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November 22, 2004 - Comprhensive list of American Indian/ Alaska Native programs that are currently funded by SAMHSA

A comprhensive list of American Indian/ Alaska Native programs that are currently funded by SAMHSA in accordance with President Bush's New Freedom Initiative

The Substance Abuse and Mental Health Services Administration (SAMHSA), part of the U.S. Department of Health and Human Services (HHS), focuses attention, programs, and funding on improving the lives of people with or at risk for mental or substance use disorders. Consistent with President Bushs New Freedom Initiative, SAMHSAs vision is a life in the community for everyone. The Agency is achieving that vision through its mission building resilience and facilitating recovery. The Agencys direction in policy, program and budget is guided by a matrix of priority programs and crosscutting principles that include the related issues of cultural competency and eliminating disparities.

To achieve the Agency's vision and mission for all Americans, SAMHSA-supported services are provided within the most relevant and meaningful cultural, gender-sensitive, and age-appropriate context for the people being served. SAMHSA has put this understanding into action for the American Indian/Alaska Native communities it serves in the design of its grant programs, the nature of its communications and outreach, and its ongoing commitment to culturally competent and culturally sensitive tribal and community-based mental health services, addiction treatment, and substance abuse prevention/mental health promotion. Only in this way can SAMHSA help ensure that all people with or at risk for mental or addictive disorders have the opportunity for fulfilling lives that include jobs, homes, and meaningful relationships with family and friends. This document highlights SAMHSA activities in support of the American Indian/Alaska Native populations across the Nation.

COMMUNITY AND FAITH-BASED APPROACHES

Access to Recovery (ATR) Program: Thousands of Americans with substance use disorders have the opportunity to select the treatment options that best meet their needs under Access to Recovery, a $100 million program announced by President Bush. The competitive program, announced in March 2004, gives recipient States, territories, tribal organizations, and the District of Columbia broad discretion to design and implement federally supported voucher programs to pay for a range of effective, community-based substance abuse treatment and recovery support services. By providing vouchers to people in need of treatment, the grant program promotes individual choice in selecting substance abuse treatment and recovery services. It also expands access to care, including access to faith- and community-based programs, and increases substance abuse treatment capacity. Five technical assistance sessions have been held in different parts of the country for prospective applicants to the program. Representatives from approximately 100 tribes attended the five sessions.

Promoting Partnerships: SAMHSA has made awards of up to $1.6 million to help improve access to mental health services, substance abuse prevention, and addiction treatment for American Indians/Alaska Natives, and other racial and ethnic communities. Grants have support the work of regional non-profit organizations in developing formal partnership with local, community-based organizations to improve access to services. Grantees are identify effective ways in which collaborations between regional and community-based organizations can help reduce disparities in access to, and availability and affordability of services, to improve the health of American Indian/Alaska Native peoples and other target populations.

First Nations Behavioral Health Association: In 2003, SAMHSA?s Center for Mental Health Services (CMHS) and the Indian Health Service (IHS) joined with the National Association of State Mental Health Program Directors, (NASMHPD) to create a new organization representative of American Indian/Alaska Native experts in the behavioral health field. Members of American Indian physician, psychologist, social worker, and family/consumer organizations were brought together in September 2003 to address research, infrastructure, and workforce needs, and to develop the critical mass to create a multidisciplinary organization to serve as a resource to State, Federal, and tribal programs to help improve access to culturally competent care. Among the objectives of the new First Nations organization that emerged from the September 2003 meeting are to increase the link between tribal colleges and universities and the behavioral health field to address workforce needs, and to increase the evidence for culturally distinct, faith based interventions. To that end and to leverage its resources and capacity, First Nations has become a part of the National Multi-ethnic Behavioral Health Association, an association of organizations representing the leaders in the field of African-American, Hispanic, and Asian/Pacific Islander behavioral health providers and consumers.

American Indian/Alaska Native and Rural Community Planning Grants: Implemented in FY 2001, the American Indian/Alaska Native Community Planning Grant Program of SAMHSA?s Center for Substance Abuse Treatment (CSAT) was expanded in FY 2003 to support community-based planning through a new American Indian/Alaska Native and Rural Community Planning Program. This $1.5 million grant program helps smaller tribes and rural locales develop or strengthen local infrastructures and collaborations to help establish effective treatment systems using culturally relevant treatment approaches. Current grantees include: Lower Elwah Klallam Tribe, Port Angeles, WA; Eagle Wing Recovery Services, Hoopa, CA; Central Council of Tlingit and Haida Indian Tribes, Juneau, AK; Native American Indian Center, Columbus, OH; Tonkawa Tribe of Oklahoma, Tonkawa, OK; and Chesterfield County Coordinating Council, Clemson, SC.

