Tarzana Treatment Centers Inc

SBIRT AT TTC - TARZANA TREATMENT CENTERS, INC. (TTC), ONE OF THE LARGEST INTEGRATED HEALTHCARE PROVIDERS IN LOS ANGELES COUNTY (LAC), WILL IMPLEMENT SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT (SBIRT) SERVICES FOR ADOLESCENTS AND ADULTS IN FIVE (5) OF TTC’S FEDERALLY QUALIFIED HEALTH CENTER (FQHC) LOOK-ALIKE CLINICS LOCATED IN DIVERSE LAC COMMUNITIES (NORTHRIDGE, RESEDA, PALMDALE, LANCASTER AND LONG BEACH). THE OVERALL PURPOSE OF TTC’S SBIRT PROJECT IS TO REDUCE UNDERAGE DRINKING, OPIOID USE, AND OTHER SUBSTANCE USE AMONG A LOW-INCOME, HIGH-RISK POPULATION OF PRIMARY CARE PATIENTS IN LAC BY INTEGRATING UNIVERSAL SCREENING AND SBIRT SERVICES IN TTC’S FQHC LOOK-ALIKE CLINICS, WHERE TTC PROVIDES A FULL CONTINUUM OF PREVENTATIVE, ACUTE, AND CHRONIC MEDICAL CARE SERVICES ACROSS THE LIFESPAN. IN 2020, TTC PROVIDED PRIMARY MEDICAL CARE FOR 7,902 UNDUPLICATED PATIENTS; OF THESE, 8% WERE 0-17, 26% WERE 18-34, 17% WERE 35-44, 41% WERE 45-64, AND 8% WERE 64+. SOME 87% OF PATIENTS WERE LIVING UNDER THE FEDERAL POVERTY LEVEL (FPL) WITH THE REMAINDER LIVING AT 100-138% FPL. MORE THAN HALF (54%) WERE FEMALE, AT LEAST 58% WERE RACIAL/ETHNIC MINORITIES (49% LATINO; 14% WHITE; 4% ASIAN/PACIFIC ISLANDER; 4% BLACK; 1% AMERICAN INDIAN; 28% OTHER/UNKNOWN), AND 22% WERE PRIMARY SPANISH SPEAKERS. THE PROPOSED PROJECT WILL ADDRESS INCREASED SUBSTANCE USE DISORDER (SUD) PREVALENCE IN LAC, INCLUDING A 48% INCREASE IN ACCIDENTAL DRUG OVERDOSE DEATHS IN LAC DURING THE FIRST FIVE MONTHS OF THE COVID-19 PANDEMIC COMPARED TO THE SAME PERIOD IN 2019, AS WELL AS IDENTIFIED SERVICE GAPS WITHIN TTC’S INTEGRATED CARE SYSTEM. SPECIFIC GOALS AND OBJECTIVES WILL BE ACCOMPLISHED BY: 1) BUILDING AGENCYWIDE AWARENESS AND COMMITMENT TO SBIRT PRINCIPLES AND EVIDENCED-BASED PRACTICES; 2) CONDUCTING A PILOT PHASE TO INTRODUCE SBIRT IN TWO TTC CLINICS DURING YEAR 1 BEFORE EXPANDING TO THREE (3) ADDITIONAL TTC CLINICS BY THE END OF YEAR 3; 3) INSTITUTING UNIVERSAL SCREENING FOR ALL PRIMARY CARE PATIENTS (AGES 12 AND OLDER) FOR A TOTAL OF 10,000 UNDUPLICATED INDIVIDUALS SERVED DURING THE 5-YEAR PROJECT (YEAR 1: 1,600; YEAR 2: 2,400; YEARS 3-5: 2,000 EACH); 4) INTEGRATING BEHAVIORAL HEALTH (SBIRT) SPECIALISTS INTO EACH CLINIC SITE TO PROVIDE BRIEF ASSESSMENT, INTERVENTION, AND TREATMENT AND ENSURE LINKAGE TO TTC’S SPECIALTY SUD TREATMENT PROGRAMS FOR PATIENTS ASSESSED WITH MODERATE TO SEVERE SUDS; AND 5) DEVELOPING A SYSTEM (INCLUDING MODIFYING THE AGENCY’S ELECTRONIC HEALTH RECORD) TO TRACK SBIRT SERVICES PROVIDED IN THE CLINICS AND MONITOR OUTCOMES ACHIEVED FOR EACH INDIVIDUAL SCREENING POSITIVE FOR RISKY USE OR AN SUD. TTC WILL UTILIZE EVIDENCED BASED SCREENING AND ASSESSMENT TOOLS, INCLUDING VALIDATED SINGLE-QUESTION PRE-SCREENERS FOR ALCOHOL AND DRUG USE, AUDIT AND DAST-10 FOR ADULTS 18+, S2BI FOR YOUTH 12- 17, AND BRIEF ASSESSMENT TOOLS UTILIZED AS PROVISIONAL REFERRAL TOOLS FOR RECOMMENDING AMERICAN SOCIETY OF ADDICTION MEDICINE (ASAM) LEVELS OF CARE. KEY OUTCOMES INCLUDE INCREASED ABSTINENCE OR REDUCED USE OF ALCOHOL/DRUGS, IMPROVED SOCIAL CONNECTEDNESS, INCREASED LINKAGE TO SPECIALTY SUD TREATMENT SERVICES INCLUDING MEDICATIONS FOR ADDICTION TREATMENT (MAT) FOR OPIOID AND ALCOHOL USE DISORDER, AND A REDUCTION IN EMERGENCY DEPARTMENT AND HOSPITAL UTILIZATION FOR SUD.

CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC PLANNING, DEVELOPMENT, AND IMPLEMENTATION GRANT. - TARZANA TREATMENT CENTERS, INC. (TTC) WILL PLAN, DEVELOP, AND IMPLEMENT A CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC (CCBHC) IN THE SAN FERNANDO VALLEY OR SERVICE PLANNING AREAS (SPA) 2, SITUATED IN NORTHERN LOS ANGELES COUNTY (LAC). THE OVERALL PURPOSE OF TTC’S PROJECT IS TO CREATE A CCBHC THAT: 1) INCREASES ACCESS TO AND AVAILABILITY OF HIGH-QUALITY MENTAL HEALTH AND SUD TREATMENT SERVICES AND SUPPORTS THAT ARE RESPONSIVE TO THE NEEDS OF THE COMMUNITY; 2) UTILIZES EVIDENCE-BASED PRACTICES THAT ADDRESS THE NEEDS OF THE INDIVIDUALS SERVED; 3) CONTINUALLY MEASURES AND IMPROVES THE QUALITY OF SERVICES; AND 4) MEANINGFULLY INVOLVES CONSUMERS AND FAMILY MEMBERS IN THEIR OWN CARE AND THE BROADER GOVERNANCE OF THE CCBHC. TTC’S CCBHC WILL PROVIDE PERSON- AND FAMILY-CENTERED INTEGRATED BEHAVIORAL HEALTH SERVICES, INCLUDING BEHAVIORAL HEALTH SCREENING, ASSESSMENT, AND DIAGNOSIS, PATIENT-CENTERED TREATMENT PLANNING, OUTPATIENT MENTAL HEALTH AND SUBSTANCE USE DISORDER (SUD) TREATMENT SERVICES, PRIMARY CARE SCREENING AND MONITORING, CARE COORDINATION, PSYCHIATRIC REHABILITATION SERVICES, PEER SUPPORT/COUNSELING AND FAMILY SUPPORT SERVICES, VETERAN-SPECIFIC SERVICES, AND CRISIS MANAGEMENT SERVICES, ALL IN ACCORDANCE WITH CCBHC CERTIFICATION CRITERIA. TTC’S TARGET POPULATION FOR CCBHC SERVICES WILL BE ANY INDIVIDUALS IN THE CATCHMENT AREA WITH BEHAVIORAL HEALTH NEEDS WITH A SPECIAL FOCUS ON POPULATION GROUPS FACING HEALTH DISPARITIES, INCLUDING INDIVIDUALS WITH SERIOUS MENTAL ILLNESS (SMI), SUD INCLUDING OPIOID USE DISORDER (OUD), OR CO-OCCURRING MENTAL AND SUBSTANCE USE DISORDERS (COD), CHILDREN AND ADOLESCENTS WITH SERIOUS EMOTIONAL DISTURBANCE (SED), AND INDIVIDUALS EXPERIENCE A BEHAVIORAL HEALTH CRISIS. AS A PROVIDER OF INTEGRATED HEALTH SERVICES FOR 50 YEARS, TTC ALREADY PROVIDES MOST CCBHC CORE SERVICES. THUS, TTC’S INITIAL EFFORTS WILL BE FOCUSED ON ENHANCING SERVICES AND UNDERTAKING SEVERAL CAPACITY DEVELOPMENT ACTIVITIES TO ENSURE COMPLIANCE WITH ALL CCBHC CERTIFICATION CRITERIA WITHIN ONE (1) YEAR OF AWARD. SPECIFIC ACTIVITIES WILL INCLUDE: 1) ADAPTING ITS ENHANCED CASE MANAGEMENT POLICIES AND PROCEDURES TO CREATE CROSS-DISCIPLINARY TREATMENT TEAMS; 2) CREATING CCBHC CARE COORDINATOR POSITIONS TO LEAD THESE TREATMENT TEAMS AND PROVIDE TARGETED CASE MANAGEMENT SERVICES; 3) ENHANCING CRISIS MANAGEMENT SERVICES, INCLUDING PROVIDING 24-HOUR PHONE SERVICE AND IMPROVING COORDINATION WITH LAC CRISIS MOBILE RESPONSE TEAMS; 4) PLANNING, DEVELOPING, AND IMPLEMENTING A HEALTH INFORMATION TECHNOLOGY (HIT) SYSTEM TO MERGE DATA FROM TTC’S TWO (2) ELECTRONIC HEALTH RECORDS (EHRS), ONE FOR BEHAVIORAL HEALTH AND ONE FOR PRIMARY CARE; 5) ENHANCING SERVICES FOR VETERANS IN COLLABORATION WITH THE VETERANS HEALTH ADMINISTRATION (VHA); AND 6) DEVELOPING AND IMPLEMENTING ENHANCED CULTURAL COMPETENCY TRAINING FOR CCBHC STAFF INCLUSIVE OF VETERANS, AMERICAN INDIAN/ALASKA NATIVE, AND OTHER IDENTIFIED SUB-POPULATIONS. IN ADDITION TO CONDUCTING A COMMUNITY NEEDS ASSESSMENT (CNA) BY THE END OF MONTH 6, TTC WILL ALSO CONDUCT THE FOLLOWING REQUIRED ACTIVITIES: 1) DEVELOP A PLAN FOR STAFFING, TRAINING, AND DELIVERY OF ALL REQUIRED CCBHC SERVICES BY MONTH 8; 2) PROVIDE AT LEAST FIVE (5) OF THE NINE (9) CORE CCBHC SERVICES BY MONTH 6; 3) DEVELOP OR STRENGTHEN FORMAL AGREEMENTS WITH OTHER COMMUNITY PROVIDERS TO STRENGTHEN CARE COORDINATION; 4) INVOLVE CONSUMERS AND FAMILY MEMBERS IN DESIGNING, IMPLEMENTING AND EVALUATING CCBHC SERVICES; AND 5) IMPLEMENTING ALL NINE (9) CORE CCBHC SERVICES AND DEMONSTRATING COMPLIANCE WITH ALL CERTIFICATION CRITERIA BY THE END OF YEAR 1. TTC’S CCBHC WILL SERVE 75 UNDUPLICATED PATIENTS IN YEAR 1 AND 150 UNDUPLICATED PATIENTS ANNUALLY IN YEARS 2-4 FOR A TOTAL OF 525 UNDUPLICATED PATIENTS SERVED DURING THE 4-YEAR PROJECT.

