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American Indian Health & Services (AIHS), a California non-profit corporation, is proposed to engage in a comprehensive planning effort – Circles of Care -- to address prevention and treatment of mental illness and substance use among Native American/Alaskan Native (AI/AN) youth residing in Santa Barbara and surrounding communities. The populations of focus are AI/AN children and their families that reside in coastal Santa Barbara and Ventura Counties, which is approximately 100 miles northwest of Los Angeles. AIHS is the only behavioral health and medical resource with a Native focus available for the 8,965 AI/AN residents of Santa Barbara, including those in combination with one or more races. In neighboring Ventura County to the south, from which AIHS also draws clients and conducts outreach, there are an additional 15,253 AI/AN residents. Our goal is to expand the range and depth of services provided to children with mental health and co-occurring substance use needs within an integrated and comprehensive system of care. We anticipate that this will be achieved through enhanced cooperation of local county government and for-profit and nonprofit agencies. Measurable objectives include conducting multiple, diverse assessments on community readiness, unmet mental health needs for children, youth and their families, as well as the potential for partnerships, maximization of resources, and solutions that enhance community wellness/mental health; developing a comprehensive blueprint in response to the community needs assessment that includes a comprehensive plan for addressing unmet needs and gaps in mental health services for children, youth and their families; and developing a short- and long-term plan for sustainability based on programmatic and service elements identified in the blueprint, ensuring that AI/AN children and their families benefit from community endorsed services expansion that addresses the most critical needs for mental health treatment. The goals and objectives are designed to create a community-wide infrastructure that will ensure short- and long-term sustainability. AIHS staff observe children and youth that are experiencing factors that place them at risk for trauma that produce a range of mental health issues, including prenatal exposure to alcohol and/or illicit drugs; physical and/or sexual abuse; gross neglect; trauma resulting from domestic, street, and/or gang violence; and being at-risk for removal from their home or from a public school setting. A centerpiece of this initiative is a thorough community needs assessment, which includes a snapshot of the current system of care that is in place and the gaps that need to be closed, which will be followed by a plan to address each of them. Through planning and blueprint design, and sharing of data with non-Native agencies and stakeholders, there will be agreement that the problems we have documented are addressable. Activities will be implemented by a team that will be formed and headed by the Project Director. Team members will bring skills that include knowledge of the AI/AN community as well as a range of lived and academic education that will ensure that they implement the project’s goals and objectives.

ABSTRACT Project Name Circles of Care VII Demographics/Clinical Characteristics The Yakama Nation is a federally recognized tribe with a reservation consisting of 1,130,000 acres in southwestern Washington. The reservation is located within the Yakima County and part of Klickitat County. There are four rural communities located within the reservation boundaries; Toppenish, Wapato, White Swan, and Harrah. Services are also provided to five communities bordering the Yakama Nation reservation; Yakima, Granger, Zillah, Goldendale, and Glenwood. There is a huge gap of between the need for mental health services and the availability and coordination of mental health, substance abuse use, and co-occurring disorders on the Yakama Reservation for children, youth, and young adults from birth through the age of 25 and their families. There is also a high rate of alcohol and drug abuse within the Native American community. Strategies/Interventions The Yakama Nation Behavioral Health will collect to capture reorganization, restructuring or turnaround of negative conditions. Measurable indicators are obtain from: 1) review of budget expenditures i.e. number of new staff hired, expansion of physical sites, etc. 2) As reported by the PD and project coordinator in the weekly data collection meetings the number of new policies developed or revisions of current policies, number of new partnerships developed or expansion of activities with current partners including the number of data sharing agreements drafted, signed, executed, 3) staff and client assessment / satisfaction survey. Goals/Measurable Objectives It is the Yakama Nation Behavioral Health’s goal to increase the capacity and effectiveness of mental health systems serving Yakama members and other AI/AN on the Yakama Reservation. Number of People Served Annually or Project Lifetime Yakama Nation Behavioral Health program provides services to all Native American and/or Native American descendants. Services are not limited to Native American and/or Native American descendants residing on the Yakama Nation reservations. According to the Yakama Nation Indian Health Services, there were a total of 12,485 patients in fiscal year 2015. This number includes 6,897 patients identified as Yakama Nation enrolled members, 3,005 patients were identified as Yakama Nation descendants, and 2,583 identified as Native American and/or Native American descendants from different federally recognized tribes. Indian Health Services estimated that 8,839 of the patient population reside on the reservation and 4,075 reside outside the reservation boundaries.

