Siletz Community Health Clinic Choosing to create a Medication Assisted Treatment Program
Presenting today: Eric Davis , MSW, BCD, LCSW, QMHP, MAC, CADC III Clinical Supervisor/Psychotherapist at Siletz Community Health Clinic Board CerDfied Diplomat American Board of Examiners in Clinical Social Work Director, State CerDfied Behavioral Health Treatment Program Member, Behavioral Health Advisory Panel Graduate School of Social Work Field Instructor and Delina John , CADC I, CRM Siletz Tribal Member
Who we are We are the Confederated Tribes of Siletz Indians of Oregon. Our aboriginal homelands stretch from Southern Washington to Northern California. There are between 27 and 54 different tribes and bands represented depending on how they are categorized. There were at least 10 different language bases recognized in our tribe. We currently serve 11 counties in Oregon. The majority of our people lived in Cedar or Sugar Pine plank structures or longhouses, although many people traveled to different seasonal camps. In the northern part of our homelands, the plank houses could be up to 100 feet long and house several families inside. On our current day Siletz Reservation we have a Cedar plank house that we use for ceremonies and celebrations. Basketry and weaving were common skills among our people across all the bands and tribes. You can still see common designs and styles in use today.
Access to care Previously, population served was limited to: • Highly affluent • Had commercial insurance • Had access to the limited amount of M.D.’s or D.O.’s that were able to prescribe • 21 st Century Cures Act “Game Changer”
Tribal community Several groups of people in the Siletz tribal community recognized the Opioid crisis and a need for alternative treatment. In February of 2018 the Siletz Tribal Council approved the Siletz Community Health Clinic to begin a comprehensive Medication-Assisted Treatment program. We are serving not only our Siletz Tribal members, but members of other tribes and our Non-Native population as well.
Tribal community We realized that many of our clients from other tribes and Non-Na8ve clients have direct 8es to our tribal popula8on. Many are in rela8onships with Siletz tribal members, or have been lifelong family friends. It is in our best interest to help as many people in our community as possible to have the greatest impact.
SCHC Treatment Program Our program is based at the Siletz Community Health Clinic (SCHC) Our program staff consists of FNP’s, DO’s, CADC’s, QMHP’s, PSS’, RN’s, MA’s, Pharmacist, support staff, as well as myself. We offer a variety of different services at SCHC. Those services include:
SCHC Treatment Program • Counseling – Individual, adding Group and Family • Medication-Assisted Therapy • Case Management for co-occurring disorders • Telemedicine • Opioid STP Funding (which can be spent on things such as housing, car repair, insurance, utilites, etc.)
SCHC Treatment Program • Help accessing other programs and resources such as Vocational Rehab, Education, Housing, Employment Assistance, Financial Education, Transportation, Gas Cards, Cultural Activities, Tobacco Cessation • Pharmaceuticals and Nutraceuticals (Such as lavender tea, passion flower tea, and lavender tincture for relaxation) • Cultural trauma awareness
SCHC Treatment Program Some of the Cultural Aspects of the program that we have or are beginning to incorporate are: • Smudging • White Bison • Beading Group • Wisdom Warriors/Living Well • Cooking MaDers
SCHC Treatment Program Some of our goals for the future are : • Sweat Lodge ceremony • Adventure based therapy • Inclusion in cultural activities such as gathering basket materials, dance practices, language classes, regalia making, and cultural food classes
Harm Reduction approach Harm Reduction Philosophy Includes a spectrum of interventions Medication Assisted Therapy Meeting patients “where they’re at” seeking to mitigate the harmful consequences of use. Addressing substance use, relapse, and abstinence.
Harm Reduction cont. M.I. Theoretical framework Non-judgmental, accepting, compassionate • Change Process • Strength-based patient centered • Why is this important to us?
Impact on treatment What we know from the research is that individuals who have become dependant on opioids have the highest dropout rates of all addic8on clients. This is especially true in abs8nence-based treatment, most clients will drop out of treatment within 72 hours.
Impact on treatment The Addictions and Mental Health Division completed a massive study of Oregon clients who had dropped out of treatment. • The highest proportion of drop-outs were opiate dependent clients • A higher proportion were ethnic minorities • A higher proportion of those were unemployed
Case studies We have been seeing clients for about a year now in our M.A.T. program. To give you an idea of the impact our program has had, we are going to look at a couple of case studies.