RYAN WHITE PART C OUTPATIENT EIS PROGRAM

TARZANA TREATMENT CENTERS, INC.'S YOUTH AND FAMILY TREE (TTC'S YAF TREE)

MAT-PDOA AT TTC - TARZANA TREATMENT CENTERS, INC. (TTC) WILL EXPAND ACCESS TO MEDICATIONS FOR ADDICTION TREATMENT (MAT) AND IMPROVE OUTCOMES FOR INDIVIDUALS WITH OPIOID USE DISORDER (OUD) IN LOS ANGELES COUNTY (LAC), WHICH EXPERIENCED A 117% INCREASE IN FENTANYL OVERDOSE DEATHS DURING THE FIRST 5 MONTHS OF THE PANDEMIC. THE POPULATION OF FOCUS FOR TTC’S MAT-EXPANSION PROJECT WILL BE ADULTS AGES 18+, ESPECIALLY VULNERABLE POPULATIONS SUCH AS INDIVIDUALS BEING RELEASED FROM JAIL/PRISON, PERSONS EXPERIENCING HOMELESSNESS, AND INDIVIDUALS EXITING PUBLICLY FUNDED INPATIENT DETOXIFICATION. IN 2020, TTC PROVIDED TREATMENT FOR 1,805 UNDUPLICATED OUD PATIENTS. THE MAJORITY WERE WHITE (53%) OR LATINO (36%) MALES (74%) AGES 18-40 (73%) WHOSE PRIMARY DRUG WAS HEROIN (71%). NEARLY THREE QUARTERS (73%) WERE REFERRED TO TTC VIA LAC’S PUBLICLY FUNDED DRUG MEDI-CAL ORGANIZED DELIVERY SYSTEM (DMC-ODS). MORE THAN HALF (58%) WERE ENROLLED IN INPATIENT DETOX, 9% IN RESIDENTIAL REHABILITATION, AND 31% IN OUTPATIENT TREATMENT WITH AN AVERAGE LENGTH OF STAY OF 51 DAYS. APPROXIMATELY 20% OF ALL TTC’S OUD PATIENTS WERE ENGAGED IN MAT SERVICES (UP FROM 6% IN 2018). MORE THAN 175,000 INDIVIDUALS IN LAC ARE ESTIMATED TO HAVE AN OUD (2% PREVALENCE), BUT ONLY ABOUT 18% WERE RECEIVING TREATMENT IN 2019. TTC HAS BEEN IMPLEMENTING THE SAMHSA-FUNDED MAT-EXPANSION PROJECT SINCE 2018. ALTHOUGH THE PROJECT HAS MET ENROLLMENT TARGETS, FOLLOW-UP RATES HAVE BEEN LOW (52% FOR 3-MONTH; 27% FOR 6-MONTH). WHILE LENGTH OF STAY WAS LONGER FOR MAT-EXPANSION PROJECT PARTICIPANTS AT 160 DAYS, TTC HAD DIFFICULTY REACHING PATIENTS TO SCHEDULE FOLLOW-UPS DUE TO LOSING CONTACT AFTER DISCHARGE. TTC’S PROPOSED PROJECT WILL ADDRESS IDENTIFIED SERVICE GAPS AND INCREASED OUD PREVALENCE IN LAC BY PROVIDING PROJECT PARTICIPANTS WITH EVIDENCE-BASED MAT SERVICES (BUPRENORPHINE PRODUCTS, METHADONE, AND NALTREXONE), CO-OCCURRING MENTAL HEALTH SERVICES, RECOVERY SUPPORT SERVICES, AND OTHER CRITICAL SERVICES (PRIMARY MEDICAL CARE, HIV AND HEPATITIS C SPECIALTY CARE AND PREVENTION SERVICES, CASE MANAGEMENT, ETC.) OFFERED THROUGH TTC’S INTEGRATED CARE MODEL AT SUBSTANCE USE DISORDER (SUD) TREATMENT FACILITIES AND CO-LOCATED OPIOID TREATMENT PROGRAM (OTP) FACILITIES IN THE SAN FERANDO AND ANTELOPE VALLEYS. IN ADDITION, TTC WILL CONDUCT THE FOLLOWING ACTIVITIES: 1) TARGETED OUTREACH AND VIRTUAL MAT TRAININGS WITH LOCAL COMMUNITY-BASED ORGANIZATIONS WORKING WITH REENTRY AND OTHER VULNERABLE POPULATIONS SUCH AS THE HOMELESS AND LGBTQ+, AND WITH PRIMARY CARE, MENTAL HEALTH, AND SOCIAL SERVICE PROVIDERS; 2) MAT TRAININGS WITH TTC’S SUD COUNSELORS AND OTHER TREATMENT STAFF; 3) MAT EDUCATIONAL GROUPS WITH OUD PATIENTS AT TTC’S INPATIENT DETOX AND OTHER TREATMENT PROGRAMS; AND 4) WEEKLY MAT SUPPORT GROUPS FOR PARTICIPANTS. TTC WILL SERVE A MINIMUM OF 150 INDIVIDUALS IN YEAR 1 AND 180 ANNUALLY IN YEARS 2-5 FOR A TOTAL OF 870 UNDUPLICATED INDIVIDUALS SERVED DURING THE FIVE-YEAR PROJECT PERIOD. KEY OUTCOMES INCLUDE AN INCREASE IN THE OVERALL PROPORTION OF OUD PATIENTS WHO ARE ENROLLED IN MAT SERVICES, INCREASED TREATMENT RETENTION, INCREASED ABSTINENCE FROM ILLICIT DRUG USE (INCLUDING PRESCRIPTION OPIOID MISUSE), DECREASED INVOLVEMENT IN THE CRIMINAL JUSTICE SYSTEM, AND INCREASED SOCIAL CONNECTEDNESS.