ABSTRACT Circle of Life’s Circles of Care Grant Project (COL CoC) will strategically plan and design a comprehensive, integrated, and community driven cross systems collaboration of care to support and promote the mental health and wellness of the 8 Northern Indian Pueblo Youth and Families of New Mexico. Goal #1 of COL CoC is to develop Task Forces of Tribal Members to provide a “community voice”. The Task Forces will include: Children, Adolescents, Transitional Aged Youth, Parents, and Caregivers along with: Tribal Service Providers, Leadership, and Stakeholders. Group input will be gathered through Tribal traditional and innovative, solution-based processes. Goal #2 is for Task Forces to develop and utilize: a Resource Asset Map, Community Needs Assessment, and Community Readiness Assessment to identify community issues and trends. Goal #3 is to develop a Social Media and/or a Community Education Plan to promote COL CoC’s objectives. Goal #4 is to identify and review existing policies to formulate new policies and/or ordinances to promote mental health and wellness for Tribal Youth and Families. COL CoC is proposing a minimum of 80 Community Members be involved in the Task Forces: Meetings, Summits, Forums, and Roundtables. COL CoC is also proposing a minimum of 24 Stakeholders receive training in mental health related best practices. COL CoC also proposes: a minimum of: 8 MOAs, 4 Strategies, and 4 Policies/Procedures/Processes be developed. COL CoC will promote mental health and wellness for Tribal Youth and Families through a series of Forums about the impact of Historical Trauma to promote finding a “path” that leads the Tribal Community to healing and wellness. COL CoC Grant Team will also coordinate a series of Summits for Tribal Youth and Families where the Youth Task Force (YTF) and Family Task Force (FTF) will process the information gathered in the Community Resource Asset Map, Community Readiness Assessment, and Community Assessment to develop priorities to promote wellness. COL CoC Grant Team, with YTF and FTF, will gain an understanding of Cultural and evidence based practices to promote wellness. A Tribal Leader Task Force (TLTF) will also form to represent Tribal Leadership, Service Providers, and Stakeholders to support YTF and FTF. Groups will meet regularly to engineer a “System” reflecting the 3 Task Force’s recommendations to better address the Tribal Youth and Family’s mental health and substance abuse issues in the 8 Northern Indian Pueblos. COL CoC’s approach will include a review of the current policies, programs, and procedures regarding Tribal Youth and Family wellness to strategically plan and coordinate services for efficient utilization of Tribal community resources and Cultural approaches. COL CoC’s collaborative approach will mirror the current collaborative leadership of Eight Northern Indian Pueblo Councils (ENIPC) to lay the foundation of a strategic plan for future program development. COL CoC’s 3 Task Forces will provide input supporting policy development and Cultural Logic Model work, outlining the implementation of a culturally and linguistically appropriate approaches, following CLAS principal standards towards Youth and Family wellness.

