Expand jail-based system of care and re-entry contiuum

In January of 2020, Grays Harbor Public Health received funding through the Rural Response to the Opioid Epidemic demonstration project. One of the initiatives of that award was to institutionalize a System of Care (SOC) in the Grays Harbor County Jail to address opioid use disorder. This included an intensive planning process, hiring a Substance Use Disorder Professional (SUDP), increasing access to Buprenorphine, initiating recovery classes in the jail for program participants, and contracting with a community agency to provide social service support (including housing) upon re-entry.

There has been significant foundational work done in creating and implementing this SOC, and the community is beginning to realize the benefits of addressing behavioral health care needs during incarceration. With implementation beginning in March of 2021 we have been able to serve 45 unique individuals with the following demographics: 70% homeless/unstable housing; 48% had no high school diploma/GED equivalent; and 86% were unemployed. We have also been successful in working with county prosecutors in securing alternative (to prison) sentencing for 6 individuals by arranging for long-term inpatient rehabilitation.

Our County’s population of just under 74,000 has one of the highest incarceration rates in the state of like-sized jails. This program has not only strengthened ties with law enforcement, the judicial system, behavioral health agencies and public health, it has also had an impact on individuals with Opioid Use Disorder (OUD) who are returning to the community in a state of sobriety and genuinely working toward their recovery goals.

With our current funding we have been able to serve the majority of individuals who would meet criteria however, if individuals don’t present with an OUD they are screened out of services. Surveillance data over the last 12 months indicates that methamphetamine was the drug most associated with overdose deaths in our county (65% of cases) while fentanyl was at 29%, prescription opioids at 29% and heroin at 19%.

Our proposal would seek to expand services by increasing capacity in the Grays Harbor County Jail to serve individuals who have a psychostimulant disorder as well. This expansion would include additional staff time for medical monitoring, managing recovery groups, and bolstering re-entry supports.

The goal of this expanded SOC would be to increase the number of affected individuals returning to the community with established sobriety and behavioral health supports, decrease morbidity and mortality for those individuals and to decrease recidivisms among this population.