GETTING OFF AT TTC

PROJECT LINC (LINKAGES IN CARE)

RYAN WHITE PART C OUTPATIENT EIS PROGRAM

PBHCI CONNECT

TTC'S COMPREHENSIVE OUTPATIENT PROGRAM FOR EMPOWERMENT (PROJECT COPE)

TTC MINORITY AIDS SERVICE INTEGRATION - PROJECT ABSTRACT TARZANA TREATMENT CENTERS, INC. (TTC) WILL STRENGTHEN AND ENHANCE ITS INTEGRATED, WHOLE-PERSON SYSTEM OF CARE AND PREVENTION SERVICES FOR INDIVIDUALS WITH MENTAL HEALTH OR CO-OCCURRING MENTAL HEALTH AND SUBSTANCE USE DISORDERS (CODS) WHO ARE LIVING WITH OR AT RISK FOR HIV AND HEPATITIS IN LOS ANGELES COUNTY (LAC). TTC’S WHOLE HEALTH INTEGRATION PROJECT PLUS SOCIAL NETWORKING STRATEGY (WHIP+SNS) WILL TARGET MEN WHO HAVE SEX WITH MEN (MSM), PEOPLE WHO INJECT DRUGS (PWID), AND OTHERS AT RISK FOR HIV/HEPATITIS, WITH A FOCUS ON RACIAL/ETHNIC MINORITIES. LAC HAS THE SECOND LARGEST NUMBER OF PERSONS LIVING WITH DIAGNOSED HIV (PLWDH) IN THE U.S. AND MINORITIES ARE AT GREATEST RISK WITH AN INCIDENCE RATE OF 39 (PER 100,000) FOR BLACK AND 14 FOR LATINX COMPARED TO 10 FOR WHITES (2019). AMONG LAC NATIONAL HIV BEHAVIORAL SURVEILLANCE (NHBS) RESPONDENTS, HIV POSITIVITY WAS HIGHEST FOR BLACK MSM AT 36% FOLLOWED BY LATINX MSM AT 18% AND WHITE MSM AT 15%. WHITE MSM HAD HIGHER LEVELS OF TESTING THAN LATINX AND BLACK MSM (83%), AND WHITE MSM PARTICIPANTS WERE MORE LIKELY TO HAVE USED PREP CONSISTENTLY FOR 2 OR MORE MONTHS IN THE PAST YEAR THAN BLACK OR LATINX MSM PARTICIPANTS. VIRAL SUPPRESSION WAS ALSO LOWER FOR BLACKS AND LATINX COMPARED TO WHITES. LIMITED ACCESS TO CARE SEEMS TO BE DRIVING THESE DISPARITIES WITH A HIGHER PROPORTION OF MINORITIES EXPERIENCING HIV SERVICE GAPS. AN EVEN HIGH PROPORTION OF PLWDH WITH A HISTORY OF MENTAL ILLNESS OR RECENT SUBSTANCE USE EXPERIENCED SERVICE GAPS. TTC HAS LONG SOUGHT TO ADDRESS THE COMPLEX NEEDS OF THE TARGET POPULATION BY CO-LOCATING AN INTEGRATING BEHAVIORAL HEALTH SERVICES WITH HIV SERVICES. HOWEVER, FUNDING FOR OUTREACH SERVICES HAS BEEN LIMITED, SO MARGINALIZED INDIVIDUALS AT HIGHEST RISK ARE NOT BEING REACHED. AS ONE OF THE LARGEST BEHAVIORAL HEALTH AGENCIES IN LAC, TTC WILL IDENTIFY AND ENGAGE PARTICIPANTS THROUGH IMPLEMENTATION OF AN INNOVATIVE COMMUNITY-BASED SOCIAL NETWORKING STRATEGY IN CONJUNCTION WITH IN-REACH AT TTC’S SUBSTANCE USE DISORDER (SUD) TREATMENT AND MENTAL HEALTH SERVICES PROGRAMS, SYRINGE EXCHANGE PROGRAM, AND HIV SPECIALTY CARE/PREP CLINIC. THE OVERALL AIM OF TTC’S WHIP+SNS IS TO EXPAND ACCESS TO FULLY INTEGRATED EVIDENCE-BASED, CULTURALLY COMPETENT BEHAVIORAL HEALTH SERVICES AND HIV/HEPATITIS TESTING AND CARE/PREVENTION SERVICES FOR THOSE MOST AT RISK FOR HIV/HEPATITIS IN LAC. THE PROJECT WILL ADDRESS THE IDENTIFIED DISPARITIES (HIGHER INFECTION RATES AMONG RACIAL/ETHNIC MINORITIES) AND SERVICE GAPS (LACK OF COORDINATED CASE MANAGEMENT TO ASSIST INDIVIDUALS WITH MENTAL ILLNESS OR COD AND LIMITED FUNDING FOR OUTREACH SERVICES TO REACH MARGINALIZED INDIVIDUALS) LEADING TO A REDUCTION IN THE INCIDENCE OF HIV AND HEPATITIS AND IMPROVED HEALTH OUTCOMES FOR THE TARGET POPULATION. IN ORDER TO ACCOMPLISH THIS, WHIP+SNS WILL: 1) IDENTIFY THE TARGET POPULATION THROUGH IMPLEMENTATION OF AN INNOVATIVE EVIDENCE-SUPPORTED OUTREACH AND ENGAGEMENT PRACTICE CALLED SOCIAL NETWORK STRATEGY (SNS) AS WELL AS IN-REACH AT TTC SERVICE SITES; 2) PROVIDE HIV/HEPATITIS PREVENTION SERVICES, INCLUDING SCREENING, RISK ASSESSMENT, PREVENTION COUNSELING, HIV/HEPATITIS TESTING, REFERRAL TO PRE-EXPOSURE PROPHYLAXIS (PREP) AND HEPATITIS VACCINATION WITHIN A BEHAVIORAL HEALTHCARE SETTING; 3) SCREEN AND ASSESS ALL PARTICIPANTS FOR MENTAL HEALTH DISORDERS OR COD AND PROVIDE THEM WITH CULTURALLY- AND TRAUMA-INFORMED BEHAVIORAL HEALTHCARE SERVICES; 4) PROVIDE REFERRAL AND LINKAGE SERVICES THROUGH ENHANCED PATIENT NAVIGATION AND CASE MANAGEMENT TO A FULL CONTINUUM OF SERVICES OFFERED ON SITE AT TTC, INCLUDING PRIMARY HIV/HEPATITIS TREATMENT AND CARE AND PREP SERVICES; AND 5) OFFER PEER SUPPORT GROUPS UTILIZING WHOLE HEALTH ACTION MANAGEMENT (WHAM). TTC WILL SERVE A MINIMUM OF 75 UNDUPLICATED INDIVIDUALS IN YEAR 1 AND 80 ANNUALLY IN YEARS 2-4 FOR A TOTAL OF 315 UNDUPLICATED INDIVIDUALS SERVED.