The FPST Circles of Care (COC) will provide the FPST community as well as the communities of the Lovelock Paiute Tribe and the Yomba Shoshone Tribe with tools and resources to plan and design a holistic, community-based, coordinated system of care approach to support mental health and wellness for children, youth, and young adults from birth through age 25 and their families. The COC project will focus on the need to reduce the gap between the need for mental health services and the availability and coordination of mental health, substance use, and co- occurring disorders. The project will promote and facilitate youth, families, community members and tribal leaders to be involved, participate and have a voice in the planning and development of a system of care model. COC will also focus on resources to reducing the impact of substance abuse and mental illness on American communities and address the behavioral health impacts of trauma and provide opportunities for the Fallon, Lovelock and Yomba tribal communities to support youth and young adults as they transition to adulthood by facilitating collaboration between child and adult serving agencies. The COC project will also participate in the development of a Tribal Action Plan, promote tribal program collaborations and cross-agency collaborations, and develop policies, procedures, and other infrastructures that will result in system-wide improvements and support implementation of the system of care model such as, standards of care for child/youth mental health services and supports. Trainings include a Gathering of Native Americans (GONA) will serve as a “kick-start” for community participation, in addition to coordinating Systems of Care trainings for community members, youth and families and for workforce development. Additional community and workforce development trainings will focus on increasing awareness of child/youth mental health and wellness issues, the need for a coordinated approach to services, and promote increased access to mental health and wellness supports and services through a system of care approach.

The Spotted Bull Recovery Resource Center (SBRRC) Circles of Care Project will plan and design a holistic, community-based system of care approach designed to support the mental health and wellness of children, youth, and families on the Fort Peck Indian Reservation. Project Name: Spotted Bull Recovery Resource Center Circles of Care Project Population to Be Served: The population to be served by the SBRRC Circles of Care Project will be Native American children, youth, and young adults (ages birth to 25) and their families, on the Fort Peck Indian Reservation. Strategies/interventions, project goals and measurable objectives: SBRRC Circles of Care Project’s goal is “to plan and design a holistic, community-based system of care approach designed to support the mental health and wellness of children, youth, and families on the Fort Peck Indian Reservation.” To accomplish this goal, the following measurable objectives will be met: Objective 1 - Catalyst for Change: During the project period of September 30, 2017 through September 29, 2020, SBRRC will serve as a catalyst for multi-agency systematic change through local capacity building designed to improve coordinated mental health treatment and wellness services to children, youth, and families on the Fort Peck Indian Reservation. The completion of Objective 1 – Catalyst for Change will be evidenced by one (1) set of revised policies and procedures, one (1) completed community needs assessment report, one (1) completed community readiness assessment report, one (1) community resource/asset map, one (1) system of care “blueprint,” six (6) signed MOUs, twenty (20) project and agency staff receiving six (6) capacity building training, project records, sign-in sheets, meeting minutes, and evaluation results. Objective 2 - Community Based Planning – During the same project period, the SBRRC Circles of Care Project will actively engage at least 405 community members in all aspects of the project including the planning process for overall systemic change and evaluation activities. The completion of Objective 2 – Community Based Planning will be evidenced by twelve (12) town hall meeting sign-in sheets per year with at least twelve (12) community members attending each meeting, one (1) community-based social marketing plan, nine (9) training sessions held with at least five (5) community members attending, meeting minutes, project records, and evaluation results.

According to a 2010 report by the State of Kansas, which ranked all counties in the state according to eight federal risk categories, Brown County, where the Kickapoo Tribe in Kansas (KTIK) reservation is located, was classified as a “high-risk community” and ranked in the lowest quartile for poverty, crime, domestic violence, high-school drop-out rate, and substance abuse. Of the more than 1,600 enrolled KTIK members, over 60% are children and youth, who will in turn become tomorrow’s community elders. Building strong supports for children and their families is critical to the continued health and success of the Kickapoo community. Nationally, Native American communities face substantial mental health inequities and challenges. Such challenges include higher rates of suicide, serious psychological distress, hopelessness, worthlessness, and substance abuse-related behavioral health issues. While behavioral health data is limited on the KTIK community, a community health assessment was conducted with KTIK community stakeholders in 2014, where respondents noted that primary health concerns included among other concerns: depression/anxiety, suicide, and posttraumatic stress disorder. Though some programs and services currently exist in the community to help address these concerns and support community members, access issues included loss of transportation, lack of trust in service providers, and the absence of a cohesive infrastructure to pull all wellness programs and supports for children and families together have, reduced effectiveness and efficiencies in community programs. The Kickapoo Tribe in Kansas (KTIK) proposes the “Kickapoo Circle of Care” to help build a Kickapoo Child and Family Programs infrastructure. The goals of this three-year project are to: 1) Develop and strengthen a system of behavioral health and wellness care for Kickapoo children and families; 2) Improve availability and accessibility of behavioral health and wellness programs in the Kickapoo community; and 3) Engage community leaders and members in building strong connections to promote Kickapoo culture and tradition.

