Essex-Medication-Re-entry-Grant-Expansion (EMRGE) - Abstract. Volunteers of America Massachusetts (VOAMASS) in collaboration with Essex County Sherriff’s Department (ECSD) propose to expand medication-assisted treatment (MAT) and recovery support services (RSS) for incarcerated (detox/diversion, pre-trial, sentenced) and justice involved persons with opioid use disorders (OUD) seeking or currently receiving MAT services. The proposed program, Essex Medication Re-entry Grant Expansion (EMRGE) in northeastern Massachusetts, will draw clients from three ECSD correctional facilities, parole, probation, and drug courts. Essex County continues to battle an incessant opioid epidemic challenging behavioral health and criminal justice services. Untreated addiction and mental disorders make up a significant population moving through the criminal justice system; ECSD has nearly 1,000 inmates receiving MAT for OUDs. Formerly incarcerated individuals have 50 times higher opioid overdose death rate than those non-incarcerated. MAT initiated early and throughout incarceration has significantly improved OUD outcomes; and MAT continued throughout probation showed an effective method of minimizing overdose risk and emergency room discharges. Services addressing social determinants of health needs has also shown to reduce risk of relapse, improve treatment retention, and reintegration into the community. While Essex County provides MAT services behind-the-wall, delivered by contracted providers, these services do not always transfer to maintenance care in the community post-release. The Bureau of Substance Addiction Services has publicly cited the need for a greater number of qualified prescribers of medication for opioid use disorder (MOUD) in the catchment area. EMRGE will provide a trained, credentialed, integrated care team (EMRGE Team) who will facilitate prescriptive, therapeutic, and restorative needs for 950 clients over the five-year funding period; Year 1–160, Year 2–190, Year 3–190, Year 4–200, and Year 5–200. Project staff will expand a continuum of MAT and RSS through whole-person, integrated care targeted for opioid addiction and co-occurring mental health conditions. Interventions include MAT; discharge transition planning, case management, and community-based service, and care navigation for continued maintenance care upon post-release. EMRGE will implement best-practice assessments to determine drug usage and prescription drug monitoring for MAT eligibility; and evidence-based practices for improving treatment retention such as trauma-informed care, motivational interviewing, cognitive behavioral therapy, integrated dual diagnosis therapy, nurturing parents, and tobacco cessation. Program goals include (1) increased capacity in Essex County to provide a continuum of MAT services; (2) expanded MOUD and comprehensive OUD psychosocial services; (3) expanded provision of rehabilitative services through a whole-person, integrated treatment model, in partnership with community-based providers; and (4) reduced recidivism rates by 80% and risk of relapse by 75% by deepening case management partnership between EMRGE, ECSD, and probation centers. EMRGE will build on the long-standing partnership between VOAMASS, ECSD, and a robust network of community providers devoted to long-term mitigation of opioid addiction and recidivated crimes influenced by opioid use. VOAMASS respectfully requests SAMHSA funding for $2,625,000 to implement the proposed EMRGE to increase MAT for incarcerated/justice involved persons with OUD and decrease OU at six-month follow-up.
