Centerstone Of Florida Inc

CENTERSTONE SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT (C-SBIRT)

CENTERSTONE'S CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC IN FORT MYERS, FLORIDA (C-CCBHC) - CENTERSTONE WILL PLAN, DEVELOP, AND IMPLEMENT A NEW CCBHC IN FORT MYERS, FLORIDA (C-CCBHC), TO PROVIDE COMPREHENSIVE, INTEGRATED, COORDINATED, PERSON-CENTERED BEHAVIORAL HEALTH CARE; IMPROVE ACCESS TO COMMUNITY-BASED MENTAL HEALTH AND SUBSTANCE USE DISORDER TREATMENT; AND SUPPORT 24/7 CRISIS SERVICES, REGARDLESS OF AN INDIVIDUAL’S ABILITY TO PAY OR PLACE OF RESIDENCE. C-CCBHC WILL SERVE 900 UNDUPLICATED INDIVIDUALS (Y1: 80; Y2: 220; Y3-4: 300/YR.). C-CCBHC WILL SERVE ANY INDIVIDUAL WITH A MENTAL OR SUBSTANCE USE DISORDER WHO SEEKS CARE AT CENTERSTONE’S FT. MYERS CCBHC, INCLUDING THOSE WITH SERIOUS MENTAL ILLNESS (SMI); SUBSTANCE USE DISORDER (SUD), INCLUDING OPIOID USE DISORDER; CHILDREN AND ADOLESCENTS WITH SERIOUS EMOTIONAL DISTURBANCE (SED); INDIVIDUALS WITH CO-OCCURRING MENTAL AND SUBSTANCE DISORDERS (COD); AND INDIVIDUALS EXPERIENCING A MENTAL HEALTH OR SUBSTANCE USE-RELATED CRISIS. C-CCBHC’S FOCUS POPULATION DEMOGRAPHICS ARE EXPECTED TO MIRROR AREA INDIVIDUALS AND CURRENT CLINIC CLIENTS: 66% WHITE; 8% BLACK; 23% HISPANIC/LATINO, WITH 49% MALE AND 51% FEMALE. OF THE AREA’S NEARLY 1,130,100 ADULTS, 23% ARE EXPECTED TO HAVE AMI; 5.5%, SMI; 17%, SUD; 2%, OUD; AND 8%, COD. AMONG THE ROUGHLY 231,410 YOUTH, 20% ARE EXPECTED TO HAVE MAJOR DEPRESSIVE EPISODE; 5%, SUD; 1%, OUD. KEY C-CCBHC STRATEGIES INCLUDE INCREASING ACCESS/AVAILABILITY OF SERVICES RESPONSIVE TO COMMUNITY NEEDS (E.G., CRISIS SERVICES; SCREENING/ASSESSMENT/DIAGNOSIS, INCLUDING RISK ASSESSMENT; TREATMENT/CRISIS PLANNING; OUTPATIENT MENTAL HEALTH/SUBSTANCE USE SERVICES; PRIMARY CARE SCREENING AND HEALTH MONITORING; TARGETED CASE MANAGEMENT; PSYCHIATRIC REHABILITATION; PEER AND FAMILY SUPPORTS; AND COMMUNITY-BASED MENTAL HEALTH CARE FOR ARMED FORCES/VETERAN POPULATIONS); MEANINGFULLY INVOLVING SERVICE RECIPIENTS/FAMILIES IN THEIR CARE; AND APPLYING A CONTINUOUS QUALITY IMPROVEMENT (CQI) APPROACH. C-CCBHC WILL INTEGRATE SAMHSA’S TIP 59: IMPROVING CULTURAL COMPETENCE AND 57: TRAUMA-INFORMED CARE IN BEHAVIORAL HEALTH TO IMPLEMENT EVIDENCE-BASED INTERVENTIONS ADDRESSING THE FULL ARRAY SERVICE RECIPIENTS’ BEHAVIORAL HEALTH NEEDS (E.G., COGNITIVE BEHAVIORAL THERAPY, MOTIVATIONAL INTERVIEWING, DIALECTICAL BEHAVIOR THERAPY, ASSERTIVE COMMUNITY TREATMENT, MULTI-SYSTEMIC THERAPY, PARENT MANAGEMENT TRAINING, SEEKING SAFETY, INTEGRATED DUAL DISORDERS TREATMENT, MAT, ILLNESS MANAGEMENT AND RECOVERY, AND DIMENSIONS). C-CCBHC WILL ACCOMPLISH THE FOLLOWING GOALS: 1) ESTABLISH COMPREHENSIVE, INTEGRATED, COORDINATED, AND PERSON-CENTERED COMMUNITY-BASED SERVICES VIA THE CCBHC; 2) ENHANCE INFRASTRUCTURE/CAPACITY FOR A FULL CONTINUUM OF QUALITY/INCLUSIVE COORDINATED CARE; 3) INCREASE ACCESS TO/AVAILABILITY OF TIMELY/HIGH QUALITY SERVICES; 4) IMPLEMENT A MEASUREMENT-BASED CARE PROCESS TO ENSURE A COMPREHENSIVE SCOPE OF EVIDENCE-BASED SERVICES/SUPPORTS; 5) IMPROVE HEALTH STATUS/OUTCOMES FOR TREATMENT SERVICE RECIPIENTS ACROSS THE LIFESPAN; AND 6) APPLY A CQI APPROACH TO DRIVE SYSTEMS, IMPROVE THE QUALITY OF SERVICES, AND ENSURE ONGOING SERVICE DELIVERY. AS A RESULT OF THESE GOALS/IMPROVEMENTS, THE PROJECT WILL ACHIEVE THE FOLLOWING MEASURABLE SERVICE RECIPIENT-RELATED OBJECTIVES: DECREASE SYMPTOMATOLOGY AMONG 45% WITH MENTAL HEALTH DISORDERS; DECREASE SUBSTANCE USE AMONG 45% OF THOSE WITH SUD/OUD/COD; PROVIDE ITPS FOR 100% OF SERVICE RECIPIENTS; IMPROVE HOUSING STABILITY AMONG 80% WHO ARE HOMELESS/MARGINALLY HOUSED; PROVIDE 100% WITH EMPLOYMENT CASE MANAGEMENT SERVICES PER ITPS; IMPROVE HEALTH INDICATORS AMONG 75% OF PARTICIPATING SERVICE RECIPIENTS; REDUCE PAST 30-DAY TOBACCO USE BY 30% AMONG TOBACCO CESSATION ACTIVITY PARTICIPANTS; ACHIEVE NO PAST 30-DAY CRIMINAL JUSTICE SYSTEM INVOLVEMENT AMONG 60% WITH CRIMINAL JUSTICE HISTORIES; ACHIEVE NO PAST 30-DAY ER/HOSPITALIZATIONS AMONG 60% OF SERVICE RECIPIENTS WITH HOSPITALIZATION HISTORIES; ACHIEVE/MAINTAIN AN 80% FOLLOW-UP RATE; AND ACHIEVE SATISFACTION OF EXPERIENCE/CARE AMONG 80% OF SERVICE RECIPIENTS/FAMILIES.