Targeted Capacity Expansion (TCE) Program: The Substance Abuse Treatment Targeted Capacity Expansion grant program under the aegis of SAMHSAs CSAT expands treatment opportunities and capacity in local communities experiencing serious, emerging drug problems, and in communities that propose innovative solutions to substance abuse treatment needs not previously met. The TCE program also includes specialized initiatives to strengthen services for youth, adolescents, and minority communities, to address the twin issues of substance abuse and HIV/AIDS, and to support services for persons in recovery. Tribes and tribal organizations have received over $31 million in TCE funds either in direct or indirect grant making during the past three years. In FY 2003, nine new awards were added to the American Indian/Alaska Native TCE grantee roster: Lummi Indian Nation, WA; Native American Connections, City of Phoenix, AZ; White Mountain Apache Tribe, AZ; Inter-Tribal Council of Michigan, Sault Ste Marie, MI; Na?nizhoozhi Center (NCI), Gallup, NM; Choctaw Nation Tribal Council, OK; Oglala Sioux Nation, SD; Yukon Kuskokwim Health Corp, AK; Copper River Native Association, AK; Fairbanks Native Association, AK; and Cook Inlet Tribal Council, AK. SAMHSA announced the availability of $12 million in TCE funds in Fiscal Year 2004 to support programs in four focus areas: (1) treatment focused on minority populations; (2) treatment in rural areas; (3) treatment focused on methamphetamine and other emerging drugs in specific States and localities; and (4) other innovative approaches to treatment capacity expansion. SAMHSA expects that approximately $3 million will be available for awards in each category.

Culturally Appropriate Instruments to Measure Program Effectiveness: SAMHSA has placed an emphasis on accountability and program effectiveness of its grant programs. To that end, SAMHSA has developed accountability measures across a series of national outcome domains. SAMHSA is working to assure that measures and instruments used to determine the effectiveness of prevention and treatment programs are appropriate for all populations, including racial/ethnic groups, and that they capture the level of performance across the national outcome domains. SAMHSA continues to engage experts in measurement for various ethnic groups to review and recommend appropriate and accurate instruments for programs serving various populations.

CHILDREN AND FAMILIES

Circles of Care for Children with Serious Emotional Disturbances: The Circles of Care grant program ? a collaboration among SAMHSA?s CMHS, the Indian Health Service (IHS), and the National Institute of Mental Health (NIMH) ? supports the implementation of mental health service models designed by American Indian/Alaska Native tribal and urban Indian communities to provide a systems-of-care community-based approach to mental health and other supportive services for American Indian/Alaska Native children with serious emotional disturbances and their families. Nine communities participated in the first cycle of grants from 1998 to 2001; each has received Federal, State, and private funding to implement and sustain their project and to improve the cultural competence of their system of care. The second cycle of seven grant communities are completing their third and final year of Federal funding, including: Central Council Tlingit and Haida Indian Tribes, AK, Puyallup Tribe, WA, United American Indian Involvement, CA, the Ute Indian Tribe, UT, the Blackfeet Nation, MT, and the Pascua Yaqui Tribe and the Salt River Pima-Maricopa Indian Community of AZ. Technical assistance and a cross-site evaluation are provided by the National Center for American Indian and Alaska Native Mental Health Research (University of Colorado), and the National Indian Child Welfare Association (NICWA). A third cycle of grants is scheduled for FY 2005, depending on funding availability.

Violence Prevention: Under the Safe Schools/Healthy Students youth violence prevention initiative, SAMHSA has supported a grant project to help develop interactive multimedia violence prevention learning materials for American Indian/Alaska Native elementary school students, teachers and their parents. The program is designed to increase knowledge of the risk factors associated with violence and to increase skills in selecting mental health interventions to reduce or respond to violent behavior. SAMHSA also is supporting development of violence prevention/resilience building curricula, including culturally relevant and appropriate behavioral interventions for American Indian/Alaska Native children. Safe Schools/Healthy Student grants are made to school districts through a unique collaboration among SAMHSA, the Department of Education, and the Department of Justice, and have included schools serving tribal communities. Participating school districts serving significant American Indian/Alaska Native student populations have been in Talequah, OK; Flandreau Indian School, Flandreau, SD; Nenana and Fairbanks, AK; San Juan Schools in Blanding, UT; Pinon, AZ; and Ethete, WY.

