HomeMy WebLinkAboutKCJ Opioid Funding RequestProject Narrative
Kittitas Gounty Jait Reqrrest for Funding from Opioid Settlement Funds for 2026-2027
Like most jaits in the United states, l(ittitas county JaiI faces high tiabitity for those who are
arrested and booked into the jait facing unknown medical issues, substance use, and
mentaI heaLth concerns. The Largest concern besides atcohotwithdrawats, is withdrawats
from opioids inctuding Fentanyt. Mental, heatth crisis is atso just as important to monitor
and address as there is atso an increased chance of a person sufferingfrom a crisis within
the first T2hours of being incarcerated, or someone who have used a substance to handte
their mental, itLness which is no Longer avaitabte to them. Depending on what research you
look at, the number varies on how many peopte are incarcerated white under the inftuence
of a substance, have a substance use disorder, and have any mentaI heal.th concerns or
conditions. Research pubtished indicates that roughty 44o/o of the poputation in American
Jaits suffer f rom a mentaI il,tness (SAMHSA 2024),63 percent of individuats sentenced in
jaits have a substance abuse disorder (Bureau of Justice Statistics 2O2O), 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 Jai[ are not very different, but what is
different is the work that is done to evatuate, treat, and set these clients up for success
through programming by medicat, mental heatth, and reentry staff in a ruraI facitity setting.
This request is to hetp the Kittitas County Jait continue these successfuI programs and this
narrative witl. provide some history, past funding source(s), the requested amount and
narrative for the attached budget spreadsheet for better understanding. ln totat, for the
second hatf of 2O26 and the entire year of 2027, the Kittitas County Jait is requesting
$1,239,981 .21 tromthe Opioid Setttement Funds and betieve the programs that have been
imptemented and the design of them directLy relates to the authorized spending of these
funds based on the guidetines provided for these funds and how they can be used for those
who are incarcerated and sufferfrom opioid use disorder, menta[ heatth issues, and/or co-
occurring disorders.
The l(ittitas County Jail, started in 201 B deveLoping processes and protocols for treating
Opioid Use Disorder (OUD), incl.uding withdrawats, by utitizing Medications for Opioid Use
Disorder (MOUD). From2O2O through September 2O26thejait has been funded bythe
Department of Justice COSSAP/COSSUP (Comprehensive Opioid, Stimutant, and
Substance Use Program formatty COSSAP)to devetop, imptement, and evatuate the
program white al.so using additionat funding from the Washington State Heatthcare
Authority MOUD/MAUD (medications for atcoho[ use disorder) in jail.s. The COSSUP
f unding is on track to be done at the end of September, and the Heatthcare funding has
been lowered everyyear since it started (2022) and neither of them appears to be a good
option for sustained funding for the jait to continue this programming that is much needed
and utitized
The jait continues to took for other funding opportunities to offset this cost, incLuding being
one of the first jaits to go Live with the 1 1 15 Waiver, but even with that in ptace the
reimbursed rates and individuats 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 tevel. of
service we have been and have been recognized for. The requested $655,829.49 (see
attached spreadsheet) is smatl. in comparison to continue a successfut program compared
to the average cost of a lawsuit because of a death in custody. Trends over the tast two
years in Washington State have indicated that counties are paying no less than two mittion
doltars to famities who have sued because their loved one died in a jait due to withdrawats
from opioids. These same trends atso show an increase in Medicat Services for carceraI
facitities and an even higher cost to the insurance to provide these services.
Atthough this programming doesn't "gLrarantee" a facitity comptetety from having a death in
custody, or even other major medical events, by someone who is incarcerated, it does offer
additionat protections and processes to lower the chances of something fatatty happening.
The jaiL has put into ptace other programs, devices and processes to increase safety and
care of those incarcerated in our jait. The reason the jail, is asking for f unds onty through
2027 atthis time is because we are stitt determining what the reimbursement from 1 1 15
Medicaid wil,l, be since we have not compteted an entire year, as wett as hope that state and
federat funding witt again become avaitabte to hetp offset these costs for rurat counties tike
ours with sustained, successfuI programming with smalter budgets.
Attached is a budget for the second hatf of 2026 and all of 2027 for MOUD services. These
numbers are based on current contracts with the appropriate rise in wages/benefits in
2O27 per CompassDirect Heatthcare (our current medicat provider team). For 2026, the
current funding/contract for the swing shift nurse ends at the end of the State fiscaI year on
June 30th because it's currentty paid out of the HCA MOUD/MAUD in Jaits funding, so the
budget line is broken out for six months. The other two tines on the budget are just an
additionat quarter (4) of costs equal, to what we are currentty paying for CompassDirect's
services from DOJ COSSUP funding. However, atl. costs incl,uded in 2027 are broken out
and include additionaI costs that have been requested to continue the program with them.
