1. Background and History of the Circles of Care Initiative Jill Erickson, MSW CMHS Project Officer

2. CIRCLES OF CARE III SM 05-008 Tribal Infrastructure Grants for Transforming Behavioral Health Systems for American Indian and Alaska Native (AI/AN) Children and their Families Standard Grant Announcement, Infrastructure Grants-INF 05 PA

4. New Freedom Commission: Transforming Mental Health Care in America Americans understand that MH care is essential for all overall health MH is consumer and family driven Disparities in MH care are eliminated, cultural and rural/remote Early MH screening, assessment and referral: common practice Excellent MH care is delivered and research is accelerated Technology is used to access MH care and information.

5. Goals, Circles of Care To develop system of care models designed by AI/AN community members, in partnership with program and evaluation staff. To engage community in assessing service system needs, gaps, potential resources, and plans. To include special emphasis on mental health/substance abuse. To increase system response and options based on values of community served To evaluate the feasibility per available resources. To support Healthy People 2010 goals: reduce suicides, increase access to treatment

6. History of the Initiative CASSP grants to States 1984, to plan a system of care, excluded Tribes OTA Report of 1990, found only 17 child trained MH providers for total Tribal population. 1992+ Series of meetings, SAMHSA, Indian Health Service, other federal agencies, providers, and Tribal leaders to address disparities. Circles of Care I awarded in 1998, followed by Circles of Care II in 2001.

7. ELIGIBILITY, Circles of Care Tribal Governments, Federally Recognized, as defined by PL 93-638 Urban Indian Programs, as defined by PL 94- 437 Tribal Colleges and Universities (TCU), added in 2004 Previous Grantees not Eligible.

8. Award Information $2.4 Million for 7-9 awards. Average annual award, $250k to $350k Awards may be requested up to 3 years, depending on availability of funds Cost sharing/match is not required. Technical assistance provided on-site and in grantee meetings

9. Circles of Care I Grantees (1998-2001 Projects) Cheyenne River Sioux Tribe – SD Feather River Tribal Health - CA Shared Vision Project - MT First Nations Community Healthsource – NM Oglala Sioux Tribe – SD Choctaw Nation of Oklahoma Urban Indian Health Board – Oakland, CA Fairbanks Native Association- AK Inter-Tribal Council of Michigan

10. Circles of Care II Grantees (2001-2004 Projects) Tlingit and Haida Tribes - AK Pascua Yaqui Tribe - AZ Salt River Pima-Maricopa Indian Community - AZ United American Indian Involvement - CA Blackfeet Indian Tribe - MT Ute Indian Tribe - UT Puyallup Tribal Health Authority - WA

11. Technical Assistance National Indian Child Welfare Association, Program Technical Assistance, (IAA, IHS) National Center for American Indian and Alaska Native Mental Health Research, (IAA, NIMH)

12. Tribal Consultation E.O. 13175, DHHS Policy on Tribal Consultation. SAMHSA participates in regional meetings with other agencies and tribes. Circles of Care was developed over 5 year period, beginning with exploratory meeting at the National Indian Health Board. An advisory committee of tribal leaders and providers in the field developed the concept for the grants.

13. Special Journal Edition, U of CO American Indian and Alaska Native Mental Health Research, V.11, #2, 2004 Circles of Care I, outcomes http://uchsc.edu/ai/ncaianmhr/journal/11(2).pdf

14. Circles III, New Announcement Announced December 16, 2004 Due date: February 25, 2005 Notification planned to all tribal programs, urban Indian programs, TCU’s TA for prospective applicants, January 2005 www.samhsa.gov

15. SAMHSA - New Address 1 Choke Cherry Road, Rockville MD, 20857 –Center for Mental Health Services –Center for Substance Abuse Treatment –Center for Substance Abuse Prevention Jill.Erickson@samhsa.hhs.gov (240) 276-1926