CENTERSTONE'S CCBHC-IA IN FLORIDA (C-CCBHCV2.0) - CENTERSTONE'S CCBHC IMPROVEMENT AND ADVANCEMENT IN FLORIDA (C-CCBHCV2.0) PROJECT WILL IMPROVE AND ADVANCE CENTERSTONE'S CCBHC IN BRADENTON, PROVIDING COMPREHENSIVE, INTEGRATED, COORDINATED, AND PERSON-CENTERED CARE TO THOSE WITH A MENTAL OR SUBSTANCE USE DISORDER, INCLUDING GROUPS FACING HEALTH DISPARITIES. C-CCBHCV2.0 WILL SERVE 1,500 UNDUPLICATED INDIVIDUALS (Y1: 300; Y2-4: 400/YR.). C-CCBHCV2.0 WILL SERVE ANY INDIVIDUAL WITH A MENTAL OR SUBSTANCE USE DISORDER WHO SEEKS CARE AT CENTERSTONE’S BRADENTON CCBHC, INCLUDING THOSE WITH SERIOUS MENTAL ILLNESS (SMI); SUBSTANCE USE DISORDER (SUD), INCLUDING OPIOID USE DISORDER; CHILDREN AND ADOLESCENTS WITH SERIOUS EMOTIONAL DISTURBANCE (SED); INDIVIDUALS WITH CO-OCCURRING MENTAL AND SUBSTANCE DISORDERS (COD); AND INDIVIDUALS EXPERIENCING A MENTAL HEALTH OR SUBSTANCE USE-RELATED CRISIS. C-CCBHCV2.0’S TARGET POPULATION IS EXPECTED TO MIRROR THOSE OF THE CATCHMENT AREA, COMPRISING COUNTIES DESOTO, HILLSBOROUGH, MANATEE, AND SARASOTA IN FLORIDA. THOSE UNDER AGE 17 ARE EXPECTED TO COMPRISE ROUGHLY 51% MALE; 49% FEMALE; 64% WHITE; 17.5% AFRICAN AMERICAN; AND 32% HISPANIC/LATINO INDIVIDUALS; AND THOSE AGES 18+ COMPRISE 48% MALE; 52% FEMALE; 63% WHITE; 12% AFRICAN AMERICAN; AND 21% HISPANIC/LATINO INDIVIDUALS. OF THE CATCHMENT AREA’S 1,803,300 ADULTS, 5.2% ARE EXPECTED TO HAVE SMI AND OF THE 457,600 CHILDREN/YOUTH, 1% ARE EXPECTED TO HAVE SED. AN ESTIMATED 15% OF ADULTS WILL HAVE SUD AND 1%, OUD; 6% OF ADOLESCENTS AGES 12-17 WILL HAVE SUD. NEARLY 7% OF ADULTS AND 3% OF ADOLESCENTS HAVE COD. C-CCBHCV2.0 WILL PROVIDE AN ARRAY OF HIGH-QUALITY INTEGRATED PRIMARY/BEHAVIORAL HEALTH CARE SERVICES (E.G., CRISIS SERVICES; SCREENING/ASSESSMENT/DIAGNOSIS, INCLUDING PRIMARY CARE AND RISK ASSESSMENT; TREATMENT/CRISIS PLANNING; OUTPATIENT MENTAL HEALTH/SUBSTANCE USE SERVICES; MEDICATION ASSISTED TREATMENT; TARGETED CASE MANAGEMENT; PEER AND FAMILY SUPPORTS; AND INTENSIVE COMMUNITY-BASED MENTAL HEALTH CARE FOR ARMED FORCES/VETERAN POPULATIONS). KEY PROJECT STRATEGIES INCLUDE EXPANDING ACCESS/AVAILABILITY OF SERVICES RESPONSIVE TO COMMUNITY NEEDS; MEANINGFUL INVOLVEMENT OF CONSUMERS/FAMILIES IN THEIR CARE; AND APPLYING A CONTINUOUS QUALITY IMPROVEMENT (CQI) APPROACH TO DRIVE IMPROVEMENTS AND SUSTAINABILITY. THE PROJECT’S INTERVENTIONS ADDRESS THE FULL ARRAY OF CONSUMERS’ BEHAVIORAL HEALTH NEEDS AND INCLUDE COGNITIVE BEHAVIORAL THERAPY, MOTIVATIONAL INTERVIEWING, ILLNESS MANAGEMENT AND RECOVERY, INTEGRATED DUAL DISORDER TREATMENT, ETC. C-CCBHCV2.0 WILL ACCOMPLISH THE FOLLOWING GOALS: 1) EXPAND AND IMPROVE DELIVERY OF COMPREHENSIVE, INTEGRATED, AND PERSON-CENTERED COMMUNITY-BASED MENTAL AND SUD SERVICES FOR THE TARGET POPULATION; 2) ENHANCE INFRASTRUCTURE/CAPACITY FOR A FULL CONTINUUM OF COORDINATED CARE; 3) INCREASE ACCESS TO/AVAILABILITY OF TIMELY SERVICES FOR THE TARGET POPULATION; 4) IMPLEMENT A MEASUREMENT-BASED CARE PROCESS TO ENSURE COMPREHENSIVE, EVIDENCE-BASED SERVICES AND SUPPORTS AND PRACTICES FOR WHOLE-PERSON WELLNESS AND RECOVERY; 5) IMPROVE HEALTH STATUS AND OUTCOMES FOR PROJECT CONSUMERS ENGAGED IN TREATMENT; AND 6) APPLY A CQI APPROACH TO DRIVE OUTCOME IMPROVEMENT AND ENSURE ONGOING SERVICE DELIVERY. PLANNED IMPROVEMENTS INCLUDE EXPANDING TECHNOLOGIES AND CARE COORDINATION PARTNERSHIPS AND ENHANCING TRAININGS AND SCREENING/ASSESSMENT PROCEDURES. AS A RESULT OF THESE GOALS/IMPROVEMENTS, THE PROJECT WILL ACHIEVE THE FOLLOWING MEASURABLE CONSUMER-RELATED OBJECTIVES: DECREASE MENTAL HEALTH SYMPTOMATOLOGY AMONG 45%; DECREASE SUBSTANCE USE AMONG 45%; IMPROVE HOUSING STABILITY AMONG 80%; DELIVER COLLABORATIVE TREATMENT PLANS FOR 100%; PROVIDE EMPLOYMENT/EDUCATION CASE MANAGEMENT FOR 100% PER TREATMENT PLANS; REDUCE TOBACCO USE AMONG 30%; IMPROVE PHYSICAL HEALTH INDICATORS AMONG 75%; OFFER LINKAGE/REFERRAL FOLLOW-UP TO 100%; ACHIEVE 80% CONSUMER/FAMILY REPORTED SATISFACTION WITH THEIR EXPERIENCE OF CARE; AND ACHIEVE 80% 6-MONTH FOLLOW-UP RATE.

CENTERSTONE'S CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC, FLORIDA

CENTERSTONE'S ASSISTED OUTPATIENT TREATMENT (C-AOT)

CENTERSTONE ACTION

BEHAVIORAL HEALTH WORKFORCE EDUCATION AND TRAINING PROGRAM

CENTERSTONE'S ACTION IN FLORIDA - CENTERSTONE’S ACTION IN FLORIDA WILL EXPAND AND MAINTAIN A RECOVERY-ORIENTED ASSERTIVE COMMUNITY TREATMENT (ACT) PROGRAM ACCORDING TO FIDELITY TO IMPROVE BEHAVIORAL HEALTH OUTCOMES AND SUPPORT COMMUNITY LIVING FOR ADULTS (18+) WITH SERIOUS MENTAL ILLNESS (SMI). ACTION’S MULTI-DISCIPLINARY TEAM WILL PROVIDE ALL ACT CORE SERVICES FOR 55 UNDUPLICATED FOCUS POPULATION ADULTS IN MANATEE AND SARASOTA COUNTIES, FLORIDA (Y1: 30; Y2-4: 7/YR.; Y5: 4). ACTION’S FOCUS POPULATION COMPRISES AN ANTICIPATED 35,919 (5.2%) CATCHMENT AREA ADULTS WITH SMI WHOSE DEMOGRAPHICS AND SOCIOECONOMICS ARE EXPECTED TO MIRROR THOSE OF CENTERSTONE’S CLIENTS WITH SMI, WITH 68% MALE, 32% FEMALE, 83% WHITE, 14% AFRICAN AMERICAN, AND 8% HISPANIC/LATINO INDIVIDUALS. AN ESTIMATED 70% LIVE BELOW POVERTY, 74% ARE UNEMPLOYED, AND 49% HAVE LESS THAN A HIGH SCHOOL DIPLOMA/GED. ACTION WILL SERVE SUBPOPULATIONS FROM AMONG THE AREA’S ESTIMATED 70,372 VETERANS; INDIVIDUALS FROM MINORITY COMMUNITIES, INCLUDING 113,973 RACIAL/ETHNIC MINORITY AND/OR 31,774 LGBT ADULTS; AND/OR 7,864 CRIMINAL JUSTICE-INVOLVED ADULTS. ACTION WILL BE IMPLEMENTED ACCORDING TO SAMHSA’S ACT EVIDENCE-BASED PRACTICES (EBP) KNOWLEDGE INFORMING TRANSFORMATION (KIT), INTEGRATING STRATEGIES TO ENSURE CULTURALLY COMPETENT, TRAUMA INFORMED, AND RECOVERY ORIENTED CARE ACCORDING TO SAMHSA’S TIP 59: IMPROVING CULTURAL COMPETENCE; TIP 57: TRAUMA-INFORMED CARE IN BEHAVIORAL HEALTH SERVICES; AND THE RECOVERY-ORIENTED SYSTEMS OF CARE (ROSC) RESOURCE GUIDE. ADDITIONAL EBPS WILL BE INTEGRATED TO COMPLEMENT IMPLEMENTATION OF CORE ACT SERVICES (E.G., EVIDENCE-BASED SUPPORTIVE THERAPIES WILL INCLUDE COGNITIVE BEHAVIORAL THERAPY (CBT) AND CBT FOR PSYCHOSIS; SUD TREATMENT, INTEGRATED TREATMENT FOR CO-OCCURRING DISORDERS; SUPPORT SERVICES, WHOLE HEALTH ACTION MANAGEMENT; ETC.). KEY ACTION STRATEGIES/INTERVENTIONS INCLUDE COMMUNITY COLLABORATIONS, PROGRAM STANDARDS, KEY PLANS (I.E., TRAINING, EVALUATION, CONTINUITY OF OPERATIONS/SUSTAINABILITY), AN ADVISORY GROUP, OUTREACH/ENGAGEMENT, CRISIS ASSESSMENT/INTERVENTION, COMPREHENSIVE ASSESSMENT, INDIVIDUAL TREATMENT PLANS, SMI TREATMENT/INTERVENTIONS, ILLNESS MANAGEMENT AND RECOVERY, SUPPORTIVE THERAPY, SUBSTANCE USE TREATMENT, RECOVERY/SUPPORT SERVICES (E.G., EMPLOYMENT AND BENEFIT ASSISTANCE, ACTIVITIES OF DAILY LIVING, PEER SUPPORT), AND CASE MANAGEMENT. ACTION’S 4 GOALS WITH MEASURABLE OBJECTIVES INCLUDE: GOAL 1: EXPAND/MAINTAIN AN ACT PROJECT COMPRISING CORE SERVICES AND CHARACTERISTICS, AND ASSEMBLE/TRAIN 6.5 FTES AND PROVIDE ACT CORE SERVICES, ASSESSMENT, CRISIS INTERVENTION/TREATMENT, AND RECOVERY/SUPPORT SERVICES TO 55 ADULTS. GOAL 2: DEVELOP CAPACITY TO EXPAND/MAINTAIN A COMPREHENSIVE SERVICE CONTINUUM, AND ESTABLISH AN ADVISORY GROUP COMPRISING 20% CLIENTS/FAMILY AND OTHER STAKEHOLDERS; REVIEW/REFINE 5 POLICIES/PROCEDURES; EXPAND/MAINTAIN LETTERS OF COMMITMENT FROM 20 STAKEHOLDERS; CONDUCT OUTREACH TO 250; PROVIDE BASIC/INTENSIVE ACT TRAINING TO 8 PROJECT STAFF AND ACT MODEL TRAINING FOR 950 AGENCY STAFF/COMMUNITY PROVIDERS; DEVELOP 2 STRATEGIES TO ADDRESS STAFF TURNOVER/CROSS TRAINING; AND IDENTIFY 2 FUNDING MECHANISMS FOR SUSTAINABILITY. GOAL 3: IMPROVE CLIENT HEALTH STATUS/OUTCOMES, AND REDUCE MENTAL HEALTH SYMPTOMATOLOGY AMONG 70% AND SUICIDE CRISIS AMONG 80%; LINK 100% IN NEED WITH EMPLOYMENT/EDUCATION; AND ACHIEVE 50% WITH LOW/NO PROBLEMS RELATED TO SUBSTANCE USE, 80% WITH NO PAST 30 DAY HOMELESSNESS, 80% WITH NO PAST 30 DAY HOSPITALIZATION, 60% WITH NO PAST 30 DAY CRIMINAL JUSTICE INVOLVEMENT, 80% REPORTING FUNCTIONING WELL IN DAILY LIFE, 80% WITH POSITIVE PERCEPTION OF CARE, AT LEAST WEEKLY INTERACTION AMONG 80%, 80% KNOWING WHO TO CALL FROM THE ACT TEAM, AND SOCIAL CONNECTEDNESS AMONG 70%. GOAL 4: DEVELOP/REFINE A REPLICABLE SERVICE MODEL, AND REPORT ANNUALLY ON A COMPREHENSIVE EVALUATION AND BIANNUALLY ON SUBPOPULATION DISPARITIES; COLLECT/ANALYZE DEMOGRAPHIC DATA; AND PRODUCE 5 MATERIALS FOR DISSEMINATION/REPLICATION.

