The Hawaii Health and Harm Reduction Center Adult Reentry Program for Adults in Hawaii's Criminal Justice System. - The Hawaii Health & Harm Reduction Center (HHHRC) Adult Reentry Program substantially increases needed opioid MAT services in Hawaii's criminal justice system. The HHHRC project collaborates efforts between SAMHSA, Hawaii's state and county agencies, community organizations and the Hawaii healthcare system to reduce incidence of problematic opioid use and overdose among justice involved persons in the state. HHHRC's MAT-focused Adult Reentry Program moves Hawaii closer to realizing its goal of an accessible continuum of care for people struggling with Opioid Use Disorders (OUD) and co-occurring disorders. HHHRC will reduce incidence of OUD and other Substance Use Disorders (SUD) for justice involved populations by expanding clinic capacity in Honolulu County by 150 unduplicated clients and will open two new clinics in the state located in Hawaii County (project yr.2) and Maui County (project yr.3) respectively. Each of the new clinics will serve 300 unduplicated clients per year. In combination, HHHRC will serve 2850 unduplicated clients by the end of the 5-year project. Individuals served by the project will be adults aged 18 and older diagnosed with OUD and who are within 4 months of reentry from incarceration. The project will emphasize engagement with individuals who have OUD associated risk factors, including homelessness or risk of homelessness and individuals with co-occurring mental health disorders, individuals with history of IV drug use, recent incarceration, and Native Hawaiian/Pacific Islander populations. Alongside MAT as the core Evidence-Based Practice (EBP), HHHRC will incorporate harm reduction strategies and other EDPs such as Motivational Interviewing/Cognitive Behavioral Therapy (MI/CBT) and Screening, Brief Intervention and Referral to Treatment (SBIRT) to effectively engage and treat the target populations. HHHRC has successfully served a unique cross-section of populations and communities at increased risk for health disparities. These include individuals experiencing homelessness, limited English proficiency, adults with OUD/SUD, serious mental illness, specific ethnic populations with a disproportionate burden of chronic disease, lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ) individuals, and persons at risk for HIV/AIDS. HHHRC has ongoing community partnerships with Hawaii prisons and jails assisting clients that are re-entering the community to engage in SUD, mental health care, re-engagement with primary care services, and linkage to social services and training of staff at jails and prisons on Oahu and Maui. HHHRC's long-term community involvement creates a unique combination of organizational skill sets that assure a high level of success for achieving the goals of this project. By the end of the 5-year project term, HHHRC will have significantly reduced incidence of OUD and opioid overdose among justice involved populations in Hawaii by increasing access to, and capacity for, MAT services and overall community availability of overdose prevention tools. The result will be a broader statewide system of coordinated MAT services and overall community availability of overdose prevention tools. The result will be a broader statewide system of coordinated MAT-focused treatment services that complement and enhance the current SUD system of care. Project success will also be reflected by additional key impacts expected beyond the term of the project. These include a strong OUD peer support network; increased training of medical, law enforcement, criminal justice and other personnel in overdose prevention and intervention; a more concrete and receptive OUD/SUD referral and engagement system that overcomes Hawaii's geographic access barriers; and greater data collection and management related to opioid use, overdose, and need for treatment.
