Recovery Ready Communities

Name(Required)

First Last

Phone(Required)

Email(Required)

Enter Email Confirm Email

Address(Required)

Street Address Address Line 2 City ZIP Code

Date(Required)

County

Your Title

Does your community have a local Ky-ASAP board that funds evidence-based prevention programs or interventions? Please list any programs, projects, or curriculum funded by the Ky-ASAP board:

Does the community have cooperation or referral agreements between community partners on substance use disorder (SUD) issues? Please explain or provide examples:

Does your community have safe medication disposal sites/programs? Please provide locations:

Does your community provide assistance for the houseless population with a special emphasis on SUD issues? Please explain and provide examples:

Does your community have community-based organizations that address needs around food, housing, and transportation insecurity? Please explain and provide examples:

Does your community provide evidence-based community youth prevention and education programs that complement school-based SUD prevention efforts? Please explain and provide examples:

Does your local school system employ evidence-based youth SUD prevention and education programs in school? Please explain and provide examples:

Does your community’s school system have student assistance programs that promote access to clinically appropriate interventions for SUD issues among the student population? Please explain and provide examples:

Does your community’s school system employ school-based mental health professionals who receive SUD anti-stigma training? Please explain and provide examples:

Does your community have pro-social peer group programs for youth? Please explain and provide examples:

Does your community have pro-social peer group programs for college-age individuals? Please explain and provide examples:

Does your community have active local chapters of recovery advocacy groups? Please explain and provide examples:

Do your community’s pharmacies stock and dispense naloxone? Please explain and provide examples:

Does your community have access to a harm reduction program that serves community members? Please explain and provide examples:

Does your community’s harm reduction program offer access to peer support and treatment location services? Please explain and provide examples:

Does your community’s harm reduction program offer access to free vaccinations? Please explain and provide examples:

Does your community’s harm reduction program offer access to free syringe support services? Please explain and provide examples:

Does your community’s harm reduction program offer access to fentanyl test strips? Please explain and provide examples:

Do eligible healthcare practitioners in the community hold DATA-2000 waiver to prescribe buprenorphine, are accepting new patients, and are actively prescribing buprenorphine? Please explain and provide examples:

Does the community host or particpate in Naloxone training and distribution? Please explain and provide examples:

Does the hospital system that serves the community participate in the Kentucky Statewide Opioid Stewardship program? Please explain and provide examples:

Are your community’s first responders (Police, EMT, and Fire) trained to administer and carry naloxone? Please explain and provide examples:

Do your community’s first responders operate a naloxone leave behind program for patients and bystanders? Please explain and provide examples:

Do your local law enforcement agencies employ police-based deflection/diversion programs for SUD/behavorial health issues? Please explain and provide examples:

Are your community's first responders authorized and trained to perform treatment referrals for SUD issues? Please explain and provide examples:

Do your local judges participate in the Responsive Education to Support Treatment in Opioid Recovery Efforts (RESTORE) Training annually?

Does your community provide access to locally funded treatment vouchers (other than KORE or UNITE) or scholarships for individuals who need financial aid to access or complete treatment? Please explain and provide examples:

Does your community have either integrated community health workers, peer support specialists, or healthcare navigators to assist people with SUD access services or treatment? Please explain and provide examples:

Do eligible healthcare practitioners in the community hold DATA-2000 waivers to prescribe buprenorphine? Please explain and provide examples:

Do pharmacies in your community stock and dispense all FDA- approved medications for opioid use disorder (MOUD) and accept new patients? Please explain and provide examples:

Does your community’s hospital emergency department provide access to peer support services or a linkage to treatment services? Please explain and provide examples:

Does your community’s local hospital system provide access to MOUD in the emergency department or other hospital and clinic settings? Please explain and provide examples:

Do the residents of your community have access to all levels of evidence-based counseling services (ASAM Levels 1-4)? Please explain and provide examples:

Do the Federally Qualified Health Centers (FQHCs), rural health clinics, or primary care practitioners provide comprehensive SUD treatment services including access to FDA-approved MOUD therapies? Please explain and provide examples:

Do MOUD prescribers and community pharmacists serving the same patients demonstrate coordinated continuum of care for patients in the community? Please explain and provide examples:

Does the local hospital system and providers employ evidence-based pain management strategies or interventions? Please explain and provide examples:

Do the treatment providers who serve your community utilize the American Society of Addiction Medicine (ASAM) assessments at intake and on an ongoing evaluation basis to determine length/intensity of treatment? Please explain and provide examples:

Do treatment providers serving the residents of the community provide meaningful access to MOUD without arbitrary tapering or quantity limits not supported by ASAM? Please explain and provide examples:

Does the community provide access or transportation support to residential treatment services to all potential clients including pregnant and parenting women? Please explain and provide examples:

Does the Community Mental Health Center (CMHC) serving the community provide SUD/OUD assessment and treatment? Please explain and provide examples:

Do treatment providers serving the community implement evidence-based treatment modalities that incorporate trauma-informed practices?