CENTERSTONE MEDICATION-ASSISTED TREATMENT SERVICES IN FLORIDA (C-MAT) - CENTERSTONE MAT SERVICES IN FLORIDA (C-MAT) WILL EXPAND/ENHANCE ACCESS TO MEDICATION-ASSISTED TREATMENT (MAT) SERVICES, DELIVERING FDA-APPROVED MEDICATIONS IN COMBINATION WITH COMPREHENSIVE AND EVIDENCE-BASED PSYCHOSOCIAL SERVICES IN 2 FLORIDA COUNTIES (I.E., MANATEE AND SARASOTA). C-MAT WILL SERVE 300 UNDUPLICATED ADULTS AGES 18 AND OLDER WITH AN OPIOID USE DISORDER (OUD) SEEKING OR RECEIVING MAT TO DECREASE ILLICIT OPIOID USE/PRESCRIPTION OPIOID MISUSE (YEAR 1: 40; YEARS 2-5: 65, ANNUALLY). C-MAT’S FOCUS POPULATION ENCOMPASSES AN ANTICIPATED 3,667 CATCHMENT AREA ADULTS WITH OUD SEEKING OR RECEIVING MAT. FOCUS POPULATION DEMOGRAPHICS ARE EXPECTED TO MIRROR THOSE OF CATCHMENT AREA CENTERSTONE CLIENTS WITH OUD, WITH 48% MALE, 52% FEMALE, 86% WHITE, 5% AFRICAN AMERICAN, AND 7% HISPANIC/LATINO INDIVIDUALS. C-MAT’S SUBPOPULATIONS INCLUDE AN ESTIMATED 2,625 VETERANS WITH OUD; 2,140 CRIMINAL JUSTICE SYSTEM INVOLVED ADULTS WITH OUD; AND THOSE WITH A CO-OCCURRING OUD AND SUBSTANCE USE (6,862) AND/OR MENTAL HEALTH DISORDERS (5,291). OF THE 8,228 CATCHMENT AREA INDIVIDUALS WITH OUD, AN ESTIMATED 72% (5,924) WILL HAVE POLYSUBSTANCE USE, 60% (4,939) EXPERIENCE SEVERE ECONOMIC DISTRESS, 57% (4,690) WILL FACE MAJOR DEPRESSIVE DISORDER, AND 57% (4,690) MAY BECOME HOMELESS. C-MAT WILL DELIVER MEDICATION-ASSISTED TREATMENT (MAT) ACCORDING TO NIDA’S PRINCIPLES OF DRUG ADDICTION TREATMENT, SAMHSA’S TREATMENT IMPROVEMENT PROTOCOL (TIP) 63: MEDICATIONS FOR OPIOID USE DISORDERS, AND HAZELDEN’S COR-12, PROVIDING FDA-APPROVED MEDICATIONS IN CONJUNCTION WITH EVIDENCE-BASED BEHAVIORAL HEALTH THERAPIES, INCLUDING HAZELDEN’S CO-OCCURRING DISORDERS PROGRAM, SEEKING SAFETY, AND DIMENSIONS: TOBACCO FREE PROGRAM. KEY C-MAT STRATEGIES/INTERVENTIONS INCLUDE COMMUNITY COLLABORATIONS; ASSEMBLY OF AN ADVISORY COUNCIL; ENHANCEMENT OF PROGRAM PROCEDURES, INCLUDING MITIGATION OF MEDICATION DIVERSION; OUTREACH/ENGAGEMENT; SCREENING/ASSESSMENT; DEVELOPMENT OF INDIVIDUAL TREATMENT PLANS; PROVISION OF MAT, OUD/COD TREATMENT/PSYCHOSOCIAL SERVICES, TOBACCO CESSATION, CARE COORDINATION, RECOVERY SUPPORT SERVICES (E.G., PEER SUPPORTS, LINKAGES TO HOUSING/EMPLOYMENT, BENEFITS ENROLLMENT); HIV/VH TESTING/LINKAGES; TELEHEALTH SERVICES; SUSTAINABILITY PLANNING; AND DISSEMINATION OF A COMPREHENSIVE EVALUATION. C-MAT GOALS ARE TO ENHANCE/EXPAND ACCESS TO MAT SERVICES, OUD TREATMENT, WRAP-AROUND/RECOVERY SUPPORTS, ETC.; DEVELOP INFRASTRUCTURE/CAPACITY TO EXPAND, ENHANCE, AND SUSTAIN SERVICES; IMPROVE CLIENTS’ HEALTH STATUS/OUTCOMES; AND DEVELOP/DISSEMINATE A REPLICABLE SERVICE MODEL. C-MAT WILL ACHIEVE THE FOLLOWING MEASURABLE OBJECTIVES: CONDUCT OUTREACH/ENGAGEMENT AMONG 750 INDIVIDUALS; PROVIDE TRAINING/WORKFORCE DEVELOPMENT FOR 100 STAFF/COMMUNITY PROVIDERS; ENSURE 8 PROVIDERS HAVE/COMPLETE DATA WAIVER TRAINING; REDUCE ILLICIT DRUG USE BY 60%; REDUCE MENTAL HEALTH SYMPTOMATOLOGY BY 50%; ASSIST 100% IN NEED TO IDENTIFY/SECURE STABLE HOUSING AND EMPLOYMENT; ACHIEVE NO PAST 30-DAY CRIMINAL JUSTICE INVOLVEMENT AMONG 60%; REDUCE TOBACCO USE BY 30%; REDUCE COSTLY SERVICE UTILIZATION BY 50%; INCREASE SOCIAL CONNECTEDNESS AMONG 70%; AND ACHIEVE 80% CLIENT RETENTION. C-MAT HAS SECURED COMMITMENTS FROM PARTNERS DEDICATED TO THE PROJECT’S SUCCESS, AND WILL COLLABORATE WITH COMMUNITY PROVIDERS, LAW ENFORCEMENT, COALITIONS, SOCIAL SERVICE AGENCIES, KEY STAKEHOLDERS, ETC.

