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WY Discretionary Funding Fiscal Year 2023

Center: FG

Grantee: EASTERN SHOSHONE TRIBE
Program: FY 2023 Support for 988 Tribal Response Cooperative Agreements
City: FORT WASHAKIE
State: WY
Grant Award Number: 1 H79 FG001306-01
Congressional District: At large
FY 2023 Funding: $250,000
Project Period: 2023/09/30 - 2026/09/29

Project Abstract The Eastern Shoshone 988 Tribal Response program will increase awareness and use of the 988 Lifeline on the Wind River Reservation located in central Wyoming. The program will train at least 20 individuals over the course of two years along with serving the Eastern Shoshone tribal members with an enrollment of 4,368 members. Access to mental health services, substance use treatment and behavioral health therapies is limited on the WRR due to rural location, limited transportation, stigma, digital inequality, and long-wait times. Foundational guidance from needs assessments, quality improvement plans, and linkage to local, state, and national resources are needed. These gaps directly impact tribal members in crisis. Data from the WRR Indian Health Service indicate that 246 individuals were treated at the clinic due to intentional self-harm diagnosis from 2016 - 2020. In 2021 there were 17 deaths by suicide in Fremont County, this was three times greater than the national average. A 2022 WRR community survey reported that the number one health concern was opioid use followed by unresolved trauma. This same survey reported that 22% do not have access to the internet and 19% are not aware of the telehealth services available (like 988), and 9% do not have access to a phone. Tribal members feel that most providers could benefit from cultural competency training. The overall goal of the ESR 988 project is to save lives through the 988 Lifeline on the WRR. Though the implementation of six specific objectives, ESR will: • Assist local 988 crisis centers with a quality improvement plan focusing on policies, first contact, assessment, referral, and access to local care to ensure there is a comprehensive and coordinated response to individuals at imminent risk for suicide. • Establish collaborations with states, territories, and local crisis centers to improve effective 988 response and linkage to local resources, including cases of emergency intervention. This will result in 20 individuals referred to ESR for services from the 988 Lifeline. • Provide training for two crisis call center staff per year that specifically addresses the needs of the WRR and tribes in Wyoming. • Develop and implement a plan for sustainability which includes ongoing collaboration with the Wyoming DOH 988 Lifeline team. • Partner with Lifeline 988 crisis centers to identify contacts and provide follow-up • Train peer support specialists and community health workers on suicide prevention and crisis response • Develop a culturally appropriate and culturally responsive curriculum for individuals in crisis The ESR 988 project will continue to work with existing partners, current SAMHSA grants, and the Indian Health Services to offer evidence-based prevention, treatment, and recovery practices to the Eastern Shoshone community.


Grantee: WYOMING STATE DEPARTMENT OF HEALTH
Program: FY 2023 Cooperative Agreements for States and Territories to Improve Local 988 Capacity
City: CHEYENNE
State: WY
Grant Award Number: 1 H79 FG001225-01
Congressional District: At large
FY 2023 Funding: $824,090
Project Period: 2023/09/30 - 2026/09/29

The Wyoming 988 Cooperative Improvement is an opportunity for the two Wyoming lifeline call centers, Central Wyoming Counseling Center and the Wyoming Lifeline, to improve their workforce, protocols, and data collection to meet the demands of 988 calls, chats, and texts. The first priority is to begin accepting chats and texts in Wyoming and bring the in-state answer rate up to 90 percent. The project will strengthen the call centers' capacity for suicide prevention as well as strengthen reporting and communication efforts between the call centers and the Wyoming Department of Health. To achieve the long-term goal of improving access to 988 resources through calls, chats, and texts, originating in Wyoming, the following goals have been outlined: Goal 1: Expand recruitment, hiring, and training of 988 workforce to meet 90% of the state calls, chats, and texts demands by December 31, 2024. Goal 2: Implement additional technology to fully support 988 infrastructure and effective coordination across the crisis continuum by September 29, 2024. Goal 3: Improve 988 support and service for high risk and underserved populations throughout the grant period. Goal 4: Collaborate with 988 centers to enhance referral connections post-988 contact throughout the grant period. Through the development of a sustainability and quality assurance plans following the grant award, Wyoming is hopeful that the collaboration between the State, both lifeline centers, and other partners will strengthen follow-up services, referral resources, and communication, as well as improve data collection.


