HomeMy WebLinkAbout11-18-19 City Commission Packet Materials - C14. Certification for Lobbying and Assurances for Combating Opioid Overdose
Commission Memorandum
REPORT TO: Honorable Mayor and City Commission
FROM: Renee Boundy, Veteran Eligible Treatment Services Court Coordinator
SUBJECT: Ratify the City Manager’s signature on the Certification Regarding Lobbying and
the Assurances – Non Construction Programs for the Combating Opioid Overdose through
Community-level Intervention Funding Application
MEETING DATE: November 18, 2019
AGENDA ITEM TYPE: Consent
RECOMMENDATION Ratify the City Manager’s signature on the Certification Regarding
Lobbying and the Assurances – Non Construction Programs for the Combating Opioid Overdose
through Community-level Intervention Funding Application Narrative
BACKGROUND: The Combating Opioid Overdose through Community-level Intervention
Notice of Funding Availability became available NOFA became available on October 1st. The
Application is due November 1st. In order to apply we need the city manager’s signature on the
Certification Regarding Lobbying and the Assurances – Non Construction Programs. Because of
the short time frame, we were not able to complete the application in time to get it on the consent
agenda before the application was due. We are asking the commission to ratify the City
Manager’s signature on these two documents for the application for funding. The notice of
funding award is scheduled for December 2, 2020. See attached funding application.
FISCAL EFFECTS: The funding application is for $149,002.00. No matching funds are
required. See attached budget and budget narrative.
ALTERNATIVES: As suggested by the Commission.
ATTACHMENTS: Funding Application
Budget
Budget Narrative
173
174
175
176
APPLICATION COVER SHEET
Combating Opioid Overdose through Community-Level Intervention (FY19)
1. PROJECT TITLE
2. APPLICANT AGENCY: City of Bozeman, PO Box 1230, Bozeman, MT 59771-1230
See Appendix A for DUNS/SAM Registration information
3. IMPLEMENTING AGENCY: Bozeman Veteran Eligible Treatment Services Court,
Bozeman Municipal Court
4. PROPOSED START/END DATES: December 2, 2019 - November 30, 2020
5. PREPARER INFORMATION: Jessie Holton and Renee Boundy
Mailing Address: 615 S 16th, St 123, Bozeman, MT 59715
Phone Number: 406 548 5950
Email Address: rboundy@bozeman.net
6. PROJECT DIRECTOR: Renee Boundy
Mailing Address: 615 S 16th, Bozeman, MT 59715
Phone Number: 406 548 5950
Email Address: rboundy@bozeman.net
7. FISCAL OFFICER: Brian Lameres
Mailing Address: PO Box 1230, Bozeman, MT 59771-1230
Phone Number: 406 582 2335
Email Address: blameres@bozeman.net
8. CIVIL RIGHTS CONTACT: James Henderson
Mailing Address: PO Box 1230, Bozeman, MT 59771-1230
Phone Number: 406 582 2346
Email Address: james.henderson@bozeman.net
177
PROJECT SUMMARY
The Bozeman Veteran Treatment Services (VETS) Court is a specialty court under the
jurisdiction of the City of Bozeman Municipal Court The Alternative Therapies Pilot Program is
a community based collaborative approach to combating the opioid epidemic designed to
mitigate some of the boundaries to treatment found in rural states.
This project is designed to offer non-traditional therapeutic activities such as Yoga,
hiking, skiing, eastern medicine, meditation, physical fitness, acupuncture, massage, and equine
therapy in conjunction with traditional substance use treatment and, where indicated, Medication
Assisted Therapy (MAT) and mental health therapy to support recovery and lessen recidivism in
the Bozeman treatment court population.
The budget supports a .5 FTE case manager to coordinate care for the participants, a .25
FTE to manage the administration of the funds, training for staff and community partners, and
funds for the activities and equipment for participants use during the approved activities.
178
PROJECT NARRATIVE
1. Problem Statement
After analyzing 3 years of data, Montana published a comprehensive statewide plan on substance
abuse in November, 2017. This report notes that an estimated 64,000 Montanans have a
substance use disorder and that 90% of the people with a substance use disorder are not receiving
treatment. It notes that Montana has 70 opioid prescriptions for every 100 residents and that
since the year 2000, more than 700 Montanans have died from opioid overdose. The report
identified six focus areas and provided strategic goals and action areas for each focus. The
Bozeman VETS Court Alternative Therapies Pilot program will address 3 of those focus areas.
Focus Area: Enforcement
Goal: Increasing access to drug
courts
The VETS Court Alternative Therapies Pilot Program
will expand the evidence base for alternative therapies
and increase options to treatment court participants
thereby increasing the effectiveness of treatment court.