Maniilaq Association is applying for funding under the FY17 Circles of Care Funding Opportunity Announcement, with the intent of using an award to improve community mental health care infrastructure in Northwest Alaska. This will be accomplished by developing a community-based Qargi model, which will improve service delivery via increased collaboration within and among the twelve federally recognized Tribal villages of the Maniilaq Service Area. Qargi is an Inupiaq word meaning ‘community house.’ Traditionally, the Inupiat inhabitants of this region had a Qargi in each community where people would gather to celebrate, share skills and wisdom with younger generations, and meet to deal with difficulties or crises which had to be resolved in their villages. Importantly, this model also focuses on community-health system partnerships that integrate local voices, priorities, and values into services available to tribal communities and stakeholders. The Qargi concept is the very embodiment of tribal self-determination, centered on a sense of unity and working together to solve problems before they become unmanageable. Maniilaq Association proposes to use this model as an organizing principle in developing a more inclusive, collaborative, and community-based mental health care system. Funding awarded under this proposal will support the expansion of village-based, Native-led wellness and health education programming, and the development of a collaborative care model to integrate behavioral health and general medical services across the region. Village Qargi meetings will build communities of practice and create local platforms for health and mental health workers, community members, and families to address mental health disparities through collaborative planning, health education, and community mobilization. This will expand upon existing village infrastructure established under the PC CARES (Promoting Community Conversations About Research to End Suicide) Program, a successful model in our region in which monthly learning circles are facilitated by community leaders in each of the villages of the Maniilaq service area. These learning circles combine region-based research evidence with local knowledge to support suicide prevention at the community level through culturally appropriate strategies. The University of Massachusetts-Amherst School of Public Health and Health Sciences will participate in program improvements by adapting the PC CARES framework for a broader range of mental health-oriented Qargi meetings. The Qargi model in the health and social service systems will involve the establishment of a division of social medicine at Maniilaq Association and the expansion of an interdepartmental committee to integrate mental health, primary care, and village clinic services. The new division will be led by community health workers, primary care providers, and mental health workers, and will be tasked with innovating mental health policy and protocols through an incorporation of social medicine perspectives into primary and mental health care delivery. The committee will build a collaborative care model to integrate mental health services on village and regional levels, and to coordinate with medical staff to ensure continuity and effective coordination of mental health care. The efforts funded by this grant will enable Maniilaq Association to reduce the gap between available and needed services, resulting in an improved system of care which helps children, youth, and families function better at home, in school, and in their communities. With previous SAMHSA support, Maniilaq Association has made significant strides in addressing the mental health and substance abuse treatment needs of this region’s residents. This FY17 Circles of Care support will enable Maniilaq Association to build on nearly twenty years of collaboration between researchers, behavioral health practitioners, and the Alaska Native villages of Northwest Alaska.

