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OFFICE OF THE MAYOR MIAMI-DADE COUNTY, FLORIDA CA_RLOS A. GIMENEZ MAYOR. June 6, 2018 Mr, Jon Adler Director Bureau ofJustice Assistance Office ofJustice Programs 810 Seventh Street, NW Washin_>ton. DC20531 Re: 13-tiie iirc'?f ,11elice4.ssistc7rtce (BJA) Comprehensive C2plolcl Abbtrse Site-bcired Program (B 4-2OJ8-13c 0 `) Dear Director Adler: In December 2016, the ivliami-Dade.Board Of County Coiiiriiissier rs passed a resolution founding the Qpioid Addiction Task. Force in an effort to curtail the impact that opioids are haling on Our residents and comMunity. Tile Task. Force was comprised of .key stakeholders rep1esentine muitipte sectors. 'Law Enforcement included City of Miami nnc1 ivtiami-D<tdie County Police, City ofltl•ianli and Mitimi-Dade County Fire Rescue, the Eleventh Judicial Circuit Coui t'Drug Court, v1 himi Dade: :Public! Defender's Office, DEA, and the State Attorney S Office. Academic, institutions are Uniteisity of Miami and Florida International University.. Jackson :Behavioral Health 1-lospital, Florida Department of Health in €Miarni-.Dade, Jessie 'Price Con -it -nullity Health Center, and Addiction Services I3oarcl represent public health. "I'he I-loineless 'I rusi and Florida Department of Children and Families represent the social services sector. This group was divided into four committees and charged with making recommendations to 1. ..identify best practices to address the opi:oid epidemic '3. Recommending existing resources to assist opioid addicted individuals. 3. Expanding available longterm treatment options, and 4. Implementing effective interventions .for opioid addicted individual The City ref Miami Col(nl}otritive Eirrly Pre-4rr.est Diversion.Pr'ogr'am accepted the challenge from the Task Force and proposed police .intervention at a critical point in the drug addiction process. They offer a unique opportuinity for people in felony possession_ of opioidss to auoid jail and agree to receive long -terra treatment for substance use disorder (SLID) and ()plaid U.se Disorder (QUM. The choice of partners is indicative of the commitment the keyplayers"in the.communitvare miking to reduce deaths due rio opioid overdoses, :and increase the chances Of personal recovery from St,D/MID.✓'the addition .of a well -qualified evwluation consultant .in, Behavioral `Sc,'ien.ce. Research Institute will enable research -driven technical assistance andreyaltiation services to deterinine the value of the Diversion Program, We applaud the efforts of'the city of Miami .Police, the State Attorney's Office. Jackson Behavioral Health Hospitaland Bchaviorat Science in collaborating ating to tackle the complex physical and .mental healthof ow residents. Sincerely, iMaurfbe J` Ke Deputy Mayor Si"EPHEN P,.CLAR}C o 111 N,W. FIRST STREET ..299TH FLOOR if MINN, FLORIDA 33128-1930 (305) 375-5071 ackson PUBLIC TRUST '•-• HEALTH SYSTEM Miracles mach. 0 June 1,2018 Chief Jorge R. Celina City of Miami Police Department 400 IN4W 24d Aveliuo Miarni, FL 33128 1611 KW, 12th Avenue Miami, FL 33136 www.JacksonHealth.cirg 1 305-585-1111 Re: Bureau qf justice Assi,Ttanee .(WA) CoMprebenSiv,e ()plaid Abuse Site -based Praiycmi (WA-2018-13607) Dear Chief Col ina: The Public 'Health Trust Of Miaini-Dade County, FL dba Jackson Health System (JHS) is a nonprofit, academic healthcare delivery system affiliated with the University of MianatiMiller School of Medicine (UM). JHS has been the prernier•prOvider of healthcare in Miami -Dade County by offering comprehensive *medical care for 41) Whp need it, regardleSs of ability to pay_ As the CountY's safety -net hospital., JHS serves vulnerable, low-income Individuals, JHS consists of its cornerstone, Jackson lyternorial Hospital (J11,41-1), which as founded in 1918 as the 13::bed 'Miami City Hospital. The Main campus just north of doWnto-Wa Miand houses JMH,.as well as Jackson Behavioral Health HopitaI (JBHH). `With 239 beds, IF3T-EH provides comprehensive inpatient and outpatient services for children, adolescents, .and adults, Who are suffering from behavioral, emotional or substance -abuse -issues. With a comprehensive public-aeadeinic psychiatric program, JBHH offers an an -ay of interdisciplinary mental health and substance abuse services delivered within the hospital and the colimumity, .TBHFI has astrong multi-tliselpl Mary team of clinicians, OsyaologisS., psyohiatristdeial worker, and pgychPloy trainees/psychiatric residents to. serve the coannunity%s. behavioral health: needs. JBI-IFI often'', innOVatiVe wellness, trauina-,set)Sitive, and te0yery-hasp4 programs, incinclirtg, Medication ASsisted 'Treatment (MAI), and resources addressing a broad-spectrum of merts.' health and co-occurring disorders, From assessment and admission through trOalin:l3t and diseharge, all 'services are provided in a supportive, and safe environment for those in substance abuse and/or mental health crisis_ The Florida. Department pf Ch ilciren and Families Certifies the hospital as an Aflaitions Receiving Facility offering inpatient detexification. 1'he-TB1-11-1 team will be a full. partrik)r in the City of Miami Police Department's application to the 13ureatt 'of Jug ice . Assistance/ComprehenSive Opioid Abuse Site based Program in Category 3. If funded, INS comnn's to providing screening, assessments, inpatient detoxification and Medication ASsisted rfreatrnent (MAT) as needed. F011oWing the Integrated Ite,atmettt of CoOccurring Disorders (ITC), SBFITI ,will provide oittpatient MAT, group counselling, cognitive heitaVioral health, and ittedieat and social service, rofeitals, One each person, diverted by Miami Police EIS an alternative toInvetvernerit V‘frith the jiiStiee s;/stetn, commits to the treatment alternative, the JBFIFI treatment warn Will work with the individual to develop a personal recovery plan,JBHII seeks lo minimize barriers that clients face N.,v.hen. Seeking pritnaty and/orhehaVioral health:treatment and will address these issues at the beOftning ot sryiee. provisien. JHS is c.enrinitted to participating actively in both proCess and oifteorne evaluations, providing tiainings to .police Officers and to Ongoing Tneetings,.and ceintrinnication A;vith the City of Miami Police..:rhis collaboration will greatly eriha Ife,serviees for the neediest populations in the City .0 i Miarn i. .,. Sin Carlos A. Migoya President and Chief Executive Officer Behaviora Research May 31, 2018 ChiefJorge R. Colina City of Miami Police Department 400 NW 2nd Avenue Miami, FL 33128 Science nstitilte Re: Bureau of Justice Assistance (BJA) FY 2018 Comprehensive Opioid Abuse Site -based Program Dear Chief Colina, Behavioral Science Research Institute (BSRI) currently provides research and evaluation services for federal and statefunded programs throughout South Florida, inlcuding a SAMHSA-BJA grant with the Miami -Dade County Adult Drug Court; The Opioid Response Partnership (ORP). This Program involves key partnerships with those in the current proposal, including individuals with opiaid use disorder, Jackson Behavioral Health's Outpatient Clinic, and criminal justice stakeholders. As a research center, we have stayed at the forefront of public health trends, including the devastating toll substance use - specifically ()plaid use — has had. on corilinunitiesnationally and in Miami, We are eager to partner with. the City of Miami on this initiative, as they have taken a progressive and proactive responseto this epidemic via the development of an Opioid Task Force in which we often participate. For the current proposed Pre -Arrest Diversion Partnership, BSRI commits to serving as the research and evaluation partner. BSRI will collaborate with the City of Miami Police Department, Jackson Health Systems, and other key stakeholders to implement an evaluation 'design that best captures the unique program's client flow, process, and client -specific outcomes. BSRI will work closely with Jackson's Electronic Health Record data, the Police Department data, and additional health and social service cost data (e.g. emergency department utilization, arrest/jail data) to produce outcome models that include reductions in substance use/misuse,reductions in. criminal activity, client retention, and cost estimates. In partnership with the proposed team, BSRI will work to disseminate findings to a strategic feedback group as a sub -committee of the Dpioid Task Force for quality improvement and rapid cycle changes. BSRI offers full support for this proposal, as it will offer evidence -based treatment and comprehensive services to meet a growing need in the Miami community. Sincerely, Angela Mooss, Ph.D. Executive Director, Behavioral Science Research Institute (BSRI) www.bsrinstitute.org amooss@bsrinstitute.:org (786) 717-5599 Helping the People who Help People 1850 SW 8th.Street; Suite 309 Miami, FL 33135 Ti June 6, 2018 Mr. Jon Adler Director Bureau of Justice Assistance Office of Justice Programs 810 Seventh Street, NW Washington, DC 20a3.1. f DLit(:) T. (); ) zii_[Z. Re: Comprehensive Opioid:A.liuse Site -based Pr•ogram FY 2018 Competitive Grant Announcement Deaf• Director _Adler;: Through the s ibinission of this letter; the City of"iMirinti Police :DepArtnxent offers its comtnitme.r l: as the implementing agency foe the rmilti-disc pl.i:ilai , :tear establishing 'Early IDiversion' services for pedple with behavioral and substance abuse challernges:who have come in contact with lawn enforcement through the City.