Our Clients Case study #1 – We had a couple join our program about five months ago. Both were homeless, dependent on opioids, unemployed, and struggling with depression, anxiety, and PTSD. The clients would often arrive to treatment experiencing a crisis and often appeared to engage in aggressive or hostile communication with each other. They struggled to trust each other and were on the verge of separating.
Our Clients The male client had several relapses occur early in treatment, and many of the team members had concerns about his future in the program. The counselors and I kept advoca=ng for and working with the family and today both individuals are clean and sober.
Our Clients Both individuals also • Are Employed • Are Living in stable housing • Attend religious support meetings weekly • Are Actively involved in N.A. meetings and have sponsors • Have a measurable decrease in their Anxiety and depressive scores
Our Clients Case Study #2 – A client came in who had lost her job, housing, and her children had been taken into custody by DHS Child Services. She was recently released from detox. She was struggling clinically with guilt, shame, chemical dependency, anxiety, PTSD, and a lack of adequate resources.
Our Clients After six months of engaging in our program • the client’s children have returned home • she has a working vehicle • she and her husband are completing their G.E.D. • she has plans to complete her 2 year degree. • They are enrolled in a pre-employment program • her anxiety has decreased 40% • she has been clean and sober for six months
Results The clients in these case studies entered the program with a long history of opioid dependence with mul7ple relapse episodes and were failing with Abs7nence-Based treatment a<empts alone.
Results Here is a look at some of our numbers from our first year: • 79% of original clients are still participating • Two thirds of the clients are Native American • 88% of clients are employed/have higher education/steady income • 95% of clients have stable housing • 75% of clients have remained clean/sober • Clients participating 90 days or more experienced around 30% decrease on PHQ-9 and GAD-7 scores
Impact on treatment One question is how long does a person stay on Medication-Assisted Therapy? So far research has found that short term (a traditional 90 day treatment program) is not as effective as longer treatment programs. The average length is about 5 years. What we know is that the longer maintenance episodes are associated with higher recovery rates, eventual abstinence, housing, employment, reduced overdose, and recidivism rates.
In conclusion We would like to thank you for your time today. We know this is a very important issue not just for the Siletz Tribe, but for all tribes. This concludes our presentation For more information about the Siletz Tribe you can visit our website at www.ctsi.nsn.us
Fluency Case Presentation 2018 NSSLHA Spring Conference Case presentation : o 14-year-old male adolescent (Sam) presents with an 11-year history of stuttering. increased speech disfluencies (repetitions, prolongations, blocks)
496 views • 6 slides
Neuronetics, Inc. NASDAQ: STIM Company Presentation May 2019 Disclaimers This presentation contains estimates and other statistical data made by independent parties and by Neuronetics , Inc. (the Company) relating to market size and
870 views • 33 slides
Transplantation Tolerance Through Therapeutic Cell Transfer: Where Do We Stand? Joseph R Leventhal MD PhD Fowler McCormick Professor of Surgery Director of Kidney Transplantation Northwestern University Feinberg School of Medicine Joseph R
1.23k views • 61 slides
S YSTEMATICALLY T RANSFORMING C ANCER I MMUNOTHERAPY Legal Information & Disclaimer This presentation includes forward-looking statements concerning our business, operations and financial performance and condition, as well as our plans,
909 views • 26 slides
Behavioral Health Services: Children, Youth, & Families System of Care Stories of API Children & Youth Spotlight on Chinatown Child Development Center Photo Credit: Asian Pacific Fund Vincy Chow, LCSW, Director of CCDC Farahnaz
518 views • 22 slides
Top Management Presentation Financial Results of FY2015 DAIICHI SANKYO CO., LTD Joji Nakayama President and CEO May 12, 2016 Forw ard-Looking Statements Management strategies and plans, financial forecasts, future projections and policies,
609 views • 49 slides
