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HomeMy WebLinkAboutKittitas County Jail Project Narative for Opioid Settlement Funding Request 3-2026 (updated)Project Narrative Kittitas County Jail Request for Funding from Opioid Settlement Funds for 2026-2027 Like most jails in the United States, Kittitas County Jail faces high liability for those who are arrested and booked into the jail facing unknown medical issues, substance use, and mental health concerns. The largest concern besides alcohol withdrawals, is withdrawals from opioids including Fentanyl. Mental health crisis is also just as important to monitor and address as there is also an increased chance of a person suffering from a crisis within the flrst 72 hours of being incarcerated, or someone who have used a substance to handle their mental illness which is no longer available to them. Depending on what research you look at, the number varies on how many people are incarcerated while under the infiuence of a substance, have a substance use disorder, and have any mental health concerns or conditions. Research published indicates that roughly 44% of the population in American Jails suffer from a mental illness (SAMHSA 2024), 63 percent of individuals sentenced in jails have a substance abuse disorder (Bureau of Justice Statistics 2020), and other research indicating up to 48% of those incarcerated suffer from both or have co-occurring disorders. The trends seen at the Kittitas County Jail are not very different, but what is different is the work that is done to evaluate, treat, and set these clients up for success through programming by medical, mental health, and reentry staff in a rural facility setting. This request is to help the Kittitas County Jail continue these successful programs and this narrative will provide some history, past funding source(s), the requested amount and narrative for the attached budget spreadsheet for better understanding. In total, for the second half of 2026 and the entire year of 2027, the Kittitas County Jail is requesting $1,238,981.21 from the Opioid Settlement Funds and believe the programs that have been implemented and the design of them directly relates to the authorized spending of these funds based on the guidelines provided for these funds and how they can be used for those who are incarcerated and suffer from opioid use disorder, mental health issues, and/or co - occurring disorders. The Kittitas County Jail started in 2018 developing processes and protocols for treating Opioid Use Disorder (OUD), including withdrawals, by utilizing Medications for Opioid Use Disorder (MOUD). From 2020 through September 2026 the jail has been funded by the Department of Justice COSSAP/COSSUP (Comprehensive Opioid, Stimulant, and Substance Use Program formally COSSAP) to develop, implement, and evaluate the program while also using additional funding from the Washington State Healthcare Authority MOUD/MAUD (medications for alcohol use disorder) in jails. The COSSUP funding is on track to be done at the end of September, and the Healthcare funding has been lowered every year since it started (2022) and neither of them appears to be a good option for sustained funding for the jail to continue this programming that is much needed and utilized. The jail continues to look for other funding opportunities to offset this cost, including being one of the flrst jails to go live with the 1115 Waiver, but even with that in place the reimbursed rates and individuals who need MOUD that are not covered by this Medicaid initiative, there is a gap in the needed funds to ensure that we continue to offer the level of service we have been and have been recognized for. The requested $655,828.49 (see attached spreadsheet) is small in comparison to continue a successful program compared to the average cost of a lawsuit because of a death in custody. Trends over the last two years in Washington State have indicated that counties are paying no less than two million dollars to families who have sued because their loved one died in a jail due to withdrawals from opioids. These same trends also show an increase in Medical Services for carceral facilities and an even higher cost to the insurance to provide these services. Although this programming doesn’t “guarantee” a facility completely from having a death in custody, or even other major medical events, by someone who is incarcerated, it does offer additional protections and processes to lower the chances of something fatally happening. The jail has put into place other programs, devices and processes to increase safety and care of those incarcerated in our jail. The reason the jail is asking for funds only through 2027 at this time is because we are still determining what the reimbursement from 1115 Medicaid will be since we have not completed an entire year, as well as hope that state and federal funding will again become available to help offset these costs for rural counties like ours with sustained, successful programming with smaller budgets. Attached is a budget for the second half of 2026 and all of 2027 for MOUD services. These numbers are based on current contracts with the appropriate rise in wages/beneflts in 2027 per CompassDirect Healthcare (our current medical provider team). For 2026, the current