Northern California Tribal MAT Consortium - Friendship House will develop and lead the Northern California Tribal MAT Consortium in response to the goals articulated by the MAT-PDOA program. Through this project, we will increase access to MOUD for American Indians and Alaska Natives (AI/ANs) living in urban, rural and tribal areas of Northern California. As a direct service provider, Friendship House will lead a consortium of tribal health programs operated by the Indian Health Service and urban Indian health programs in Northern California. In doing so, we will create a more coordinated continuum of referral, treatment and recovery support services for AI/ANs experiencing opioid use disorder. The epidemic of opioid use disorder has disproportionately impacted AI/ANs, who experience the second highest rate of opioid overdose of all racial/ethnic populations. Unfortunately, AI/ANs have poor access to treatment. Nationally 71% of AI/ANs now live in urban areas, with that percentage closer to 90% in California. These urban areas lack culturally-informed systems and services. For AI/ANs in rural or tribal areas, they often live hours away from a tribal clinic or pharmacy, preventing access to OUD treatment. These access gaps are not unique to Northern California. By addressing access gaps for AI/ANs in urban, rural and tribal areas, the Northern California Tribal MAT Consortium can serve as a national model, and a roadmap for other regions to create their own Tribal MAT Consortium. As the lead direct service provider, Friendship House will expand screening across a sprawling Northern California region and increase the number of AI/ANs receiving residential treatment at our San Francisco facility. This project will make our existing treatment program more accessible to AI/ANs living in more remote areas, establish recovery support services for AI/ANs when they return to their communities, and coordinate long-term MOUD and behavioral health care with tribal health programs. Friendship House will provide residential treatment and MOUD to 675 people throughout the 5 years of the project. Our recovery support services will reach an additional 433 unduplicated people over this period. The following are goals and measurable objectives of our proposed project: Goal 1: Increase access to medication-assisted treatment for individuals with OUD Objective 1a: By the end of Year 1, Friendship House will have increased the number of annual individuals screened for OUD by 75% (from 500 to 875). Objective 1b: By the end of Year 1, Friendship House will have increased the number of annual individuals admitted for residential OUD treatment by 50% (from 70 to 105). Goal 2: Improve care coordination for individuals with OUD from rural or tribal areas Objective 2a: Friendship House will have increased the number of annual referrals by tribal health programs and county courts by 50% (from 300 to 450). Objective 2b: 90% of individuals exiting residential OUD treatment will have stable housing and access to local behavioral and medical health care. Objective 2c: Friendship House will have engaged with each IHS clinic to collaborate on care coordination. Goal 3: Reduce relapse rates among individuals receiving MAT Objective 3a: 90% of individuals in residential treatment program will have co-created an individualized recovery plan before discharge from residential treatment. Objective 3b: 75% of individuals in recovery will participate regularly in peer-based recovery support services for at least 3 months after discharge from residential treatment. Objective 3c: 90% of individuals in recovery will have successfully continued their prescribed MAT for at least 3 months after discharge from residential treatment.