- of iMiami Collaborative Early Pre -Arrest Di -version :Program. If funded by the Bureau o:rJ rstice Assistance (i3)A), this initiative will improve the lives of people suffering from substance use disorder and opioid ttse disorder, icy increasing access to an integrated treatment model that offers critical services ancl support that promotes recovery. The City of Miami Pollee Department (MPD) will commit its Problem -Salving Team (PST) officers and other sworn personnel evorking [n the O stern area, to often a binding treatment agreement 'to people they encounter in possession of opioicls, PST officers will then einplo, a "warm -hand Off' approach tci deliver patients to Jackson 1:1c alth System for integrated treatrtnent services. The City of M.i:ami. Police Department oohs :fnnvai•d to aiding inefforts to expand the continuum of care with Jackson Health System and its team of.uiulti-disciplinary experts in the men-tal :and behavioral health fields. The opportunity to expand the eontiii n:iiii of Goo to ,provide dtv'e;rsion from arrest fits per.fectl?' with the needs of an t nderse tied population vJio often gets lost in the crir tiniil jUstiee system instead .Of receiving the care and services that are desperately needed. -This partnership is a natural tit to Work With lawn enforcement to both preserve add protect puiblic safety, while responding TO the needs of those with co- occurring mental illness and substance abuse. disorders. Sincerely, Jorge R.Colina. Chief of Police -,.,1AytIPULti:E ..SIJPARTViEN! P..0.-BPX .01 li-7.77' a:.,.: ,!1..t1),')t1P!' _ d ere ttv, Ct, i-(,palm t-=) 1)i))tvti•t'l::S.a ] fl:r STATE ATTORNEY ELEVENTH JUDICIAL CIRCUIT OF FLORIDA F. R. GRAFJAM BUILDING 1350 N.W. 1.2TH AVENUE MIAMI, FLORIDA 33136-21I1 KATHERINE FERNANDEZ RUNDLE STATE ATTORNEY June 5, 2018 Chief Jorge R. Colina City of Miaini Pelice'Department 400 NW 2nd Avenue Miami, FL 33128 Dear Chief Colina: TELEPHONE (305) 54i-01i 0 www:mi aniiSAO. cnm Through the. submittal of this letter, the Miami -Dade County State Attorney's Office (State Attorney's 'Office) offers its commitment as a partner in. the planning and implementation or Cily of Miami Collaborative Early Pre -Arrest Diversion Prograrz. The proposed program will.serve as a comprehensive and multi -.faceted response to curtail the impact that the opioid epidemic is having on residents,, families, neighborhoods, local government, the health care system, law enforcement and the judicial system in Miami -Dade County. As youknow, I assumed a leadership role in fighting this epidemic in formulating the Miami -Dade County Opioid Addiction Task Force. Currently, the State Attorney's Office generally provides offenders with non-violent priors a pre-trial diversion program as an alternative to prosecution, The program services criminal defendants allowing them to make significant changes in their lives so that they can avoid further involvement with the criminal justice system. Additionally, the Miami -Dodo' county Drug Court, which. was the first of its kind in the nation, has a specific track for opioid-dependent individuals to receive treatment for their addiction. The City of Miaini Collaborative Early Pre -Arrest Diversion Program provides an innovative approach offering pre -arrest alternatives to divert people suspected of opioid related offenses in hen of arrest to obtain comprehensive social, Medical, and psychological services. This is the only pre -arrest program of its type in Miami -Dade County providing an opportunity to offenders to free themselves of the problems caused by opioid addiction. As a partner in the planning phase and the on -going outcorie evaluation of the proposed pre -arrest. early diversion prograin, the State Attorney'sOffice will also assist in drafting the binding treatment agreement. Additionally, a representative fioni the State Attorney's Office will participate in monthly/quarterly Meetings with the project team, collaborating with MPD, Jackson .,Behavioral Health Hospital, the Miami -Dade County Opioid Addiction Task Force, and Behavioral Science_ Research Institute, to discuss project progress, outcomes, and challenges. The State Attorney's Office is committed to its role in supporting comprehensive cross -system planning and collaboration, while helping to expand the continuum of care for early diversion services, We are looking- forward. to working with the Miami Police Department in this innovative Collaborative Early Pre An'esf Diversion Program. I continue to support progranissuch as this, which lead to a better and safer community for all. SJnce'Ie ,/. r. KATHERINE FERNANDEZ RUN, L> State .Attorney Citv t anti G411LIO T. GONZALEZ, Ph.D. City Manager June 4, 2018 Bureau of Justice Assistance Office of Justice Programs 8.10 Seventh Street, NW Washington, DC 20531 Re: Comprehensive Opioid Abuse Site -based Program To Whom It May Concerns On behalf Of die City of Miami leadership, please accept this letter.of commitment for the '`City of Miami Collaborative Eaily Pre Arrest Diversion Program" project by the City of Police_ Department (MDP), As City Manager, 1 have the executive authority to approve and support the.City of Miami Police Department's application establishing "System -Level Early Diy eision" services for people:with behavioral :and substance abuse challenges Who hive come in contact with Iaw enforcement. Chrertolrn, a historically black neighborhood near downtown ,llicrnii, hcr,s been the epicenter of the crisis in South Florida.. Heroin and prescription painkillers hceve caused dozens of deaths and hund eds of overdoses in South Florida in recent years. 71u ough all of 2016 and thc, f rst six months .of this' year, 177 people died in the city.from opioicl overdoses, according to records compiled by the police department, (Miami Herald; September 27, 2017), Miami -Dade County is h.orne to the largest percentage of people with serious mental illness. in any urban community in the United States, with the highest number o'f'consumers With mental health disorders living Within Miami's city limits. Therefore, innovative progianis to aggiessi-Vely assist individuals with these illnesses and.co-occurring disorders are crucial to the City of Miami. If funded by the Comprehensive Opioid Abuse Site -based Program, the "City of Miami Collaborative Early Pre -Arrest Diversion Program" will improve the lives of people where the opioid;Crisis is at its most critical. This project will mitigate the suffering of those afflicted by co-occurring mental illness and .substance -abuse disorders by increasing access to an integrated treatment model that offers critical services and support that promotes recovery. We will collaborate With our partner, Jackson Health System to ensure the success of this pr ogram. The City of Miami supports all efforts to enhance the cominunity's cotnmitm.ent to providing the necessary treatment for individuals with.mental health and/or substance abuse disorders. The opportunity to expand the continuum of care to provide diversion from.arrest,, aligns ,perfectly with the City's mission to. be a global city that works to improve the quality of life for all who live and visit :Miami, Please be assured of our continued support for this: endeavor. Should additional information be required; please contact me at (a05) 416-1025.. Emilio T. Gonzalez, Ph.D. Miami City Manager OFFICE OF GRANTSADMINISTRr1Tl©N 444 S,\N. 2rid Avenue, 5th Fluor, M am1, Florida 33130 (305) 416-1.509 Fax: (305) 416-2151 Wi.lirt, Address: PiO. Box 330708-0708 Miami, FL 33233..0708 Part I.: Please identify the applicant point of contact (POC) OMB No. 1121-0329 Approval Expires 12/31/2018 Applkant POC Organization Name City of Miami POC Name Lillian P. Blondet Phone Number 305-416-1536 Email Address Iblondet@miamigov.com Mailing Address 444 SW 2nd Avenue, 5th Floor Miami, FL 33130 Part 2: Please identify the application Solicitation Name Comprehensive Opioid Abuse Site -based Program FY 2018 Competitive Grant Announcement Project Title City of Miami Collaborative Pre -Arrest Early Diversion Program Proposed Start Date 10/1/2018 Proposed End Date 9/30/202:1 Funding Amount Requested $900,000 Part 3: Please identify the project location and applicant type LocationProject and ApplicantType Project Location (City, State) Miami, Florida Applicant Type (Tribal Nation, State, County, City, Nonprofit, Other) City U.S. Department of Justice Office of Justice Programs Save nab Part 4: Please provide a project abstract Enter additional project abstract information. Unless otherwise specified in the solicitation, this information includes: • Brief description of the problem to be addressed and target area and population • Project goals and objectives • Brief statement of project strategy or overall program • Description of any significant partnerships • Anticipated outcomes and major deliverables Text should be single spaced; do not exceed 400 words. Project Abstract The opioid crisis is a public health problem and limited resources for treatment strap even the most robust city and county budgets. Law enforcement and first responders are key in efforts to stem the effects of opioid use and dependency. In 2017, the City of Miami Police Department (MPD) handled 911 narcotics -related incidents and arrests. Statistics show that in the first nine months of 2016, City of Miami Fire -Rescue administered 1,700 Narcan doses. Opioid poisoning deaths jumped four fold to 229 between 2013 and 2016. The City of Miami Police Department (MPD) is responsible for the public safety of 453,579 residents and 15 million annual visitors. MPD and Jackson Behavioral Health Hospital (JBHH) will partner to implement the City of Miami Collaborative Pre -Arrest Diversion Program. Funding from the BJA Justice and Mental Health Collaboration Program will support activities under Category 3: System -level Diversion Programs. The cross -discipline collaboration will prioritize adults with opioid use disorders (OUD) and substance use disorder (SUD) who are at a high risk of recidivism. Objectives include the expansion of law enforcement & victim service partnerships; Support of comprehensive cross -system planning and collaboration among law enforcement, health care providers and public health partners; and expansion of law enforcement diversion programs. The Diversion Program will give MPD officers, who encounter a subject in felony possession of opioids within the city's jurisdiction, authority to offer a 12-month treatment program at JBHH as an alternative to arrest and involvement with the criminal justice system. If the person agrees to participate, the officer will ask the person to sign a legally binding agreement formulated by the State Attorney's Office and MPD. The MPD officer will transport the individual to JBHH for screening and assessment, including criminogenic and violence risk assessments by behavioral health specialists. JBHH will admit participants to the hospital for medically supervised opioid withdrawal and the induction of Medication Assisted Treatment (MAT). Participants will receive continuing MAT, and individual and group therapies on a closely monitored outpatient basis under an integrated treatment program for co-occurring disorders. The Diversion Program has a strong evaluation component, using Behavioral Science Research Institute (BSRI) as the research and program evaluation partner, and an established information exchange between MPD, JBHH and BSRI to connect participants directly to treatment. The request to fund the Diversion Program is for $900,000 for 36 months to support the mental health services and provide medication and routine testing. U.S. Department of Justice Office of Justice Programs ave rint; Part 5: Please indicate whether OJP has permission to share the project abstract If the applicant is willing for the Office of Justice Programs (OJP), in its discretion, to make the information in the project abstract above publicly available, please complete the consent section below. Please note, the applicant's decision whether to grant OJP permission to publicly release this information will not affect OJP's funding decisions. Also, if the application is not funded, granting permission will not guarantee that information will be shared, nor will it guarantee funding from any other source. 0 Permission not granted 0 Permission granted (Fill in authorized official consent below.) On behalf of the applicant named above, I consent to the information in the project abstract above (including contact information) being made public, at the discretion of OJP consistent with applicable policies. I understand that this consent is only necessary to the extent that my application is unfunded; information submitted in an application that is funded (including this abstract) is always releasable to the public consistent with FOIA rules. I certify that have the authority to provide this consent. Authorized Official (AO) Consent Signature Date AO Name Lillian P. Biondet Title Director, Office of Grants Administration Organization Name City of Miami Phone Number 305-416-1536 Email Address Iblondet©miamigov.com Note: This document is to be submitted as a separate attachment with a file name that contains the words "Project Abstract." U.S. Department of Justice Office of Justice Programs Y4 nn PROGRAM NARRATIVE City o 'Miami Collaborative Early Pre -Arrest Diversion Program A. Statement of the Problem The opioid epidemic is part of a larger problem of untreated substance abuse disorder. The National Institutes for Health on Drug Abuse reported more than 64,000 drug overdose deaths in 2016, surpassing the 52,404 deaths reported in 2015. The opioid crisis is a public health problem and communities and healthcare organizations have responded with prevention, treatment, and hand -minimization measures. Limited resources for drug treatment strap even the most robust city and county budgets. Law enforcement and first responders are involved in efforts to stem the effects of opioid use and dependency. As the law enforcement agency of the largest municipality in Miami -Dade County (MDC) and the second largest city in Florida, the City of Miami Police Department (MPD) is responsible for the safety of 453,579 residents and over 15 million yearly visitors. One of the challenges facing MPD is the high-level of drug -related incidents in Miami, in particular opioids. In 2017, the MPD handled 911 narcotics -related incidents and arrests. The South Florida Behavioral Health Network plotted deaths in MDC by zip codes and identified the historic African -American Overtown neighborhood in Miami as having the most opioid deaths. David Ovalle (Miami Herald, Dec 7, 2016) called Overtown the 'hot zone' where addicts go to buy drugs and are dying. The most recent statistics show that in the first nine months of 2016, Miami Fire -Rescue used Narcan nearly 1,700 times - more than double the rate of the previous year. Since 2015, at least 31 people have fatally overdosed in Miami's Overtown neighborhood with heroin or fentanyl - often both - in their blood. That makes it the deadliest zip code for opioid deaths in MDC. The City of Miami (City) itself accounted for nearly 43 percent of all 236 county overdoses recorded since 2015 (Miami Herald December/2016). MDC Medical Examiner's Office reported alaiiiiing increases in opioid-related overdoses and deaths from 2005 to 2015. Between 2013 and 2016, 1 of 20 PROGRAM NARRATIVE City of Miami Collaborative Early Pre -Arrest Diversion Program opioid poisoning deaths in the County went from 58 to 229, a nearly 4 fold increase. For 2016-17, Miami had more deaths (118) than MDC (96), which is much larger in both population and square miles. In December 2016, MDC Commissioners foinied a Task Force to assess the opioid epidemic, identify best practices and develop an action plan (released in June 2017). Recognizing the limited effectiveness of traditional law enforcement strategies, the Florida Department of Children and Families recommended that Task Force members improve access to Medically Assisted Treatment (MAT), enhance care coordination for overdose victims, and adopt police diversion programs. The principles of the proposed City of Miami Collaborative Early Pre Arrest Diversion Program (Diversion Program) are in keeping with the Task Force recommendations. The program will emphasize the rapid deployment of public health and public safety resources to high -priority areas to provide "earlier" intervention services. Both the Task Force, and the Miami -Dade State Attorney's Office will assist in the planning of the proposed project. MPD and Jackson Behavioral Health Hospital (JBHH) of Jackson Health System will partner to implement the Diversion Program. Funding from this opportunity will support activities under Category 3: System -level Diversion Projects. This cross -discipline collaboration of local law enforcement and mental health professionals will prioritize adults with substance use disorders (SUD) and opioid use disorder (OUD), who are at a higher risk of recidivism. By reducing recidivism among this population, the number of encounters between law enforcement and people suffering from SUD and OUD decreases. For every encounter that is eliminated, there is a decrease in opioid overdoses and narcotics -related arrests/incidents, a barrier to treatment that is removed, and an improved and coordinated access to supportive benefits is provided. The Diversion Program provides a positive linkage between law enforcement and mental healthcare resources at 2 of 20 PROGRAM NARRATIVE City of Miami Collaborative Early Pre -Arrest Diversion Program Intercept Service Level 0. MPD and JBHH will partner with Behavioral Science Research Institute (BSRI), who will serve as the project' s