Native American Community Health Center, Inc. (NATIVE HEALTH) will collaborate with community partner agencies and individuals to facilitate a program to determine the mental health service needs and initiate a response as appropriate to American Indian children, youth (including young adults) and families residing in Maricopa County, Arizona. The three year project will increase capacity for American Indian & Alaskan Native targeted behavioral health services. The program will also endeavor to improve service provision to be culturally responsive to the unique needs and traditions of American Indians. NATIVE HEALTH will form a Community Advisory Board to assess the county’s gaps for services, resources available and cultural relevance to the local American Indian/Alaska Native population. Urban Indians at present do not have adequate, culturally relevant services available for numerous emotional and psychiatric concerns. Services with cognizance for the special aspects of the American Indian condition including recognition of historical trauma and ongoing oppression continue as limited. The project will address the mental health care at numerous levels including policy reform, infrastructure development and community engagement based upon the system of care principles, and trauma informed care. The project will engage a wide range of American Indians through all aspects of the proposed and required activities. The project will place an emphasis on a community based system that is guided by American Indian families, inclusive of youth perspectives to assure relevance to the American Indian youth experience consciences of cultural and linguistic perspectives. Project Name: NATIVE HEALTH Circles of Care Project Population to be served: The program will target network expansion to serve urban dwelling American Indian/Alaska Native (AI/AN) Children, Youth, Young Adults and affected Families that reside in Maricopa County, Arizona. Maricopa County has a population of approximately 33,265 AI/AN residents that are 25 and younger. Strategies/interventions: The program will assemble an Community Advisory Board, facilitate a Community Needs Assessment relative to behavioral health needs and gaps for services, facilitate a community readiness and resource/asset mapping through key informant interviews and focus groups, facilitate Strategic Planning to address programmatic needs and implement activities to Expand and Culturally Enhance local Behavioral Health Services, utilizing a focus group setting for capacity building and system strengthening. The program will engage youth in assessments for acculturation and development of youth-led media campaign. The media campaign will provide graphic material for the Marketing & Social Media Plan and Campaign. The agency will utilize a community based participatory research methodology in evaluation and system development. The final output of the proposal will be a blue print of a system of care model that includes an implementation plan for feasibility and sustainability. Project Goal: NATIVE HEALTH will design, develop and implement a system of care model that is based on the needs of the community, resulting in the development of a ‘blue print’ for a system of care model that meets the needs of the Maricopa County urban Indian community.

The Sacramento Native American Health Center, Inc. (SNAHC) seeks funding for a Sacramento Circles of Care Project to plan and build infrastructure to implement a system of care model for mental health disparities in urban American Indian/Alaska Native (AI/AN) youth, birth to 25 and their families living in Sacramento County. SNAHC is located in the City of Sacramento, California and plays a major role as a part of the “safety net” in the Sacramento Area. SNAHC provides primary care services to medically underserved communities residing in Sacramento, County and the organizational purpose is committed to the legacy of a healthy AI/AN community based on cultural values delivered through a traditional, innovative and accessible patient-centered health home. SNAHC’s goal is to develop the infrastructure necessary to implement a holistic, comprehensive, coordinated behavioral health system of care for urban American Indian/Alaska Native (AI/AN) children and youth, 0-25, and their families living in Sacramento, County. These objectives and activities include: Objective 1: Create a culturally relevant integrative system of care with youth, adults, respected elders, agencies, and providers in Sacramento County. Activity 1: Engage AI/AN Families and Community Members Activity 2: Engage AI/AN Youth Activity 3: Engage Multi-Agency Partners Objective 2: Develop a community-based blueprint/system of care model, for how AI/AN children/youth Mental Health and Wellness services and supports will be provided in Sacramento, County. Activity 1: Complete a Community Needs Assessment, Community Readiness Assessment and Community Resource/Asset Map Activity 2: Develop Sacramento System of Care Blueprint Objective 3: Actively build a culture of learning to support goals of system change. Activity 1: Build knowledge of system of care, family-driven and youth-guided care, and community-based participatory evaluation. Activity 2: Develop Circles of Care Toolkit & conduct community engaged evaluation. Objective 4: Increase awareness of child/youth mental health and wellness issues through social marketing. Activity 1: Develop and implement community-based social marketing and public education plan. SNAHC will build collaboration between families, youth, and system partners that addresses the current local need for increased capacity, efficiency, sustainability, and culturally-appropriate behavioral health delivery system. The purpose of this project is to bring the Sacramento urban American Indian community together to plan and perform an in-depth gap analysis of the systems of care impacting the mental health and wellness of American Indian children and their families.

