Project Grant H79TI085660

MMHC TRIBAL OPIOID RESPONSE PROJECT III (2022 TOR) - MATHIESEN MEMORIAL HEALTH CLINIC (MMHC) SERVICE AREA IS LOCATED IN AND AROUND JAMESTOWN, CALIFORNIA, (ZIP CODE 95327) AND EXPANDS INTO THE NORTH-EASTERN SIERRA FOOTHILLS (ZIP CODE 95370) IN TUOLUMNE COUNTY. THIS COMMUNITY HAS BEEN GREATLY AFFECTED BY THE ECONOMIC DOWNTURN TO THE COVID PANDEMIC. WE ARE SEEING AND EXPERIENCE AN INFLUX USE OF ILLICIT DRUGS AND OVERINDULGENCE OF OPIOIDS RESULTING IN HIGH NUMBERS OF OVERDOSES IN OUR EMERGENCY DEPARTMENTS. MMHC WAS FORTUNATE TO HAD BEGUN PROVIDING MEDICATION ASSISTANCE TREATMENT (MAT) AND SUBSTANCE USE COUNSELING SERVICES JUST PRIOR TO THE PANDEMIC, THANKS TO OUR FIRST TOR GRANT. AT FIRST, WE BEGAN A SMALL PROGRAM WITH A FEW PATIENTS. AS THE PANDEMIC RAGED, WE BEGAN CARING FOR A HIGHER NUMBER OF PATIENTS THAN ANTICIPATED. WITHIN A YEAR WE HAD TO MOVE OUR MAT SERVICES TO A LARGER DEDICATED SPACE, WHICH WE NOW CALL THE RED FEATHER CLINIC. BY THE END OF LAST YEAR, WE HAD 345% MORE PATIENTS THAN WE ORIGINALLY ANTICIPATED. THUS, MMHC WILL NEED TO CONTINUE TO BE A STRONG SOURCE OF CARE FOR OUR TRIBAL MEMBERS AND COMMUNITY AT LARGE. MMHC WILL CONTINUE TO ENHANCE AND EXPAND OUR EXISTING MAT AND SUBSTANCE USE COUNSELING PROGRAM PROVIDED BY HIGHLY EXPERIENCED AND PASSIONATE STAFF. OVER THE NEXT YEAR WE EXPECT TO CARE FOR 180 NEW PATIENTS AND 40 THE FOLLOWING YEAR. WE HAVE BEEN OUTREACHING TO SCHOOLS AND NOTICED THE NEED FOR A YOUTH TREATMENT PROGRAM, WHICH THERE ARE NONE IN OUR AREA. OUR PLAN WITH THE 2022 TOR FUNDING IS TO BEGIN A MORE AGGRESSIVE OUTREACH CAMPAIGN, SEEKING AND EDUCATING YOUTH ON DRUG USE AND PREVENTION OF OVERDOSE. WE PLAN TO DO 10 EDUCATIONAL COMMUNITY EVENTS; AT WHICH TIME WE WILL DISTRIBUTE OVERDOSE KITS CONTAINING NALOXONE. OVER THE TWO YEARS WE HOPE TO DISTRIBUTE AT LEAST 500. MMHC'S MAT/SUD COUNSELORS HAVE TAKEN BASIC TRAINING IN CONTINGENCY MANAGEMENT THIS LAST YEAR. ALL AGREE IT IS A PROMISING CARE MODALITY FOR POSITIVE REINFORCEMENT WHICH WILL SUPPORT PATHWAYS TO RECOVERY. THIS NEXT YEAR, WITH THE TOR FUNDING, MMHC WILL DEVELOP A CONTINGENCY MANAGEMENT IMPLEMENTATION PLAN, AND TAKE THE GUIDED STEPS IN PROVIDING THE EVIDENCE-BASED PROGRAM THAT INCLUDES PROTOCOLS, STAFF TRAINING, DEVELOPING TRACKING A SYSTEM FOR INCENTIVES, PATIENT EDUCATION AND EVALUATION PLAN. WE HOPE TO HAVE THE PROGRAM AVAILABLE MID-YEAR. MMHC IS COMMITTED TO DELIVERING BEST PRACTICES, EVIDENCE BASED AND TRAUMA-INFORMED CARE FOR OUR CLIENTS DIAGNOSED WITH OPIOID USE/SUBSTANCE USE DISORDERS. WE HAVE DEDICATED INDIVIDUALS THAT PROVIDE NEEDED SERVICES AND ARE OPEN TO ANYONE IN NEED, NO MATTER HOW THEY ENTER: SELF-REFERRED, WALK-IN OR REFERRAL. THUS, WE NEED TO ADD AN ADDITION CERTIFIED SUBSTANCE USE COUNSELOR TO OUR FAMILY OF CLINICIANS. WITH THIS FUNDING WE WOULD IMMEDIATELY BEGIN THE RECRUITMENT. SERVICE AREA: MMHC'S SERVICE AREA IS THE CITY OF JAMESTOWN, A NATIONAL DESIGNATED HISTORIC TOWN LOCATED IN WESTERN TUOLUMNE COUNTY, CALIFORNIA, AND THE SURROUNDING AREA. JAMESTOWN IS A RURAL AND SOMEWHAT REMOTE AREA WITH MINIMAL SERVICES LOCATED IN THE SIERRA NEVADA MOUNTAIN FOOTHILLS. TARGET POPULATION: THE TARGET POPULATION IS THE CHICKEN RANCH RANCHERIA TRIBAL MEMBERSHIP OF 32 MEMBERS, 840 UNAFFILIATED NATIVE AMERICAN INDIANS WHO RESIDE IN TUOLUMNE COUNTY, AND THE LOW-INCOME POPULATION THAT RESIDE IN AND AROUND JAMESTOWN. EXPECTED OUTCOMES: MMHC EXPECT OUTCOMES ARE: 1) PROVIDE 220 PATIENTS IN THE TWO YEARS 2) HIRE ANOTHER PART TIME SUBSTANCE ABUSE COUNSELOR; 3) INCREASE OUTREACH TO HIGH-RISK YOUTH PROVING CARE TO AT LEAST 20 TEENS, AND 4) DEVELOP AND IMPLEMENT A CONTINGENCY MANAGEMENT PROGRAM.