Do treatment providers who serve the community make referrals to other providers to ensure that there are no treatment waiting lists for potential clients? Please explain and provide examples:

Do treatment providers serving the community provide access to simultaneous treatment of SUD and co-occurring mental health disorders? Please explain and provide examples:

Does the community have a family Recovery/Drug Court? Please explain and provide examples:

Do your community’s judges follow the recommendations of evidence-based assessments and not order specific modalities or lengths of treatment not supported by evidence-based assessments? Please explain and provide examples:

Do your community’s judges implement treatment recommendations by the Department of Public Advocacy's Alternative Sentencing Worker Program? Please explain and provide examples:

Does your community have any prosecutor-based diversion or alternative sentencing programs for SUD/behavioral health issues? Please explain and provide examples:

Does your community’s County Attorney utilize Casey's Law?

Does your community have a Veterans Treatment Court or specialized veteran’s treatment docket? Please explain and provide examples:

Do your community’s judges utilize graduated sanctions for probationers in regards to SUD issues? Please explain and provide examples:

Does your community’s local jail or detention center provide inmates access to MOUD during incarceration and community supervision periods? Please explain and provide examples:

Do state inmates serving time in the community’s county jail or detention center have access to evidence-based treatment programs? Please explain and provide examples:

Do county inmates serving time in the community’s county jail or detention center have access to evidence-based SUD treatment programs? Please explain and provide examples:

Does your community utilize a multidisciplinary quick response team (QRT) for overdoses? Please explain and provide examples:

Does your community have recovery support meetings that occur at least once a day?(Required)

Yes

No

Does your community have recovery support meetings that support multiple schedules or work shifts?(Required)

Yes

No

Does your community have recovery support meetings open to and supportive of people taking MOUD? Please explain and provide examples:

Does your community have recovery support meetings for family/loved ones dealing with SUD? Please explain and provide examples:

Does the community provide SUD anti-stigma training for employers? Please explain and provide examples:

Does your community’s local chamber of commerce have a policy or resolution encouraging members to engage in fair chance employment? Please explain and provide examples:

Do your community’s local employers employ individuals in treatment or recovery from SUD and those who may be justice-involved? Please explain and provide examples:

Do your community’s local employers have employee assistance programs (EAP) consistent with the requirements of Kentucky Transformation Employment Program (KTEP)? Please explain and provide examples:

Does your community’s county jail or detention center participate in a work release program that incorporates local fair chance employers? Please explain and provide examples:

Does your community’s county jail or detention center provide education and employment services to inmates? Please explain and provide examples:

Does your county jail or detention center provide re-entry support services provided prior to release? Please explain and provide examples:

Does your community provide SUD anti-stigma training opportunities for public officials and first responders? Please explain and provide examples:

Does your community have available recovery housing stock? Please explain and provide examples:

Is your community’s recovery housing stock certified as compliant with either the National Association of Recovery Residences (NARR) standards or the Oxford House model? Please explain and provide examples:

Does your community have available recovery housing stock that allows residents who utilize MOUD? Please explain and provide examples:

Do the residents of your community have access to financial support programs for rent, utilities, groceries, clothing, or other necessities? Please explain and provide examples:

Does your community have access to quality affordable childcare programs or provide subsidies for parents affected by SUD? Please explain and provide examples:

Does the community provide residents with access to no or low-cost employment and educational support? Please explain and provide examples:

Does your community have a Recovery Community Center (RCC)? Please explain and provide examples:

Does your community’s RCC adhere to the Association of Recovery Community Organizations (ARCO) National Standards of Best Practices for Recovery Community Organizations? Please explain and provide examples:

Does your community provide SUD anti-stigma training to faith-based organizations? Please explain and provide examples:

Does your community provide SUD anti-stigma training for community members? Please explain and provide examples:

Does your community provide access to high speed/reliable internet service at no cost for individuals in recovery from SUD? Please explain and provide examples:

Does your community provide access to free expungement services? Please explain and provide examples:

Does your community provide access to transportation support for accessing recovery services? Please explain and provide examples:

Name

This field is for validation purposes and should be left unchanged.