All right, good morning, everyone. Thank you all for joining us this morning. On behalf of ORN, our ORN partners, AAAP, ATTC, Columbia, and KAI, in coordination with SAMHSA and OTAP, I would like to welcome you all to the TOR webinar series. This is the second session in the series, and today we'll be talking about Native trauma and resilience and prevention rooted in culture. This webinar series is designed for Tribal Opioid Response Grantees, but all are welcome to join and participate in the session today. My name is Chelsea Kimura. I am Nupiak on my maternal grandmother's side. I'm a social worker by training, and I now serve as a training and technical specialist for the ORN in the Northwest region. I will be helping to facilitate this session today. I would now like to give a warm welcome to Krista Catron, who will be helping to open our session in a good way today. Thank you, Krista. Good morning and hello. My name is Krista Catron and I'm a citizen of the Caribbean Potawatomi Nation and I'm a descendant of the Kickapoo Nation of Kansas. And I recently found out that I'm also, we have some Pokagon Potawatomi also. So that's exciting and fun to learn. So I did just share with you my introduction and I provided you an introduction, my spirit name while we out and about. And what that is, that's something that goes around. So as many of the tribal languages, it describes some circular, cyclical kind of going. So my grandma always called me Whirlwind Girl. And that's kind of stuck with me my whole life. My parents are Tina Wyotton and Daryl Catron. And I'm the proud granddaughters of the late Ronald and Lovita Wyotton and Benny and Maxine Catron. So just a little about me. I was raised on the reservation in Mayetta, Kansas, which are the traditional homelands of the Ka, Kansa, Osage, the Osheti, Shakowin and Kickapoo and many others who had migration patterns and trades through that state. I currently live and work out of St. Louis, Missouri. So similar to Kansas, it's a traditional homeland of the Osage. And we also have the Quapaw, Miami, Osheti, Shakowin, Kaskaskia and Kickapoo. I'm honored to share a few words this morning. It's been exactly a month since we lost our Misho or my grandfather. So typically what comes with that are some restrictions. And, you know, those are out of protection for those who are grieving. And I know many other tribes have similar ways, you know, for grieving. And one of those is to limit myself in participating in ceremonies or maybe leading prayers for at least a year. You know, and some restrictions are a little bit more immediate during that time of grief. So, you know, no looking in mirrors or anything shiny, reflections, you know, because during that time we call the spirits to, you know, help our relative make that journey. And so for some of those reasons, I won't share a prayer, but what I can do is what I am actually happy to do is share a story and to share a story from a lay elder who's actually from the Forest County Pottawatomie tribe. There's about nine bands of Pottawatomie all through the U.S. and up through Canada. And so we do a lot of sharing. And I thought, well, let me share this story that I was just told myself. And I'll do it in English because if I did it in Pottawatomie, we'll be here for another 30 minutes or so. And I don't know if that would be a great use of everyone's time for such an amazing topic that we're going to talk about today. So what I'll share with you is a story of how the rabbit got their short tail. And so a long time ago, it was said that the rabbits used to have long tails. And one time when this rabbit was out searching for something to eat, he came to the edge of this big flowing river and he spotted, you know, across the shore an abundance of clover, something he really loved, something that was real tasty, but he had no way to get over there. And he just kept repeating on the shore, you know, jumping up and down. I really want to get over there. I really want to go to the other side. Well, it just so happened that there was an alligator who was there close to the shore and only his nose was showing above the water. And he heard the rabbit and he says, oh, little brother, little sister, you know, what's happening? What's going on? And, you know, the rabbit said, I just wish I could get to the other side. I wish I could go to the other shore. And the alligator is like, well, that's nothing. It's real simple to get over there. You know, and the rabbit's like, well, you live in the water, so it's very easy for you to say that. And you can swim there. And I can't. And it wasn't too long before the rabbit kind of actually grew a little leery of the alligator and maybe the intentions. And, you know, didn't really know what to do with what the alligator then offered, and that was to help the rabbit get across to the other side so he can get that clover. And so he thought, well, maybe it's true. They're going to take me across the water. And sure enough, the alligator gathers. He calls to some of the other water beings, other alligators, and, you know, asked them to lay across like a bridge from one side to the other. And they said, you know, just take our backs as a