Youth Violence Prevention Program: SAMHSAs Youth Violence Prevention Program promotes the creation and expansion of collaborations to prevent youth violence, substance abuse, suicide, and other behavioral problems, and to implement prevention, intervention, and treatment services to enhance social development, resilience and positive mental health in individuals from birth to age 21. Grantee organizations typically include community-based service organizations; schools; tribal governments and organizations; public mental health, social service, or juvenile justice agencies; and colleges and universities. Program grants of $150,000 a year for up to 2 years, have been awarded to the Prairie Band Potawatomi Band, KS; Cook Inlet Tribe, AK; and the American Indian Training Institute, University of Oklahoma.

Child Mental Health Initiative: SAMHSAs Comprehensive Community Mental Health Services for Children and Their Families Grant Program provides funding for direct services to improve systems of care for children and adolescents with serious emotional disturbance and their families. With up to a 6-year grant, the program, managed by SAMHSA?s CMHS, is available to tribal and State governments. Seven tribal organizations are among the current total of 63 grantees: Yukon Kuskikwim Delta and Fairbanks Native Association, AK; United Indian Health, CA; Northern Arapaho Tribe, WY; Oglala Sioux Tribe, SD; Sault Tribe of Chippewa Indians, MI; and Choctaw Nation of OK. CMHS has an agreement with IHS to provide technical assistance to tribal grantees in this program by means of a contract with the Indian Child Welfare Association.

Protection and Advocacy: The Protection and Advocacy Program for individuals with mental illness was established by statute to protect the rights of persons with mental illness from abuse, neglect, and civil rights violations. As part of this program, since 2000, the American Indian Consortium of New Mexico has been funded at $180,000 per year to advocate for American Indian/Alaska Native citizens (4 tribes) with significant mental illness and emotional impairments.

STRATEGIC FRAMEWORK FOR PREVENTION AND EARLY INTERVENTION

Strategic Prevention Framework State Incentive Grant (SIG) Program: To provide the Nation with a structured approach to substance abuse prevention and mental health promotion based on the best that science has to offer, HHS Secretary Tommy G. Thompson launched the Strategic Prevention Framework State Incentive Grant program. A Notice of Funding Availability for Strategic Prevention Framework State Incentive Grants was published by SAMHSA in the Federal Register on April 29, 2004. The $45 million competitive grant program enables States, Territories and the District of Columbia to bring together multiple funding streams from multiple sources to create and sustain a community-based approach to substance abuse prevention and mental health promotion that cuts across existing programs and systems. The program goals are to: prevent the onset and reduce the progression of substance abuse, including childhood and underage drinking, reduce substance abuse related problems in communities, and build prevention capacity and infrastructure at the State and community levels. SAMHSA?s State Incentive Grants for Substance Abuse Prevention program has a history of serving American Indian/Alaska Native populations through coalitions of tribal entities working to stem the tide of substance abuse. Among the States that received SIG grants in the past, a total of 1,496 programs have been implemented. Data related to the demographic characteristics of the populations served are available on 2,092 of these programs. Of these, 598 (39%) report serving American Indian or Alaska Native populations.

Building Resilience Among Children of Substance-Abusing American Indian/Alaska Native Parents in Treatment: In partnership with the National Association for Children of Alcoholics, and White Bison, Inc., SAMHSA has developed the Native American Childrens Program Kit, an important resource for providers working with American Indian/Alaska Native children of addicted parents. SAMHSA recognizes that children of addicted parents are at significantly greater risk for emotional problems and the use of alcohol and drugs of abuse, leading to potential school failure and run-ins with the juvenile justice system. The Kit provides all the materials necessary for the substance abuse treatment professional to both publicize and offer age-appropriate, culturally relevant, educational support group sessions for school-age children of American Indian/Alaska Native clients in treatment for substance use disorders. The Kit can be ordered by calling SAMHSAs National Clearinghouse for Alcohol and Drug Abuse at 1-800-729-6686.