Focus Area: Family and Community Resources
Goal: Increase access to peer
mentors, housing and other
evidence based recovery supports
The VETS Court Alternative Therapies Pilot Program
increases access to evidence based recovery supports
Focus Area: Treatment
Goal: Strengthen the Continuum
of holistic SUD care in
communities across Montana
The VETS Court Alternative Therapies Pilot Program
supports traditional therapy and gives participants
several options to pursue in recovery.
179
2. Project Description
The proposed Alternative Therapies program is based on current best-practices in
treatment courts and addiction recovery. The three prong approach of Biological, Psychological,
and Social Awareness is commonly used in tandem with individual treatment, group treatment,
and criminal justice treatment courts (Rezansoff, Morniruzzaman, Clark, & Somers, 2015). This
program uses the same three prong approach to focus on assisting participants with learning how
to use community resources as a healthy alternative to mimic the effects of using substances.
Biological
Because opioids and other substances effect the chemical reactions in the brain to induce
euphoria and curb negative feelings, a barrier to recovery is finding effective ways to reduce the
downfall into a depressive state as the brain attempts to recover to homeostasis (Wupperman,
2019). We will select alternative therapies which have biological benefits such as increasing
serotonin, dopamine, and oxytocin. It is believed the downward depressive state involved with
recovery will be reduced. By providing the opportunity to engage in alternative therapies per
week, the likelihood of relapse due to depression and cravings will be suppressed significantly.
Psychological
Recovery, especially from opioid addiction, can have psychological effects as the brain
attempts to recover from the damage caused by the interruption of chemical balance and the
increase of cortisol as stress increases (Wupperman, 2019). Being shamed as an addict,
involvement in the justice system, and additional mental health issues such as Post Traumatic
Stress Disorder, Bi-polar Disorder, Anxiety, Depression, etc., combine to produce an unbearable
stress level in participants. Often, the use of substances is a coping mechanism for prior
stressors. The Alternative Therapies approach includes effective stress reducing activities
180
combined with clinical treatment and allows for a psychological support system with more
interventions throughout a week/month/year. The reduction in stress allows for an increase of
communication during clinical sessions providing for a deeper understanding of the underlying
psychological issues which can then be addressed more effectively.
Social
It is often said, the first step in recovery is changing your people, places, and things. The
social prong of the recovery approach focuses on having participants connect, or reconnect, with
people around them who live a non-substance abuse lifestyle. This piece of recovery is often
difficult for participants due to the shame of the addiction label and feeling rejected by their
communities, especially for those in the justice system. The Alternative Therapies approach
allows participants to engage with members of the community and others in recovery who are
using healthy lifestyle approaches and have likeminded interests. These connections will
continue to serve the participants in recovery management.
3. Project Priority Areas and Evidence-Based Categories
The Alternative Therapies program is focused on two Priority Areas: 1) implementing
and evaluating community-based efforts to fight the opioid epidemic, and 2) supporting and
promoting the partnership of law enforcement and public health agencies.
The new program is a collaborative effort of criminal justice practitioners, community
members and business owners, mental health clinicians, and local government leadership. As a
rural community, the opioid epidemic has landed in Gallatin County and we understand this
epidemic must be addressed effectively and with every resource available to avoid further loss.
Like many communities, we have implemented overdose counter-measures such as Narcan, but
this is not a long term fix. We believe confronting the root cause of the substance use by
181
implementing an alternative methods program within our community will be a long term,
sustainable solution, which can be replicated in other communities.
An additional unique approach to this program implementation is the team approach of
the justice system and community members. The Veterans Treatment Court has law
enforcement & probation officers, mental health clinicians, legal representatives, and community
mentors who meet weekly and discuss the progression of each participant. Instead of working as
separate entities, the team approach not only allows for buy-in and support of the justice system
practitioners, but the participants themselves often build rapport and support relationships. In
addition, this allows law enforcement and probation officers to no longer be perceived as the
enforcement side of the justice system, but also as a mentor and peer-support resource for
participants. As members of the community observe law enforcement and probation engaging in
positive relationships and support of participants, community support for both officers and
participants will increase.
The Alternative Therapies program is focused on the following Evidence-Based
Categories: Criminal justice interventions, Treatment for substance use disorders/drug misuse,
Polysubstance misuse, Harm reduction programs, Recovery programs for substance use
disorders/drug misuse, Healthcare systems interventions, and Drug Policy reform.