Center: SM

Grantee: CAMPBELL COUNTY MEMORIAL HOSPITAL
Program: FY 2023 Certified Community Behavioral Health Clinic Planning, Development, and Implementation Grant
City: GILLETTE
State: WY
Grant Award Number: 1 H79 SM089217-01
Congressional District: At large
FY 2023 Funding: $965,123
Project Period: 2023/09/30 - 2027/09/29

The CCH BHS Certified Community Behavioral Health Clinic Planning, Development, and Implementation (CCBHC-PDI) project has been developed to expand behavioral health services in Campbell County, Wyoming. CCH BHS has been providing mental health (MH) and substance use disorder (SUD) services to residents in the area for 35 years. Over the years our services have grown and adapted. It is now necessary to expand further to meet the needs of the community. The population of focus for the CCH BHS CCBHC-PDI project includes individuals across the lifespan in Campbell County, from all demographics, who need behavioral health services. As of July 1, 2022, there were 47,058 individuals living in Campbell County. Based on the National Alliance on Mental Illness’s US statistics, there are approximately 6,870 adults and 1,524 kids between the ages of 6 and 17 adults in Campbell County experiencing mental health (MH) issues. The demographics of Campbell County’s population include: White, not Hispanic 86.9%: Persons in Poverty 8.5%: Hispanic Latino 8.8%; Veterans 6.6%; American Indian and Alaska Native 1.7%; Male 51.1%; Female 48.9%; Asian 0.7%; Disabled under 65 years old 6.9%; Black 0.7%; No Health Insurance under 65 years old 13.0%; Pacific Islander 0.1%; Persons under 18 years of age 27.0%; Multiracial 2.3%; Persons over 65 years of age 12.2%; Per Capita Income $36,568; and 3.3% of the people living in Wyoming identify as lesbian, gay, bisexual, or transgender (LGBT)-9.3% of LGBT Wyoming residents identify as transgender. To align with the population of focus and address disparities in access to MH and SUD services, CCH BHS will expand its services in the following ways: • Expand telemedicine to increase access to crisis care, MH services, and SUD care for individuals who are in crisis or cannot get to appointments. • Implement crisis education programs in the community to decrease suicide rates among all patient demographics. This is essential to the community as Campbell County specifically had a record number of twenty-one suicides in 2022. • Implement MH programming specific to veterans and members of the armed forces. • Implement educational programs about MH and SUDs to decrease stigma and encourage individuals to seek help when they need it. In calendar year 2022 CCH BHS provided 582 in-person crisis assessments and behavioral health services were provided to 2,115 patients. In that same year, Campbell County’s suicide rate was almost triple the national rate and the Health Resources and Services Administration has identified Campbell County as a Health Professional Shortage Area for MH. As it is a rural area, many northeast Wyoming residents encounter barriers to accessing MH and SUD care. Examples of those barriers include provider shortages, longer distances from services, and stigmas about MH and SUD services. The combination of the extensive need for MH and SUD services and the barriers referenced above equates to significant gaps in MH and SUD services in the area. The CCH BHS CCBHC-PDI project will help close some of those gaps and expand the services they provide to the community.