funding/contract for the swing shift nurse ends at the end of the State flscal year on June 30th because it’s currently paid out of the HCA MOUD/MAUD in Jails funding, so the budget line is broken out for six months. The other two lines on the budget are just an additional quarter (4) of costs equal to what we are currently paying for CompassDirect’s services from DOJ COSSUP funding. However, all costs included in 2027 are broken out and include additional costs that have been requested to continue the program with them. The following paragraphs will explain each roll broken down on the spreadsheet to understand the position/fee and purpose in the jail requesting this. The MOUD Prescriber is the medical staff that comes to the facility, multiple times a week, and completes the necessary assessment, treatment, and follow up for those who seek MOUD treatment in the jail. Although the nurses may triage individuals requesting this programming, the prescriber has received additional training and makes the flnal decision as well as the treatment plan they will take while prescribing the appropriate medications. The prescriber is also available 24/7 by phone if nursing staff or jail staff have any questions or concerns. The prescriber we currently have has done a lot of research and received help from others in the same fleld to ensure that what he is doing is best practice and successful. There are two MOUD Nurse positions. The flrst is a full-time position that works 40 hours a week. They are responsible for the ordering, stocking, inventorying, and dispensing medications every day they are here. The nurse also triages requests to be put on MOUD programming, collecting previous medical records if necessary, communicating with SUDPs (Substance Use Disorder Professional) in the community, educating the clients including the use of naloxone we provide at release and other harm reduction tips, as well as setting up follow up community visits for the client upon release. This nurse also plays an important role in evaluating, assessing, appropriately treating and monitoring those who are on withdrawal protocols in the facility. The additional Nurse labeled “.4FTE” is for an additional MOUD Nurse on weekends, or 16 hours. This nurse is an additional piece to continuity of care and performs the same duties as the MOUD nurse with some minor differences in the medication control and ordering. Other than that, the weekend nurse performs all the same duties as the full-time MOUD Nurse and keeps jail staff from having to handle narcotics. The swing shift nurse is another 40 hour a week shift that we added in 2025 because we saw a gap in care between the dayshift nurses leaving and the time they return. These nurses have added another layer of protection allowing for further assessment and follow up for fresh intakes that may begin to suffer from some type of withdrawals, as well as monitor other medical issues in the facility that before would fall on jail staff who are not medical professionals. Ideally the facility would like another .4-hour swing shift nurse for weekends, but right now the jail is simply asking to keep this one to further assist with the ongoing and increasing medical care needed for those incarcerated and who suffer from any type of substance abuse. They also assist with triaging, assessing, evaluating, treating, and dispensing medications when they are on duty. Two budget requests are for MOUD Training/Education and Management/Administrative Overhead. These are not uncommon in jail medical contracts, or most contracts, because there is a cost to doing business including continued education and management of contracted positions in jails. The requests for the Training/Education allows our MOUD nurses and Prescriber to attend trainings or conferences that help them learn about new trends, things to be aware of, different medication or treatment, as well as best practices speciflcally designed for jails since they are a community medical provider. The second line is for management and administrative overhead for CompassDirect Healthcare. This funding would be used to pay for indirect business expenses that accrue including Human Resources, Finance, IT, insurance and liability coverage, licensing fees, and other additional costs. The MOUD Program at the Kittitas County Jail has been successful and has the recognition and stats to prove it. There has been a research component to COSSAP/COSSUP grants by Dr. Roger Shaefer from Central Washington University. Because of the jail still actively part of the 2nd of those two grants, Dr. Shaefer has provided a complete document covering statistics from the flrst three years and the impact it had on the facility, those who were incarcerated, and those getting released. Some of the highlights out of the lengthy document (which is available upon request) show a decrease in major inmate behavior incidents, increased involvement in treatment, and that no one who was released during the timeframe he was conducting his research had a fatal overdose in our community. Because of the success the Kittitas County had implementing this type of program in a rural jail they received multiple accommodations and had the opportunity to share about the program from the community level to the national level. The