This alternative therapies program was designed to focus several evidence-based and
promising practice categories. Both the Gallatin County Drug Treatment Court and the Bozeman
Veterans Treatment Court have been trained and evaluated by the National Association of Drug
Court Professionals (NADCP), which uses evidence-based criminal justice interventions. The
court structures and practices have been constructed using evidence-based practices for treatment
for substance use disorders/drug misuse, polysubstance abuse/misuse, and harm reduction
182
programs (Peters, Young, Rojas, & Gore, 2016). This is provided by combining resources and
treatment responses using the Level of Service/Case Management Inventory assessment tool,
which allows for proper clinical services and supervision. The clinical responses are all
evidence-based therapies and responses which include, Alcoholics/Narcotics Anonymous,
Cognitive Behavioral Therapy (CBT), Cognitive Processing Therapy (CPT), Moral Reconation
Therapy (MRT), and additional therapies for addressing mental health issues, such as Eye
Movement Desensitization and Reprocessing (EMDR) and Moral Reconation Therapy (MRT). .
In addition to the therapeutic approach, there is healthcare system interventions, such as
Medically Assisted Treatment (MAT), and recovery programs for substance use disorders/drug
misuses with in-patient treatment options and Self-Care assessments implemented as part of the
court phase process.
The alternatives therapy approach focuses on using each piece of the evidence-based
process listed above by partnering with community resources for innovative approaches in the
following: eastern medicine, yoga, meditation, outdoor recreation, animal-assisted therapy,
physical fitness, financial advising, mental wellness programs, acupuncture, eastern medicine,
trauma informed yoga, trauma informed meditation, and outdoor recreation, These evidence-
based and promising practices have been used in substance abuse recovery, stress reduction, and
trauma therapy. Testing these approaches as criminal justice interventions allows for further
exploration into drug policy reform.
4. Evaluation Plan, Goals and Objectives, and Outcome-Based Performance Measures
Goals: (1) short-term: to use community resources to assist treatment court participants with
substance abuse recovery, (2) long-term: to combine community and criminal justice
partnerships to curve the opioid epidemic, and substance abuse overall, by reducing recidivism
183
through stronger substance abuse recovery programs, building closer relationships between
participants and law enforcement leading to more effective practices for battling distribution, and
provide an innovative approach for other communities to follow.
Objectives:
1. Drug & Veterans Treatment Court implement alternative therapy options within
treatment phases with participants.
2. Training is provided to all team members and stakeholders on the program.
3. A part-time Case Manager will conduct screenings using the Level of Service/Case
Management Inventory. This tool will be used to suggest possible alternative therapy
options.
4. Mentor Coordinator, Law Enforcement Liaison Officers, and additional team
members will implement alternative therapy options with participants to increase
rapport and community relationships.
5. Clinical providers will examine the impact of the alternative therapy options.
6. Relapse plans and Self-care assessments will now include alternative therapy options.
Outcome-based Performance Measures:
1. Benchmarks will be examined by comparing Gallatin County Drug and Veterans
Treatment Court success and relapse rates with the previous 3 years.
2. Clinicians will monitor the impact of which therapies are being used, number of times
accessed per week and reduction in stress through weekly/biweekly sessions.
3. Law Enforcement / Supervision will document compliance and ability to obtain
feedback from participants to assist with investigations of sales and distribution of
street drugs.
184
4. The case manager will document the number of times alternative therapies were
accessed each week, rapport with team members, graduation rates and phase
completions.
5. The team will identify which therapies are most effective and used throughout the
year.
5. Strategy and Timeline
Strategy
After 3 meetings with the Bozeman Veteran Eligible Treatment Services Court and several
communications with potential community partners we developed a program outline. This
program will fit into the phase structure that is already set up for court. It is our intention to
incorporate this program into the existing phase structure of the treatment court. During the grant
period, we will hold 3-4 stakeholder meetings including both community partners and one
participant representative to address the progress of the program, including both strengths and
the boundaries we encounter. The stakeholders and the leadership team will use gathered data to
make decisions about policies and procedures in the implementation of the program.
Timeline
Task Person Responsible Date Due
Hire a part time case manager Court Coordinator
Human Resources Dept
January 15, 2020
Develop contract to use with community
partners
Court Coordinator
City Attorney
December 7, 2019
185
Signed contracts with community partners to
University of Baltimore
Court Coordinator January 1, 2020
Define program Policies and Procedures for
the VETS Court Operations Manuals
Leadership Team
Court Coordinator
February 28, 2020
Stakeholder meeting with community partners,
a participant representative, and leadership
team
Court Coordinator,
Case Manager
February 28, 2020
Participant surveys Case Manager February 28, 2020
Purchase equipment needed for program Case Manager February 28, 2020
Begin screenings with current participants Case Manger March 1, 2020
Stakeholder Meeting- review Policies and
Procedures
Court Coordinator,
Case Manager
April 30, 2020
Stakeholder Meeting – Review data collected;
revise Policies and Procedures
Court Coordinator Sept. 30, 2020
6. Management Capabilities
Qualifications and Experience: The Bozeman Veterans Eligible Treatment Court has been in
operation for 18 months. We follow evidence based 10 Key Components of Drug Courts
published by the National Association of Drug Court Professionals (NADCP). Adherence to
these components is reviewed monthly at a leadership team meeting. Team members participate
in ongoing training including the NADCP Annual conference, Bureau of Justice Assistance
Operational Tune-Ups, and quarterly team specific training.
