Franklin County Gets Nearly $10 Million for Addiction Care and Jail MOUD

Nearly $10 million in federal grant money will go to two agencies in rural western Massachusetts: about $6.2 million to the Opioid Task Force of Franklin County and the North Quabbin Region, and $3.75 million to the Franklin County Sheriff's Office for addiction treatment inside the county jail and after release. The awards were announced Friday at the Franklin County Justice Center in Greenfield, with U.S. Rep. Jim McGovern, state Rep. Aaron Saunders and an aide to Sen. Ed Markey in the room.

The task force's share comes from two four-year grants. A Rural Communities Opioid Response Program award funds an initiative called RESTORE — Rural Engagement and Substance-Use Treatment through Outreach, Recovery and Education — at $750,000 a year. A First Responders–Comprehensive Addiction and Recovery Act grant, known as FR-CARA, funds CONNECT, the Community Outreach, Network, Navigation, Engagement and Care Team, at $800,000 a year.

The sheriff's money is a five-year, $3.75 million grant titled the Rural Jail-to-Community MOUD and Recovery Continuity Program, run in partnership with The Salasin Project. It expands access to medication for opioid use disorder at the Franklin County Jail and House of Correction and is meant to strengthen reentry services and care coordination so that treatment continues after someone leaves custody.

Two programs, one stated goal

RESTORE is built around coordinated care: community-based outreach, data-informed planning, workforce development and tighter connections among the region's many partners. According to the task force, the design starts from the barriers rural residents actually hit — transportation and a thin supply of providers — rather than from a single clinical service.

CONNECT focuses on the minutes and days after an overdose: response and follow-up, prevention education, and distribution of and training in overdose reversal medications.

"We have a shared vision," said Heather Bialecki-Canning, executive director of the North Quabbin Community Coalition. "This really does take everybody, and it impacts everybody. We are all facing the same folks. The people are not different."

Only 37 communities nationally received FR-CARA funding, according to the Recorder. Within Massachusetts, Northampton, Fall River and the state Department of Public Health were also awarded.

"Through this work, we break down these barriers," said Dr. Allison van der Velden, chief executive of the Community Health Center of Franklin County. "This funding will facilitate and accelerate the good work of the Opioid Task Force and [its] partners."

A jail program that starts before release

The sheriff's grant is the piece of the package that touches a population with the least continuity of care. Medication for opioid use disorder begun in custody typically has to be re-established within days of release, and the new program pairs jail-based treatment with care coordination through The Salasin Project.

"I see these grants as a shared investment across our region," said interim Franklin County Sheriff Lori Streeter. "Our staff and community partners make this possible."

Massachusetts has been building the evidence base for that approach. A seven-year study of the state's jail-based medication program, published in late October, found lower overdose and reincarceration rates among people who received treatment in custody — and located the real gap in the handoff to community care rather than in the medication itself. Nationally, opioid treatment programs remain the most regulated route into medication-assisted treatment, and jail-to-community handoffs are among the least standardized parts of it.

"Far from hanging the 'Mission Accomplished' banner"

The mood at Friday's event was celebratory but deliberately hedged. "You're doing some amazing work out here … it's a model for the rest of the state," said U.S. Rep. Jim McGovern. "We are able to celebrate something extraordinary today." Jesse Lederman, regional director for Markey's office, read a statement from the senator: "The task force sets the standard for how the rest of the country should address substance use disorder."

State Rep. Aaron Saunders, a Democrat from Belchertown, supplied the counterweight. "We're far from hanging the 'Mission Accomplished' banner," he said, while allowing that "to spring forth real money … it's a good day to celebrate."

The task force has been at this since September 2013. In the years since, 304 people have died of opioid overdose in Franklin County and the North Quabbin region — a number its coordinator, Debra McLaughlin, keeps in front of the room.

"This has been an emotional experience," McLaughlin said. "I truly draw incredible inspiration from all of the leaders in this room. Behind every one of those numbers is a person."

Whether the money changes that count is the open question. The grants are four and five years long, they carry reporting requirements, and the programs they fund are service expansions rather than new clinical models. What the region gets in the meantime is a jail that can start medication before release, a follow-up team assigned to overdose survivors, and four more years of transportation, outreach and care coordination in a part of Massachusetts where the nearest specialist is often a long drive away.

For people leaving custody in Franklin County, the practical change is narrower and more concrete: the possibility of walking out with a treatment plan already in place rather than a phone number. Massachusetts law already requires county jails to offer all three approved medications and to arrange community continuation; what the seven-year MassJCOIN evaluation found missing was not the medication but the handoff — which is what the new grant pays for.