MS-CORE (Mississippi Community Overdose Response and Engagement) - The Mississippi State Department of Health (MSDH), through the First Responders-Comprehensive Addiction and Recovery Act, aims to combat the opioid crisis in Mississippi (MS) by equipping first responders and community members with training in the administration and distribution of opioid overdose reversal medications (OORM), overdose prevention, and linkage to treatment and recovery support services. Targeting eight high-need, rural counties, Jackson, Harrison, Hancock, Pearl River, George, Jones, Warren, and Lamar, the initiative will focus on areas disproportionately affected by opioid misuse. The primary populations of focus include first responders, community partners, and individuals at high risk of substance use-substance-related adverse outcomes in limited-service rural communities. The eight targeted MS counties show wide variation in population size and rurality, with Harrison (217,136) and Jackson (147,666) as the most populous, and George (26,331) the smallest and fully rural. Rural populations in Pearl River (71%), Jones (62.5%), and Lamar (53.7%) exceed the state's average of 51%. Poverty rates are elevated in Warren, George, and Jones. Uninsured rates exceed the state average (14.6%) in Pearl River, George, and Lamar, while food insecurity is consistently higher across all eight counties, reaching 22% in George. Housing problems are most acute in Harrison and George (16%), surpassing the state average of 14%. Although all persons in need will be served, Mississippians aged 35-44 (highest overdose rate) and men (2x overdose rate and OD death rate) are expected to be served in large numbers. The FR-CARA project outlines five strategic goals to strengthen OD prevention, response, and linkages to care. Goal 1 focuses on training and education. The project will increase naloxone training completions by 25% annually (Obj. 1.1); train 75, 125, 125, and 175 stakeholders in emerging drug threats in Yrs. 2–4 (total: 500) (Obj. 1.2); deliver at least four statewide trainings on OD awareness and Good Samaritan protections (Obj. 1.3); and expand training reach by leveraging existing community-based workforce and volunteer networks (Obj. 1.4). Goal 2 strengthens community partnerships. MSDH will formalize partnerships with at least two community anchor organizations to deliver OD prevention education (Obj. 2.1); expand the Interagency Naloxone Collaboration to serve as a project advisory committee, meeting quarterly (Obj. 2.2); complete a resource mapping assessment by February 28, 2027, to identify gaps and guide implementation (Obj. 2.3); and engage priority counties in program planning and outreach (Obj. 2.4). Goal 3 enhances infrastructure and service coordination. A care management team will link 100 individuals in Year 1 and 200, 200, and 300 in Yrs. 2–4 to treatment and recovery (total: 800) (Obj. 3.1). MSDH will adopt a two-way referral protocol and other evidence-based policies (Obj. 3.2). Quarterly data reporting and evaluation will guide continuous improvement (Obj. 3.3). Goal 4 expands access to naloxone and low-threshold treatment. At least 100 patients per year (total: 400) will be referred from UMMC’s ED to MSDH’s MSUD program via a shared referral protocol (Obj. 4.1). MSDH will distribute 5,000 naloxone kits annually to individuals and 5,000 kits annually to schools and community organizations (total: 40,000 kits over four years) (Obj. 4.2 & 4.4). The program will also hire a Pharmacist and secure Training and Evaluation Consultants in Year 1 (Obj. 4.3). Goal 5 supports sustainability through a Train-the-Trainer (TtT) model. MSDH will deliver four annual TtT sessions and train at least two new partners each year (eight total) to expand community-based naloxone distribution (Obj. 5.1) and track the number of individuals trained through TtT (Obj. 5.2).