186
Present Staff:
Program Director: Renee Boundy-This position is currently funded through a Bureau of Justice
Assistance grant. If we received this award, .25 FTE would be charged to this program and .75
FTE would be charged to the existing BJA grant.
Financial Officer: Brian Lameres-This position is funded through the City of Bozeman
Human Resources: James Henderson-This position is funded through the City of Bozeman
Municipal Court Judge: J. Colleen Herrington—This position is funded through the city of
Bozeman
Proposed Staff
Case Manager (.5 FTE Funded through the grant)
7. Project Evaluation & Sustainability
Qualitative information will be obtained through participant surveys conducted by the case
manager throughout their progression through the court. These surveys will provide information
on whether or not the alternative therapies assisted with reducing stress, lowering recidivism and
relapse, and increased rapport and relationships with justice system employees and community
partners. If the funds are awarded, a Case Manager will be hired to assist in creating the surveys.
Quantitative information will consist of examining the previous three years within the Drug and
Veterans Treatment Court on recidivism and relapse among participants. An additional
comparison will examine relapse/recidivism among four (4) comparison cities within the State of
Montana; Great Falls, Billings, Helena, and Missoula, which each have treatment courts.
Longitudinal data will be collected if there is a statistical significant in changes at a time to be
determined. If the alternative therapies pilot program results indicate a need for further
development and research, current partnerships with local research institutions such as Montana
187
State University and the University of Montana will allow for an expanded opportunity in grant
funding, summative evaluations, and empirical research support.
8. Letters of Support/Commitment
References:
Peters, R., Young, M., Rojas, R., & Gorey, C., (2016). Evidence-based treatment and
supervision practices for co-occurring mental and substance use disorders in the criminal
justice system. The American Journal of Drug and Alcohol Abuse, 43(4) 475-488
Rezansoff, S., Morniruzzaman, A., Clark, E., & Somers, J., 2015. Beyond recidivism: changes
health and social services involvement following exposure to drug treatment court.
Substance Abuse Treatment, Prevention, and Policy. 10(42) 244-258.
Wupperman, P., (2019) Treating Impulsive, Addictive, and Self-destructive Behaviors:
Mindfulness and Modification Therapy. Guilford Publications, New York, NY.
188
COOCLI FY19 Subaward Budget
Project Name:
Agency:
LINE ITEM Name of employee Title Hourly Rate Cost
1 Renee Boundy Court coordinator $23.15 12,251.00$
2 Case Manager Case Manager $22.00 22,880.00$
3
4
5
35,131.00$
LINE ITEM Name of employee Title Hourly Rate Cost
6 Renee Boundy Court Coordinator $23.56 3,675.00$
7 Case Manager Case Manager $22.00 4,576.00$
8
9
10
8,251.00$
LINE ITEM Cost
11
12
13
-$
LINE ITEM Cost
14 2,197.00$
15 4,818.00$
16 1,125.00$
8,140.00$
LINE ITEM Cost
17 87,750.00$
18
19
87,750.00$
LINE ITEM Contractor/Agency Title Hourly Rate Cost
20 Dually licensed therapist LCSW/LAC or LCPC/LAC $85.00 2,550.00$
21
22
2,550.00$
LINE ITEM Cost
23 600.00$
24 300.00$
25 300.00$
1,200.00$
Description
LS/CIS booklets
office supplies
printing (surveys, business cards, posters for community partners
Supplies Total:
SUPPLES
Therapeutic Activities provided by Community Partners
SERVICES
Services Total:
Alternative Therapies Pilot Program (ATPP)
Operating Expenses/Other Total:
Fringe Total:
Travel/Training Total:
MRT Training
NADCP National Conference
LS/CIS
Contractual Services Total:
Personnel Total:
Item
City of Bozeman
PERSONNEL
FRINGE
FACILITIES
TRAVEL/TRAINING
CONTRACTUAL SERVICES
Description
189
COOCLI FY19 Subaward Budget
LINE ITEM Cost
26 5,000.00$
27 1,200.00$
28 980.00$
7,180.00$
LINE ITEM Cost
29
-$
149,002.00$
cell phone
TOTAL REQUESTED BUDGET:
EQUIPMENT
INDIRECT COST
Item
Indirect Cost Rate
Equipment Total:
Indirect Cost Total:
Equipment needed for alternative therapies
Notebook computer for case manager
190
COOCLI FY19 Subaward Budget Narrative
Project Name:
Agency:
LINE ITEM
1
2
3
4
5
LINE ITEM
6
7
8
9
10
LINE ITEM
11
12
13
LINE ITEM
14
15
16
LINE ITEM
SERVICES
