By Joseph V. Sowmick, NAJA Contributing Writer
Representatives from the Midwest Alliance of Sovereign Tribes (MAST) joined with the U. S. Department of Health and Human Services, Indian Health Services (IHS), Health Resources and Services Administration (HRSA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) for the Tribal Opioid Strategic Planning Conference on August 22 – 23, 2018.
The two-day collaborative project featured Tribal leaders and personnel from 34 Tribes with two urban Indian communities with the purpose of Region V Bemidji area Tribes to address the impact of the opioid crisis as expressed in the March 27, 2018 MAST emergency declaration on the opioid crisis supported by the Saginaw Chippewa Indian Tribe.
Stockbridge Munsee Tribal member and MAST Executive Director Scott Vele spoke and encouraged Tribes to share their existing opioid Tribal Action Plans (TAP) and current data related to the impact of the opioid crisis.
“We are creating a union, a strong bridge between Tribes and the funding sources to deal with the struggles of opioid addiction that come to our reservations wherever we are. It’s a tragedy what is going on but it’s not the first tragedy that Indians have faced throughout the history of our people,” Vele said. “We have to find out from each other on how to deal with this crisis. When we were in D. C. for MAST Impact Week in March, our friends Tyler LaPlaunt (Great Lakes Area Tribal Health Board) and Frank Ettawageshik (United Tribes of Michigan) presented the resolution that mentioned the state of emergency in Indian Country that brings us here today.”
LaPlaunt mention the Great Lakes Tribal Health Board was created several years ago to bring consistency in the region and sees the value of declaring a state of emergency around the opioid epidemic because he has seen it first-hand in site visits.
“The problem I’ve seen is families destroyed, Elders crying from losing their children and raising their grandchildren and mothers and fathers along with aunties and uncles devastated by addiction. The problems in the communities may differ in the region, but the tears and sadness are the same across Indian Country,” LaPlaunt said. “Part of our challenge in the Bemidji area is we have been underfunded for health care. We know tribes are working for resolutions to solve what is happening and we can stand together when we can combat the issues that arise regarding health care for our communities.”
LaPlaunt mentioned the need to outreach for funding sources on a federal basis as he views the challenge as not as much a community issue but favors an interstate approach.
The SCIT delegation in attendance was represented by Behavioral Health Director David Garcia, Dr. Barry Kissoondial of the Nimkee Memorial Wellness Center and Saginaw Chippewa Tribal Court Healing to Wellness Coordinator Joseph Sowmick. Tribal Council Secretary Frank Cloutier also serves as the President of MAST and was in Washington representing the tribe during MAST Impact Week.
“In order to meet the challenges of the opioid crisis it will take a collaborative effort involving federal, state and local representatives. Meetings such as this give us the opportunity to share different ideas and solutions with one another that are working,” Dr. Kissoondial said. “It also gave us the opportunity to address some of the challenges that need to be overcome. From a medical standpoint I was able to discuss strategies with representatives from the Indian Health Services at the federal level as well as other physicians and staff from other Health Centers.”
Dr. Kissoondial looks forward to bringing information back to his Nimkee medical care providers and continuing to work on solutions to meet this crisis.
Garcia believes the conference was a great opportunity to work towards solutions on the opioid crisis with other tribes in the region.
“We are all working to address this issue and we were able to share ideas, hindrance and solutions. It was very beneficial for the federal agencies, such as IHS and SAMHSA, to be there to assist with the problem solving from the programing and funding aspect,” Garcia said. “Some of the common themes across the tribes were; lack of funding, being handcuff by funding requirements, lack of resources in rural areas, lack of outreach programs and providing a safe environment / housing for those coming out of treatment. We, as a tribe, are fortunate to have sufficient funding to make a difference, compared to other tribes.”
Capt. Jeffrey Coady, Psy.D, of the United States Public Health Service is a SAMHSA Regional Administrator and worked with IHS Region V Health Director Chris Poole to bring the strategic planning conference to St. Paul, Minn.
“We wanted to find out where tribes were at and to look at how tribal strategic planning will be moving in the future and how we can maximize our collaborative efforts to positively impact the region. It really addresses the strength of partnerships when you see a gathering of tribal leaders and health care professionals working in tandem with federal agencies on assistance of implementing tribal action plan within their communities they serve,” Coady said. “What we’re seeing in Minnesota is similar to the Gathering of All Nations discussion at the training in Albuquerque on how tribes can advance efforts with state and federal partnerships. As we look at our individual action plans it’s imperative to identify where those resources are and many of those resources are represented here today.”
Coady informs other national participants in attendance at the conference were U. S. Department of Housing and Urban Development, Federal Office of Rural Health Policy, Corporation for National and Community Service, Drug Enforcement Administration, Department of Veterans Affairs and the U.S. Department of Labor Employment and Training Administration.
Poole enjoyed his last trip to the tribe when he attended a reception with SCIT Tribal Council at the June 12, 2018 Tribal Opioid Summit.
“Speaking with Chief Ekdahl and Council, we had a robust discussion on what challenges are out there and how to position ourselves to meet the needs of your community regarding the opioid crisis. There is a challenge in the number of residential beds that are out there and the IMD waivers that need to be looked on a state basis that Doug O’Brien (DHHS Regional Director) discussed and we need to increase the access to medically assisted treatment,” Poole said. “The Bemidji office of IHS has been very committed to tele-behavioral health and we’ve recently hired a prescribing psychologist to begin increasing access to tele-behavioral health and I’m working with (Nimkee Health Director) Karmen Fox on the possibility of bringing that service to the clinic.”
O’Brien informed the delegations present that the HHS Secretary and other DHHS officials know this crisis does not have a Washington solution.
“I think everyone in the room can appreciate that because Tribal communities know all too well that Washington solutions are generally not applicable to local and regional settings. They do not typically take in account the unique community aspects of Indian Country,” O’Brien said. “That’s why we can appreciate events like this that help to nurture, identify and build those community based solutions because those are the ideas that will generate honest dialogue to solve this crisis. There are obviously some things at the federal level we can assist with like research and generating models of pain management that can be used as best practices to treat addiction.”
When it comes to getting help to people in need, O’Brien firmly believes local solutions to treatment have to be riveted with community input.
SAMHSA Tribal Training and Technical Assistance Facilitator Seprieono Locario shared about re-entry from incarceration in the justice system and how Tribal nations can welcome home all members of our community.
“We look at re-entry in a holistic, traditional way on whether a member was incarcerated or coming home from military service or a boarding school experience, trauma is there. We have learned addiction can live in the darkness and if treatment doesn’t address the healing and wellness the family can bring, re-connection will be difficult,” Locario said. “Relatives can benefit from local support and local teachings when trauma informed care is introduced and that transition is done in a good way.”
(Dr. Joseph Sowmick is a member of the Native American Journalist Association and contributing writer for the Tribal Observer. He is a member of the Saginaw Chippewa Indian Tribe of Michigan who has presented at Tribal Law and Policy Institute workshops.)