Project Grant H79TI084239

ENHANCING ACCESS TO MEDICATION-ASSISTED TREATMENT (MAT) SERVICES FOR EX-OFFENDERS AND HOMELESS WOMEN WITH OPIOID USE DISORDER IN TENNESSEE. - THIS PROJECT WILL ADDRESS A CRITICAL GAP IN ACCESS TO MEDICATION-ASSISTED TREATMENT (MAT) FOR 500 EX-OFFENDERS AND HOMELESS WOMEN WITH OPIOID USE DISORDER (OUD) BY USING AN INTEGRATED, COMPREHENSIVE EVIDENCE-BASED APPROACH TO PROVIDE MEDICATION, BEHAVIORAL THERAPY, COUNSELING, AND RECOVERY SUPPORT SERVICES ACROSS THE FULL CONTINUUM OF CARE. MENDING HEARTS, INC. (THE APPLICANT AGENCY) AIMS TO ACHIEVE COMPLETE RECOVERY FOR PROJECT PARTICIPANTS IN THE NASHVILLE, TENNESSEE METROPOLITAN STATISTICAL AREA, CONSISTING OF BEDFORD, CHEATHAM, DAVIDSON, DICKSON, MARSHALL, MAURY, MONTGOMERY, ROBERTSON, RUTHERFORD, SUMNER, WILLIAMSON, AND WILSON COUNTIES. THE OUD CRISIS IS PARTICULARLY DIRE IN THE CATCHMENT AREA, WHICH RANKS HIGHEST IN TN IN TERMS OF BOTH REPORTED SUD AND CHRONIC HOMELESSNESS. IN TN, THE NUMBER OF OPIOID OVERDOSE DEATHS INCREASED FROM 861 IN 2014 TO 1,304 IN 2018. THE RATE OF HEROIN OVERDOES INCREASED OVER 150%, FROM 147 IN 2014 TO 367 IN 2018. ALARMINGLY, THE RATE OF FENTANYL OVERDOES ROSE CLOSE TO 1,000%, FROM 69 TO 742 DURING THE SAME PERIOD. IN 2020, FENTANYL CONTRIBUTED TO MORE THAN HALF OF ALL REPORTED OVERDOSES IN THE STATE. HOMELESS INDIVIDUALS HAVE SIGNIFICANTLY HIGHER OPIOID-RELATED ER VISITS/HOSPITAL ADMISSIONS AND ARE NINE TIMES MORE LIKELY TO FACE OVERDOSE DEATHS COMPARED TO LOW-INCOME INDIVIDUALS WITH HOUSING. FURTHERMORE, APPROXIMATELY 33.8% OF THE OVERDOSE DEATHS DUE TO OPIOIDS IN TN WERE WOMEN, COMPARED TO 30.5% IN THE US. IN TN, WOMEN ACCOUNTED FOR 44.2% OF OPIOIDS ADMISSIONS AND 37.8% OF THE HEROIN ADMISSIONS TO SUD TREATMENT, YET ONLY 20 OF THE 64 TREATMENT FACILITIES (31%) IN THE STATE PROVIDE SERVICES TO WOMEN; THIS SIGNIFICANT SERVICE GAP LEAVES WOMEN, PARTICULARLY THOSE WHO ARE UNINSURED AND/OR INDIGENT, DRASTICALLY UNDERSERVED. THIS PROJECT IS DESIGNED TO PROVIDE A COORDINATED, PERSON-CENTERED RECOVERY SERVICE MODEL THAT WILL OFFER ACCESSIBLE, EFFECTIVE, AND CULTURALLY APPROPRIATE CARE FOR THIS POPULATION OF FOCUS. THE OUTCOMES INCLUDE AN INCREASE IN THE NUMBER OF INDIVIDUALS WITH OUD RECEIVING MAT, PSYCHOTHERAPY, AND RECOVERY SUPPORT SERVICES, A DECREASE IN ILLICIT OPIOID DRUG USE AND PRESCRIPTION OPIOID MISUSE AT SIX-MONTH FOLLOW-UP, REDUCED RECIDIVISM AMONG EX-OFFENDERS, AND REDUCED HOMELESSNESS. PARTNERING AGENCIES INCLUDE HOSPITALS, ERS, MENTAL HEALTH PROVIDERS, LAW ENFORCEMENT, FAITH-BASED ORGANIZATIONS, EMPLOYMENT PROVIDERS, AND OTHERS TO SUPPORT THE NEEDS OF THESE WOMEN. MS. TRINA FRIERSON, MENDING HEARTS CEO, HAS EXPERIENCED HOMELESSNESS, POVERTY, SUBSTANCE USE DISORDER, AND INCARCERATION. SHE HAS MADE IT HER PRIMARY MISSION IN LIFE TO HELP OTHERS STRUGGLING WITH SIMILAR ISSUES. THE GOALS OF THIS PROJECT ARE: (1) TO DEVELOP OUTREACH AND ENGAGEMENT STRATEGIES FOR RECRUITMENT OF 500 INDIGENT WOMEN WITH OUD (100 PER YEAR); (2) TO CONDUCT SCREENING AND ASSESSMENT TO DELIVER MAT AND RECOVERY SERVICES FOR OUD FOR 500 INDIGENT WOMEN WITH OUD (100 PER YEAR); (3) TO PROVIDE EVIDENCE-BASED MAT AND RECOVERY SERVICES FOR 500 INDIGENT WOMEN WITH OUD (100 PER YEAR); AND (4) TO DECREASE ILLICIT OPIOID USE, PRESCRIPTION OPIOID MISUSE, ILLICIT DRUGS AND ALCOHOL USE AT SIX-MONTH FOLLOW-UP FOR 500 INDIGENT WOMEN WITH OUD (100 PER YEAR) AS MEASURED USING THE GPRA TOOL.