WHOLE HEALTH INTEGRATION PROJECT AGAINST HIV (WHIP-HIV)

GROWING MIRACLES

HUMAN IMMUNODEFICIENCY VIRUS (HIV) PREVENTION PROJECTS FOR COMMUNITY-BASED ORGANI

VALLEY INTEGRATED TREATMENT ALLIANCE (VITA)

RAPID TESTING, OUTREACH, AND TRAINING ENHANCEMENT (RAPID TOT)

MENTAL HEALTH SERVICES IN MINORITY COMMUNITIES FOR PERSONS WITH HIV

GROWING MIRACLES

MAT-EXPANSION PROJECT (PROJECT MAT-E)

PROJECT HELP (HEALTHY EDUCATED LEADERS IN PROGRESS)

TTC HARM REDUCTION PROGRAM (HRP) - TARZANA TREATMENT CENTERS, INC. (TTC) WILL EXPAND ACCESS TO HARM REDUCTION SERVICES FOR RESIDENTS OF LOS ANGELES COUNTY (LAC). THE POPULATION OF FOCUS WILL BE ADULTS AGES 18+, PRIMARILY RACIAL/ETHNIC MINORITY (39% LATINO; 15% BLACK; 4% OTHER/MIXED RACE) MALES (69%) WITH SUBSTANCE USE DISORDER (SUD) EXITING TTC’S PUBLICLY FUNDED INPATIENT DETOX OR RESIDENTIAL TREATMENT PROGRAMS AND/OR ENROLLED IN RECOVERY SUPPORT SERVICES AS WELL AS PEOPLE WHO USE DRUGS (PWUD) PARTICIPATING IN TTC’S SYRINGE EXCHANGE PROGRAM (SEP), THE MAJORITY (81%) OF WHOM ARE HOMELESS. HARM REDUCTION SERVICES ARE CRITICALLY NEEDED IN LAC TO COMBAT THE NEGATIVE CONSEQUENCES ASSOCIATED WITH DRUG USE, ESPECIALLY AMONG THIS VULNERABLE POPULATION. LAC HAS BEEN GRAPPLING WITH TWIN OPIOID AND METHAMPHETAMINE EPIDEMICS ALONGSIDE THE REST OF CALIFORNIA AND THE U.S. FOR SOME TIME NOW AND THE COVID-19 PANDEMIC HAS ONLY EXACERBATED THE CRISIS LEADING TO A 52% INCREASE IN ACCIDENTAL DRUG OVERDOSE DEATHS WITH RATES INCREASING MOST FOR RACIAL/ETHNIC MINORITIES. ALTHOUGH TTC HAS CHAMPIONED HARM REDUCTION SERVICES FOR MANY YEARS, SERVICE GAPS DIMINISH IMPACT: 1) TTC HAS EXPERIENCED AN UNPRECEDENTED INCREASE IN DEMAND FOR HARM REDUCTION SERVICES THAT FAR EXCEEDS ITS CURRENT CAPACITY. TTC’S SEP DOES NOT HAVE SUFFICIENT SYRINGES OR OTHER SUPPLIES, SUCH AS FENTANYL TEST STRIPS AND NALOXONE, TO MEET GROWING DEMAND NOR IS THERE SUFFICIENT STAFF TO PROVIDE ADEQUATE OVERDOSE PREVENTION SERVICES OR REFERRAL AND LINKAGE SERVICES TO CRITICAL SERVICES; AND 2) TTC IS A LARGE AGENCY WITH NEARLY 1,200 EMPLOYEES ACROSS 13 SERVICE SITES IN SEVEN DIVERSE COMMUNITIES ACROSS LAC. HARM REDUCTION PROGRAMS HAVE BEEN SILOED WITHIN SPECIFIC SITES AND NOT ALL STAFF ARE ADEQUATELY TRAINED IN HARM REDUCTION PRINCIPLES AND STRATEGIES. FURTHERMORE, TTC HAS ALSO NOT HAD THE OPPORTUNITY TO ADDRESS SOCIAL STIGMA ASSOCIATED WITH PWUD AND HARM REDUCTION SERVICES IN THE BROADER COMMUNITY. THE PROPOSED PROJECT WILL ADDRESS THESE IDENTIFIED SERVICE GAPS THROUGH CAPACITY DEVELOPMENT AND SERVICE EXPANSION. THE OVERALL PURPOSE OF TTC’S HARM REDUCTION PROGRAM (HRP) IS TO IMPROVE TTC’S CAPACITY TO PROVIDE HARM REDUCTION SERVICES ACROSS ALL SERVICE SITES, PROGRAMS, AND ORGANIZATIONAL LEVELS AND TO EXPAND HARM REDUCTION SERVICES, INCLUDING SYRINGE EXCHANGE AND RELATED SERVICES, OVERDOSE PREVENTION EDUCATION AND NALOXONE DISTRIBUTION, AND REFERRAL AND LINKAGE TO BEHAVIORAL HEALTHCARE, PRIMARY/SPECIALTY MEDICAL CARE, HIV/HCV PREVENTION SERVICES, AND OTHER SUPPORT SERVICES. IN ADDITION TO CONDUCTING AN ORGANIZATIONAL ASSESSMENT OF THE AGENCY’S CURRENT CAPACITY TO PROVIDE HARM REDUCTION AND TRAUMA-INFORMED SERVICES AND DEVELOPING A STRATEGIC ACTION PLAN TO FURTHER INTEGRATE THESE SERVICES THROUGHOUT THE AGENCY, TTC WILL CONDUCT THE FOLLOWING ACTIVITIES: 1) CONVENE A HARM REDUCTION ADVISORY COUNCIL COMPRISED OF KEY STAKEHOLDERS, INCLUDING STAFF, PATIENTS, ALUMNI, SEP PARTICIPANTS, REPRESENTATIVES FROM LOCAL COMMUNITY-BASED ORGANIZATIONS SERVING THE TARGET POPULATION, ETC. TO ASSIST TTC IN DEVELOPING/IMPLEMENTING THE PROJECT; 2) PROVIDE SUPPORT FOR THE COUNTYWIDE HARM REDUCTION STEERING COMMITTEE LED BY LACDPH SAPC TO ENSURE ALL HARM REDUCTION EFFORTS ARE IN ALIGNMENT WITH COUNTY-LEVEL GOALS AND OBJECTIVES; 3) DEVELOP AND IMPLEMENT STAFF AND COMMUNITY TRAININGS PROMOTING CONCEPTS OF HARM REDUCTION TO REDUCE STIGMA ASSOCIATED WITH PWUD AND HARM REDUCTION SERVICES; 4) EXPAND HARM REDUCTION SERVICES, INCLUDING SYRINGE EXCHANGE AND RELATED SERVICES, OPIOID PREVENTION AND NALOXONE DISTRIBUTION, AND REFERRAL AND LINKAGE TO SERVICE; AND 5) DEVELOP/IMPLEMENT A COMMUNICATIONS CAMPAIGN TO REDUCE STIGMA. TTC WILL SERVE A MINIMUM OF 400 UNDUPLICATED INDIVIDUALS IN YEAR 1 AND 500 ANNUALLY IN YEARS 2 AND 3 FOR A TOTAL OF 1,400 UNDUPLICATED INDIVIDUALS SERVED, WITH 1,120 OF THOSE BEING REFERRED TO SUPPORT SERVICES AND A TOTAL OF 2,240 LINKAGES BEING MADE DURING THE THREE-YEAR PROJECT.

