CNO 988 Tribal Response Cooperative Agreements - The Choctaw Nation of Oklahoma (CNO) proposes to expand its Tribal 988 Response System to improve culturally responsive behavioral health crisis services for American Indian and Alaska Native (AI/AN) individuals across the Choctaw Reservation in southeastern Oklahoma. Building on the infrastructure established through prior Tribal 988 funding, the project will strengthen partnerships with Oklahoma's 988 Lifeline, increase behavioral health workforce capacity, enhance care coordination and follow-up, expand access to mobile crisis and peer recovery services, and implement a culturally responsive communications campaign to increase awareness of available crisis resources. The project will serve Tribal citizens and other AI/AN individuals of all ages experiencing suicidal ideation, suicide attempts, mental health crises, substance use disorders, co-occurring conditions, or other behavioral health emergencies. The Choctaw Reservation spans approximately 10,992 square miles and includes many rural, medically underserved communities where geographic isolation, transportation challenges, and behavioral health workforce shortages limit timely access to crisis care. These barriers contribute to significant disparities in suicide risk, behavioral health outcomes, and access to treatment. Through this project, CNO will expand culturally responsive crisis assessment, suicide prevention, mobile crisis intervention, peer recovery support, care coordination, and post-crisis follow-up. Individuals will access services through multiple entry points, including the 988 Suicide & Crisis Lifeline, Tribal behavioral health programs, healthcare providers, first responders, schools, and community organizations. Ongoing staff training, quality improvement, data-driven performance monitoring, and strengthened collaboration with the Choctaw Nation Health Services Authority, Oklahoma Department of Mental Health and Substance Abuse Services, Tribal Police, emergency medical services, hospitals, and community partners will support high-quality, coordinated crisis response. Over the three-year project period, CNO will strengthen the Tribal behavioral health workforce, improve equitable access to crisis services across rural communities, increase timely engagement in behavioral health treatment, expand mobile crisis response capacity, improve continuity of care following behavioral health crises, and enhance coordination across the behavioral health continuum. Expected outcomes include increased access to culturally responsive crisis services, improved follow-up after crisis intervention, stronger partnerships among behavioral health providers and first responders, reduced unnecessary emergency department utilization, and improved recovery outcomes for Tribal citizens. The Choctaw Nation Health Services Authority has the clinical expertise, organizational infrastructure, financial management systems, and federal grants management experience necessary to successfully implement this cooperative agreement. By integrating Tribal-led, culturally responsive behavioral health services with existing healthcare and community partnerships, CNO will continue building a sustainable crisis response system that promotes healing, resilience, recovery, and equitable access to comprehensive community-based behavioral health care.