research partner. BSRI will document program operations and processes, measure program outcomes, use a data -driven approach for continuous program improvement, assess implementation fidelity and help develop a sustainability plan to grow the early Diversion Program. Miami's Strategic Plan Public Safety Priority aligns with the proposed program as it seeks to create and sustain a safe environment for residents, businesses and visitors. Having a safe and healthy environment to live, work and play is a critical component of the quality of life for all Miami families including those directly touched by the opioid epidemic. Miami's police officers and firefighter -paramedics are highly trained in responding to emergency situations and are critical in connecting individuals in need with treatment at the earliest possible stage of system interaction. The Diversion Program will expand crime prevention programs and foster a sense of safety in Miami's communities, while providing a proactive response and innovative diversion program to "high frequency" utilizers of services. The proposed initiative's law enforcement/ mental health professional collaboration will reduce recidivism, and opioid overdoses/incidents. By disrupting addict use patterns, the Diversion Program will also exert economic pressure against illicit drug traffickers by reducing the number of potential buyers supporting their operations. The high cost of medical and mental health treatments within the parameters of the proposed program exceed MPD's and JBHH's capacity to fund the program. The initial and ongoing lab work, urine tests, monthly medication costs for 50 patients, telehealth equipment, treatment staff and case managers necessary require federal assistance in order to plan and implement the program for 36 months. Additionally, implementation of the proposed initiative will 3 of 20 PROGRAM NARRATIVE City of Miami Collaborative Early Pre -Arrest Diversion Program require extensive program evaluation and data collection, costs for which exceed existing funds to support project operation. The Sequential Intercept Model for Developing a Criminal Justice and Behavioral Health Partnership for system -level change calls for the creation of a task force, comprising mental health, substance abuse, criminal justice and other stakeholders, and encourages collaboration among them. Faced with a growing opioid epidemic and rising numbers of overdose deaths, Miami -Dade County convened the Opioid Task Force (Task Force) in December 2016. The June 2017 report concluded with recommendations to fill the gaps in service for those with an opioid use disorder. These recommendations align with the Action Steps in the Intercept Model. Current programs that exist are the pre-trial diversion program for those arrested and taken to drug court. This BJA-SAMHSA funded collaboration between JBHH and the 1 lth Judicial Circuit allows individuals to undergo detoxification and MAT and remain in touch with the court to monitor their sobriety for an extended period. The South Florida Behavioral Health Network funds JBHH to serve individuals outside the court system to go through detoxification and begin MAT. Other non-profit groups provide detoxification, clinical therapy, short-term residential and social services for this population. JBHH is the only comprehensive hospital -based substance and opioid abuse treatment facility in Miami -Dade County. Patients with substance use disorder (SUD) or opioid use disorder (OUD) are at ten times the risk of an overdose death in the first month after hospital discharge. Despite the cost, MAT is highly effective in managing OUD and withdrawal symptoms when combined with evidence - based therapy practices. The Diversion Program partnership with JBHH concretizes the Task Force's recommendation for a pilot project at a hospital, which can initiate detoxification and MAT, and includes therapy for opioid dependence. However, staffing for the anticipated increase 4 of 20 City of PROGRAM NARRATIVE lam! Collaborative Early Pre -Arrest Diversion Program of treatments in the ED and admissions to the hospital are not budgeted, especially not in a year when safety -net hospitals like JHS/JBHH are incurring Disproportionate Share Hospital (DSH) and Low -Income Pool (LIP) funding losses. Funds to cover the many lab tests and drugs are vital to the success of the individual in defeating addiction. Federal funding to combat the opioid crisis is being funneled through the states and those funds are not yet available to local providers. The Florida Senate approved a Medicaid expansion plan in 2015 under the Affordable Care Act (ACA), which the governor rejected. That left a gap in insurance coverage for many low income Floridians that also directly affected non-profit hospitals, especially large public safety -net hospitals like JHS. B. Project Design and Implementation The Diversion Program is a waini hand-off approach patterned on the Law Enforcement Assisted. Diversion (LEAD) program in Seattle, WA. LEAD diverts people suspected of low-level drug and prostitution offenses at pre -booking to obtain social, medical, and psychological services. MPD's pre -arrest Diversion Program follows the LEAD program model to divert those suspected of low-level drug offenses from jail and prosecution and into case management and other supportive services. Compared to controls, LEAD participants had 60% lower odds of re -arrest during the 6 months after evaluation entry, and both a 58% lower chance of arrest and 39% lower chance of being charged with a felony over the longer tent. These statistically significant differences in arrests and felony charges for LEAD versus control participants indicated positive effects of the LEAD program on recidivism. MPD officers, who encounter any subject of legal age and any gender who meets the 21st Century Cures Act requirements in felony possession of opioids, will have the authority to offer them a 12-month program of direct treatment services at JBHH as an alternative to arrest and entering the criminal justice system. If the person accepts the offer to participate, the officer will 5 of 20 PROGRAM NARRATIVE City of Miami Collaborative Early Pre -Arrest Diversion Program ask the subject to sign a legally binding agreement foiinulated by the State Attorney's Office and MPD. Because the highest incidents of opioid use occur in Overtown, officers who comprise the Overtown Problem Solving Team (PST) will receive a ten (10) hour Diversion Program Advanced Training to ensure law enforcement properly executes its role in the process, the legalities of the binding agreement, and polices/procedures. The Program Manager from JBHH's treatment team will give PST officers an understanding of the treatment process participants will undergo. While Overtown is the "hot zone" for opioid activity, per department policy, MPD will not limit the program exclusively to Overtown. To receive priority consideration, MDP has included with this proposal a set of recommendations that are being used to design the solution and evaluate the proposed initiative. The Diversion Program will be following three of the four Task Force committee suggestions: Healthcare Solutions; Treatment and Recovery; Law Enforcement, First Responders and Justice. Proposed project objectives aligning with COAP's designated program objectives include: Objective 1;: Objective 2 Objective 3 Expand law enforcement and victim service partnerships. Encourage and support comprehensive cross -system planning and collaboration. Expand law enforcement diversion programs. In order to address mandatory project components for Category 3, the Diversion Program will establish a team of stakeholders from across government and the community to engage in the planning process. The composition of the team will include MPD, JBHH, BSRI, the Task Force and the State Attorney's Office. The project will document the impact of the opioid epidemic based on local and regional data, and will include a project coordinator to designate at least 50% of his/her time to daily operations. An administrative services assistant will work alongside the project coordinator part time 30 hours per week to assist with daily program operations. In the Diversion 6 of 20 PROGRAM NARRATIVE City of Miami Collaborative Early Pre -Arrest Diversion Program Program, team members will work closely with BJA's designated TTA providers, as well as an evaluator who may conduct a future site -specific evaluation. The project will track quarterly perfouiiance measures with full consideration of data collection requirements, and will budget for travel expenses for 3 staff to attend a national meeting in Washington D.C. Areas that the proposed project will address include: ® Linking high frequency drug users with evidence -based treatiiient and recovery support services, to reduce overreliance on emergency health care and the criminal justice system. ® Expanding use of cognitive behavioral treatment, in combination with MAT, to help offenders engage in the treatment process, and modify their behaviors