San Diego American Indian Health Center Department of Health and Human Services SAMHSA Circles of Care VI FOA No. SM-17-002 Project Abstract The San Diego Circles of Care Planning Project, proposed by the San Diego American Indian Health Center (SDAIHC), will develop a comprehensive, quality, culturally respectful system of care (SOC) that responds to the mental health needs of American Indian and Alaska Native (AI/AN) youth birth to 25 and their families of the San Diego metropolitan area. The community-owned, youth-guided, and family-driven process will result in a model of care that promotes health and wellness. The proposed project will serve urban Indians, a population that has been described as “invisible” because it is not affiliated with a single Tribe, reservation, or cultural tradition. Yet there are an estimated 29,782 AI/AN residents within the SDAIHC service area. This population is characterized by a lower than average age, socioeconomic status, and level of educational achievement. Youth among this population struggle with intergenerational trauma, chronic grief, substance abuse, domestic violence, child abuse, and other issues that illustrate a critical need for appropriate mental health services. SDAIHC proposes to implement strategies that will achieve four underlying goals, each with measurable outcomes. Goal #1: Engage the local Native community to guide the project. Goal #2: Conduct community-wide training on mental health and Systems of Care. Goal #3: Complete a Community Needs and Service System Assessment. Goal #4: Develop a Service System model that meets the needs of youth and families and is feasible to implement within the San Diego service system. Through a community-based participatory program model, using the Gathering of Native Americans (GONA) as a strategic planning framework, SDAIHC will support the San Diego Native Community in building a System of Care for AI/AN youth and their families. Through coordination and support of a Youth Council and Community Advisory Board, consumer youth and their families will guide the development of a needs and service system assessment and will support many aspects of the work. The Needs and Service System Assessment will provide data and new knowledge to support the community in developing an SOC model that meets the needs of their local youth and families. Through training and capacity building, the project will empower youth and community advisors to support local education and advocacy for the System of Care, test the feasibility, and prepare for implementation. Digital Storytelling Workshops will support youth-friendly methods for telling the local story and will guide their social marketing campaign. Ongoing trainings for the community and providers will support the development of a culturally competent mental health workforce that is trauma-informed and prepared for the SOC. Through advocacy, training, and education SDAIHC will work to formalize agreements with the County of San Diego and area organizations and make necessary policy changes to support implementation of a comprehensive, quality, integrated, and holistic SOC for San Diego’s Native youth and families in 2017. We believe that this Circles of Care initiative will result in meaningful engagement; increased hope, community connections, and ethnic identity among participants; strong system partners, and a clear plan for implementing a System of Care for our community.

Project Name: Honoring our Children and Families Population served: Native Americans in Lassen County, California ages 0-25 and their families. We will serve a minimum of 30 households the first year, 40 households the second, and 50 households the last year for a total of at least 50 households over the grant cycle. Vision: A community that honors its children by making a commitment to assure all children reach their full potential in a nurturing, health, family environment. Project Goal: Design a holistic, community based, coordinated system of care to support mental health and wellness for children, youth, and families ages 0 – 25 years. Objective 1 Engage the community as partners by identifying at least 4 community partners and establishing a monthly focus group to discuss and collaborate on our missions. Objective 2 Develop a system of care that is family driven, strengths based, and builds upon assets and resources within the community by building and implementing a variety of programming. Success will be measured by participation rates in the proposed activities. We anticipate serving at least 30 families in the first year, and increasing by 10 additional families each subsequent year. Objective 3 Create at least 3 opportunities to train community members to deliver services by the end of the grant period. The Susanville Indian Rancheria Lassen Indian Health Center will develop a system of care that offers prevention, promotion, treatment, and recovery services that is consumer driven, family focused, evidence and strengths based, and culturally focused for children, youth, and families ages 0-25. We will strive to reduce social stigma, embrace a wellness model, and communicate that recovery is possible.

