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Tribal MAT Project

Described by its lead entities as “A unified response to the opioid crisis in California Indian Country,” the Tribal MAT Project was designed to meet the specific opioid use disorder prevention, treatment, and recovery needs of California’s Tribal and Urban Indian communities. In close partnership with representatives of the communities served, the California Department of Health Care Services developed the project to promote opioid safety, improve the availability and provision of MAT, and facilitate wider access to naloxone with special consideration for Tribal and Urban Indian values, culture, and treatments.

The Tribal MAT Project is focused on sharing knowledge among Tribal and Urban Indian communities, Tribal and Urban Indian health programs, and community-based partners on best practices for prevention, treatment and recovery from opioid use disorder, stimulant use disorders, and other co-occurring substance use disorders in California Indian Country. For more information about the Tribal MAT Project overall, contact Jessica Nasello. The Tribal MAT Project receives funding from the State Opioid Response (SOR) grant through the Substance Abuse and Mental Health Services Administration (SAMHSA).

The following organizations are implementing complementary initiatives to achieve the goals of the Tribal MAT Project:

California Indian Opioid Safety Coalition

Led by the California Consortium for Urban Indian Health (CCUIH), the California Rural Indian Health Board, Inc. (CRIHB), and Kauffman & Associates, Inc. (KAI), the California Indian Opioid Safety Coalition (CIOSC) is a statewide coalition of American Indian and Alaska Native (AI/AN) and AI/AN serving organizations collaborating in an organized response to the opioid epidemic in California Indian Country. CIOSC shares successful and emerging examples of Tribal and Urban Indian community health approaches to promote opioid safety, integrate MAT services into health care, and address stimulant misuse during tri-annual CIOSC meetings.

California Indian Harm Reduction Workgroup

CCUIH and CRIHB support the statewide California Indian Harm Reduction Workgroup to develop and articulate approaches and principles for Native harm reduction that represent Tribal and Urban Indian communities’ values and needs. The workgroup will identify and disseminate best practices for harm reduction strategies within California’s AI/AN communities. It may also provide funding and technical assistance opportunities for local AI/AN harm reduction efforts. CCUIH and CRIHB convenes this workgroup with Tribal and Urban Indian community members from across the state, with support from KAI.

Tribal and Urban Indian Community Defined Best Practices

Led by a partnership between The Center at Sierra Health Foundation, CCUIH, CRIHB, KAI, and USC, the Tribal and Urban Indian Community Defined Best Practices program is a grant funding and technical assistance opportunity for Tribal and Urban Indian health programs. The goal of the program is to support the local integration of cultural and traditional healing and recovery practices into developing or existing Tribal and Urban Indian health programs for SUD services. The program will offer individualized technical support to grantees through a planning track, which is focused on facilitating community discussions and readiness assessments, as well as through an implementation track, which is focused on strategic planning and implementation.

Tribal and Urban Indian MAT and Stimulant Use Disorder Learning Community

KAI is leading the implementation of the Learning Community, a funding and technical assistance opportunity for Tribal and Urban Indian organizations to develop, enhance, and sustain MAT and/or stimulant use disorder services in ways that leverage the local Tribal cultural context and facilitate peer-to-peer learning. With support from CCUIHC, CRIHB, and the Center at Sierra Health Foundation, the Tribal MAT Learning Community will establish a vibrant community of Tribal and Urban Indian MAT and stimulant use disorder treatment providers that integrate treatment best practices with cultural best practices to develop locally meaningful and sustainable community response to substance use disorder.

Tribal and Urban Indian Local Opioid Coalitions

CRIHB will continue supporting Tribal health programs to establish Tribal Local Opioid Coalitions, which are multisector, interagency partnerships of community members, stakeholders, and service providers who work together to reduce and eliminate opioid- and stimulant-related deaths and other impacts of opioid and stimulant use in Tribal communities. KAI will support CRIHB as the Tribal Local Opioid Coalition activities move forward. Coalition activities include completing a community readiness assessment, developing tribal action plans, conducting program evaluation, and implementing plans to combat opioid and stimulant misuse. In addition, CCUIH will continue supporting Urban Indian health organizations to participate in CIOSC and Local Opioid Safety Coalitions, all part of the California Opioid Safety Network.