The National Association for Drug Court Professionals will provide an opportunity for 2 community
partners to learn about treatment courts and help them better tailor their services to meet the
needs of participants. These partners will report back at a stakeholders meeting. They will offer
training to other stakeholders. [Training fee = $750.00, Lodging = $181 (GSA rate), x 4 nights =
$724, Airfare = $700.00, per diem = $47.00 x 5 days = $235]
Training to adminsiter the LS/CMI Risk Assessment Tool. This tool assesses criminogenic rsk and
treatmetn needs. In addition, it will give informaiton about ancillary needs and will help the case
manager direct the participant towards effective alternative therapeutic activities. Fro the case
manager and the court coordinaotro. It is an online training that requires the purchase of a starter
kit. (Starter kit = $127.00, training = $500.00 x 2) $1000 + $127 = $1127.00
Moral Reconation Therapy is an evidence-based intervention that does not need to be administered
by a licensed mental helath professional. It greatly reduces relapse and recidivism. [Training fee =
$600.00, Airfare = $700.00, Lodging = $123.00 (GSA Rate x 5 nights = $615.00), Per diem = $47.00 x
5 days =$235.00] $600 + $700 + $615 + $282 = $2197
Fringe benefits @ 20% of salary (.20 X 22880 = $4576.00
Fringe benefits @ 30% of salary (.30 x 12251 = $3675.00)
TRAVEL/TRAINING
Alternative Therapies Pilot Program
PERSONNEL
FRINGE
FACILITIES
The Court Coordinator's salary is $49,004.00. This position will use .25FTE for grant administration.
($49.004 x .25 =$12251 in sub award funds) The Court Coordinator will use this time for program
administration, case manager supervision, developing community partnerships, processing invoices,
mananging contracts, and reporting.
The Case Manager position will be a part time position. (.5FTE x $45,760=$22880 in subaward grant
funds) The case manager position will coordinate grant services for participants, provide MRT and
coordinate with therapists. In addition, this position will assist in developing community
partnerships, submitting invoices, and gathering data.
City of Bozeman
191
COOCLI FY19 Subaward Budget Narrative
17
18
19
LINE ITEM
20
21
22
LINE ITEM
23
24
25
LINE ITEM
26
27
28
LINE ITEM
29
These are the therapeutic activities provided in the grant program. They might include nutrition
services, physical training, equine therapy, outdoor activities, chinese meditation, acupuncture,
therapeutic massage, and trauma informed medication and yoga. It is anticpanted that participants
will use alternative therapies an average of 1.5 times per week for 39 weeks during the funding
period. iT is anticpated that hte pilot program will serve 20 participants. The average cost of
activities will be $75.00. (20 particpants x 1.5 activites x 39 weeks x $75.00 = $87750)
SUPPLIES
The LS/CMI assessmetn requires an assessmetn booklet and online scoring access. The package for
25 assessments is $600.00.
CONTRACTUAL SERVICES
The program will contract with a daully licensed therapist to provide 14 hours of input in to the pilot
program development in the first three months of funding to ensure that we are developing a
program which will support traditional therapy. This time will be used for consultation and
development of program materials. In addition, the therapist will aprticpante in the stakeholder
meetings and be available for consultation for 16 hours during the funding cycle.
Office supplies to support the program including copies, paper, pens, postage, and other office
supplies.
This is to print surveys for evaluationa, business cards for the case manager, and branding material
for community partners to palce in their business showing support for the program.
EQUIPMENT
The cost of equipment can be a barrier to particpants that want to try alternative therapies. This
funding will support the purchase of equipment so that particpants don't find the cost a barrier to
treatment. It is anticipated that participants will leave the program with the tools to support
effective activities in their long term recovery plan.
The case manager will require a laptop to effectively manage the requirements of the position.
The case manager will require a cell phone to effectively manage the requirements of the position.
(500.00 for phone + 12 months of service @ $40.00/month = $980.00)
INDIRECT COST
192