CENTERSTONE'S COMMUNITY CRISIS RESPONSE PARTNERSHIPS IN FLORIDA (C-CCRP) - CENTERSTONE'S COMMUNITY CRISIS RESPONSE PARTNERSHIPS IN FLORIDA (C-CCRP) PROJECT WILL ENHANCE INFRASTRUCTURE TO EXPAND MOBILE CRISIS RESPONSE TEAMS (MCRT) TO PROVIDE CULTURALLY, DEVELOPMENTALLY, AND AGE-APPROPRIATE SERVICES TO DIVERT INDIVIDUALS EXPERIENCING MENTAL HEALTH CRISES FROM LAW ENFORCEMENT ENCOUNTERS IN A HIGH NEED GEOGRAPHIC AREA COMPRISING DESOTO AND MANATEE COUNTIES, FLORIDA. C-CCRP WILL SERVE 1,050 UNDUPLICATED INDIVIDUALS (Y1: 150; Y2-4: 300/YR.). C-CCRP WILL SERVE ADULTS, CHILDREN, AND YOUTH EXPERIENCING MENTAL HEALTH CRISES IN DESOTO AND MANATEE COUNTIES, FLORIDA, WHERE UP TO 38% OF THE 387,000+ CALLS TO LAW ENFORCEMENT WERE RELATED TO BEHAVIORAL HEALTH ISSUES. IN 2021, ONLY 5% OF AREA LAW ENFORCEMENT OFFICERS RECEIVED CIT TRAINING. FOCUS POPULATION DEMOGRAPHICS ARE EXPECTED TO MIRROR THOSE OF THE GEOGRAPHIC CATCHMENT AREA, WHICH COMPRISES 82% ADULTS AND 18% CHILDREN/YOUTH; 49% MALE AND 51% FEMALE, INCLUDING 0.55% TRANSGENDER INDIVIDUALS; AND 70% WHITE, 9% BLACK/AFRICAN AMERICAN, AND 18% HISPANIC/LATINO INDIVIDUALS. PREVALENT MENTAL HEALTH, SUBSTANCE USE, AND SOCIOECONOMIC RISK FACTORS FOR BEHAVIORAL HEALTH CRISIS POINT TO A NEED TO IMPLEMENT EFFECTIVE MOBILE CRISIS SERVICES. FOR EXAMPLE, OF THE CATCHMENT AREA’S 352,050 ADULTS, 21% ARE EXPECTED TO HAVE A MENTAL ILLNESS. APPROXIMATELY 12% OF AREA YOUTH AGES 12-17 HAVE HAD SERIOUS THOUGHTS OF SUICIDE. MENTAL HEALTH/SUBSTANCE USE RELATED HOSPITALIZATIONS IN MANATEE WERE 56% HIGHER THAN THE STATE, AND DESOTO EXCEEDED FLORIDA IN NON-FATAL SUICIDE ATTEMPTS BY 122%. C-CCRP WILL INCREASE THE CAPACITY OF AND TIMELY ACCESS TO 24/7 MCRTS, INCREASE COLLABORATION WITH LAW ENFORCEMENT/988/CALL CENTERS, AND IMPROVE EQUITY IN THE CONTINUITY OF CARE AND POST-CRISIS FOLLOW-UP. C-CCRP’S 2-PERSON MCRTS WILL PROVIDE IN-PERSON/TELEHEALTH RESPONSE INCLUDING SCREENING/ ASSESSMENT; COMMUNITY STABILIZATION; SAFETY PLANNING; REFERRAL TO ENHANCED SERVICES AFTER STABILIZATION; AND POST-CRISIS FOLLOW-UP. C-CCRP WILL CONDUCT COMMUNITY MAPPING TO IDENTIFY SERVICE NEEDS/GAPS, PROVIDE CRISIS INTERVENTION TRAINING, DEVELOP PROTOCOLS TO IMPROVE COORDINATION WITH FIRST RESPONDERS AND COMMUNITY PROVIDERS, COORDINATE WITH RELEVANT STATE EFFORTS, AND IMPLEMENT A DATA SYSTEM TO TRACK OUTCOMES. C-CCRP WILL ACCOMPLISH THE FOLLOWING GOALS: 1) DEVELOP A SOUND INFRASTRUCTURE AND INCREASED CAPACITY TO DELIVER MOBILE CRISIS RESPONSE SERVICES FOR PERSONS OF ALL AGES IN THE GEOGRAPHIC CATCHMENT AREA; 2) INCREASE CRISIS SYSTEM COLLABORATION WITHIN THE PROPOSED HIGH-NEEDS COMMUNITIES TO ENSURE A COMPREHENSIVE, INTEGRATED SERVICES TO ADDRESS THE FOCUS POPULATIONS’ NEEDS; 3) ENHANCE MOBILE CRISIS RESPONSE TEAMS TO ENSURE TRAUMA-INFORMED AND CULTURALLY, AGE, AND DEVELOPMENTALLY APPROPRIATE SERVICES TO DIVERT ADULTS, CHILDREN, AND YOUTH EXPERIENCING MENTAL HEALTH CRISES FROM LAW ENFORCEMENT TO COMMUNITY STABILIZATION; 4) IMPROVE CRISIS SYSTEM PERFORMANCE VIA EXPANDED ACCESS TO MOBILE CRISIS RESPONSE SERVICES IN PROPOSED HIGH-NEED COMMUNITIES; 5) PROMOTE IMPROVED MENTAL HEALTH OUTCOMES AMONG ADULTS, CHILDREN, AND YOUTH EXPERIENCING MENTAL HEALTH CRISES; AND 6) DEVELOP/DISSEMINATE A DOCUMENTED SERVICE MODEL FOR STATEWIDE AND NATIONAL REPLICATION/ADOPTION. AS A RESULT OF THESE GOALS/IMPROVEMENTS, THE PROJECT WILL ACHIEVE THE FOLLOWING MEASURABLE OBJECTIVES AMONG POPULATIONS RECEIVING CRISIS RESPONSE: SCREEN 100%, REFER 100% TO NEEDED SERVICES, INCREASE ACCESS TO SERVICES FOR 60%, REDUCE SUICIDE RISK FOR 100%, AND REDUCE ARREST/DETENTION BY 30%. THE PROJECT WILL ACHIEVE THE FOLLOWING MEASURABLE OBJECTIVES IN THE HIGH NEEDS COMMUNITY SERVED: RESOLVE 70% OF MCRT RESPONSES IN THE COMMUNITY, DIVERT 40% FROM LAW ENFORCEMENT, INCREASE REFERRALS TO MCRT BY 50%; AND INCREASE KNOWLEDGE OF EFFECTIVE CRISIS RESPONSE AMONG 60% OF FIRST RESPONDERS TRAINED.

GRADUATE PSYCHOLOGY EDUCATION PROGRAMS

CENTERSTONE CONNECTIONS (CONNECTIONS): CONNECTING WITH PEOPLE THROUGH HOME, RECOVERY, AND COMMUNITY IN FLORIDA

CENTERSTONE'S SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT (C-SBIRT) - CENTERSTONE’S SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT (C-SBIRT) WILL EXPAND THE UPTAKE OF THE SBIRT MODEL IN PRIMARY CARE/PEDIATRIC, COMMUNITY HEALTH, AND SCHOOL SETTINGS IN 14 FLORIDA COUNTIES, WITH A FOCUS ON SCREENING FOR UNDERAGE DRINKING, OPIOID USE, AND OTHER SUBSTANCE USE. C-SBIRT WILL SCREEN AN UNDUPLICATED 16,000 (I.E., Y1: 1,500; Y2: 3,000; Y3: 5,000; Y4: 4,500; Y5: 2,000) VIA SCREENING; OF THOSE, MORE THAN 50% WILL BE YOUTH AGES 12-21. C-SBIRT’S FOCUS POPULATION IS EXPECTED TO MIRROR AREA RESIDENTS’ (12+) DEMOGRAPHICS (E.G., 49% MALE; 51% FEMALE, 66% WHITE) AND SOCIOECONOMICS (E.G., 12% EXPERIENCE POVERTY, 12% LACK HEALTH INSURANCE). C-SBIRT WILL SERVE UNDER-SERVED/RESOURCED SUBPOPULATIONS FROM AMONG THE AREA’S RACIAL/ETHNIC AND SEXUAL/GENDER MINORITY COMMUNITIES; VETERAN/MILITARY POPULATIONS, INCLUDING VETERAN HOUSEHOLDS WITH CHILDREN; AND/OR SYSTEMS-INVOLVED YOUTH POPULATIONS. LOW PERCEPTION OF RISK IN USING SUBSTANCES (E.G., 50% OF 12-17 YEAR OLDS DO NOT SEE USING COCAINE 1 TIME A MONTH AS RISKY) INCREASES EARLY INITIATION, RISK OF MISUSE, AND LIKELIHOOD OF SUD FOR THE FOCUS POPULATION; AN ESTIMATED 95.5% WITH SUD DO NOT RECOGNIZE THE PROBLEM, IMPACTING 570,000+ IN THE FOCUS POPULATION. AN ESTIMATED 46,810 YOUTH AND 550,520 ADULTS WILL HAVE SUD; OF THOSE, 3% OF YOUTH AND NEARLY 10% OF ADULTS WILL HAVE AUD AND 1% OF YOUTH AND 2% OF ADULTS WILL HAVE OUD. NEARLY 3% OF YOUTH AND 8% OF ADULTS ARE ANTICIPATED TO HAVE COD. C-SBIRT WILL ESTABLISH YOUTH AND ADULT TRACKS FOR INTEGRATING SBIRT IMPLEMENTATION PROTOCOLS, INCLUDING POPULATION-SPECIFIC IMPLEMENTATION SITES, SBIRT TEAMS, TOOLS, INTERVENTIONS, ETC. C-SBIRT’S STRATEGIES/INTERVENTIONS INCLUDE CAPACITY-BUILDING EFFORTS (E.G., TECHNOLOGY INTEGRATION, ANNUAL ASSESSMENT OF GAPS/NEEDS); TARGETED OUTREACH/EDUCATION TO YOUTH- AND ADULT-FOCUSED ENTITIES (E.G., PEDIATRICIANS, SCHOOLS/UNIVERSITIES, PRIMARY CARE PROVIDERS); EXPANDING SCREENINGS TO IDENTIFY RISKY SUBSTANCE USE, ALCOHOL/OTHER DRUG CONSUMPTION, SUICIDE RISK, AND CO-OCCURRING DISORDERS; AND INITIATING APPROPRIATE EVIDENCE-BASED RESPONSE. C-SBIRT WILL UTILIZE AGE-APPROPRIATE, VALIDATED PRE-SCREENS, SUCH AS THE NATIONAL INSTITUTE OF DRUG ABUSE’S AND NATIONAL INSTITUTE OF ALCOHOLISM AND ALCOHOL ABUSE’S SINGLE QUESTION SCREEN, BSTAD, AND PHQ-2; VALIDATED FULL SCREENS SUCH AS THE AUDIT, DAST-10, CRAFFT, PHQ-9/-A, C-SSRS; EVIDENCE-BASED BRIEF INTERVENTION VIA BRIEF NEGOTIATED INTERVIEW AND TIP 34: BRIEF INTERVENTIONS AND BRIEF THERAPIES FOR SUBSTANCE ABUSE; AND BRIEF TREATMENT VIA COGNITIVE BEHAVIORAL THERAPY, MOTIVATIONAL INTERVIEWING, AND MULTI-DIMENSIONAL FAMILY THERAPY. CASE MANAGEMENT FOR THOSE REFERRED TO SPECIALTY TREATMENT WILL BE GUIDED BY TIP 27: COMPREHENSIVE CASE MANAGEMENT FOR SUBSTANCE ABUSE TREATMENT AND WILL INCLUDE ASSESSMENT FOR HOMELESSNESS RISK, PEER SUPPORTS. PROJECT GOALS INCLUDE: 1) IMPLEMENT A PROJECT TO PROVIDE COMPREHENSIVE, TRAUMA-INFORMED SBIRT SERVICES; 2) IMPLEMENT CAPACITY BUILDING TO EXPAND AND SUSTAIN SBIRT SERVICES; 3) IMPROVE OUTCOMES AMONG PARTICIPANTS RECEIVING BRIEF INTERVENTION, BRIEF TREATMENT, AND TREATMENT VIA REFERRALS; AND 4) DEVELOP/DISSEMINATE A DOCUMENTED SERVICE MODEL FOR STATEWIDE REPLICATION/ADOPTION. MEASURABLE PARTICIPANT-RELATED OBJECTIVES INCLUDE: REDUCE REPORTED DAYS EXPERIENCING MENTAL HEALTH SYMPTOMS BY 40% AMONG THOSE WITH COD; REDUCE REPORTED DAYS OF OPIOID USE BY 50-60% AMONG THOSE WITH RISK AT INTAKE; INCREASE ABSTINENCE FROM SUBSTANCE USE AMONG 40-60%; REDUCE INPATIENT/ER USAGE AMONG 40%; REDUCE TOBACCO USE AMONG 60% WITH RISK AT INTAKE; INCREASE SOCIAL CONNECTEDNESS AMONG 70%; ASSESS 100% REFERRED TO TREATMENT FOR WRAPAROUND NEEDS AND PROVIDE 100% WITH CASE MANAGEMENT; ACHIEVE 80% FOLLOW UP AMONG THOSE REFERRED TO TREATMENT. C-SBIRT HAS SECURED COMMITMENTS FROM COLLABORATORS DEDICATED TO THE PROJECT’S SUCCESS, AND WILL COLLABORATE WITH PRIMARY CARE PROVIDERS, INCLUDING PEDIATRIC PROVIDERS, SCHOOLS, AND OTHER KEY COMMUNITY STAKEHOLDERS.