The fottowing paragraphs witt exptain each rott broken down on the spreadsheet to
understand the position/fee and purpose in the jait requesting this.
The MOUD Prescriber is the medicat staff that comes to the facitity, mul,tipte times a week,
and comptetes the necessary assessment, treatment, and fotl,ow up for those who seek
MOUD treatment in the jait. Atthough the nurses may triage individuats requesting this
programming, the prescriber has received additionat training and makes the finat decision
as wet[ as the treatment ptan they witt take whil.e prescribing the appropriate medications.
The prescriber is atso avaita ble 2417 by phone if nursing staff or jait staff have any questions
or concerns. The prescriber we currentl,y have has done a lot of research and received hel'p
f rom others in the same fiel.d to ensure that what he is doing is best practice and
successfut.
There are two MOUD Nurse positions. The first is a futt-time position that works 40 hours a
week. They are responsibte for the ordering, stocking, inventorying, and dispensing
medications every day they are here. The nurse atso triages requests to be put on MOUD
programming, cottecting previous medicat records if necessary, communicatingwith
SUDPs (Substance Use Disorder Professional,) in the community, educating the clients
incl,uding the use of naloxone we provide at retease and other harm reduction tips, as wetl
as setting up fol,tow up community visits for the ctient upon retease. This nurse atso ptays
an important role in evatuating, assessing, appropriatety treating and monitoring those who
are on withdrawat protocots in the facil,ity. The additionaI Nurse tabeted ".AFTE" 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 att the same duties as the futt-time MOUD Nurse and keeps jait staff from having
to handte 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 tayer of protection attowing for further assessment and fottow
up for fresh intakes that may begin to suffer from some type of withdrawats, as wetl as
monitor other medicat issues in the facitity that before woutd fatt on jait staff who are not
medicat professionats. ldeatty the facitity woutd [ike another .4-hour swing shift nurse for
weekends, but right now the jait is simpty 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 atso assist with triaging, assessing, evatuating, 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 incl,uding continued education and management of
contracted positions in jaits. The requests for the Training/Education altows our MOUD
nurses and Prescriber to attend trainings or conferences that hetp them learn about new
trends, things to be aware of, different medication or treatment, as wetl as best practices
specificatty designed for jaits since they are a community medicat provider. The second
line is for management and administrative overhead for CompassDirect Heatthcare. This
funding woutd be used to pay for indirect business expenses that accrue inctuding Human
Resources, Finance, lr, insurance and Liabitity coverage, licensingfees, and other
additionaL costs.
The MOUD Program at the Kittitas County JaiL has been successfut and has the recognition
and stats to prove it. There has been a research component to COSSAP/COSSUp grants by
Dr. Roger Shaefer from Centrat Washington University. Because of the jail, stitl, activety part
of the 2nd of those two grants, Dr. Shaefer has provided a comptete document covering
statistics from the first three years and the impact it had on the facil,ity, those who were
incarcerated, and those getting reteased. Some of the hightights out of the Lengthy
document (which is avaiLabte upon request) show a decrease in major inmate behavior
incidents, increased invotvement in treatment, and that no one who was released during
the timeframe he was conducting his research had a fatat overdose in our community.
Because of the success the Kittitas County had imptementing this type of program in a ruraI
jait they received muttipte accommodations and had the opportunity to share about the
program from the community [eve[ to the nationa[ levet.
The jaiL atso keeps monthty stats on various parts of this program. Utitizing just 2025 as a
snapshot of the program and what it achieves, it shows that the program is a vatue-added
benefit. Last year there were 1795 intakes comp[eted. These do not incl.ude those who are
administrativel,y booked and reteased. Of these 1795 bookings, 3077 unique individuat
services were performed, indicating that around 171o/o of those booked received some type
of service. MOUD was an important part of this white inducting or continuing2lg
individuats on their MOUD medications, 27 introductions into MAUD (medication for
atcohol use disorder), 29 individuals treated for acute opioid withdrawats, and 19 for
atcoho[ withdrawats. A third of atl, bookings gave a votuntary Urine Drug Screen at intake,
and 104 had individuatized retease ptanning compteted, 70 substances use disorder
assessments by a SUDP, and '134 connected with peers for hetp with their reentry. These
are just pieces ot prograrirming that hel.ped the jait provide 171o/oof the inmates booked
with services, but important ones to highl.ight the vatue-added benefit and need for MOUD
programming tike the jait has atready estabtished.