related to opioid abuse. ® Supporting the mandatory project coordinator position. • Engaging a research partner to conduct action research providing assistance in identifying performance measures, tracking measures to assist with program implementation, providing subject expertise, conducting performance evaluations, and/or outcome evaluation assistance. The Pre Arrest Diversion Program partners' responsibilities include: MPD serves as the implementing agency for the multi -disciplinary team establishing pre - arrest diversion services for people with behavioral and substance abuse challenges who have come in contact with law enforcement through the proposed initiative. MDC Opioid Task Force set the targets for the County, fostering this first-time collaboration between law enforcement and a behavioral health hospital. The Task Force will be receiving reports from this partnership effort. The State Attorney's Office is collaborating with MPD to foriiiulate a legally binding agreement that can be offered to adults of any age and gender who meet the 21st Century Cures 7 of 20 City of PROGRAM NARRATIVE iami Collaborative Early Pre -Arrest Diversion Program Act requirements regarding felony possession of opioids. They will assist in the planning phase of the project, to contribute to program progress, outcomes and challenges. Jackson Behavioral Health Hospital (JBHH) is in a unique position to provide critical and comprehensive care along the continuum of care from the initial diagnosis and evaluation to ongoing medical and therapeutic treatment. JBHH treatment team will provide evidence -based services (MAT) to participants using Integrated Treatment for Co -Occurring Disorders. Behavioral Science Research Institute (BSRI) will be responsible to plan data collection, protect data privacy under HIPAA, monitor and evaluate services through regular partner meetings, develop the Evaluation Plan and adhere to the Category 3 Implementation Guide. The following Diversion Program process was developed by MPD, JBHH and BSRI: 1VIPD , ofFicers'offer`a subject (legal adult) m felony possession of opioids a choice between a`l2 month diversion program to receive treatment`or routine cri final justice processing. • CRIMINAL JUSTICE PATH — subject is arrested, processed through the court system, and does not enter the Diversion Program. • DIVERSION PROGRAM PATH — MPD officer has subject sign binding agreement; calls JBHH Emergency Department (ED) to alert staff that they are in transit. Police conducts warm hand-off to.,.... the,LCSW_or.CHW. JBHH registers ard ,., completess full assessment and screening of subj ect (crimmogemc risk, needs assessment,' behavioralhealth :, evaluation) . • FINANCIAL ASSESMENT to determine insurance eligibility/coverage. If eligible, enrolled in coverage. NOTE: Health insurance carrier is billed first before grant funds for treatment, medications, and lab costs. • LCSW conducts BIOPSYCHOSOCIAL ASSESSMENT for substance abuse and mental health disorders, evaluation of criminogenic and violence risk factors to identify those who might commit violence in the future and be a threat to public safety. • Family Practice Advanced Registered Nurse Practitioner (ARNP) completes medical history to include prescribed medications and evaluates patient's mental health status. If needed, provide emergency medical treatment. • Conduct PSYCHIATRIC EVALUATION & review inforrrration from the LCSW, CHW and ARNP. Psychiatrist evaluates severity of the opioid/substance use disorder. 8 of 20 PROGRAM NARRATIVE City of Mk, i Collaborative Early Pre -Arrest Diversion Program • Mental healthcare team works with subject to develop personal recovery treatment plan and CHW is assigned to remain in long-teini contact with the subject/patient to encourage continued engagement in the recovery treatment plan. • JBHH Program Manager provides subject/patient assessment update to MPD Program Director Case Management, service coordination and opioid recovery treatment services provided to subject/Patient as per recovery treatment 'plan. Wben patient complies with 12- month treatment .' program, JBHH notifies MPD that the patient is ehgible for discharge from treatment • Physicians with DATA 2000 waiver start induction of Medically Assisted Treatment (MAT) to mitigate symptoms of opiate withdrawal. MAT is combined with evidenced -based behavioral interventions as outlined in Integrated Treatment of Co -Occurring Disorders. • For inpatient residential care, the patient is transferred to local Rehabilitation Center. • When social services are needed, the CHW makes social service referrals. • Patient begins the outpatient treatment plan with weekly to monthly drug screenings, MAT treatment, and ongoing therapy to manage opioid use disorder, substance use disorder, serious mental illness, or other co-occurring disorders. • Patient is assigned to outpatient individual/group psychotherapy, Cognitive Behavioral Therapy, and other recovery -based treatment programs. • Provide monthly updates to MPD on patients' progress. • If patient relapses/does not comply with agreement/treatment plan, CHW contact patient to request voluntarily return to program. If patient cannot be found/refuses to return, JBHH will petition for an ex-parte order (Marchman Act) for involuntary treatment. MPD will serve the ex-parte order and bring the patient to JBHH to continue treatment or will jail for failure to comply with agreement. BSRI has a history of collaboration with JBHH's Opioid Clinic on a BJA-funded Adult Drug Court enhancement grant, collecting perfoiiriance assessment data. The Opioid Addiction Task Force has collaborated with JBHH to address the issue of opioid abuse in the community. Additionally, the City and MPD continuously collaborate with the State Attorney's Office on public safety issues. Continuing these partnerships for the proposed early diversion initiative will help in the planning and implementation of the project leading to successful achievement of the stated objectives. MPD commits to train its entire force in this program and will track number of officers trained per year and number of officers receiving the 10-hour intensive Diversion Program training. MPD 9 of 20 PROGRAM NARRATIVE City of Miami Collaborative Early Pre -Arrest Diversion Program will also keep records of all who are offered the treatment option, those who accept and those who are retained. MPD will check Florida Crime Info illation Center (FCIC) and National Crime Inforination Center (NCIC) databases on a monthly basis to flag participants who incur subsequent arrests. MPD will assign an experienced officer as Project Coordinator. The law enforcement policies and processes for the Diversion Program will be added to MPD 's Departmental Orders, which dictate police procedures. MPD will assign the Executive Officer to the Police Chief as the Program Director (Director) who will oversee the overall program implementation, facilitate policy decision -making process, develop data collection and information sharing processes, and attend partners' meetings. The Director will draft the Departmental Order (DO) to be reviewed and approved by the Professional Compliance Section. Reporting directly to the Chief of Police, the Section ensures compliance with national accreditation standards per the Commission on Accreditation for Law Enforcement Agencies, Inc. (CALEA). The Director will also work with MPD's Training Administration Unit to develop and roll out police officer Diversion Program training. Persons with SUD and OUD face significant barriers to treatment. Economic instability prevents many from accessing preventive healthcare and only a health crisis brings people to an emergency department. Though it serves as one of the nation's leading centers for trade, banking, tourism, and finance, Miami is among the poorest cities of its size in the country (28.3% of residents live in poverty). The Diversion Program is an opportunity to align the resources of law enforcement and the healthcare sector to help participants overcome these barriers to rehabilitative treatment. Furthermore, it will protect our most vulnerable residents from becoming victims of this epidemic. 