops the CHIP, which describes how the department and community will work together to improve the health of county residents. The CHIP is developed and implemented collaboratively and defines a vision for the community’s health. Through this process, the community identified opioid response and prevention as a top priority.
☒ 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 $1,038,351 for the period upon execution through June 30, 2026. The grant award will fully fund 2.0 Full Time Equivalent increase in the personnel complement for clinical services in SSP. During the grant period, outcomes and effectiveness of the program will be evaluated to determine the sustainability of the requested positions.
Last Previous Action
None.
Attachments
1. Grant Agreement from the Minnesota Department of Human Services