The Thrive Team and Community Outreach Specialists (COS) initiative

Berkshire County, MA proposes to build on existing capacities that will
establish and expand replicable community-centered, field-based interventions to address the full
Opioid Use Disorder (OUD) Lifecycle of prevention, harm reduction, treatment and recovery in
each of the three regions of Berkshire County. The purpose is to expand access to harm
reduction, evidence-based treatment and recovery support services to underserved populations
that will advance equity and enhance the research base to be replicable in similar rural areas that
face long-standing disparities in access to affordable care. Project activities include 1) extend
and expand the Berkshire Post Overdose Program to provide regionally specific medical and
behavioral health-centered field outreach to individuals who recently experienced an overdose or
are otherwise identified at higher risk for overdose; 2) outreach to and engagement with
disadvantaged communities disproportionately affected by substances; 3) supplement existing
capacities to address the OUD prevention, harm reduction, treatment and recovery landscape of
the area; 4) extend and expand public communications strategies to directly support these efforts while reducing stigma; and 5) provide training to increase the toolkits and supports for first
responders, practitioners, providers, families and social networks to reduce the number of
community members intercepted by law enforcement and the courts. Expected outcomes include
a reduction in fatal overdoses, a decrease in recidivism and intercepts by law enforcement,
development of detailed process guides and toolkits that are replicable in similar areas, regular
program assessments, and sustainable implementation of community-centered interventions that
will empower the communities of Berkshire County to reimagine their futures free from the
harms stemming from substance misuse and the related stigma. Subrecipient activities include
field medical services, linkage to behavioral health resources, communications strategies to
support these services, skill building training for professionals and social networks interacting
with those struggling with substance use and contributing to the local and national knowledge
base to replicate these activities in other rural areas experiencing similar disparities in the cost of
care. The bulk of the funding (46%) will be directed towards field-initiated projects that bring
together justice, behavioral health, and public health practitioners. Additional allowable
expenses (14%) include embedding peers and experienced community members at intercepts 0
and 1 of the Sequential Intercept Model. Allowable uses also include harm reduction activities
and linkage to evidence-based treatment and recovery for those at higher risk of overdose, arrest
and/or recidivism; naloxone for law enforcement and first responders; and real-time data
collection (2.5%). Less grant funding is needed for these activities as naloxone is provided at no
cost, and real-time data collection is provided in-kind from the Northampton Department of
Health and Human Services. Remaining project funds cover staff time and resources to
implement these strategies (35.6%) and related trainings for first responders, professionals in the
field, and families and social networks of those struggling with substance use (2%).