CENTERSTONE PERSONAL RESPONSIBILITY EDUCATION PROGRAM IN FLORIDA (C-PREP)

CENTERSTONE'S WELLNESS ON WHEELS (C-WOW) - CENTERSTONE’S WELLNESS ON WHEELS (C-WOW) WILL TAKE A SYNDEMIC APPROACH TO PROVIDING PORTABLE CLINICAL CARE FOCUSED ON INTEGRATING LOW BARRIER SUBSTANCE USE DISORDER (SUD) TREATMENT; HIV AND OTHER INFECTIOUS DISEASES/CONDITIONS TESTING AND TREATMENT; MENTAL HEALTH CARE; AND HARM REDUCTION SERVICES FOR AN UNDUPLICATED TOTAL OF 300 INDIVIDUALS EXPERIENCING UNSHELTERED HOMELESSNESS IN RURAL DESOTO AND NON-RURAL MANATEE COUNTIES, FLORIDA, ACROSS THE 3-YEAR PROJECT PERIOD (Y1: 60; Y2: 110; Y3: 130). DEMOGRAPHICS AND CLINICAL CHARACTERISTICS OF FOCUS POPULATION INDIVIDUALS WILL MIRROR THOSE OF THE UNSHELTERED POPULATION IN FLORIDA’S CONTINUA OF CARE (COCS) 500 AND 517 SERVING CATCHMENT AREA COUNTIES, WITH 49% MALE, 51% FEMALE, 75% WHITE, 24% BLACK, AND 37% HISPANIC INDIVIDUALS. BASED ON THE FL-500/517 COCS, C-WOW’S SUBPOPULATIONS ARE EXPECTED TO INCLUDE 242 RACIAL/ ETHNIC MINORITIES; 67 SEXUAL/GENDER MINORITIES; AND 28 VETERANS. RATES OF HEALTH/BEHAVIORAL CONDITIONS AMONG FOCUS POPULATIONS ARE HIGHER THAN CATCHMENT AREA INDIVIDUALS: HIV (0.5% VS. 0.3%, RESPECTIVELY), HEPATITIS C (22% VS. 0.04%), CHLAMYDIA (7% VS. 0.4%), AND SERIOUS MENTAL ILLNESS (14% VS. 6%). CO-OCCURRING HIV AND MENTAL ILLNESS ARE EXPECTED AMONG 50% OF THE FOCUS POPULATION, AND NEARLY 12% WILL EXPERIENCE SUD. OPIOID MISUSE CONTRIBUTES TO HIV PREVALENCE, WITH NEARLY 17% OF THOSE WHO ARE HIV POSITIVE HAVING HAD INJECTED DRUGS. C-WOW’S EVIDENCE-BASED STRATEGIES/INTERVENTIONS INCLUDE THE SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH’S HOMELESS HEALTH OUTREACH AND MOBILE ENGAGEMENT (HHOME) PROGRAM, SAMHSA’S TIP 59: IMPROVING CULTURAL COMPETENCE, AND SAMHSA’S HARM REDUCTION FRAMEWORK TO GUIDE OVERALL ACTIVITIES; ON-SITE INTENSIVE CASE MANAGEMENT, MOTIVATIONAL INTERVIEWING, AND SOAR; FACILITY-BASED COMMUNITY-FRIENDLY HEALTHY RECOVERY PROGRAM; AND OTHER FACILITY-BASED INTERVENTIONS AT CENTERSTONE AVAILABLE TO C-WOW PARTICIPANTS PER THEIR GOALS/ NEEDS (E.G., MEDICATION ASSISTED TREATMENT, HAZELDEN’S CO-OCCURRING DISORDERS PROGRAM, WHOLE HEALTH ACTION MANAGEMENT, DIMENSIONS). C-WOW’S GOALS INCLUDE: 1) IMPLEMENT A PILOT PROJECT FOR UNDERSERVED POPULATIONS EXPERIENCING UNSHELTERED HOMELESSNESS THROUGH THE PROVISION OF PORTABLE CLINICAL CARE, FOCUSED ON THE INTEGRATION OF BEHAVIORAL HEALTH AND HIV TREATMENT AND PREVENTION SERVICES; 2) DEVELOP/IMPLEMENT SYSTEM CAPACITY BUILDING ACTIVITIES TO ENHANCE AND SUSTAIN PROJECT SERVICES; 3) INCREASE ON-SITE POINT OF CARE FOR THE FOCUS POPULATION; 4) DECREASE BARRIERS TO CARE FOR THE FOCUS POPULATION; AND 4) DEVELOP/DISSEMINATE A DOCUMENTED SERVICE MODEL/PILOT PROGRAM FOR REPLICATION/ADOPTION. C-WOW’S MEASURABLE PARTICIPANT-RELATED OBJECTIVES INCLUDE CONDUCTING SCREENINGS/ASSESSMENTS AND/OR TESTING FOR HIV, HEPATITIS, SEXUALLY TRANSMITTED INFECTIONS (STIS), MPOX, TUBERCULOSIS, SUD/COD, AND OTHER MENTAL HEALTH CONDITIONS; DEVELOPING INDIVIDUAL TREATMENT AND SERVICE PLANS; AND PROVIDING CASE MANAGEMENT, CARE COORDINATION, LINKAGE TO SERVICES FOR 300 INDIVIDUALS. FOR 100% OF PARTICIPANTS PER THEIR NEEDS/GOALS, C-WOW WILL PROVIDE ON-SITE LOW-BARRIER SUD TREATMENTS, INCLUDING FDA-APPROVED MEDICATIONS, PRIMARY CARE HEALTH SERVICES, AND INFECTIOUS DISEASE SERVICES; LINKAGES TO HOUSING RESOURCES; AND TRANSPORTATION TO INFECTIOUS DISEASE TREATMENT/VACCINATION AND TO PREP/PEP, SUD/COD/MENTAL HEALTH TREATMENT, PRIMARY CARE TREATMENT SERVICES, MPOX, AND RECOVERY SUPPORT SERVICES. C-WOW WILL INCREASE ACCESS TO TRAUMA-INFORMED, CULTURALLY RESPONSIVE, INTEGRATED MENTAL HEALTHCARE SERVICES AMONG 80% AND TO HARM REDUCTION EDUCATION, SUPPLIES, AND OTHER RELATED SERVICES AMONG 100% OF PARTICIPANTS. ADDITIONAL OBJECTIVES INCLUDE TRAINING 50 CENTERSTONE/PROJECT STAFF AND OTHER PROVIDERS IN SUD/CO-OCCURRING DISORDERS IDENTIFICATION, CULTURALLY-/LINGUISTICALLY-APPROPRIATE CARE, HARM REDUCTION, HIV/INFECTIOUS DISEASE TREATMENT/PREVENTION, ETC. AND ESTABLISHING AN ADVISORY COUNCIL COMPRISING 20% FOCUS POPULATION/INDIVIDUALS WITH LIVED EXPERIENCE.