jail also keeps monthly stats on various parts of this program. Utilizing just 2025 as a snapshot of the program and what it achieves, it shows that the program is a value-added beneflt. Last year there were 1795 intakes completed. These do not include those who are administratively booked and released. Of these 1795 bookings, 3077 unique individual services were performed, indicating that around 171% of those booked received some type of service. MOUD was an important part of this while inducting or continuing 219 individuals on their MOUD medications, 27 introductions into MAUD (medication for alcohol use disorder), 29 individuals treated for acute opioid withdrawals, and 19 for alcohol withdrawals. A third of all bookings gave a voluntary Urine Drug Screen at intake, and 104 had individualized release planning completed, 70 substances use disorder assessments by a SUDP, and 134 connected with peers for help with their reentry. These are just pieces of programming that helped the jail provide 171% of the inmates booked with services, but important ones to highlight the value-added beneflt and need for MOUD programming like the jail has already established. Currently the Jail Based Mental Health Team consists of one case manager and two therapists. To have this quantity of professionals focused on one area of treatment in a rural jail like Kittitas County, the jail applied for and were awarded a grant through the Bureau of Justice Assistance for Justice and Mental Health Collaboration in 2022. The jail was awarded $483,552 and has used this to build the jail-based therapy team. There haven’t always been two therapists due to recruitment and retention issues, so when the grant was ready to sunset in September of 2025, a no cost extension was granted for an additional 12 months. With the raising costs of mental health professionals in the region, the funding remaining only allows for this team to be fully funded through quarter 2, or until June 30th, 2026, roughly. The Kittitas County Jail leadership team has looked for multiple avenues to apply for funding through available federal or state dollars, but there has been nothing released or indicated that it would become available before the jail runs out. We are asking for an additional $583,152.70 through the end of 2027 for the purpose of continued funding for the jail-based therapy team. (see attached budget) This team is contracted to have assessments completed on all booked individuals (if they are still incarcerated) within 72 hours. In 2025 every person who met those criteria was assessed either in person, or if they refused to speak with the mental health team, their records were researched to determine any necessary assistance or treatment they could beneflt from while in the facility. This was possible because for most of the year we had all three positions fllled but currently are looking for the 2nd therapist. This same team was able to provide 2015 one on one services (therapy sessions or meetings), and case management towards reentry for 55 clients. They also worked closely with regular medical staff, MOUD (medications for opioid disorders), and a psychotropic provider to ensure that co-occurring disorders were being addressed as well as additional medication treatment needs based on their time spent with the clients while incarcerated. These stats don’t refiect the immediate impact this team has on the jail overall, the care and custody of individuals, helping with behavioral matters or intervening prior to someone having a crisis. The future of this program has different treatments and approaches they want to take including group therapy, anger management and domestic violence therapy, and increase involvement with the jail reentry group for a more comprehensive handoff for those being released to both the Kittitas County community, and other places. The jail is working with Comprehensive Healthcare leadership to flnd a second therapist, to develop processes and procedures to allow for Medicaid eligible client’s treatment to be billed by the jail under the 1115 reentry waiver initiative, and how we can increase the programming we provide to those incarcerated. Like every program in the facility, the jail leadership team continues to evaluate, communicate, and implement enhancements to the base level of each programming that they have begun with. The Kittitas County Sheriff’s Office vision statement is “a physical infrastructure and agency culture that enable us to provide the same level of service to our community that we would to our own families.” This programming was the start of most of the other community based, reentry focused programming that has grown to the point it’s outgrown the actual jail’s infrastructure. But that is not going to stop the jail and the staff from providing the highest level of care for those incarcerated, while lowering liability for the county, and helping people begin a path towards recovery and reentry. Because of this type of programming, many of the people who are booked into the Kittitas County Jail receive the best medical care for their substance use disorders, treatment for their addictions, treatment and therapy for their mental health disorders, and planning for release at the highest level. Thank you for your consideration.