Grantee: EASTERN SHOSHONE TRIBE
Program: Support for 988 Tribal Response Cooperative Agreements
City: FORT WASHAKIE
State: WY
Grant Award Number: 1 H79 SM087586-01
Congressional District: At large
FY 2023 Funding: $250,000
Project Period: 2022/12/31 - 2024/12/30

The Eastern Shoshone 988 Tribal Response program will increase awareness and use of the 988 Lifeline on the Wind River Reservation located in central Wyoming. The program will train at least 20 individuals over the course of two years along with serving the Eastern Shoshone tribal members with an enrollment of 4,368 members. Access to mental health services, substance use treatment and behavioral health therapies is limited on the WRR due to rural location, limited transportation, stigma, digital inequality, and long-wait times. Foundational guidance from needs assessments, quality improvement plans, and linkage to local, state, and national resources are needed. These gaps directly impact tribal members in crisis. Data from the WRR Indian Health Service indicate that 246 individuals were treated at the clinic due to intentional self-harm diagnosis from 2016 - 2020. In 2021 there were 17 deaths by suicide in Fremont County, this was three times greater than the national average. A 2022 WRR community survey reported that the number one health concern was opioid use followed by unresolved trauma. This same survey reported that 22% do not have access to the internet and 19% are not aware of the telehealth services available (like 988), and 9% do not have access to a phone. Tribal members feel that most providers could benefit from cultural competency training. The overall goal of the ESR 988 project is to save lives through the 988 Lifeline on the WRR. Though the implementation of six specific objectives, ESR will: • Complete a tribal readiness or needs assessment and a comprehensive strategic plan based on the most current epidemiological data for the WRR to address the gaps in crisis response services. ESR will utilize SAMSHA’s Tribal Action Planning guidelines as a resource. • Assist local 988 crisis centers with a quality improvement plan focusing on policies, first contact, assessment, referral, and access to local care to ensure there is a comprehensive and coordinated response to individuals at imminent risk for suicide. • Establish collaborations with states, territories, and local crisis centers to improve effective 988 response and linkage to local resources, including cases of emergency intervention. This will result in 20 individuals referred to ESR for services from the 988 Lifeline. • Provide training for 10 crisis call center staff per year that specifically addresses the needs of the WRR and tribes in Wyoming. • Will develop and implement a plan for sustainability which includes ongoing collaboration with the Wyoming DOH 988 Lifeline team. • Will create a tribal specific community resource from the Path to Wellness App that links to Lifeline 988 crisis centers. The ESR 988 project will continue to work with existing partners, current SAMHSA grants, and the Indian Health Services to offer evidence-based prevention, treatment, and recovery practices to the Eastern Shoshone community


Grantee: EASTERN SHOSHONE TRIBE
Program: Cooperative Agreements for Tribal Behavioral Health
City: FORT WASHAKIE
State: WY
Grant Award Number: 5 H79 SM082670-04
Congressional District: At large
FY 2023 Funding: $250,000
Project Period: 2020/07/31 - 2025/07/30

Grantee: NORTHERN ARAPAHO TRIBE
Program: FY 2023 Tribal Behavioral Health
City: FORT WASHAKIE
State: WY
Grant Award Number: 1 H79 SM088769-01
Congressional District: At large
FY 2023 Funding: $250,000
Project Period: 2023/09/30 - 2028/09/29