10 of 20 City of Mia PROGRAM NARRATIVE i Collaborative Early Pre -Arrest Diversion Program As the county's public health system, JBHH's capacity is already stretched thin with the increase of opioid abuse and overdoses. Noinially, participants would have been lost to the criminal justice system and not routed to care as MPD does not have a local program to assess and treat individuals in custody. With this program, each year there will be about 50 people with significant opioid addiction/mental health needs, who are at higher risk of reoffending, receiving intensive 12-month treatment that is not currently available. If awarded, $883,586 in grant funds will be utilized over a 36-month period for one (1) Licensed Clinical Social Worker, two (2) Community Health Workers and associated clinical costs, including MAT and the Research Partner for the successful treatment of an average of 50 participants/year. The research partner will ensure guidelines are properly developed to maintain adherence to program design and evidence - based models. Grant funds will also be utilized to purchase a computer and hotspot for the Program Coordinator, and a computer for the Admin Services Assistant, and pay for mandatory travel meetings. This Diversion Program will be the first of its kind in Miami and MDC to legally bind participants to direct substance abuse and mental health treatment services without having to enter the criminal justice system. Current local government programs for individuals found in felony possession of illegal substances are either within the criminal justice system or it is strictly voluntary, allowing the person to end treatment at any time. The Diversion Program will be a model that can be replicated by MDC and other jurisdictions nation-wide, which involve individuals with significant substance abuse needs and a higher risk of recidivism. All evaluation data to assess and process outcomes of this program will be overseen by BSRI. JBBH Cerner data will include comprehensive patient -level indicators including diagnoses, 11 of 20 PROGRAM NARRATIVE City of Miami Collaborative Early Pre -Arrest Diversion Program treatment plans, drug screenings, and encounters with the JBBH clinical team. This data is owned by Jackson Health System and will be transferred to BSRI via secure FTP server upload without patient identifiers. BSRI will also monitor program processes via patient -flow diagramming and tracking of overdose cases at stakeholder meetings and with input from members from MPD, SAO, JBBH, and other involved parties. The process data will be used to track efficiency in getting patients into services and in meeting the needs of the local community. All outcome and process data will be shared and reported to stakeholders via monthly meetings for process refinement and improvement. Qualitative data via focus groups will be captured with a subset of patients to identify treatment challenges and successes as well as to gather additional infoiination to reach those not in care who are at high risk of overdosing. A monthly snapshot report will be provided to the City and will include a process and an outcomes section with analysis based on the goals and objectives outlined for the program and consistent with the evaluation design. All data will be reported in aggregate fol.ni to protect patient identity. C. Capabilities and Competencies The City will serve as the fiscal agency for this project and MPD will function as the implementing department in partnership with Jackson Health System, which operates JBHH. The City manages 34 departments and agencies with approximately 4,346 employees and has an operating budget of $979 million dollars including $75 million federal, state, and local grants. MPD has extensive experience in managing and implementing DOJ grants. In 2016, the MPD Administration Division provided administrative and financial oversight for 34 grant -funded programs, totaling $24,894,788, In December 2014, the MPD received re -accreditation from the Commission on Accreditation for Law Enforcement Agencies (CALEA) reinforcing MPD's 12 of 20 PROGRAM NARRATIVE City o, flll *arn1 Collaborative Early Pre -Arrest Diversion Program commitment to quality law enforcement and excellent policies and procedures. MPD will monitor grant expenditures and drawdowns, which are subsequently reviewed by the City's Management and Budget Department. As required by DOJ, tracking drawdowns and expenditures will be maintained separately from other funding. Expenses will be handled by the City's Finance Department, which was recently awarded the Certificate of Achievement for Excellence in Financial Reporting. JBHH provides comprehensive inpatient and outpatient services for children, adolescents, and adults who are suffering from behavioral, emotional or substance -abuse issues. JBHH offers an array of mental health and substance abuse services delivered within a full continuum of care — emergency, inpatient, and outpatient settings. In FY 2016-2017, more than 6,000 individuals received inpatient treatment. Of that number, 596 received treatment for substance abuse. The Florida Agency for Health Care Administration licenses and the Joint Commission's Hospital Accreditation Program accredits all JHS hospitals. The Florida Department of Children and Families certifies the JBHH substance abuse services for the Inpatient Detoxification Program. Executive Officer to the Police Chief, Eldys Diaz, will function as the Program Director for the Diversion Program. Officer Diaz will be the liaison between MPD and JBHH, as well as the primary contact for all required grant reporting. Officer Diaz will oversee officer Diversion Program training, develop a data sharing agreement with JBHH, and coordinate monthly meetings and updates. Officer Diaz is an 11-year MPD veteran with extensive experience in special projects aimed at improving efficiency agency -wide. As Executive Officer to the Chief, Officer Diaz is tasked with researching and implementing emerging evidence -based models and technologies for crime prevention innovation in the City of Miami. 13of20 PROGRAM NARRATIVE City of Miami Collaborative Early Pre -Arrest diversion Program Dr. Patricia Ares -Romero will oversee the JBHH Diversion Program treatment team as the Program Manager. She will be responsible for hiring and training staff, refining treatment procedures, overseeing data collection, and working with the research partner. Dr. Ares -Romero is an experienced psychiatrist and currently JBHH Chief Medical Officer with expertise in integrating evidence -based treatment modalities and best practices. Officer Walter Byars will serve as the Diversion Program Project Coordinator. The Project Coordinator will manage the day-to-day operations of the program during both the planning and implementation phases of the project. The Project Coordinator will work closely with BJA's TTA providers as well as an evaluator who may conduct a site -specific or cross -site evaluation in future years, and responsibilities of this role will be data -driven and data -inspired. Tasks will include identifying the needs of the community, design and appropriate outreach and prevention strategy, organize and lead stakeholder meetings regarding project implementation, respond to requests for data and information about the initiative, and monitor continued success of implementation. The Project Coordinator will be housed within MPD and will dedicate approximately 20 hours per week to the proposed initiative. Officer Byars is a 14-year MPD veteran and has extensive experience in community outreach and pilot program implementation. His most recent assignment involves managing a number of youth mentorship cases through the agency's Community Relations Section. Behavioral Science Research Institute (BSRI) will serve as the research partner and evaluation team for the Pre -arrest Diversion Partnership Program. B SRI has more than 40 years conducting program evaluations related to federal and state initiatives for behavioral health services, criminal justice, and integrated care. BSRI currently works with JNHH's Opioid Clinic 14 of 20 PROGRAM NARRATIVE City of lam' Collaborative Early Pre -Arrest Diversion Program on a BJA-funded Adult Drug Court enhancement grant and collects perfoinnance assessment data. BSRI is well -versed in action research frameworks and emphasizes the context that a program operates in to better elucidate quantitative findings Additionally, BSRI researchers are trained in rapid cycle monitoring and quality improvement models and incorporate these process data into reporting and feedback loops with key stakeholders. BSRI has extensive experience collecting and analyzing qualitative and quantitative data and in reporting within federal data systems, including the Performance Management Tool (PMT), as well as collecting and analyzing client outcomes, cost -per client and other cost figures, and quality assurance measures. Prior to executing the evaluation plan and data transfer, BSRI will sign a Business Associate's Agreement (BAA) with JBHH that outlines the secure transfer of Electronic Health Record (EHR) data and patient consent process. The program timeline includes planning and implementation, and activities include: V Planning (months 0-4): Grant award notification and grant contract review by Miami City Commission; develop and finalize MOU and contracts; project planning sessions are conducted with MPD, JBHH, BSRI, Task Force and State Attorney's Office; health care partner to hire and train staff and initiate pre -service training on program model, services and cultural competency for staff; design data collection processes and data sharing agreement between MPD, JBHH and BSRI; receive technical assistance from BJA's TTAprovider. ✓ Implementation (months 5-36): Conduct diversion program advanced training for Overtown PST officers and conduct diversion program introductory training for sworn police