TOR strategic plan ppt

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Kauffman & Associates, Inc.
Dr. Iris PrettyPaint
Lead Facilitator
January 4, 2018

Table of Contents

• Background and context
• Workshop participants
• Current reality
• SWOT analysis
• Vision themes
• Strategic pillar themes
• Strategic outcome themes
• Lessons learned

Background and Context

  • In FY18, the Substance Abuse and Mental Health Administration (SAMHSA), through the Department of Health and Human Services, funded the Montana State University’s (MSU) Rural Opioids Technical Assistance Grants (ROTA).  
  • MSU partnered with Kuaffman and Associates Inc. to conduct 2-day strategic planning workshops with participating Tribal Opioid Response (TOR) grant recipients.
  • TOR grant recipients are dedicated to addressing the opioid crisis in tribal communities by
    increasing access to culturally appropriate and evidence-based treatment, including medication-assisted treatment (MAT).
  • The goal of the program is to reduce the unmet treatment need and opioid overdose-related deaths through prevention, treatment, and/or recovery activities for opioid use disorder (OUD). 

2-Day Strategic Planning Workshops

Kauffman and Associates Inc. conducted four TOR strategic action planning workshops


Tribe Location Key Point of Contact Participants
Crow Tribe Crow Agency, MT
October 16–17, 2018
Peter Big Hair and
Dayle Felicia 
Chippewa Cree
Rocky Boy, MT
October 23–24, 2018
Jessica Windy Boy  26
Salish and
Kootenai Tribes
St. Ignatius, MT
November 8–9, 2018
Brandy Couture
Patricia Buffalo
Blackfeet Tribe  Browning, MT
November 13–14, 2018
Louella Heavy
Total participants      100


Workshop Participant Profiles

Participant Organizations Participant Titles 

• Treatment and recovery centers
• Tribal councils
• Tribal courts
• Tribal police departments
• Faith organizations
• Community members
• Tribal health departments
• Tribal colleges
• Bureau of Indian Affairs
• Tribal social services
• Public schools (Pre-K–12)
• County health departments
• Radio stations
• Tribal housing departments 

• Licensed addiction counselors
• Medical doctors
• Clinical pharmacists
• Tribal health directors
• Police chiefs
• Elders
• Program managers
• Spiritual advisors
• Cultural advisors
• Tribal councilmen
• Social advocates
• Tribal court judges
• Head start teachers
• K–12 administrators
• Recovering addicts

TOR Current Reality Overview*

•Low community awareness of available treatment options
• High rates of substance use by high school students
• Pregnant women testing positive for opioid use
• Newborns show signs of neonatal abstinence syndrome
• Grandparents caring for grandchildren
• Limited treatment options that integrate culture-based practices
• Limited available housing for individuals and their families in recovery

*As reported during TOR strategic planning workshops by participants

SWOT Analysis Overview

Internal Strengths



External Opportunities External Threats
• Family and cultural values
• Cultural awareness and benefits of traditional practices
• Ceremonies, religion, spirituality, and prayer
• Behavioral health services
• Health educators
• Community role models and mentors
• Community coalitions, including neighborhood watch,    and community policing
• Drug diversion
• Law enforcement resources
• Tribal laws and codes
• Support groups for family and individuals in recovery
• Available recovery housing
• IHS communication related to protocols for pain management
• Education about OUD
• Loss of cultural identity among youth 
• Existing community
resources, including
community services and
• Community educational
• Behavioral health
• College substance use
disorder classes
• 24-hour drug treatment
• Medicaid billing
• Ongoing drug trends
• Limited available data
• High department staff
• Political micro-management of
• Loss of culture/language
• Acceptance of dysfunction
• Territorialism
• Budgetary uncertainty
• Denial of mental illness

Vision Themes

Overarching Themes:

healing, treatment, outreach,family, culture, and safety

Notable Quotes

• “To see our families turn to our culture and begin to heal”
• “Offering treatment through culturally informed approaches”
• “Offering outreach support to families”
• “To see our community work together”
• “To create safe environments for our families”

Strategic Pillar Themes

Develop evidence-based OUD treatment and recovery approaches
• Increase OUD treatment and recovery service capacity
• Integrate culture-based practices into treatment and recovery care models
• Create OUD education for community, students, and leadership
• Develop data collection processes
• Develop MAT clinic service capacity
• Increase housing accessibility for individuals in recovery

Strategic Outcome Themes

Targeted OUD education campaign for the general population
• Inventory of community program services related to healing and recovery support
• Available housing for those in recovery
• Data collection plans across community programs
• Increase MAT clinic participation levels and services offered
• Expanded in-patient and out-patient treatment capacity
• Regular workforce development training related to OUD

Lessons Learned

  • Tribes need authoritative information about
    evidence-based prevention, treatment, and
    recovery services for opioid use disorders
  • Tribes need guidance for local governments,
    advocacy organizations, nonprofits,
    providers, state agencies, and others
    involved in resolving critical, controversial
    matters regarding opioid abuse treatment.
  • Tribal communities need to develop
    community-wide education approaches at
    their level of community readiness for OUD
    treatment and prevention.
  • Tribes need intense technical assistance for
    grant needs assessments, data collection,
    and implementation.