bridge to get over there. It will take you a little while, but you'll get there, and we'll help you. So the rabbit did as the alligator told them, and they lined up, and the rabbit prepared his trek across the backs of the alligators. And it was happy. The rabbit was happy. It was like, wow, this is amazing. They're going to help me, this little rabbit. And so they said, all right, get ready. Get ready to run across, and they lined up. And so while the rabbit was running across the backs, he saw something at the end, and it looked like a den. And what he had realized as he got closer is it was that alligator who was laying there with his mouth wide open, ready for the rabbit. And so the alligator's intentions were to eat the rabbit, to swallow it, but the rabbit was too quick. And the alligator had caught the tail of the rabbit, and that is how the rabbit had got the short tail that we see today. And so there's a lot of, I think, inherent lessons and teachings in that from the time of, you know, the abundance of the clover, just all the way down to maybe the lesson that the rabbit had learned towards the end. And I know that each of you could kind of draw your own themes and messages and conclusions from this story, and I hope that maybe you can take this story or work with your team or those that you do work with to sort of understand the role of storytelling in the work that you do. It's a tremendous way to build trust. It's also a way just to remain in good relation with those that you work with. And many tribes have these stories, you know, of our four-legged relatives, our water relatives, those in the sky and those underground. And so, you know, I just want to share this with you as maybe something to think about and sort of, you know, set you in the right way as you, you know, continue this learning today with those here. So thank you for allowing me to share that. Aho and iiigwein. Thank you so much, Krista, and thank you for taking time to be here with us today. We very much appreciate you. I would like to provide a quick overview of logistics for our session today. We will begin today with some OTAP updates. We'll then share an overview about the opioid response network and then transition to our presentation for the day. The chat box will be open during our session, and we will aim to answer all of your questions throughout the presentation. At the end of the session today, we will have a brief survey, and we kindly encourage your participation in that piece. With that, I would like to invite Michelle Carnes to share some OTAP updates with us all. Michelle, whenever you are ready today. Thank you so much. I believe we have some slides for our time today. Wonderful. Thank you so much. So we're going to start today with just a couple of things for the benefit of the group around our grant processes. These are important things to keep in mind. Everything we're going to be sharing with you today will be something that you can get more details from your project officer, your project manager, and your project manager. So we'll go through these rather quickly. Next slide, please. Okay. So first closeout. If you're in a no-cost extension, this doesn't apply to you. You'll do this at the end of your no-cost extension. Be sure that if your grant ended in September of 2023, and if you're in a new grant now, you still need to close out your old one. You're in a liquidation period right now through the end of December, and you'll want to take notes of those final reports due at the end of that 120 days that you have to provide that information at the end of January. Next slide, please. Everyone will do an annual progress report if you're in a no-cost extension or if you're in a regular grant. Make sure that you get those annual progress reports to us by the end of December. There was guidance sent out in September. You'll put that into ERA. Again, let your project officer know if you need that to be re-sent to you. Next slide, please. All right. Carryover and FFR. These are also due at the end of December, so make sure that you know how much carryover you expect to submit for. If it's more than 25% of your annual amount, you'll need to do a formal carryover. Again, please refer to those instructions that were sent out in September, and again, we can re-send them if you need us to. Next slide. All right. GPRA data is required for everyone. It is a 12-question tool. There are support documents and videos available on the SPARS website. These are some of the things that we collect data on in the SPARS system. These are the activities that you'll be reporting to us in SPARS. Next slide, please. There's also the client-level data collection, which we all know about. It's not required for prevention activities, but you do have these data collection moments, baseline, six-month, and discharge. This also goes into SPARS, and again, there are information there in SPARS regarding this requirement. Next slide, please. Okay, so this is an overview of the things that are due typically at various moments during the year. We are about to enter quarter two, so you can see there, January 31st, there's quite a few things there to take note of for that quarter if