officers (annual training throughout remainder of diversion program); collect outcomes, measurement of goals and objectives and performance measurement for quarterly report 15 of 20 PROGRAM NARRATIVE City of Miami Collaborative Early Pre -Arrest Diversion Program (recurring activity throughout remainder of grant period); begin diverting opioid users/high risk offenders to treatment services; conduct monthly partner meetings with MPD, JBHH and BSRI for project planning, case review and planning sessions (ongoing through end of grant period); review 1st year program performance and adjust program as needed; MPD reviews Departmental Order for revisions to protocol and officer training and provide updated trainings; meeting to review all final program outcomes. Potential barriers to implementing the project and strategies to overcome these barriers: artier t6 Implenu ntatio� trategie.s to Overcome Participant may transportation not have JBHH will provide the client with a MetroRail or MetroBus pass for the next appointment. Participant may not have eaten, especially if homeless JBHH will provide the person with a meal card to use in the main hospital cafeteria. Participant fails to attend a treatment session At the initial session once registered as a patient, CHW will with permission from the patient, download a telehealth program on the patient's smart phone that enables face-to-face communication. JBHH already has the infrastructure in place and there is no cost to download or use the application under Jackson's license. CHW will be able to remain in close touch with participant. Participant fails to attend multiple sessions; does not respond to attempts to reach them MPD will check Florida Crime Information Center (FCIS) and National Crime Information Center (NCIC) databases on a monthly basis to flag participants who incur subsequent arrests. Participant refuses to return to treatment JBHH will request an ex parte order under the Marchman Act. MPD will serve the order and return the patient to treatment or to jail if they refuse to complete treatment. D. Plan for Collecting the Data Required for this Solicitation's Performance Measures MPD is creating the Diversion Program collaboration so law enforcement can identify prospective participants and directly connect them to treatment services at JBHH. MPD and JBHH will work together to develop a data sharing agreement to guarantee HIPAA privacy and establish and revise data collection criteria for performance measures. MPD will utilize their public safety 16 of 20 City of Miami Coll PROGRAM NARRATIVE borative Early Pre -Arrest Diversion Program records management system to track the number of people to whom the Diversion Program is offered, number ofpeople registered in the program, location of their encounter, demographics and criminal charges which would have been applicable had the subject not been placed into treatment. MPD will check Florida Crime Information Center (FCIC) and National Crime Information Center (NCIC) databases on a monthly basis to flag participants who incur arrests. During the first four months, MPD, BSRI and JBHH will develop protocols for collecting, tracking, and exporting data reports from their respective programs. Data fields to be collected and analyzed in the aggregate will include: trainings, agreements signed, client demographics, screening assessment scores, MAT, attendance, drug and urine tests, linkages to care, development of personal recovery plan, program completion and goals reached. The Program Evaluator will use the data to generate monthly performance assessments. BSRI will report performance measures and data collected to the MPD Project Director, MPD Project Coordinator, and JBHH Program Manager. Program Objec es Performance,Measures DatavGrantee Provides 1. Expand law enforcement and Outcome Measure la.# of people in program who victim service partnerships 1. Reduce recidivism rate in incur arrest during 12-month SUD/OUD target population. treatment lb.#of people in program who incur arrest 6 months after completing program 2. Encourage and support 2a. # of people offered program; # comprehensive cross -system of people signing agreement planning and collaboration Outcome Measure 2b. # of people relapsing/not among officials who work in 2. Increase # of SUD/OUD complying with agreement; # of law enforcement, emergency individuals receiving case people completing treatment. medical services, health care management and service 2c. # of behavioral health and # of providers and public health coordination services, including criminogenic risk/need screening partners evidence -based treatment assessments completed; models. 2d. # of people receiving treatment using Medication Assisted Treatment (MAT) and 17 of 20 PROGRAM NARRATIVE City of Miami Collaborative Early Pre -Arrest Diversion Program Integrated Treatment for Co - Occurring Disorders (ICT). 3. Expand law enforcement Outcome Measure 3a. # of sworn officers diversion programs 3. Increase capacity of MPD to completing Diversion Program identify and respond Introductory Training per year. appropriately to incidents in 3b. # of Overtown PST officers which individuals with completing Diversion Program SUD/OUD are involved. Advanced Training per year. Primary sources of data will include the Cerner EHR system from JBBH, MPD reports on number of individuals picked up and transported, data from first responders regarding Opioid overdoses and Narcan use, and qualitative data from patient focus groups for patients willing to participate. Because all parties involved are members of the team of stakeholders, relationships and data sharing have been discussed at length, and overdose and Narcan tracking reports are already shared. BSRI will execute a BAA with JBBH for data sharing within Cerner to minimize barriers with patient -level data. As with any JBBH program, patients have the right to refuse consent allowing providers to share their data. In this case, these patients will not be included in the program, but will still receive services. Regarding qualitative data — some patients may not feel comfortable participating in a focus group and this may present a barrier in capturing process data about treatment services; however, the groups will remain voluntary. No other barriers for aggregating data are envisioned. Data Management. BSRI will work with the Project Director and Project Coordinator during the first quarter to develop protocols for collecting, tracking, and exporting data reports via Cerner EHR and MPD reporting systems consistent with the evaluation design and program goals. BSRI will create a program client registry with comprehensive data, which will be used to generate performance assessments and to assist in population health management. 18 of 20 City of PROGRAM NARRATIVE lam! Collaborative Early Pre -Arrest Diversion Program Program Monitoring. Performance assessments will be submitted to MPD and JBHH monthly and will include: tracking progress toward client, program, provider level and system - level goals and objectives, tracking the number of patients enrolled in program services, medical and behavioral health indicators for consumer improvement, and other BJA required indicators. Quantitative and qualitative data will be used to determine which clients benefitted most from various combinations of services based on behavioral health diagnosis, medical issues, ancillary services support, race/ethnicity, age, gender, and retention in services. BSRI will analyze data on services received, and estimates of cost of care and hospitalization, based on healthcare coverage or lack of insurance and type and length of stay. Program Enhancement and quality Improvement. A Performance Improvement Plan will assist the program in attaining its goals and objectives and improve program quality. BSRI is trained and certified in the I IATx Quality Improvement Process and personnel will be involved in ongoing quality management, measurement, and feedback processes. Process data will be examined relating programmatic processes to socio-demographic variables identify a correlation. Findings will be reported to MPD and JBHH and strategies will be employed to minimize disparities and maximize comprehensive health outcomes for patients enrolled. After federal funding ends, the proposed pre -arrest Diversion Program will be financially sustained through the establishment of a collaborative network of partners with resources to support program operations. Partners will contribute financial resources for medication assisted treatment and comprehensive psychosocial services; first -responders and opiate -related response training; and substance abuse treatment partners. MPD will seek funding, including but not limited to, developing and implementing a stable funding source to support opioid addiction services, including paying for the appropriate medication(s) in MAT. 19 of 20 PROGRAM NARRATIVE City of Miami Collaborative Early Pre -Arrest Diversion Program The early Diversion Program will create savings in healthcare and criminal justice costs, which will foster an increasingly sustainable service model as the program continues. According to the Task Force fmal report, every $1 invested in addiction treatment yields a return of between $4 and $7 in reduced drug -related crime, criminal justice costs and theft. When savings related to healthcare are included, total savings can exceed costs by a ratio of 12:1. Federal and statewide laws can be strengthened by incorporating a broader definition of the controlled substance analogues to address fentanyl, its derivatives, and other powerful unknown synthetic opioids. Proposed legislation, such as Florida House Bill 477 and Senate Bill 150, would target persons selling fentanyl and carfentanil and charge them with manslaughter, thereby making it easier to prosecute drug dealers. With this funding, the City of Miami Collaborative Pre Arrest Diversion Program will become MPD's standard operating procedure, so that law enforcement dialogue about how to treat persons with opiate addiction increasingly shifts to a proactive focus on early intercept for treatment rather than punishment within the criminal justice system. 