PARTNERS FOR HOMELESS HEALTH TTC & SFVCMHC

PS06-618 HIV PREVENTION PROJECTS FOR YMCSM & YTG

VALLEY STREET SMART (VSS)

OPIOID OVERDOSE TREATMENT ACCESS TECHNICAL ASSISTANCE (OD-TA) PROGRAM

VALLEY TELE-TREATMENT PROGRAM

PROJECT HOMECOMING

SAVING LIVES PROJECT (SLP)

TARZANA TREATMENT CENTERS, INC. WILL USE FUNDING TO ADDRESS THE NEED FOR INTEGRATED BEHAVIORAL HEALTH AND DIVERSION SERVICES AMONG LOW-INCOME YOUTH AGES 12-17, WHO HAVE BEEN IMPACTED BY OPIOID AND OTHER SUBSTANCE USE DISORDERS (SUDS) IN LOS ANGELES COUNTY. PROPOSED PROJECT GOALS ARE TO: 1) EXPAND ACCESS TO CULTURALLY-COMPETENT, DEVELOPMENTALLY-APPROPRIATE, AND EVIDENCE-BASED EARLY INTERVENTION AND SUD TREATMENT SERVICES, INCLUDING CO-OCCURRING MENTAL HEALTH SERVICES, FOR LOW-INCOME YOUTH AT RISK FOR ENTERING OR REENTERING THE JUVENILE JUSTICE SYSTEM; 2) INTEGRATE SPECIALIZED DIVERSION PROGRAMMING AND SERVICES FOR JUSTICE-INVOLVED YOUTH SUD PATIENTS; AND 3) STRENGTHEN REFERRAL PATHWAYS WITH JUVENILE JUSTICE AGENCIES AND SCHOOLS, INCLUDING OFFERING ON-SITE SCREENING, INTAKE AND ASSESSMENT SERVICES. THE OVERALL AIM IS TO IMPROVE OUTCOMES FOR HIGH-RISK YOUTH, INCLUDING A REDUCTION IN THE NUMBER OF FIRST-TIME OFFENSES. THE APPLICANT ALSO RECEIVED PRIORITY CONSIDERATION BY INCLUDING POLICIES, PRACTICES, AND /OR PROCEDURES THAT ARE RESPONSIVE TO DOJ PRIORITIES.