Rural/Tribal Frontier Intervention Development and Evaluation Centers: SAMHSAs CMHS awarded a grant to the University of Oklahoma Health Sciences Center to develop the Indian Country Child Trauma Center, that is developing trauma-related treatment protocols, outreach materials, and services specifically adapted for Native American children. Funding is $600,000 for up to four years.

Preventing Fetal Alcohol Spectrum Disorders (FASD): SAMHSAs Fetal Alcohol Spectrum Disorders Center for Excellence ? an initiative now funded through Fiscal Year 2005 was designed to help prevent FASD and to improve the lives of those with an FASD and their families. The Center provides resources to expand the knowledge base and promote best practices; study adaptations of innovative interventions and service delivery improvement strategies; identify communities with exemplary comprehensive systems of care for those with an FASD; and provide training to community providers and technical assistance to communities. A Women?s Recovery Summit focused on FASD is being planned for mid-2004 in Phoenix, AZ. Drawing from treatment centers within the area, the conference is expected to host approximately 150 women, about half of whom are anticipated to be Native American. In 2001, SAMHSA funded the Alaska Integrative, Comprehensive Approach to FASD which seeks to prevent FASD, identify individuals with an FASD earlier, enhance service delivery, and evaluate the overall initiative. Alaska Natives are full participants in every area of Alaska's FASD program.

Community-Initiated Prevention Interventions: This SAMHSA grant program assesses the effectiveness of substance abuse prevention interventions that appear to prevent or reduce tobacco, alcohol, or illegal drug use and/or associated social, emotional, cognitive or behavior issues among high-risk populations in local communities. Several of these programs are being funded in American Indian/Alaska Native communities.

For example, Walking in Beauty seeks to reduce risk factors for substance abuse among young American Indian women in New Mexico through a program that combines outdoor experiences, rites of passage ceremonies and talking circles. Ginew/Golden Eagle is a grant program to prevent substance abuse and reduce risk factors among urban Ojibwe and other American Indian/Alaska Native youth in Minneapolis, MN. The intervention combines Native traditions, talking circles and the Botvin life skills program. Both programs are in their last year of funding and evaluation. A third program, Project Venture has ended but is important to mention. The program engaged American Indian/Alaska Native youth actively in service as a means of investing in the community and reconnecting them with positive adult role models. Because it demonstrated significant reductions in delaying the onset of lifetime use of alcohol and marijuana, Project Venture has been identified by SAMHSA as a model program as part of the National Registry of Exemplary Programs.

ENHANCING SUBSTANCE ABUSE TREATMENT CAPACITY

American Indian/Alaska Native National Resource Center (NRC): In FY 2003, a $1 million grant, jointly funded by SAMHSA?S CSAT and CSAP, was awarded to the Oregon Health and Science University to establish the One Sky Center, an American Indian/Alaska Native National Resource Center. The Center identifies and fosters effective, culturally appropriate substance abuse prevention and treatment programs and systems to support American Indian/Alaska Native populations. The NRC provides technical assistance, training, dissemination and communication to increase substance abuse prevention and treatment knowledge and skills among service providers, policy makers, tribal communities, funding organizations and consumers.

Minority Fellowship Program: To increase the pool of professionals qualified to develop and implement programs and services for American Indians/Alaska Natives with mental and/or substance use disorders, SAMHSA makes grants through its long-time Minority Fellowship Grant Program. The program promotes the training and development of American Indian/Alaska Native nurses, psychiatrists, psychologists, and social workers to address the most critical mental health and substance abuse related service needs in these respective fields.

Cultural Competence in Mental Health Service Delivery: A consensus-driven publication highlights core services standards for managed mental health care applicable to American Indian/Alaska Native populations as well as the other three major U.S. ethnic/racial populations. Two precepts underlie Cultural Competence Standards in Managed Mental Health Care Services: (a) the need for consumers be viewed and engaged within the context of their cultural groups and their experiences as members of those groups; and (b) the need for culturally competent and appropriately qualified bicultural and bilingual personnel to provide mental health services. The document is available on line at SAMHSA at www.samhsa.gov/centers/cmhs/cmhs.html (click on consumer/survivor and then on specific populations).

