Recovery Connect provides comprehensive, coordinated, and evidence-based treatment for unsheltered community members with Substance Use Disorder (SUD) and co-occurring mental health conditions in Ramsey County, Minnesota. Recovery Connect is an interdisciplinary collaboration among four Ramsey County departments: Community Corrections, Housing Stability, Public Health, and Social Services; and two community partners: Specialized Treatment Programs (STS) and NUWAY. The project aims to serve justice-involved people entering Ramsey County correctional facilities and unsheltered community members engaging at partner programs and mobile outreach sites. Strategies include case management, the use of Medication for Opioid Use Disorder (MOUD), referrals to licensed Opioid Treatment Programs (OTPs), recovery group programming, outreach and harm reduction education, and recovery support services. Recovery Connect aims to serve 500 people over five years (50 – Year 1, 75 – Year 2, 100 – Year 3, 125 – Year 4, 150 – Year 5).
Project goals include:
1) Reduce the unmet SUD treatment needs of justice-involved individuals
2) Improve behavioral health outcomes of unsheltered community members with SUD and co-occurring mental health conditions
3) Increase connection to sustainable permanent housing for unsheltered community members with SUD and co-occurring mental health conditions
4) Improve delivery of coordinated, comprehensive services to reduce substance use and improve housing stability for unsheltered community members.
Measurable project objectives associated with Goal 1 include:
1) By end of project period, the RN will have provided care related to SUD including MOUD to 300 clients in Ramsey County correctional facilities
2) By end of project period, 100% of justice-involved clients with OUD will be referred to licensed Opioid Treatment Programs (OTPs) following release
Measurable project objectives associated with Goal 2 include:
1) By end of project period, 50 individuals with SUD and co-occurring mental health conditions will have been enrolled in the evidence-based recovery group program
2) By end of project period, 100% of justice-involved clients on MOUD will have received harm reduction education
3) By end of project period, harm reduction education and supplies will have been distributed to 150 unsheltered community members
4) By end of project period, 100% of unsheltered individuals receiving harm reduction education and supplies will be referred to Clinic 555 for screening and treatment of STIs, Hepatitis C, and HIV
Measurable project objectives associated with Goal 3 include:
1) By end of project period, 100% unsheltered clients will have been referred to Coordinated Entry housing assessment by project staff, Housing Stability, or community-based homeless services providers
Measurable project objectives associated with Goal 4 include:
1) By end of project period, 500 total clients (including clients receiving MOUD, recovery group program, harm reduction education/services) will have received case management to support stability across services and housing transitions
2) By end of project period, develop iterative project performance management to ensure timely, quarterly review of data and implementation of quality improvement projects