Community Campaign and MAT Champions

CCUIH and CRIHB develop and disseminate culturally adapted prevention, treatment, and recovery materials that are specific to Tribal and Urban Indian communities, patients, providers, and stakeholders. In addition, CCUIH and CRIHB serve as MAT Champions to support the development of Tribal and Urban Indian stakeholders’ prevention, treatment, and recovery services, and to coordinate relevant MAT-related resources and technical assistance services available to Tribal and Urban Indian providers. The CCUIH and CRIHB MAT Champions also distribute naloxone and provide trainings for Tribal and Urban Indian communities and health programs on addiction, MAT, harm reduction, opioid safety, and naloxone.

SUD Policy Advocacy Training Program

The University of Southern California (USC) Keck School of Medicine will lead a policy advocacy training course for members of and/or individuals working with Tribal and Urban AIAN communities in California. The goal of the online training is to teach effective approaches to engage local, state, federal, and Tribal policymakers about substance use disorder (SUD)-related community needs. The SUD Policy Advocacy Training Program will focus on using data-informed approaches to enhance advocacy messaging, leverage stakeholder opportunities, and tailor concrete policy proposals for targeted audiences. In addition, the USC Keck School of Medicine is conducting an evaluation of the AIAN organizations funded by the Tribal and Urban Indian Community Defined Best Practices program. Lastly, they will be working with AIAN-serving MAT providers to understand the facilitators and barriers involved in implementing and maintaining a MAT program.

Tribal MAT Project Data Analytics

UCLA Integrated Substance Abuse Programs (ISAP) is spearheading the Tribal MAT Project Data Analytics initiative with the goal of supporting strategic planning efforts to identify and reduce disparities for AI/AN individuals with substance use disorder. UCLA will examine data to show how the county-based behavioral health delivery system is meeting the needs of AI/AN individuals with substance use disorder as compared to other racial and ethnic groups with respect to access to care, rates and duration of service utilization, quality of care, and health outcomes. In addition, the Tribal MAT Project Data Analytics initiative will offer starting point resources for counties to consider with respect to engagement with local Tribal communities.

Pathways to Healing (PaTH)

UCLA ISAP will offer regional training opportunities for Tribal, Urban Indian, and community-based behavioral health providers to learn more about culturally driven treatment modalities and practices for AI/AN individuals with substance use disorder. The training curriculum and events will focus on implementing evidence-based and culturally-informed strategies that providers and clinicians can use to improve their treatment programming and services in ways that incorporate the Tribal beliefs, cultures, traditions, and values of their patients. Opportunities to network and engage with other providers, clinicians and communities treating AI/AN individuals across the state is a key element to this set of work. This project is part of the UCLA Opioid and Stimulant Implementation Support-Training and Technical Assistance (OASIS-TTA) Program.

Tribal MAT Project ECHO

UCLA ISAP hosts a monthly Tribal MAT ECHO™ Clinic supporting health care providers in Indian Country to improve the delivery of culturally responsive, evidence-based treatment for opioid and stimulant use disorders.  The Project Extension for Community Healthcare Outcomes (ECHO™) model is a distance learning method that links specialists at academic medical centers with primary care clinicians in local communities. The Tribal MAT ECHO™ Clinic is scheduled for the fourth Monday of each month. Each clinic begins with a presentation on a topic relevant to the delivery of opioid and/or stimulant use disorder treatment and features a facilitated discussion of a case or clinical question. Attendees are encouraged to bring complex patient cases and clinical questions for peer-to-peer discussion with input and consultation experts. Continuing education credits are available for certified and licensed participants. This project is part of the UCLA OASIS-TTA Program.

State/Local-Tribal Collaboration Project

This set of work will support improvements in state/local-Tribal collaboration around health topics related to OUD/SUD. This is an outstanding need nationwide. Additionally, trainings in topics such as cultural competency and trauma-informed care are becoming more widely acknowledged as important for health equity.

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