Functional Somatic Symptoms in Children and Adolescents: An Integrative Approach Antra Bami, MD, & Wendy Plante, PhD April 9 th , 2020 Disclosure We have no financial relationship with a commercial entity producing health-care related
473 views • 28 slides
EASL Investor & Analyst Event Thursday April 11, 2019 Vienna, Austria Cautionary Note Regarding Forward-Looking Statements This presentation contains forward-looking statements, including, but not limited to, statements regarding the
804 views • 35 slides
Using Technology to Improve Access to Mental Health Services in Canada A REVIEW OF THE EVIDENCE ON INTERNET-DELIVERED COGNITIVE BEHAVIOURAL THERAPY Calvin Young, MSc Clinical Research Officer, CADTH Disclosure Funded by federal,
534 views • 25 slides
Regulatory For reprint orders, please contact: firstname.lastname@example.org Effective presentation of immunogenicity risk assessments and related data in regulatory dossiers Paul Chamberlain* ,1 1 NDA Advisory Services, Ltd, Grove House,
649 views • 12 slides
UNC School of Social Work Clinical Lecture Series The DBT Skills presented by Kristin Webb, PsyD March 27, 2015 Kristin B. Webb, PsyD 104 So. Estes Drive, Suite 206 Chapel Hill, NC 27514 919/225-1569 email@example.com (not for
1.17k views • 99 slides
ISCTM Integrated Therapeutics Working Group Integrated Therapeutics : Combining learning-based interventions with drug and neuromodulation devices. The challenges to trial design and regulatory approval. Introduction Drugs and devices are
648 views • 10 slides
9/17/2015 INTRODUCTION TO INTEGRATIVE HEALTH Pamela J. Potter, DNSc, RN, CNS-BC Patricia H. Cox, DNP, MPH, FNP-BC University of Portland School of Nursing Portland, Oregon, USA October 2015 DISCLOSURES There are no conflicts of interest or
366 views • 14 slides
Creating a New Diversified Biopharmaceutical Company The Combination of AbbVie and Allergan Investor Presentation June 25, 2019 NO OFFER OR SOLICITATION This presentation is not intended to and does not constitute an offer to sell or the
531 views • 28 slides
Presentation Accommodations The educator identi fi es presentation accommodations for a student with a disability based on his or her individual learning strengths and needs. Key Method The educator uses a set of guiding questions to identify
565 views • 4 slides
Presentation Accommodations What are Presentation Accommodations? Presentation accommodations alter the method or format used to administer a PARCC assessment to a student, including auditory, tactile, visual, and/or a combination of these,
290 views • 4 slides
Presentation tiPs n Subsequent sections of this notebook Proofread all printed materials. provide options for delivering presentations n that will help faculty fully include students Practice, practice, practice by yourself with
1.5k views • 20 slides
Access Program Faculty Workshop 1 Advisors: Lisa Husamadeen, M.Ed. Charles Patti, M.Ed. Paul Shane, Ph.D. Susan Sawyer, M.Ed. 2 Procedure All colleges are required to have a procedure for students with disabilities to request
1.06k views • 25 slides
Richard Woods, Georgias School Superintendent Educating Georgias Future gadoe.org Special Education 101: A Instructional Leaders Role in Ensuring a Free and Appropriate Education (FAPE) for SWDs February 12, 2019 Leigh Ann
505 views • 37 slides
Creating Inclusive Classrooms: Accommodations, Modifications, and Co-Teaching Strategies Caitlin Smith, B.S.Ed Intervention Specialist, Kings Local SD Todd Juengling, M.A. Intervention Specialist, Cincinnati City SD What is Inclusion?
532 views • 37 slides
All About Accommodations For Testing Debbie Bergtholdt COABE Conference 2018 Phoenix 1 GEDtestingservice.com GED.com Agenda Overview JAWS Demonstration Testing Accommodations Documentation How can you help
408 views • 20 slides
Michigan Association on Higher Education and Disability presents Accessing Disability Support Services at the Post Secondary Level Federal Mandates Individuals with Disabilities Education Act (IDEA), Re-authorized 2005
1.1k views • 36 slides
Career and Technical Education Special Populations ED Garcia, CTE Specialist Barbara Gonzales, Specialist Region One Education Service Center Region One Education Service Center Email:firstname.lastname@example.org Email:email@example.com (956)
1.16k views • 50 slides
ACCOMMODATING STUDENTS with DISABILITIES Disability Services for Students Protect rights of students and university under ADA, Section 504 and FHA ADAAA- broader definition increase students Accommodations are in place to provide
1.04k views • 26 slides