Effective Substance Abuse Treatment for American Indian/Alaska Native Populations: Cultural Issues in Substance Abuse Treatment sheds light on the ways in which cultural perspectives affect substance abuse treatment efficacy. Designed as a guide to service providers and other substance abuse treatment professionals, it helps provide greater understanding of the range of forces affecting substance abuse treatment for American Indians/Alaska Natives and the three other core racial/ethnic populations.

Training for Effective, Culturally Competent Substance Abuse Prevention: SAMHSA joined with the HHS Office of Minority Health and the Health Resources and Services Administration to develop a nine-volume series providing a multi-cultural approach to the structure, staffing, and evaluation of community-based substance abuse prevention programs. The series includes a volume dedicated specifically to and focused on American Indian/Alaska Native populations. At the same time, in collaboration with the Indian Health Service, SAMHSA has developed and disseminated a condensed version of the Gathering of Native Americans curriculum, developed by SAMHSA with a team of American Indian/Alaska Native trainers from across the U.S. The curriculum provides culturally specific substance abuse prevention training to help American Indian/Alaska Native communities address the effects of alcohol and drug abuse.

Understanding the Need through National Data: SAMHSA gathers, analyzes, and disseminates data on substance abuse practices in the United States, including the implementation and analysis of three annual broad-based studies: the National Survey on Drug Use and Health (NSDUH) the Drug Abuse Warning Network (DAWN), and the Drug and Alcohol Services Information Services System (DASIS). From these data sets, SAMHSA also regularly issues Short Reports that provide specific information on particular trends in substance abuse. A number of these reports focus on racial/ethnic groups including American Indian/Alaska Native populations. The Short Report, Substance Use among American Indians or Alaska Natives, for example, compares substance use by American Indians or Alaska Natives with substance use by Hispanics, Asians, Blacks and Whites. The full short report and its findings can be found on the SAMHSA web site . Other American Indian/Alaska Native-related Short Reports may be found by accessing the full listing of Short Reports at http://www.samhsa.gov/oas/facts.csm.

DRUG ABUSE AND HIV/AIDS

Substance Abuse Prevention and HIV Prevention and Treatment: SAMHSA supports grants to help community-based organizations establish and/or expand their capacity to provide and sustain effective, integrated substance abuse prevention and HIV prevention and treatment services in American Indian/Alaska Native and other communities of color that traditionally have been underserved or unserved. Grant recipients include: Native American Community Health Center, AZ; Native American Interfaith Ministries, NC; Native American Health Center, Urban Indian Health Board, Inc, CA; Indian Township Health Center, ME; National Indian Youth Leadership Project, NM; Native Images, Inc., AZ; Ahmium Education, Inc., CA; University of New Mexico, NM; Upper Midwest American Indian Center, MN; Arizona Board of Regents; AZ; Indigenous Peoples Task Force, MN; Inter-tribal Addictions Recovery Organization, Sheridan, WY; and Friendship House Association of American Indians, San Francisco, CA. Total funding in Fiscal Year 2003 was approximately $4.85 million, with grant funding ranging from one to five years between Fiscal Years 2001 and 2007.

CO-OCCURRING DISORDERS

State Incentive Grants for Treatment of Persons with Co-Occurring Substance Related and Mental Disorders (COSIG): Jointly funded by SAMHSAs CSAT and CMHS, COSIG grants are designed to stimulate States to provide comprehensive, evidence-based treatment to persons with at least one mental disorder as well as an alcohol or drug use disorder. Alaska received a COSIG grant in FY 2003 of $1.1 million over five years to increase the capacity of its treatment systems to provide effective, coordinated and integrated treatment services to persons with co-occurring substance abuse and mental disorders, including Alaska Natives. To improve identification and treatment of individuals with co-occurring disorders throughout a diverse delivery system, Alaska has committed to addressing SAMHSA goals of improved screening, assessment, treatment, and training, which will be accomplished through infrastructure development, focusing on staff competency, credentialing, and licensure; financial planning and reimbursement; and information sharing and data collection.

FUNDING OPPORTUNITIES

SAMHSA supports programs, policy and knowledge development about substance abuse prevention, addiction treatment and mental health services through two major funding streams: (1) Block and Formula Grants; and (2) Programs of Regional and National Significance. For detailed information about current grant opportunities, browse the SAMHSA website and click on grants. Visit regularly for updates.