CENTERSTONE TRAUMA TREATMENT AND TRAINING (CT3)

CENTERSTONE'S REENTRY AND RECOVERY (CRR) - CENTERSTONE’S REENTRY AND RECOVERY (CRR) WILL EXPAND SUBSTANCE USE DISORDER (SUD) TREATMENT AND RELATED RECOVERY/REENTRY SERVICES FOR AN UNDUPLICATED 260 UNDUPLICATED SENTENCED ADULTS WITH SUD AND/OR CO-OCCURRING MENTAL DISORDERS (COD) WHO HAVE BEEN SENTENCED TO, ARE SERVING AT LEAST 1 MONTH IN, AND WITHIN 4 MONTHS OF RELEASE FROM A CORRECTIONAL FACILITY; OR WHO ARE ON PROBATION/PAROLE AND AT RISK OF RE-INCARCERATION WITHIN LEE COUNTY, FLORIDA(YR. 1: 30; YRS. 2-3: 50; YRS. 4-5: 65). FOCUS POPULATION DEMOGRAPHICS ARE EXPECTED TO MIRROR THOSE OF THE AREA’S INCARCERATED POPULATION (E.G., 90% MALE; 40% WHITE, 45% BLACK/AFRICAN AMERICAN, 18% HISPANIC/LATINO; 15% UNEMPLOYED; 49% BELOW POVERTY). AN ESTIMATED 68% OF JAIL INMATES ARE EXPECTED TO HAVE SUD AND 8.5% OF ALL INCARCERATED PERSONS, OPIOID USE DISORDER (OUD), VS 17.3% AND 2.1% OF THE GENERAL PUBLIC, RESPECTIVELY. AN ESTIMATED 70% OF LEE’S JAIL INMATES WILL NOT RECEIVE DRUG TREATMENT WHILE INCARCERATED AND LESS THAN 10% OF SUPERVISEES WILL RECEIVE TREATMENT POST-RELEASE. OF FLORIDA’S STATE INMATES, 2.8% WILL HAVE HIV, DOUBLE THE NATIONAL RATE (1.2%). CRR’S EVIDENCE-BASED STRATEGIES/INTERVENTIONS INCLUDE SAMHSA’S GUIDELINES FOR SUCCESSFUL TRANSITION OF PEOPLE WITH MENTAL OR SUBSTANCE USE DISORDERS FROM JAIL AND PRISON, TIP 30: CONTINUITY OF OFFENDER TREATMENT FOR SUBSTANCE USE DISORDERS FROM INSTITUTION TO COMMUNITY, AND TIP 59: IMPROVING CULTURAL COMPETENCE AS GUIDING FRAMEWORKS; LIVING IN BALANCE, MORAL RECONATION THERAPY, TIP 63: MEDICATIONS FOR OPIOID USE DISORDER, MOUD, AND DIMENSIONS: TOBACCO FREE TO ADDRESS SUD/COD; AND TASC CASE MANAGEMENT MODEL, SOAR, SAMHSA’S OPIOID OVERDOSE PREVENTION TOOLKIT, AND MENTAL HEALTH FIRST AID FOR REENTRY/EDUCATION SERVICES AND ACTIVITIES. CRR GOALS INCLUDE: (1) IMPLEMENT A COMPREHENSIVE PROJECT TO EXPAND ACCESS TO SUD/COD TREATMENT AND REENTRY SERVICES AMONG FOCUS POPULATION ADULTS RETURNING TO THEIR COMMUNITIES FROM INCARCERATION; (2) DEVELOP A SOUND INFRASTRUCTURE AND CAPACITY TO EXPAND, ENHANCE, AND SUSTAIN SERVICES FOR FOCUS THOSE RETURNING TO THEIR COMMUNITIES FROM INCARCERATION; (3) ADDRESS BEHAVIORAL HEALTH DISPARITIES; SOCIAL DETERMINANTS OF HEALTH; AND DIVERSITY EQUITY, INCLUSION, AND ACCESSIBILITY VIA EVIDENCE-BASED AND BEST PRACTICES; (4) IMPROVE CLIENT HEALTH STATUS AND OUTCOMES VIA EVIDENCE-BASED, POPULATION-APPROPRIATE TREATMENT; AND (5) DEVELOP, DOCUMENT, AND REFINE A REENTRY SERVICE MODEL TO SUPPORT REPLICATION. AS A RESULT OF THESE GOALS, CRR WILL ACHIEVE THE FOLLOWING MEASURABLE PARTICIPANT-/COMMUNITY-RELATED OBJECTIVES: EDUCATE 1,000 CORRECTIONS STAFF AND OTHER STAKEHOLDERS ON OVERDOSE RISK AMONG THE FOCUS POPULATION, NALOXONE INFORMATION/DISTRIBUTION, ETC.; OUTREACH TO 200 ORGANIZATIONS/STAKEHOLDERS TO DEVELOP/ENHANCE REFERRAL PATHWAYS; OFFER TRAINING/WORKFORCE DEVELOPMENT TO 50 STAFF AND OTHERS (E.G., PROVIDERS, CORRECTIONS STAFF); LINK 100% IN NEED TO CERTIFIED RECOVERY HOUSING PARTNERS; FACILITATE BENEFITS ENROLLMENT FOR 100% IN NEED; PROVIDE 100% OF CLIENTS IN NEED WITH RESOURCES TO IDENTIFY/SECURE HOUSING, EMPLOYMENT/EDUCATION, AND/OR IMPROVE TREATMENT ACCESS/RETENTION AS INDICATED BY CARE PLANS; IMPROVE INDIVIDUAL/FAMILY FUNCTIONING AND WELL-BEING AMONG 70%; INCREASE SOCIAL CONNECTEDNESS (E.G., FEELING SUPPORTED BY FRIENDS/FAMILY) AMONG 70%; REDUCE HEALTH/BEHAVIORAL/SOCIAL CONSEQUENCES (E.G., IMPROVED QUALITY OF LIFE, MENTAL HEALTH SYMPTOMATOLOGY) OF SUBSTANCE USE AMONG 75%; REDUCE MENTAL HEALTH SYMPTOMS (E.G., DEPRESSION) AMONG 60% ASSESSED/DIAGNOSED WITH COD; REDUCE TOBACCO/NICOTINE USE (E.G., SMOKING, VAPING) AMONG 50 INDIVIDUALS PARTICIPATING IN TOBACCO/NICOTINE CESSATION ACTIVITIES; REDUCE RISKY BEHAVIORS (E.G., UNPROTECTED SEX, SYRINGE USE) AMONG 60% OF PARTICIPANTS SCREENED AS HAVING AND/OR AT RISK FOR HIV, VIRAL HEPATITIS, ETC.; REDUCE PAST 30-DAY INVOLVEMENT WITH THE CRIMINAL JUSTICE SYSTEM (E.G., PROBATION/PAROLE VIOLATION) AMONG 60%; AND ACHIEVE 80% PARTICIPANT FOLLOW-UP/RETENTION RATE.

