The Hamilton County Addiction Response Coalition has built a sustainable model to improve health and health equity for marginalized individuals and as a result, offers a guide for implementation and best practices. Read our article in the Journal of Public Health Management and Practice.
Since 1999, the United States has been experiencing an overdose epidemic that has claimed the lives of nearly 1 million people. The annual death rate has been on a continuous upward trend, reaching an all-time high and surpassing 100,000 deaths in 2021. In contrast to failed policies that criminalized substance use, there has been a slow but increasing shift over the last two decades to manage addiction at the community level and with a public health lens.
Ohio has been severely impacted by the opioid epidemic and has consistently ranked among the states with the highest drug overdose mortality rates. Hamilton County (Cincinnati, Ohio), the third largest county in Ohio, set out to find a solution to the growing issue through a centralized effort coordinated by the Hamilton County Addiction Response Coalition (HC ARC). Through their efforts, HC ARC launched two pre-arrest diversion and deflection programs – Quick Response Team (QRT) and Law Enforcement Assisted Diversion (LEAD). QRTs are multidisciplinary deflection programs that typically provide overdose follow-up, engagement, “in-home” triage, and assessment. LEAD is a community-based diversion and harm-reduction approach for responding to low-level offenses committed by people who struggle with addiction.
What We Found
We were interested in examining the efforts of HC ARC and the impact of data-driven decision-making on the sustainability of those programs and, by default, those around the country.
- Quick Response Team (QRT): The first QRT of its kind was created in Colerain Township in 2015 and the second was formed shortly after in Norwood, both located in Hamilton County. A Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) grant through the Bureau of Justice Assistance (BJA) was awarded in 2020 to expand QRTs to the remaining jurisdictions in the county. Since the expansion, teams have received 2,100 inbound referrals and have provided proactive outreach with 4,000 interactions in the community.
- Law Enforcement Assisted Diversion (LEAD): Based on the success of the QRT in Hamilton County, HC ARC applied for and received a COSSAP award in 2018 to pilot the LEAD initiative. People are eligible for LEAD in Hamilton County if they are homeless, use substances, or have a mental illness and have committed one of five low-level eligible offenses or if they are known by law enforcement or other professionals to struggle with these social and health issues challenges and may thus benefit from LEAD. As of January 2022, 76 percent of eligible individuals who have completed an intake assessment are receiving ongoing support.
Advancing the Science of Deflection
As deflection programs proliferate, evaluation teams and researchers must do their part to advance the evidence base for these interventions. These programs hold much promise for changing the way in which communities manage issues such as substance abuse, mental illness, and homelessness.
We hope our work—and the data gathered and examined from it—can benefit efforts to inform and improve other existing programs and to develop data-driven recommendations that can help create standards for different types of deflection and pre-arrest diversion programs.
Want to learn more about HC ARC and our findings? Read our paper here:
Sarah M Manchak is an Associate Professor in the School of Criminal Justice at the University of Cincinnati. Her research focuses on programs and policies that aim to improve the outcomes for justice-involved people with behavioral health and substance use disorders. She received her Ph.D. in Psychology and Social Behavior with concentrations in experimental psychopathology and psychology and the law from the University of California, Irvine in 2011. Prior to that, she earned her MA in forensic psychology at John Jay College of Criminal Justice.
Meagan E Gosney is the Social Program Administrator of the Hamilton County Addiction Response Coalition (HC ARC), which is housed under the Board of County Commissioners and Hamilton County Administration. As the Coalition’s Administrator, she is responsible for overseeing the day-to-day work of the Coalition, as well as the Coalition’s county-wide Quick Response Team (QRT) and the Law Enforcement Assisted Diversion Program (LEAD). Megan earned her bachelor’s in Philosophy, Politics, and the Public Honors Program and Master’s in Private Interest and the Public Good from Xavier University in Cincinnati, Ohio.
Kelly Firesheets is the VP, Strategy and Partnerships for Cordata Healthcare Innovations, where she provides consultation and guidance to communities implementing deflection initiatives. She is also a member of the Police Treatment and Community Collaborative (PTACC) Executive Committee, and co-chair of PTACC’s Research and Evaluation workgroup. She holds a Doctor of Psychology in Clinical Psychology from Xavier University.