The Northern Arapaho Tribe seeks the FY2023 Tribal Behavioral Health Short Title: Native Connections (Standing Funding Announcement) for Hinono’eino’ Heetoxnenii3i’ Cee’kohei3i’- Arapaho Families Rising, The Healing Village within the Traditional Practices to Wellness Office of the Wind River Family and Community Healthcare System (WRFCHCS), Northern Arapaho Tribe proposes to enhance Traditional Practices to Wellness Office intergenerational family wellness focused group work. Hinono’eino’ Heetoxnenii3i’ Cee’kohei3i’ and The Healing Village will strengthen tribal youth members Arapaho (Hinono’ei) identity and resilience against suicide and substance misuse in an integrated public health model approach to improve behavioral health disparities and lay the foundations for a coordinated network of health professionals, tribal programs, and community partners such as law enforcement, hospitals, and court systems serving tribal youth. Through a community needs assessment and community readiness assessment and leadership support, a tribal strategic action plan for universal prevention, selective and targeted prevention, and indicated prevention strategies and postvention protocols. The Traditional Practices to Wellness Office within WRFCHCS will coordinate all service providers around culture and language and strong connection to tribal elders, Beesneeniteeno (old people) to increase cultural humility, healing and braid traditional practices to wellness with evidence based practices. The Wind River Family and Community Health Care System is the Public Health Authority of the Northern Arapaho Tribe and the provider of direct health care services through an Indian Self-Determination and Education Act contract with the Indian Health Care Services. The Traditional Practices to Wellness Office at WRFCHCS will partner with all the WRFCHCS service providers and with the other tribal programs of the Northern Arapaho Tribe including the Northern Arapaho Language and Cultural Commission, whose members will also serve on the Advisory Council. The behavioral health disparities faced by the Northern Arapaho Tribe are significant, higher that national figures and highest in the State of Wyoming. The Wind River Indian Reservation (WRIR), home to the Northern Arapaho Tribe, has the lowest average of death in all of Indian Country at age 53. Those who abuse drugs and alcohol die even younger with an average age of death of 32 despite the WRIR having the lowest consumption of alcohol in the state of Wyoming. Adverse Childhood Experiences (ACE) scores rank at the top end of the scale due to this mortality and the trauma of early death within families and the reason those deaths occur. Trauma is a major cause of addiction and substance misuse as is the poverty found at Wind River where the health disparities of diabetes, heart disease, stroke and cancer strike down those who do not die due to the injuries that are a major cause of death (homicide, suicide, and substance involved motor vehicle crashes.) Research has shown that Tribal practices that build resiliency and connections American Indians to community, family, and culture, can over time, reduce risk factors for suicide and substance misuse. However, many youth for whom alcohol/drugs has become their culture are unfamiliar with who they really are. Many others have lost family over time who did not or could not convey the strength and healing that our culture, language and traditions contain. This Tribal Practices approach provides for shared knowledge between western providers of health care and traditional and ceremonial Elders. Through consultation, peer group, family heritage and language learning activities, they will connect cultural teachings to health, resilience, strengthen cultural connectedness, wellbeing, and enable intergenerational learning that supports wellbeing and resilience. $250,000 per year is being requested for a five-year program total of $1,250,000.


Grantee: SOUTHWEST COUNSELING SERVICE
Program: FY 2022 Certified Community Behavioral Health Clinic
City: ROCK SPRINGS
State: WY
Grant Award Number: 5 H79 SM086583-02
Congressional District: At large
FY 2023 Funding: $1,000,000
Project Period: 2022/09/30 - 2026/09/29

Grantee: UNIVERSITY OF WYOMING
Program: Mental Health Awareness Training Grants
City: LARAMIE
State: WY
Grant Award Number: 5 H79 SM084423-03
Congressional District: At large
FY 2023 Funding: $124,894
Project Period: 2021/09/30 - 2026/09/29

Grantee: UPLIFT
Program: Statewide Family Network Program
City: CHEYENNE
State: WY
Grant Award Number: 5 H79 SM086274-02
Congressional District: At large
FY 2023 Funding: $120,000
Project Period: 2022/09/30 - 2025/09/29

Grantee: WYOMING STATE DEPARTMENT OF EDUCATION
Program: Cooperative Agreements for School Based Trauma-Informed Support Services and Mental Health Care for Children and Youth
City: CHEYENNE
State: WY
Grant Award Number: 1 H79 SM087189-01
Congressional District: At large
FY 2023 Funding: $1,940,000
Project Period: 2022/12/31 - 2026/12/30

Wyoming Trauma-Informed Services in Schools will partner with two LEAs (Sweetwater County School District #1 and Sweetwater County School District #2) and one Behavioral Health Partner (Wyoming Behavioral Institute) to deliver trauma-informed services primarily within the student population aiming to serve 300 unique students annually. The 300 student estimate is based on 4% of the total student population of the districts of approximately 7500 students. Tier 1 services will not be counted unless SAMHSA requests this counting. There will be processes developed that will impact the entire student population.


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