CENTERSTONE'S TRAUMA AND GRIEF TREATMENT (C-TGT) FOR CHILDREN, ADOLESCENTS, AND FAMILIES - CENTERSTONE’S TRAUMA AND GRIEF TREATMENT (C-TGT) WILL INCREASE ACCESS TO EFFECTIVE TRAUMA- AND GRIEF-FOCUSED TREATMENT AND SERVICE SYSTEMS IN 3 FLORIDA COUNTIES (DESOTO, MANATEE, AND SARASOTA) FOR 570 CHILDREN/ADOLESCENTS (AGES 0-17) AND THEIR FAMILIES WHO EXPERIENCE TRAUMATIC EVENTS, INCLUDING UNDER-SERVED/RESOURCED CHILDREN OF LGBTQ+, RURAL, RACIAL/ETHNIC MINORITY, AND NON-ENGLISH SPEAKING COMMUNITIES AND VETERAN/MILITARY FAMILIES (YR. 1: 90; YRS. 2-5: 120/YEAR). C-TGT’S FOCUS POPULATION DEMOGRAPHICS ARE EXPECTED TO MIRROR THOSE IN THE CATCHMENT AREA UNDER AGE 18 WITH: 51%, MALE; 49%, FEMALE; 57%, WHITE; 11%, BLACK; AND 25%, HISPANIC/LATINO INDIVIDUALS. C-TGT WILL SERVE UNDERSERVED/-RESOURCED SUBPOPULATIONS FROM AMONG THE AREA’S 5,506 LGBT, 6,495 RURAL, 60,162 RACIAL/ETHNIC MINORITY, AND 22,385 NON-ENGLISH SPEAKING CHILDREN/ADOLESCENTS, AND THE 17,680 VETERAN FAMILIES. CONSISTENT WITH FLORIDA YOUTHS’ CLINICAL CHARACTERISTICS, 72,754 (52%) WILL FACE AN ADVERSE CHILDHOOD EXPERIENCE (ACE); 34,978 (25%) WILL EXPERIENCE 2+ ACES; AND AN EXPECTED 18,190 UNDER AGE 18 WILL HAVE A SERIOUS EMOTIONAL DISTURBANCE. IN 2021, CHILD ABUSE CASES IN DESOTO, 752; MANATEE, 1,103; AND SARASOTA, 631, EXCEEDED FLORIDA, 540/100,000. TRAUMA RISKS AMONG AREA CHILDREN INCLUDE FOOD INSECURITY AMONG 26,675 FACING; NO INSURANCE AMONG 12,800; AND CHRONIC SCHOOL ABSENCE AMONG 17,425. C-TGT’S CORE EVIDENCE-BASED STRATEGIES/INTERVENTIONS WILL LEVERAGE CULTURAL COMPETENCY GUIDANCE FROM SAMHSA’S TIP 59: IMPROVING CULTURAL COMPETENCY AND INCLUDE NCTSN-ENDORSED ASSESSMENT-BASED TREATMENT FOR TRAUMATIZED CHILDREN: TRAUMA ASSESSMENT PATHWAY (TAP); TRAUMA-FOCUSED COGNITIVE BEHAVIORAL THERAPY (TF-CBT); CHILD-PARENT PSYCHOTHERAPY (CPP); AND TRAUMA AND GRIEF COMPONENT THERAPY FOR ADOLESCENTS (TGCTA). ADDITIONAL POPULATION-SPECIFIC STRATEGIES/INTERVENTIONS INCLUDE SKILLS-BASED PREVENTION/RECOVERY (E.G., NCTSN’S SKILLS FOR PSYCHOLOGICAL RECOVERY), LET’S CONNECT, AFFIRM, AND DIMENSIONS TOBACCO FREE PROGRAM. C-TGT’S GOALS INCLUDE: (1) IMPLEMENT COMMUNITY-BASED, CULTURALLY COMPETENT, QUALITY, ACCESSIBLE PROGRAMMING FOR THE FOCUS POPULATION; (2) DEVELOP INFRASTRUCTURE AND EXPAND COMMUNITY CAPACITY TO IMPLEMENT/SUSTAIN TRAUMA-/GRIEF-INFORMED SERVICES FOR THE FOCUS POPULATION; (3) IMPROVE THE HEALTH STATUS AND OUTCOMES FOR YOUNG CHILDREN (AGES 0-10) AND CHILDREN/ADOLESCENTS (AGES 11-17); AND (4) DEVELOP/DISSEMINATE A REPLICABLE SERVICE MODEL. MEASURABLE OBJECTIVES INCLUDE: TRAIN 5 PROJECT STAFF ON THE IMPACT OF COMPLEX TRAUMA, ETC.; PROVIDE AGE-APPROPRIATE SCREENING/ASSESSMENT/REFERRAL AND TRIAGE INTO APPROPRIATE EVIDENCE-BASED TRAUMA-/GRIEF-INFORMED THERAPIES, CARE MANAGEMENT, ETC., FOR AN UNDUPLICATED 570 CHILDREN/ADOLESCENTS AND THEIR FAMILIES; PROVIDE LANGUAGE ACCESS SERVICES TO 100%; ESTABLISH MOBILE SERVICES IN 1 COUNTY; SCREEN/ASSESS 100% OF PARENTS/CAREGIVERS; DEVELOP/IMPLEMENT OUTREACH/REFERRAL PATHWAYS WITH 50 STAKEHOLDERS/ORGANIZATIONS; INCREASE LETTERS OF COMMITMENT BY 10; DEVELOP/IMPLEMENT SCREENING/REFERRAL PROCEDURES WITH 10 PARTNERS; COORDINATE WITH/PROVIDE TRAINING FOR 3,000 CENTERSTONE AND OTHER CHILD-SERVING ORGANIZATION STAFF; ANNUALLY DEVELOP/REVISE TRAINING/ONBOARDING PROCEDURES; COLLABORATE BIANNUALLY WITH TREATMENT AND SERVICE ADAPTATION CENTERS; CONVENE AND ADVISORY COUNCIL COMPRISING 20% FOCUS POPULATION YOUTH/FAMILIES; OUTREACH TO 10,000 AREA INDIVIDUALS; LINK/COORDINATE WITH 2 FUNDING MECHANISM; AND REPORT BIANNUALLY ON AN EVALUATION AND SUBPOPULATION DISPARITIES. C-TGT WILL REDUCE MENTAL HEALTH SYMPTOMATOLOGY AMONG 60%, TOBACCO/NICOTINE USE AMONG 50% RECEIVING DIMENSIONS, PAST-30 DAY CRIMINAL JUSTICE INVOLVEMENT AMONG 60% WITH CRIMINAL JUSTICE HISTORY, AND PAST-30 DAY UNEXCUSED ABSENCES BY 30%; IMPROVE SOCIAL CONNECTEDNESS AMONG 60%, EVERYDAY FUNCTIONING AMONG 60%, HOUSING STABILITY AMONG 80% RECEIVING RESOURCES; AND PARENTING SKILLS/CONFIDENCE AMONG 60% OF PARENTS/CAREGIVERS; AND ACHIEVE SATISFACTION AMONG 80% AND AN 80% RETENTION RATE.

COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING - CONSTRUCTION

CENTERSTONE REACH FLORIDA (REACH-FL)

CENTERSTONE TRAUMA TREATMENT AND TRAINING (CT3)

CENTERSTONE’S COMPREHENSIVE TREATMENT COURT (C-CTC) - CENTERSTONE’S COMPREHENSIVE TREATMENT COURT (C-CTC) WILL EXPAND SUBSTANCE USE DISORDER (SUD) TREATMENT AND RECOVERY SUPPORT SERVICES FOR AN UNDUPLICATED 240 ADULTS (AGES 18+) WITH SUD AS THEIR PRIMARY CONDITION PARTICIPATING IN FLORIDA’S MANATEE COUNTY DRUG COURT (I.E., Y1: 40; Y2-5: 50, YEARLY). FOCUS POPULATION DEMOGRAPHICS ARE EXPECTED TO MIRROR THOSE OF CURRENT DRUG COURT PROGRAM PARTICIPANTS, WITH 69% MALE, 31% FEMALE, 63% WHITE, 19% BLACK, AND 13% HISPANIC/LATINO INDIVIDUALS. MANATEE COUNTY DRUG COURT SERVES 164 YEARLY, AND ANOTHER 100+ MAY BE ELIGIBLE FOR DRUG COURT PARTICIPATION; OF THOSE, AT LEAST 50% (132) ARE EXPECTED TO HAVE MODERATE TO SEVERE OPIOID USE DISORDER (OUD) AND UP TO 40% (106), CO-OCCURRING SUD AND MENTAL HEALTH DISORDERS (COD). BY 2023, AREA HOMELESSNESS HAD INCREASED 300% FROM 2021. COMPARED TO AREA WHITE ADULTS, AREA BLACK ADULTS HAVE LOWER RATES OF PAST-YEAR SUD AND ARE INCARCERATED FOR DRUG CHARGES AT HIGHER RATES; HIV DIAGNOSIS RATES ARE 6 TIMES HIGHER FOR BLACK VS. WHITE MALES. IN 2017-21, AREA INJECTION DRUG USE RESULTED IN A 366% INCREASE IN ACUTE HEPATITIS C INFECTIONS; FROM 2013 TO 2022, SYPHILIS RATES GREW BY 360%. C-CTC’S CULTURALLY APPROPRIATE AND EVIDENCE-BASED STRATEGIES WILL BE IMPLEMENTED IN ALIGNMENT WITH NADCP’S DEFINING DRUG COURTS: KEY COMPONENTS AND GUIDED BY SAMHSA’S HARM REDUCTION FRAMEWORK AND TIP 59: IMPROVING CULTURAL COMPETENCE. TREATMENT INTERVENTIONS INCLUDE COGNITIVE BEHAVIORAL THERAPY; MOTIVATIONAL INTERVIEWING; INTEGRATED COD TREATMENTS (E.G., SAMHSA’S INTEGRATED TREATMENT FOR COD EBP KIT, TIP 42: SUD TREATMENT FOR PERSONS WITH COD); SUPPLEMENTED BY MORAL RECONATION THERAPY; DIALECTICAL BEHAVIOR THERAPY; SEEKING SAFETY; MEDICATION ASSISTED TREATMENT AS GUIDED BY SAMHSA’S TIPS 63: MEDICATIONS FOR OUD AND 49: INCORPORATING ALCOHOL PHARMACOTHERAPIES INTO MEDICAL PRACTICE; AND DIMENSIONS, AS APPROPRIATE. CASE MANAGEMENT SERVICES WILL BE GUIDED BY THE TASC SPECIALIZED CASE MANAGEMENT MODEL AND INCLUDE, AS APPROPRIATE, HOUSING FIRST AND SSI/SSDI OUTREACH, ACCESS, AND RECOVERY. SAMHSA’S OPIOID OVERDOSE PREVENTION AND RESPONSE TOOLKIT WILL INFORM HARM REDUCTION EDUCATION. C-CTC’S GOALS INCLUDE: 1) IMPLEMENT A COMPREHENSIVE PROJECT TO EXPAND ACCESS TO SUD TREATMENT AND RECOVERY SUPPORT SERVICES; 2) IMPLEMENT CAPACITY-BUILDING ACTIVITIES TO EXPAND, ENHANCE, AND SUSTAIN SERVICES; 3) USE EVIDENCE-BASED TREATMENT & CASE MANAGEMENT PLANNING (TCMP) TO ADDRESS BEHAVIORAL HEALTH DISPARITIES; SOCIAL DETERMINANTS OF HEALTH; AND DIVERSITY EQUITY, INCLUSION, AND ACCESSIBILITY; 4) IMPROVE CLIENT HEALTH STATUS/OUTCOMES VIA EVIDENCE-BASED, POPULATION APPROPRIATE TREATMENT SERVICES; AND 5) DEVELOP/DISSEMINATE A DOCUMENTED SERVICE MODEL FOR AGENCY REPLICATION/ADOPTION THROUGHOUT THE STATE. C-CTC WILL ACHIEVE THE FOLLOWING MEASURABLE OBJECTIVES: PROVIDE TRAINING FOR 5 C-CTC STAFF AND 50 CENTERSTONE/OTHER PROVIDERS IN SUD/COD IDENTIFICATION, CULTURALLY/LINGUISTICALLY-APPROPRIATE CARE, HARM REDUCTION, AND RELAPSE PREVENTION; PROVIDE/FACILITATE COMPREHENSIVE SCREENING/ASSESSMENT, DRUG TESTING, TCMP, AND EVIDENCE-BASED SUD TREATMENT FOR AN UNDUPLICATED 240 FOCUS POPULATION ADULTS; ESTABLISH AN ADVISORY COUNCIL COMPRISING 51% FOCUS POPULATION/INDIVIDUALS WITH LIVED EXPERIENCE; OUTREACH TO 200 STAKEHOLDERS; DEVELOP A SUSTAINABILITY PLAN WITH LINKAGES TO 2 FUNDING MECHANISMS; LINK 100% OF THOSE IN NEED TO APPROPRIATE RESOURCES (E.G., HOUSING/RECOVERY HOUSING, EMPLOYMENT, TRANSPORTATION, LANGUAGE ACCESS SERVICES); INCREASE SUBSTANCE USE ABSTINENCE AMONG 70%; REDUCE MENTAL HEALTH SYMPTOMS AMONG 60% WITH COD; REDUCE TOBACCO/NICOTINE USE AMONG 30% WITH SUCH GOALS; IMPROVE EMPLOYMENT/EDUCATION STATUS AMONG 60% WHO RECEIVED SUCH SERVICES; IMPROVE HOUSING STABILITY AMONG 60% WHO RECEIVED SUCH SUPPORTS; REDUCE PAST 30-DAY CRIMINAL JUSTICE INVOLVEMENT AMONG 60%; IMPROVE INDIVIDUAL/FAMILY FUNCTIONING AMONG 70%; INCREASE SOCIAL CONNECTEDNESS AMONG 70%; AND RETAIN 60% IN SERVICE FOR TREATMENT/COMPLETION.

