Community Project Funding/Congressionally Directed Spending - Construction - Nisqually MAT Facility Project Abstract The Nisqually Tribe is currently developing an off-reservation SUD/MAT clinic in the Olympia/Lacey area. The 31 million dollar project includes 12 million from the state of Washington, 5 million from the CDF program, and 14 million from the Nisqually tribe. The Tribe has become acutely aware of the devasting impact of the opioid crisis on both tribal and nontribal populations within the region. The Tribe has accordingly reached out to local groups and jurisdictions who are dealing with this issue, and is coordinating its MAT program development efforts with these other groups to effectively address this regional crisis. The Tribe currently provides some basic SUD/MAT services out of its existing corrections facility on the Nisqually Reservation. The Tribe is also currently working to enhance this on-reservation program through development of a Detox/Step-down program to serve the corrections population at the facility. The Tribe has, through its feasibility and development work for the on-reservation MAT program identified as a tribal priority the development of a larger off reservation SUD/MAT clinic to serve the larger Thurston County/Lacey/Olympia area. Nisqually has consulted with several other Tribes within Western Washington who are currently operating larger off reservation SUD/MAT clinics. The Tribe has been impressed with the level and quality of services provided at these clinics and believes a similar model can be adapted to this area. The Tribe visited the “We Care Daily Clinic” in Auburn run by the Muckleshoot Tribe. The clinic has been in operation for two years, and provides Saboxin, Methadone, and other medically assisted treatment services (MAT) to both the tribal and general populations in the area. Other clinics are located at Jamestown, Swinomish, ands Quinault. The Tribe has secured an off-reservation site on Pacific Avenue in Olympia that will be used for an off-reservation an SUD/MAT clinic in this area. The Tribe has retained a project architect and project consultant to work with a tribal team to complete programming, design, local government consultation, facility construction, and start up. Moving forward on the project will involve development of a solid business and operating plan, a financing plan, an outreach plan, and substantial interaction on permitting and operations with local jurisdictions. This due diligence is currently being carried out, including development of a business plan that addresses competition, startup costs, licensing/regulatory issues, revenue projections, operating costs, and management approach. The Tribe has retained Moss Adams to assist with this feasibility work, (and we have the example of other Tribes who have already developed successful SUD/MAT clinics.) The proposed larger MAT clinic could be a significant new project that provides a needed service to the larger community, and generates needed revenue for the Tribe that can be put back into enhanced program services. An MAT clinic is not a project to be undertaken lightly. The facility cost can easily exceed 30 million dollars, and staffing needs, operating costs, and compliance requirements are substantial. A key factor that makes an MAT clinic feasible for Tribes are current Medicaid reimbursement rates for tribal clinics, which provide for a significantly higher reimbursement rate than is available to non-tribal clinics. A critical component of the Tribe’s emerging SUD/MAT treatment model is to ensure that clients are not reinserted back into the same situation which may have contributed to their initial problem. These individuals will be provided a clear road map and encouraged to build on the growth they have experienced in treatment. The aftercare plan is a crucial staple of high-quality addiction treatment programs and an important key to successful recovery. Each individual will have a continuum of care that offers a high level of support and