Currentty the Jait Based MentaI Heatth Team consists of one case manager and two
therapists. To have this quantity of professionals focused on one area of treatment in a
rurat jait tike Kittitas County, the jail. apptied for and were awarded a grant through the
Bureau of Justice Assistance for Justice and Mental. Heatth CotLaboration in 2022. The jait
was awarded $483,552 and has used this to buitd the jaiL-based therapy team. There
haven't atways been two therapists due to recruitment and retention issues, so when the
grant was ready to sunset in septemb er of 2025, a no cost extension was granted for an
additionat 12 months. With the raising costs of mentaI heatth professionats in the region,
the funding remaining onl,y atLows for this team to be futty funded through quarter 2, or untiI
June 3Oth, 2026, roughl.y. The Kittitas County Jai[ leadership team has [ooked for muttipte
avenuestoapptyforfundingthroughavaitabtefederatorstatedottars,buttherehasbeen
nothing reteased or indicated that it woutd become avaitabte before the jait runs out. We
are asking for an additional, $583,t 52J0 through the end ot 2027 for the purpose of
continued funding for the jait-based therapy team. (see attached budget)
This team is contracted to have assessments compteted on at[ booked individuats (if they
are stitt incarcerated) within 72 hours. ln 2O25 every person who met those criteria was
assessed either in person, or if they refused to speak with the mental heatth team, their
records were researched to determine any necessary assistance or treatment they coutd
benefit from white in the facitity. This was possibte because for most of the year we had att
three positions fitted but currentty are tool<ing for the 2nd therapist. This same team was
abte to provide 2015 one on one services (therapy sessions or meetings), and case
management towards reentry for 55 clients. They atso worked ctosety with regular medical
staff, MOUD (medications for opioid disorders), and a psychotropic provider to ensure that
co-occurring disorders were being addressed as wetl as additionat medication treatment
needs based on their time spent with the ctients white incarcerated. These stats don't
reftect the immediate impact this team has on the jait overatt, the care and custody of
individuats, hetping with behavioraI matters or intervening prior to someone having a crisis.
The future of this program has different treatments and approaches they want to take
inctuding group therapy, anger management and domestic viotence therapy, and increase
invotvement with the jait reentry group for a more comprehensive handoff for those being
reteased to both the Kittitas County community, and other ptaces. The jait is working with
Comprehensive Heatthcare teadership to find a second therapist, to devetop processes
and procedures to attow for Medicaid etigibte ctient's treatment to be bitted bythe jait under
the 1 1 1 5 reentry waiver initiative, and how we can increase the programming we provide to
those incarcerated. Like every program in the facitity, the jait teadership team continues to
evaluate, communicate, and imptement enhancements to the base level of each
programming that they have begun with.
The l(ittitas County Sheriff's Office vision statement is "a physicaI infrastructure and
agency cutture that enabte us to provide the same [eve[ of service to our community that
we woutd 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 actuat jait's inf rastructure. But that is not going to stop the jait and the staff from
providing the highest [eve[ of care for those incarcerated, white lowering tiabitity for the
county, and hetping peopte begin a path towards recovery and reentry. Because of this type
of programming, Tany of the peopte who are booked into the Kittitas County Jait receive
the best medicat cdre for their substance use disorders, treatment for their addictions,
treatment and therapy for their mental heatth disorders, and ptanning for retease at the
highest levet.
Thank you for your consideration.
t
Fiscal year 2026
Ju September October November
$6,000.00 $6,000.00N/A N/AN/AMOUD Prescriber
$76,712.16 $16,712.16N/A N/AN/AMOUD Nurses (1.0 FTE +.04 FTE)
$15,106.00 $1s,106.00$15,106.00 $15,106.00$15,106.0oSwing Shift Nurse (1.0 FTE)
$7,695.86$7,695.86 $7,695.86 $z,ogs.eo$7,695.80MentaI Heath Case Manager
$'1.7,289.21$!r,289.21 $11,289.2t$11.,289.21 $11,289.21MH Therapist #1
$72,367.23 $12,967.23 $12,367.23$12,367.23 $12,967.29MH Therapist #2
Fiscat r 2027
Monthty Cost Totat
I Request $1,238,981.21
Costs for staff include both Satary and Benefits for each position
$6,oo0.oo $72,ooo.ooMOUD Prescriber
$12,691.43 $1.52,297.rsMOUD Nurse (1.0 FTE)
$5,076.57 $oo,sre.eoMOUD Nurse (.4 FTE)
$4,8oo.ooN/AMOUD Training and Education
$24,000.00N/AMOUD Mgt/Admin Overhead
$183,040.00$15,253.33SwingShift Nurse (1.0 FTE)
$g6,goz.zg$8,080.65Mental Heatth Case Manager
$142,244.06$11,853.67MH Therapist #1
$1ss,827.07$12,985.59MH Therapist #2
FY2O27Req $892,094.93
December Totat
$6,000.00 $1B,ooo.oo
$16,712.16 50,136.48
$1s,106.00 $90,636.00
$7,69s.86 $46,175.16
$tt,2s9.21 $oz,zgs.z6
$12,967.29 $74,203.38
FY2026Req $gae,gge.Zg