Analenisgi Medication Assisted Treatment Program by the Cherokee Indian Hospital Authority of the Eastern Band of Cherokee Indians - The Eastern Band of Cherokee Indian is the only federally recognized tribe in North Carolina and serves approximately 12,190 enrolled members. More than 1/3 struggle with ongoing substance use. A devastating community opioid epidemic. Aimed at those 4,500 enrolled members, we will expand access to MAT in jail, extend hours, expand peer support, provide individual and group education to those in residential treatment and incorporate additional native traditions into curriculum offered. We will offer services to an additional 200 enrolled members within the first grant year and 1,235 by the end of the project. Comprised of nine staff, we work in conjunction with MAT medical staff, utilizing approved Evidence Based Practices: individual/group/family therapy, Matrix, Seeking Safety, White Bison, Warrior Down, CBT, MI, and EMDR in combination with Buprenorphine or Methadone. Goal 1: To provide outreach, engagement and Peer Support Services to clients in MAT. 1. By the end of the first grant year, Peer Support staff will implement one additional WRAP class held each week, and 2. Peer Support staff will serve 80 clients in the MAT Program. 3. By the end of the second, third, fourth and fifth grant year, 80 participants will be respectively participating in three or more therapeutic activities per month. Goal 2: To provide individual support and group education to MAT participants engaged in residential treatment services. 1. By the end of the first grant year, the Certified Alcohol and Drug Counselor (CADC) will implement one new group targeted towards women living at the Women's Home. 2. By the end of the second grant year, the CADC will implement one new group targeting men living at the Men’s Home. Goal 3: To provide therapeutic service options to clients in MAT during additional extended hours. 1. By the end of the first grant year, the Master’s Level Therapist will provide therapeutic services to 40 clients during extended evening hours, and 2. the MAT team will provide therapeutic services to 40 clients during extended morning hours. 3. By the end of the fourth grant year, there will be three additional group therapy services added to the program schedule offered during extended hours. Goal 4: Decrease barriers for participants discharging from jail back into the community. To increase follow-up engagement in substance use services post incarceration. The Re-Entry Specialist will work with at least 35 program participants within the first grant year. 1. The Re-Entry Specialist will track participant's engagement in Substance Use Services for the first 60 days post release and provide community-based services to increase support and connection to services. By the end of the first grant year, at least 70% of participants will engage in substance use services within 60 days of release. 2. The Re-Entry Specialist will assist program participants with needs such as housing, employment, access to entitlements, connection with a Primary Care Physician, linkage to other community resources. By the end of the second grant year, the Re-Entry Specialist will have had at least one successful intervention in the above domains with 80% of program participants and by the end of the fifth year, the jail re-entry specialist will have had at least two successful interventions in the above domains with 80% of program participants. Goal 5: To continue building traditional Native American and culturally competent practices into individual and group sessions. By the end of the first grant year, 40 participants will engage in one of the Native American tradition groups (beading, drumming, fishing, etc.) 1. By the end of the second grant year, an additional 15 participants will engage in one of the Native American tradition groups, 2. By the end of the fifth grant year, an additional 30 participants will engage in one of the Native American tradition groups.
