Project Grant H79TI085635

CHAPA-DE INDIAN HEALTH (CHAPA-DE) TREATMENT, RECOVERY & HARM REDUCTION - CHAPA-DE INDIAN HEALTH WILL ADDRESS OPIOID USE DISORDERS (OUD) AND SUBSTANCE USE DISORDERS (SUD) BY PROVIDING COMPREHENSIVE, FLEXIBLE, CULTURALLY ATTUNED TREATMENT, RECOVERY, AND HARM REDUCTION SERVICES THAT INCORPORATE NATIVE HEALING PRACTICES, TO AMERICAN INDIANS AND ALASKA NATIVES (AIAN) AND LOW INCOME INDIVIDUALS IN CALIFORNIA'S PLACER AND NEVADA COUNTIES AND SURROUNDING AREAS. WE WILL SERVE 162 UNDUPLICATED INDIVIDUALS WITH A 50% RETENTION RATE. NEED & POPULATION TO BE SERVED: CHAPA-DE'S PROGRAM WILL ADDRESS THE SIGNIFICANT INCREASE IN OPIOID DEATH RATES, PARTICULARLY FOR THE AIAN POPULATION AND OTHER BIPOC INDIVIDUALS, THE RISING USE OF STIMULANTS, AND THE LOW PERCENTAGE OF PEOPLE THAT SEEK CARE. THE PROGRAM WILL INCREASE ACCESS TO CULTURALLY ATTUNED AND COMPREHENSIVE MEDICATION ASSISTED TREATMENT (MAT) FOR OUDS (MOUD) AND OTHER SUD TREATMENT IN OUR UNDERSERVED COMMUNITY. CHAPA-DE WILL SERVE AIAN AND OTHER LOW-INCOME ADULTS, INCLUDING PRENATAL AND POSTPARTUM PATIENTS, AND UNHOUSED PATIENTS, IN THE CHAPA-DE SERVICE AREA WHICH INCLUDES CALIFORNIA'S PLACER AND NEVADA COUNTIES AND SURROUNDING AREAS. CHAPA-DE IN PRIVILEGED TO PARTNER WITH AND OPERATE UNDER THE AUTHORITY OF THE UNITED AUBURN INDIAN COMMUNITY TO PROVIDE FREE AND CULTURALLY RELEVANT CARE TO AIAN PEOPLE FROM FEDERALLY RECOGNIZED AND CALIFORNIA TRIBES. OF CHAPA-DE'S 2021 PATIENT BASE OF 25,132, 30% WERE AIAN. STRATEGIES/INTERVENTIONS: CHAPA-DE WILL EMPLOY SEVERAL EVIDENCE BASED PRACTICES FOR TREATING OUD AND OTHER SUDS INCLUDING NURSE CASE MANAGEMENT MODEL FOR MOUD; PERINATAL CARE WITH MAT; NATIVE RECOVERY PROGRAMS INCLUDING RED ROAD TALKING CIRCLES; BEHAVIORAL HEALTH SUPPORT INCLUDING COGNITIVE BEHAVIORAL THERAPY (CBT); CONTINGENCY MANAGEMENT FOR STIMULANT USE; SEEKING SAFETY; AND SUD SCREENING AND SBIRT INTERVENTIONS. OUR PROGRAM IS BECOMING A BEACON IN THE COMMUNITY AND INCREASING SPECIALIZED STAFFING; RESUMING FORMAL CONTINGENCY MANAGEMENT FOR STIMULANT USE; AND INCREASING HARM REDUCTION, OUTREACH AND AWARENESS-RAISING ACTIVITIES, WILL ENHANCE OUR OFFERINGS. GOAL 1: EFFECTIVELY SERVE AIAN AND OTHER CHAPA-DE PATIENTS WITH COMPREHENSIVE NURSE CASE MANAGED MOUD/SUD TREATMENT AND RECOVERY SERVICES SUPPLEMENTED BY BEHAVIORAL HEALTH CARE/THERAPY, AND NATIVE HEALING PRACTICES. GRANT FUNDING WILL SUPPORT HIRING AN ADDITIONAL SUD NURSE CASE MANAGER, AN SUD COUNSELOR, TWO PART-TIME SUD THERAPISTS AND ADDITIONAL ADMINISTRATIVE AND CLINIC STAFF TO INCREASE CAPACITY TO SERVE MORE PATIENTS WITH COMPREHENSIVE SERVICES. KEY EXPECTED OUTCOMES AND OBJECTIVES INCLUDE (I) SERVING A TOTAL OF 162 PATIENTS DURING THE GRANT PERIOD; AND (II) MAINTAINING A PROGRAM RETENTION RATE OF AT LEAST 50%. GOAL 2: ENHANCE MOUD/SUD TREATMENT SERVICES. KEY OBJECTIVES INCLUDE THE (I) IMPLEMENTATION OF A COMPREHENSIVE CONTINGENCY MANAGEMENT PROGRAM THAT ANNUALLY SERVES 20 PATIENTS BEING TREATED FOR STIMULANT USE, AND (II) THE DEVELOPMENT OF FIDELITY MONITORING PROTOCOLS FOR NURSE CASE MANAGEMENT MODEL FOR MOUD, PERINATAL CARE WITH MAT, BEHAVIORAL HEALTH SUPPORT INCLUDING CBT, CONTINGENCY MANAGEMENT, AND SBIRT. GOAL 3: IMPLEMENT HARM REDUCTION EFFORTS THAT INCLUDE EQUIPPING PATIENTS AND COMMUNITY MEMBERS WITH REVERSAL MEDICATIONS AND FENTANYL TEST STRIPS (FTS) AND INCREASING COMMUNITY AWARENESS OF TREATMENT AND RECOVERY OPTIONS. KEY OBJECTIVES INCLUDE: (I) PURCHASING AND DISTRIBUTING A SUPPLY OF 50 NALOXONE/NARCAN DOSES AND 2,120 FTS; (II) PROVIDING A LEAST TWO (2) TRAININGS PER YEAR FOR PATIENTS, PEERS, FAMILY MEMBERS, AND OTHER KEY TRIBAL MEMBERS ON THE RECOGNITION OF OPIOID OVERDOSE AND APPROPRIATE USE OF THE OVERDOSE REVERSAL/PREVENTION MEDICATIONS; AND (III) IMPLEMENTING AN OUTREACH AND AWARENESS RAISING CAMPAIGN TO ENSURE THE WIDER COMMUNITY IS AWARE OF THE CHAPA-DE TREATMENT, RECOVERY & HARM REDUCTION PROGRAM.