20 of 20 OFIAt TS.QOV� WORKSPACE FORM 1-800-518-4726 SUPPORT@GRANTS.GOV This Workspace form is one of the forms you need to complete prior to submitting your Application Package. This form can be completed in its entirety offline using Adobe Reader. You can save your form by clicking the "Save" button and see any errors by clicking the "Check For Errors" button. In -progress and completed forms can be uploaded at any time to Grants.gov using the Workspace feature. When you open a form, required fields are highlighted in yellow with a red border. Optional fields and completed fields are displayed in white. If you enter invalid or incomplete information in a field, you wit receive an error message. Additional instructions and FAQs about the Application Package can be found in the Grants.gov Applicants tab. OPPORTUNITY& PACKAGE DETAILS: Opportunity Number: BJA-2018-13607 Opportunity Title: BJA FY 18 Comprehensive Opioid Abuse Site -based Program Opportunity Package ID: PKG0C241883 CFDA Number: 16.838 CFDA Description: Comprehensive Opioid Abuse Site -Based Program Competition ID: BJA-2018-13889 Competition Title: Category 3: System -level Diversion Projects Opening Date: Closing Date: 05/08/2018 06/07/2018 Agency: Bureau of Justice Assistance Contact Information: For technical assistance with submitting an application, contact the Grants.gov Customer Support Hotline at 800-518-4726 or 606-545-5035, or via email to support@grants.gov. The Grants.gov Support Hotline operates 24 hours a day, 7 days a week, except on federal holidays. An applicant that experiences unforeseen Grants.gov technical issues beyond its control that prevent it from submitting its application by the deadline must email the contact identified below within 24 hours after the application deadline in order to request approval to submit its application after the deadline. Additional information on reporting technical issues appears under Experiencing Unforeseen Grants.gov Technical Issue♦ in the How to Apply section. For assistance with any unforeseen Grants.gov technical issues beyond an applicant/ s control that prevent it from submitting its application by the deadline, or any other requirement of this solicitation, contact the National Criminal Justice Reference Service (NCJRS) Response Center: toll -free at 800-851-3420; via TTY at 301-240-6310 (hearing impaired only); email grants@ncjrs. gov; fax to 301-240-5830; or web chat at https://webcontact.ncjrs.gov/ncjchat/chat. jsp. The NCJRS Response Center hours of operation are 10:00 a.m. to 6:00 p.m. eastern time, Monday through Friday, and 10:00 a.m. to 8:00 p.m. eastern time on the solicitation close date. APPLICANT &' WORKSPACE DETAILS: Workspace ID: WS00153160 Application Filing Name: City of Miami DUNS: 0722207910000 Organization: MIAMI, CITY OF Form Name: Application for Federal Assistance (SF-424) Form Version: 2.1 Requirement: Mandatory Download Date/Time: Jun 04, 2018 01:08:15 PM EDT Form State: No Errors FORM ACTIONS.',.,' OMB Number: 4040-0004 Expiration Date: 12/31/2019 Application for Federal Assistance SF-424 * 1. Type of Submission: Preapplication Application * 2. Type of Application: * If Revision, select appropriate letter(s): X New Continuation Revision * Other (Specify): X Application Changed/Corrected * 3. Date Received: 4. Applicant Identifier: Completed by Grants.gov upon submission. 5a. Federal Entity Identifier: 5b. Federal Award Identifier: State Use Only: 6. Date Received by 7. State Application Identifier: State: 8. APPLICANT INFORMATION: * a. Legal Name: City of Miami * b. Employer/Taxpayer Identification Number (EIN/TIN): * c. Organizational DUNS: 59-6000375 0722207910000 d. Address: * Streetl: Street2: * City: County/Parish: *State: Province: *Country: * Zip / Postal Code: 444 SW 2nd Avenue 5th Floor Miami FL: Florida USA: UNITED STATES 33130-1910 e. Organizational Unit: Department Name: Division Name: f. Name and contact information of person to be contacted on matters involving this application: Prefix: Middle Name: * Last Name: Suffix: Ms . * First Name: Lillian p Blondet Title: Director, Office of Grants Administration Organizational Affiliation: City of Miami *Telephone Number: 305-416-1536 Fax Number: 305-416-2151 * Email: lblondet@miamigov.com Application for Federal Assistance SF-424 * 9. Type of Applicant 1: Select Applicant Type: C: City or Township Government Type of Applicant 2: Select Applicant Type: Type of Applicant 3: Select Applicant Type: * Other (specify): * 10. Name of Federal Agency: Bureau of Justice Assistance 11. Catalog of Federal Domestic Assistance Number: 16.838 CFDA Title: Comprehensive Opioid Abuse Site -Based Program * 12. Funding Opportunity Number: BJA-2018-13607 * Title: BJA FY 18 Comprehensive Opioid Abuse Site -based Program 13. Competition Identification Number: BJA-2018-13889 Title: Category 3: System -level Diversion Projects 14. Areas Affected by Project (Cities, Counties, States, etc.): Areas Affected By Project.pdf ant Delete Attachment; iew'Attachment * 15. Descriptive Title of Applicant's Project: City of Miami Collaborative Early Pre -Arrest Diversion Program Attach supporting documents as specified in agency instructions. Add Attachments `` aS chmeri Application for Federal Assistance SF-424 16. Congressional * a. Applicant Districts Of: FL-025 * b. Program/Project FL-025 Attach an additional list of Program/Project Congressional Districts if needed. City of Miami Congressional Districts.pdf Adu:Attachmenn Delete Attachment I iew Attachment 17. Proposed * a. Start Date: Project: 10/01/2018 * b. End Date: 09/30/2021 18. Estimated Funding ($): *a. Federal * b. Applicant *c. State * d. Local * e. Other * f. Program Income *g.TOTAL 883,586.00 122, 569. 00 0 . 0 0 0 . 00 0.00 0 .00 1,006,155.00 * 19. Is Application a. This application b. Program Subject to Review By State Under Executive was made available to the State under is subject to E.O. 12372 but has not been selected is not covered by E.O. 12372. Order 12372 Process? the Executive Order 12372 Process for review on • by the State for review. X c. Program * 20. Is the Applicant Yes If "Yes", provide Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.) X No explanation and attach 3'Ald �fta�hmss' "Ot fete Attachment? View hitacjtrtent 21. *By signing herein are true, comply with any subject me to this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001) and assurances, or an Internet site where you may obtain this list, is contained in the announcement or agency X **IAGREE ** The list of certifications specific instructions. Authorized Representative: Prefix: Middle Name: * Last Name: Suffix: Ms . * First Name: Lillian P Blondet *Title: Director, Office of Grants Administration * Telephone Number: 305-416-1536 Fax Number: 305-416-2151 * Email: lblondet@miamigov.com * Signature of Authorized Representative: Completed by Grants.gov upon submission. * Date Signed: Completed by Grants.gov upon submission. Budget Summary Note: Any errors detected on this page should be fixed on the corresponding Budget Detail tab. Year 1 Year 2 (if needed) Year 3 (if needed) Year 4 (if needed) Year 5 (if needed) (a � a) ti a1 A. Personnel $21,060 $43,523 $29,060 $35,523 $21,060 $43,523 So $0 $0 so $193,749 B. Fringe Benefits •;$1,,612,,, $ '$1,612 $ $0 $i $0 $4,836 C. Travel $4,530 so $4,530 $0 $4,530 so $0 so $0 $o $13,590 D:;Equipment- $3,458 So, $ 0 ; $3;458 E. Supplies $0 $0 so so So So $0 $o $0 so $o F. Construction .>. $O so $o. G. Subawards (Subgrants) $262,494 so $263,294 $0 $263,294 $0 so $0 So $o $789,082 H. Procurement, Contracts. I. Other $480 $0 $480 $0 $480 $0 $0 $0 $0 $0 $1,440 Total •Difect'Eosts $293;634 '$43,523; ;523 $290;9.76 523-•, I$ $ j$ $1006;155= J. Indirect Costs so $0 $o so $o so $o so $o so $o Total Project Costs 93;63‘c Does this bbdgetcontal conference costswhch,is;defined, $298,976 , broadnpiude fteetings;'retreats;;serninars symposia;';and tra riing aetr pt es? •Y/ $43523tr $0 ;$1 Yes $1,006;i 1