YOUTH MENTAL HEALTH FIRST AID (YMHFA) - TARZANA TREATMENT CENTERS, INC. (TTC) WILL PROVIDE YOUTH MENTAL HEALTH FIRST AID (YMHFA) TRAINING TO YOUTH-SERVING STAFF AT COMMUNITY-BASED AGENCIES AND OTHER INTERESTED COMMUNITY MEMBERS, INCLUDING TEACHERS AND PARENTS, IN SERVICE PLANNING AREAS (SPAS) 1 & 2 IN NORTHERN LOS ANGELES COUNTY (LAC). TTC’S POPULATION OF FOCUS WILL BE PRIMARILY BLACK AND LATINO YOUTH AGES 12-17 IN SPAS 1 AND 2 WHOSE FAMILIES EXPERIENCE LOWER EDUCATIONAL LEVELS AND HIGHER RATES OF POVERTY, OVERCROWDED HOUSING, AND FOOD INSECURITY THAN OTHER RACIAL/ETHNIC GROUPS IN THE COMMUNITY. AS A RESULT, THESE YOUTH AND THEIR FAMILIES HAVE GREATER DIFFICULTY ACCESS HEALTH CARE, INCLUDING MENTAL HEALTH SERVICES, THAN THEIR WHITE COUNTERPARTS, DESPITE HAVING GREATER MENTAL HEALTH NEEDS. LOCAL COMMUNITY HEALTH NEEDS ASSESSMENTS POINT TO SOCIAL STIGMA AND A LACK OF MENTAL HEALTH PROVIDERS SERVING LOW-INCOME FAMILIES AS KEY BARRIERS. TTC’S PROPOSED PROJECT WILL ADDRESS THESE SERVICE GAPS BY INCREASING AWARENESS OF MENTAL HEALTH DISORDERS AND AVAILABLE MENTAL HEALTH RESOURCES IN THE COMMUNITY AND IMPROVING REFERRAL PATHWAYS TO MENTAL HEALTH AND OTHER SERVICES FOR LOW-INCOME, PRIMARILY BLACK AND LATINO, YOUTH AGES 12-17. THE OVERALL PURPOSE OF TTC’S VALLEY FIRST AIDERS (VFA) PROJECT IS TO IMPROVE TARGETED YOUTH’S ACCESS TO NEEDED MENTAL HEALTH SERVICES BY PROVIDING MENTAL HEALTH AWARENESS TRAINING AND IMPROVED REFERRAL PROTOCOLS TO A WIDE RANGE OF COMMUNITY MEMBERS, INCLUDING HEALTH AND SOCIAL SERVICE PROVIDERS, TEACHERS, YOUTH COACHES, SCHOOL PERSONNEL, PARENTS, AND OTHER CONCERNED COMMUNITY MEMBERS IN LAC SPAS 1 AND 2. THE PROJECT’S SPECIFIC GOALS AND OBJECTIVES WILL BE ACCOMPLISHED BY: 1) STRENGTHENING OR FORGING NEW PARTNERSHIPS WITH YOUTH-SERVING COMMUNITY-BASED ORGANIZATIONS, SCHOOLS, AND OTHER RELEVANT AGENCIES IN THE TARGETED COMMUNITIES TO PROMOTE THE IMPORTANCE OF MENTAL HEALTH AWARENESS TRAINING; 2) CONDUCTING TARGETED ORGANIZATIONAL AND COMMUNITY OUTREACH TO RECRUIT INDIVIDUALS TO BE TRAINED IN YMHFA; 3) DEVELOPING MATERIALS AND SPECIFIC REFERRAL PROTOCOLS FOR TRAINED FIRST AIDERS TO USE WHEN ASSISTING YOUTH IN NEED OF SERVICES, ESPECIALLY THOSE WITH SEVERE MENTAL ILLNESS (SMI), SERIOUS EMOTIONAL DISTURBANCE (SED), OR CO-OCCURRING SUBSTANCE USE DISORDER (COD/SUD); 4) CONDUCTING YMHFA TRAINING WITH A MINIMUM OF 180 UNDUPLICATED INDIVIDUALS IN YEAR 1 AND 200 UNDUPLICATED INDIVIDUALS ANNUALLY IN YEARS 2-5 FOR A TOTAL OF 980 UNDUPLICATED INDIVIDUALS TRAINED DURING THE 5-YEAR PROJECT; AND 5) TRACKING THE NUMBER OF YOUTH ENCOUNTERS, REFERRALS, AND LINKAGES TO SERVICES MADE BY TRAINED FIRST AIDERS EACH YEAR. OUTCOMES INCLUDE INCREASED KNOWLEDGE OF MENTAL HEALTH DISORDERS AND AVAILABLE COMMUNITY RESOURCES AMONG TRAINED INDIVIDUALS, INCREASED CONFIDENCE TO APPROPRIATELY AND SAFELY RESPOND TO YOUTH IN DISTRESS AMONG TRAINED INDIVIDUALS, AND AN OVERALL INCREASE IN ENROLLMENT IN YOUTH MENTAL HEALTH SERVICES AT TTC EACH YEAR. AS ONE OF THE LARGEST PUBLICLY FUNDED INTEGRATED BEHAVIORAL HEALTH PROVIDERS IN LAC, TTC WILL ALSO PROVIDE REFERRED YOUTH TO TRAUMA-INFORMED, CULTURALLY RESPONSIVE COMMUNITY-BASED MENTAL HEALTH SERVICES WITH AN EMPHASIS ON PREVENTION AND EARLY INTERVENTION. TTC ALSO HAS THE CAPACITY TO PROVIDE SPECIALIZED MENTAL HEALTH SERVICES FOR YOUTH WITH SMI, SED, OR COD/SUD.