The Toiyabe Circles of Care Project (Toiyabe CoC), led by Toiyabe Indian Health Project, Inc. (Toiyabe), will design a Native American-guided, family driven, consumer youth-informed mental and behavioral health system of care for the children and youth (birth - 25) of seven tribes and two tribal communities in remote Inyo and Mono Counties, California. Strategies include: Talking Circles, consumer satisfaction, and mental health perception surveys. Project Goals: Working alongside a collaborative of 31 Native Americans (e.g., Red Horse Nation therapist, Fatherhood is Sacred director, RAVE coordinator, sweat lodge leaders, consumer youth, young adults with lived experience, etc.) and 12 child-serving agency representatives (e.g., judges, Sheriff, probation, Child Protective Services, Re-Entry Coordinator for Inmates, school liaisons, medical providers, etc.), the Toiyabe CoC will be a catalyst of systemic change through policy reform and mental health infrastructure development guided by community-based and culturally relevant planning processes and through the engagement of consumer youth and family members. Strategies: As a planning and development grant, no participants receive services. However, a minimum of 240 Native Americans will be involved in Talking Circles, key informant interviews, consumer satisfaction surveys, Native American mental health perception surveys, collaborative work groups for needs assessment, community readiness assessment, resource/asset map, Blueprint, implementation plan, and feasibility study efforts. The Toiyabe CoC Public Education Plan will invite tribal mental health consumers and those with lived experience to share their stories face to face, in groups, and on social media to raise awareness of the need for a new system of service provision, and to spotlight positive stories of recovery among youth and families. The language, content, tone, faces, and voices of the Public Education Plan will be grounded in local tribal culture. Collaborative work groups will design the Outcome Measurement Plan based on extensive community input from tribal communities about what criteria they prefer to use to measure the success of proposed services (e.g., which measures indicate increased mental well-being of tribal children/youth and enhanced stability of tribal families, what measures reflect authentic cultural competency within Toiyabe CoC system provider services, etc.). To implement the Mental Health Systems of Care Blueprint, the Toiyabe CoC Collaborative will establish work groups, including Native American and consumer members, to develop policies, procedures, and other infrastructure needs as follows: 1) standards of care for child/youth mental health services and supports; 2) credentialing, licensure, core training requirements, and accreditation requirements; 3) the role of local traditional healing/helping practices in supporting children, youth, and families; 4) the role of western/clinical mental health practices for children, youth, and families; and 5) support of ongoing family and youth leadership and involvement. Memoranda of Agreement will document Native and non-Native partner commitments to long-term, collaborative care for mental health.

The Winnebago Tribe of Nebraska will take a leadership role to work with several project partners in Sioux City, Iowa to plan and develop a working system of care model for Native American children, youth, and their families that face behavioral health access and coordination of service gaps and barriers. Approximately 20% of the Native American population in Sioux City are Winnebago Tribal members. This group of individuals and families are challenged in working through a complex system of care that is cumbersome and challenging in the best of circumstances. The Four Directions Circle of Care Project will engage Native American children, youth, and their families from Sioux City in assisting in the development of workable solutions that will increase the capacity and effectiveness of mental health systems serving the Native American community in Sioux City, IA. We will focus on addressing the need to reduce identified gaps, barriers, and challenges for mental health services and the availability and coordination of mental health, substance use, and co-occurring disorders for children, youth, and young adults from birth through age 25 and their families that will lead to wellness. The Tribe requests $643,914 over a three year period from the U.S. Health and Human Services Substance Abuse and Mental Health Services Administration under the Planning and Developing Infrastructure to Improve the Mental Health and Wellness of Children, Youth and Families in American Indian/Alaska Natives (AI/AN) Communities, also known as Circles of Care VII funding opportunity announcement. The services and products developed which is planned to include a fully developed “blueprint” including policies and procedures that service providers have a voice in developing to assure the identified needs are met. Trainings for service providers and others from the project will be supported and complimented by two current SAMHSA grants awarded to the tribe to minimize training costs to the project and to facilitate smooth transition of services for tribal members that move between Sioux City and the Winnebago Reservation.