Preventing Drug Overdoses: Community Prevention and Response - The Missouri Overdose Systems for Access, Infrastructure, and Coordination (MOSAIC) initiative will strengthen Missouri's statewide overdose prevention infrastructure by building regional and statewide systems, partnerships, and workforce capacity to expand overdose prevention initiatives, increase access to OORMs, and improve linkage to treatment, recovery, and other supportive services. MOSAIC will strengthen regional primary prevention capacity through targeted Prevention Resource Centers (PRCs), expand the capacity of street-based service organizations (SBSOs) to create new pathways to treatment and recovery services, enhance cross-sector workforce skills through regional simulation learning intensives, create access to high-quality online overdose prevention and response training, and synthesize statewide data to continuously improve OORM deployment. MOSAIC will participate in a Community Prevention Collaborative to support coordination, information sharing, and implementation of prevention activities across grant objectives. Together, these coordinated strategies will help ensure individuals at risk of overdose are less likely to fall through the cracks between overdose prevention, treatment, recovery, and other supportive service settings. MOSAIC's geographic catchment area is statewide, with concentrated capacity building in Missouri's two high-need metropolitan regions: the Eastern catchment (St. Louis City and County) and the Western catchment (Jackson County/Kansas City), which together accounted for 53% of Missouri's fatal opioid overdoses in 2024. Regional implementation will involve partnerships with PRCs and SBSOs, while statewide activities will expand workforce capacity, strategic OORM deployment, and data-informed quality improvement. The population of focus includes adults with opioid use disorder who are at risk of experiencing or witnessing an overdose and frontline professionals serving youth and/or individuals with SUD. The Missouri Department of Mental Health (PDO FY16 & 21) will lead MOSAIC in partnership with the University of Missouri - St. Louis, Missouri Institute of Mental Health and regional service organizations. The five primary goals of the MOSAIC initiative are: 1) Strengthen regional prevention capacity through Missouri's Prevention Resource Centers; 2) Build the capacity of street-based service organizations to improve linkage to care; 3) Strengthen cross-sector workforce skills in overdose response and education, treatment navigation, and continuity of care through regional simulation learning intensives; 4) Develop and provide statewide asynchronous access to high-quality online overdose education for rural and other populations historically lacking access to overdose prevention and response training; & 5) Use data to optimize OORM distribution and continuously improve the quality and impact of the centralized statewide distribution system. Across the three-year project, MOSAIC will advance prevention by training 1,800 youth-serving professionals, 1,500 individuals through asynchronous online overdose education, and 12 cohorts of healthcare trainees on evidence-based opioid prescribing, while implementing counterfeit pill awareness campaigns reaching 45,000 individuals. To expand crisis intervention care and services and improve access to evidence-based treatment, MOSAIC will distribute 21,000 OORM kits, establish dedicated linkage-to-care capacity to facilitate 1,200 treatment/recovery referrals, and strengthen treatment navigation and support long-term recovery by engaging 200 multi-disciplinary professionals through simulation learning intensives to strengthen continuity of care. To identify and address emerging behavioral health threats, MOSAIC will use integrated statewide data and the Community Prevention Collaborative to identify emerging threats and create resources to guide strategic OORM deployment.