TTC'S OVERDOSE TREATMENT ACCESS (OD-TA) PROJECT - TARZANA TREATMENT CENTERS, INC. (TTC) WILL EXPAND ACCESS TO OPIOID OVERDOSE (OO) EDUCATION AND NALOXONE DISTRIBUTION (OEND) IN LOS ANGELES COUNTY (LAC) THROUGH THE DEVELOPMENT AND IMPLEMENTATION OF TWO SCALABLE TRAINING OF TRAINERS (TOT) PROGRAMS: 1) OEND BEST PRACTICES FOR FQHCS, COMMUNITY CLINCS AND PHARMACIES TOT PROGRAM (OENDCCP); AND 2) OEND BEST PRACTICES FOR COLLEGE CAMPUSES TOT PROGRAM (OEND CC). THE OENDCCP WILL RECRUIT HEALTHCARE "CHAMPIONS" OR PROVIDERS (DOCTORS, PHYSICIAN ASSISTANTS, NURSE-PRACTITIONERS, NURSES, MEDICAL ASSISTANTS, COMMUNITY HEALTH WORKERS, ETC.) AND PHARMACISTS FOR A HALF-DAY, IN-PERSON TRAINING ON INNOVATIVE PRACTICES, POLICIES, PROCEDURES, AND MODELS OF CARE FOR PRESCRIBING/CO-PRESCRIBING AND OTHERWISE EXPANDING ACCESS TO NALOXONE IN COMMUNITIES WITH HIGH RATES OF OO DEATHS. PARTICULAR FOCUS WILL BE PLACED ON CULTURALLY INFORMED APPROACHES THAT ADDRESS SOCIAL STIGMA, MEDICAL MISTRUST, AND OTHER BARRIERS TO NALOXONE ACCESS IN THE PREDOMINANTLY RACIAL/ETHNIC MINORITY POPULATIONS SERVED BY THE TRAINEES. OEND "CHAMPIONS" WILL THEN RETURN TO THEIR SITE TO TRAIN OTHER STAFF AND BUILD SITE-SPECIFIC CAPACITY TO PROVIDE EFFECTIVE OEND SERVICES THAT ARE CULTURALLY RESPONSIVE TO THE POPULATION SERVED. AT LEAST TWO (2) TRAININGS WILL BE HELD EACH YEAR (1 DURING YEAR ONE) WITH 30-40 PROVIDERS EACH FOR A MINIMUM OF 270 OEND CHAMPIONS TRAINED DURING THE 5-YEAR PROJECT. THE OEND CC WILL RECRUIT "COLLEGE AMBASSADORS" OR STUDENT LEADERS AND CAMPUS HEALTH CENTER PERSONNEL FROM LOCAL COMMUNITY COLLEGES AND UNIVERSITIES THROUGHOUT LAC FOR A HALF-DAY, IN-PERSON TRAINING ON INNOVATIVE PRACTICES, POLICIES, PROCEDURES, AND MODELS OF ENGAGEMENT FOR INCREASING ACCESS TO OEND ON COLLEGE CAMPUSES. FOCUS WILL BE PLACED ON CULTURALLY INFORMED APPROACHES FOR HISPANIC-SERVING INSTITUTIONS (HSIS) WHERE THE SAME CULTURAL BARRIERS TO NALOXONE ACCESS MAY PREVAIL AS IN PREDOMINANTLY LATINX COMMUNITIES. AT LEAST TWO (2) TRAININGS WILL BE HELD EACH YEAR (1 DURING YEAR ONE) WITH APPROXIMATELY 25 TRAINEES EACH FOR A TOTAL OF 225 OEND COLLEGE AMBASSADORS OR TRAINERS TRAINED DURING THE 5-YEAR PROJECT. BETWEEN THE TWO TOT PROGRAMS, A TOTAL OF 495 UNDUPLICATED INDIVIDUALS WILL BE TRAINED AS TRAINERS WITH AWARD FUNDS. EACH OEND CHAMPION OR TRAINER COMPLETING THE TOT PROGRAM WILL COMMIT TO TRAINING A MINIMUM OF 5 PROVIDERS AT THEIR SITE FOR A TOTAL OF 150-200 INDIVIDUALS TRAINED IN YEAR 1 AND 300-400 TRAINED ANNUALLY IN YEARS 2-5 FOR A TOTAL OF 1,350-1,800 INDIVIDUALS TRAINED IN OEND BEST PRACTICES FOR FQHCS, COMMUNITY CLINICS, & PHARMACIES BY THE END OF YEAR 5. MEANWHILE, EACH OEND COLLEGE AMBASSADOR COMPLETING THE TOT PROGRAM WILL TRAIN A MINIMUM OF 5-10 STUDENTS/HEALTH CENTER STAFF AT THEIR CAMPUS FOR A TOTAL OF 125-250 INDIVIDUALS TRAINED IN YEAR 1 AND 250-500 TRAINED DURING YEARS 2-5 FOR A TOTAL OF 1,125-2,250 INDIVIDUALS TRAINED BY THE END OF YEAR 5. TTC'S TOT PROGRAMS WILL ADDRESS SERVICE GAPS IN LAC WHERE HIGHER RATES OF AREA POVERTY WERE ASSOCIATED WITH HIGHER OO DEATH RATES. THE SPECIFIC GOALS OF THE TOT PROGRAMS ARE TO: 1) INCREASE CAPACITY OF LOCAL FQHCS, COMMUNITY CLINICS, AND PHARMACIES TO DEVELOP EFFECTIVE OEND PROGRAMS, INCLUDING INNOVATIVE AND CULTURALLY RESPONSIVE PRACTICES, IN HIGH-NEED COMMUNITIES; AND 2) INCREASE CAPACITY OF LOCAL HIS COMMUNITY COLLEGES AND STATE UNIVERSITIES TO DEVELOP EFFECTIVE AND INNOVATIVE OEND PROGRAMS, INCLUDING CULTURALLY RESPONSIVE PRACTICES, AMONG DIVERSE STUDENT POPULATIONS. BY THE END OF YEAR 5, THE RATE OF ED VISITS AND HOSPITALIZATIONS DUE TO OO WILL BE REDUCED BY AT LEAST 25% FROM BASELINE (2022). ANNUALLY DURING YEARS 1-5, AT LEAST 533 NALOXONE NASAL SPRAY KITS WILL BE DISTRIBUTED TO OEND CHAMPIONS FOR DISTRIBUTION TO PATIENTS AT HIGHEST RISK FOR OO, AND APPROXIMATELY 5-10 PATIENTS WHO HAVE EXPERIENCED AN OO WILL BE LINKED TO OUD TREATMENT EACH YEAR THROUGH AN ENHANCEMENT OF LINKAGE TO TREATMENT PROTOCOLS WITH PARTICIPATING FQHCS AND COMMUNITY CLINICS.

HEALTHCARE, ASSESSMENT, LINKAGE & TESTING FOR HEP C (HALT HEP C)

AMERICAN RESCUE PLAN ACT FUNDING FOR LOOK-ALIKES

HUMAN IMMUNODEFICIENCY VIRUS(HIV)PREVENTION PROJECTS FOR CBO

GROWING MIRACLES

SAN FERNANDO VALLEY SA/HIV/HEP C INITIATIVE

PROJECT HOMECOMING

HOMELESS TO HEALTH SUPPLEMENTAL PROJECT

PARTNERS FOR HOMELESS HEALTH TTC & SFVCMHC

PROJECT FAIR

FOCUS ON THE FAMILY YOUTH SUBSTANCE ABUSE TREATMENT PROGRAM

ANTELOPE VALLEY DRUG PREVENTION COALITION

FY 2023 EXPANDING COVID-19 VACCINATION

CONTINUUM OF CARE PROGRAM

HOMELESS ASSISTANCE

HOMELESS ASSISTANCE

HOMELESS ASSISTANCE

HOMELESS ASSISTANCE

HOMELESS ASSISTANCE

HOMELESS ASSISTANCE

HOMELESS ASSISTANCE

CONTINUUM OF CARE PROGRAM

CONTINUUM OF CARE PROGRAM

THE BASIC CENTER PROGRAM

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS

IAWARE IEDUCATE

SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE

RYAN WHITE HIV/AIDS PROGRAM PART C EIS COVID-19 RESPONSE

TTC HCV SCREENING FOR OTP

FY 2023 BRIDGE ACCESS PROGRAM

COMPREHENSIVE HIGH-IMPACT HIV PREVENTION PROJECTS FOR COMMUNITY-BASED ORGANIZATIONS

VALLEY INTEGRATED TREATMENT ALLIANCE (VITA)

PROJECT FAIR