Quality Improvement Fund - Justice Involved - Carbon Medical Service Association (CMSA) proposes the CMSA Carbon and Emery County Justice-Involved Re-entry (JI-R) Program (“Program”) to improve re-integration for Justice-Involved individuals (JI-Rs)pre- and post-release from Carbon and Emery County jails. CMSA has served Carbon and Emery Counties, two rural counties on the CDC’s list of the 220 most vulnerable counties due to high rates of opioid use disorder (OUD) (https://opioid.amfar.org/UT), for over fifty years. CMSA already works with the Carbon and Emery jails and this funding would allow CMSA to enhance the services they offer to JI-Rs pre- and post-release. This proposal is meant to address the disproportionate rate of Substance Use Disorder (SUD)-related deaths in Carbon and Emery Counties. SUD-related death rates from 2013-2022 were 50 per 100,000 persons in Carbon County and 39 per 100,000 persons in Emery County. The only areas in Utah with higher drug-associated death rates were inner-city Salt Lake City and Ogden (https://ibis.health.utah.gov/ibisph-view/indicator/view/PoiDth.SA.html). This proposal is also meant to address rates of incarceration among residents of Carbon and Emery Counties. As overdose deaths increased in Carbon County between 2000 and 2018, the rate of local jail incarceration took a similar trajectory (https://www.vera.org/publications/overdose-deaths-and-jail-incarceration/ut) and the majority of incarcerated were local residents. The pattern was different in Emery County because I-70, a major drug transportation corridor (https://www.justice.gov/archive/ndic/pubs11/18862/transport.htm), transects this very rural county and many of their jail inmates were arrested for transporting drugs. However, the high overdose death rate in Emery County suggests its residents also experience higher rates of incarceration associated with drug use. The Program seeks to reduce SUD-related deaths and improve access to mental health (MH) and SUD treatment to address two critical needs: 1. Facilitate JI-Rs’ access to CMSA services pre-release by having a CMSA licensed therapist and peer support specialist (PSS) team provide onsite care coordination and management services. 2. Have the therapist/PSS team verify JI-Rs’ eligibility for appropriate public benefits, including Medicaid, and assist them with enrollment pre-release. 3. Assess community input by hosting an Advisory Committee, implementing a patient satisfaction survey for JI-Rs, and enhancing relationships between the jails and community agencies to address the physical, social, and MH needs of JI-Rs post-release. 4. Increase access to CMSA services for JI-Rs by hiring an additional licensed therapist at CMSA and by furthering partnerships with local agencies to meet critical social needs, including transportation, housing, education, food, and employment. 5. Offer medication-assisted treatment (MAT) and counseling at CMSA for all types of SUD to improve JI-Rs’ treatment outcomes and reduce the risk of relapse. 6. Provide JI-Rs with a supply of their prescription medications upon release to ensure immediate access to needed medications and ease their transitions to community-based services. This sixth activity includes outreach to JI-Rs post-release to get them into a CMSA clinic as soon as possible. CMSA recognizes that not all JI-Rs may choose CMSA as their care provider; as such, the outreach will include asking JI-Rs whether they are scheduled to receive care elsewhere. While CMSA is well-suited to provide care for JI-Rs, the Program wants to ensure JI-Rs are connected to any system of care to reduce SUD-related deaths and ensure JI-Rs have access to MH and SUD services. The Program will evaluate the number of JI-Rs served pre-release, and those receiving comprehensive care post-release. Other information to be evaluated includes the number of successful connections to local social service agencies, the number of JI-R drug-associated deaths, and Program acceptability in the community.