CENTERSTONE'S COVID-19 EMERGENCY RESPONSE FOR SUICIDE PREVENTION IN FLORIDA (FL-ERSP)

SYNDEMIC APPROACH TO PREVENTION AT CENTERSTONE (SAP-C) - SYNDEMIC APPROACH TO PREVENTION AT CENTERSTONE (SAP-C) WILL TAKE A SYNDEMIC APPROACH TO ADVANCE EQUITY FOR RACIAL/ETHNIC MINORITY COMMUNITIES, ESPECIALLY ALL BLACK FEMALE IDENTITIES, EXPERIENCING DISPARITIES RELATED TO HIV, VIRAL HEPATITIS, STIS, SUBSTANCE USE, SUBSTANCE USE DISORDERS, AND/OR ANY MENTAL HEALTH CONDITION. SAP-C SERVICES WILL BE DELIVERED IN DESOTO, HILLSBOROUGH, MANATEE, PINELLAS, AND SARASOTA COUNTIES, FL; REACH 3,500; AND SERVE AN UNDUPLICATED 300 PERSONS (Y1: 80; YRS. 2-3: 110/YR.). SAP-C’S POPULATION TO BE SERVED INCLUDES PERSONS FROM AMONG 1,181,165 CATCHMENT AREA RACIAL/ETHNIC MINORITY (REM) INDIVIDUALS, WHO COMPRISE 49% MALE AND 51% FEMALE INDIVIDUALS, WITH 17% UNINSURED, IN POVERTY, AND WITH LESS THAN A HIGH SCHOOL DIPLOMA. SUBPOPULATIONS OF AREA REMS INCLUDE AN ESTIMATED 96,000 AT RISK FOR HOMELESSNESS, 2,000 EXPERIENCING HOMELESSNESS, AND MIGRANT WORKERS IN 87 AREA MIGRANT HOUSING SITES. THE 205,799 FOCUS POPULATION BLACK FEMALE IDENTITIES COMPRISE 1.4% TRANSGENDER/NONBINARY AND 5% ETHNICALLY HISPANIC PERSONS, WITH HIGHER RATES OF POVERTY (17%), OF UNEMPLOYMENT (6%), WITHOUT A HIGH SCHOOL DIPLOMA (10%), AND WITH NO HEALTH INSURANCE (14%), AS COMPARED TO THE CATCHMENT AREA. THESE DISPARITIES, AS WELL AS EXPECTED RISK FACTORS AMONG REM (E.G., 21% REPORTED ADVERSE CHILDHOOD EXPERIENCES, 71%, RACIAL DISCRIMINATION), CONTRIBUTE TO A HIGHER RISK OF SYNDEMIC CONDITIONS (I.E., HIV, VIRAL HEPATITIS [VH], SEXUALLY TRANSMITTED INFECTIONS [STIS], SUBSTANCE USE [SU] AND SUBSTANCE USE DISORDERS [SUD], AND/OR ANY MENTAL HEALTH [MH] CONDITIONS). AMONG AREA REMS, AN ESTIMATED 92,000 HAVE SUD; 110,000 ANY MENTAL ILLNESS (AMI); 9,200 HIV; 13,230 VH; AND 10,630 STIS. AN ANTICIPATED 9,600 FOCUS POPULATION INDIVIDUALS ARE EXPECTED TO HAVE SUD; 42,000 AMI; 2,000 HIV; 1,300 VH; AND 3,290 STIS. SAP-C’S STRATEGIES/INTERVENTIONS WILL BE TRAUMA-INFORMED, CULTURALLY-APPROPRIATE, AND EVIDENCE-BASED, AND GUIDED BY SAMHSA’S STRATEGIC PREVENTION FRAMEWORK AND NATIONAL GUIDELINES (E.G., NATIONAL HIV/AIDS STRATEGY). TO ADDRESS HIV/VH/STI RISKS, PROJECT WILL USE SISTER-TO SISTER AND MPOWERMENT. MOTIVATIONAL INTERVIEWING AND COGNITIVE BEHAVIORAL THERAPY WILL BE USED TO ADDRESS SU/SUD/MH CONDITIONS. FOR HEALTH EDUCATION, PROJECT WILL IMPLEMENT WHOLE HEALTH ACTION MANAGEMENT, AND MENTAL HEALTH FIRST AID WILL BE USED TO TRAIN ANCHORS. SAP-C’S GOALS INCLUDE: 1) DEVELOP AN INFRASTRUCTURE TO IMPLEMENT/SUSTAIN A MULTI-PRONGED, SYNDEMIC APPROACH TO ENHANCE PREVENTION SYSTEMS/SERVICES; 2) PROVIDE EVIDENCE-BASED AND CULTURALLY RESPONSIVE PREVENTION EDUCATION/OUTREACH/INTERVENTIONS FOR SYNDEMIC CONDITIONS; 3) PROVIDE SU PREVENTION/PSYCHOSOCIAL SUPPORT/HEALTH EDUCATION FOR PARTICIPANTS; 4) ADVANCE EQUITY IN BH HEALTH OUTCOMES FOR REM COMMUNITIES, INCLUDING ALL BLACK FEMALE IDENTITIES, WHO ARE AT RISK FOR/LIVING WITH HIV; AND 5) DEVELOP/DISSEMINATE A MODEL FOR REPLICATION. SAP-C WILL ACHIEVE THE FOLLOWING MEASURABLE OBJECTIVES: FORM A STEERING COMMITTEE COMPRISED OF 20% OF REM; CONDUCT RESOURCE MAPPING AND DEVELOP STRATEGIC, EVALUATION, AND SUSTAINABILITY PLANS FOR 5 COUNTIES; EXPAND RELATIONSHIPS WITH 50 ANCHORS; IDENTIFY 7 AGENCIES WHO WILL PROVIDE PREP, PEP, HIV, VH, AND STI TREATMENT; ENHANCE 2 AGENCY PROCEDURES THAT INITIATE CULTURAL NORM SHIFTS AND PRIORITIZE SYNDEMIC EFFORTS; DEVELOP 15 PREVENTION RESOURCES TAILORED TO REM/SUBPOPULATIONS; CONDUCT OUTREACH AMONG 3,500; REACH 100,000 PEOPLE VIA SOCIAL MEDIA; TRAIN 50 ANCHORS; PROVIDE HARM REDUCTION EDUCATION TO 500 STAKEHOLDERS; DISTRIBUTE 520 OD REVERSAL KITS; CONDUCT SUPPORT GROUPS AT 5 ANCHOR SITES; AND PRODUCE 3 PUBLICATIONS/PRESENTATIONS FOR MODEL DISSEMINATION. SAP-C WILL DEVELOP A PREVENTION PLAN FOR 300 PARTICIPANTS; OF THOSE, 100% WILL RECEIVE, AS APPROPRIATE, SCREENING; INDICATED TESTING; LINKAGE TO NEEDED SERVICES, INCLUDING PREP, PEP AND HIV/VH/STI TREATMENT; HEALTH CARE; AND TRANSPORTATION AND NON-CASH INCENTIVES.