you're in year one of your grant. Next slide, please. If you're in year two, slightly fewer. You'll do your GPRA for the next quarter, quarter two, so it's a little more manageable, but again, everybody has those due dates at the end of December, so those are the ones that are the most urgent. Next slide, please. If you are having trouble with SPARS, if you need a password reset, if you're having a struggle getting access, these are your resources there to get in touch with SPARS. Next slide, please. We do have a tour forecast up on grants.gov. So make sure that you're tracking on that. I can actually drop the link into the slide or into the chat there so that folks can track on that forecast. The NOFO is anticipated to come out February of 2024. Next slide, please. We're chatting with you on a regular basis. Make sure that you've got your calls in your calendar to talk to your GPO. This is a great opportunity for us to share this kind of information with you, provide you with the support and reminders. Next slide, please. This is all of our contact information. My information's in there, as well as my colleagues, Brittany, Irene, William, and Steven. Next slide, please. This is our mission. We're glad you're with us. That's our website. And I think I'm done with 40 seconds to go. I'll pass it back. Thank you. Awesome. Thank you so much, Michelle. And we are just gonna get our slide deck back up here in just a moment. All right. Next slide, please, Kelly. Thank you. All right, we do want to acknowledge that today's webinar is funded by SAMHSA. We do have ORN and SAMHSA staff on the call today, as well as leadership and project officers. The Opioid Response Network is funded by SAMHSA to provide free training and consultation to communities across the country. The ORN can assist with requests related to opioid and stimulant use, prevention, treatment, recovery, and harm reduction. Next slide, please. The ORN has a pool of over 300 consultants that help provide training and consultation for TA requests. The ORN has also designated teams spread out across the country who provide local expertise to help fulfill those TA requests. And we'll talk more about those teams in just a moment here. Next slide, please. You can submit a TA request online at the opioidresponsenetwork.org, and your local TTS will respond to your request within one business day. All education and training is locally relevant, culturally specific, and tailored in response to the requester to meet the specific needs of the individual, community, or organization. Next slide, please. The ORN has created the Indigenous Community Response Team to help support TOR grantees and other Native communities. This is a map that shows the different TOR regions across the country. There are two ORN team members available to support each TOR grantee region that you see here on this map. Next slide, please. These are the TTSs who serve on the Indigenous Communities Response Team. Do take a look and maybe make a mental note of which TTS might be serving in your specific region. They will be your primary contact on any TA requests that you make to the ORN. Next slide, please. The Opioid Response Network has also created the Indigenous Communities Workgroup. The workgroup builds capacity to deliver culturally responsive TA to diverse tribal communities. The group provides guidance to TTSs and consultants to enhance knowledge about Native populations and tribal best practices. Next slide, please. All right, it is my pleasure and with much gratitude that I introduce our speaker for today's session, Kelly King. Kelly is the Indigenous Resilience Coordinator at Kauffman and Associates, as well as Technology Transfer Specialist for the ORN. She is a descendant of the Miss Kwaki Nation, Ponca Tribe of Oklahoma, and Sac and Fox Tribe of Oklahoma. Kelly received her Bachelor of Science in Sociology before earning her Master of Social Work degree with a focus in Indigenous Trauma and Resiliency from the University of Toronto. Kelly has 15 years of experience working in the social work field. Some of this experience includes parent education, case management for mental health facilities, drug and alcohol counseling for youth, case management for women's re-entry programs, as well as working as a mental health therapist in a private practice. With that, I will turn it over to you, Kelly. Thank you so much for being here with us today. We're excited to learn from you. Thank you for that introduction, Chelsea. I'm honored to be able to present on this topic today. I hope everyone's able to gain a deeper understanding of the impacts of trauma on our native communities, the resilience we possess, as well as how we can lean on culture and prevention work. So if anybody has any questions throughout the presentation, if you could put them in the chat, I'll do my best to answer them at the end. So the flow of the presentation, we'll begin with a brief overview of tribal life prior to, during, and after colonization. We'll then move into looking at indigenous resiliency. And then lastly, we'll discuss prevention, religion, and culture. Okay. So examples of tribal life pre-colonization. Tribal people were agricultural, hunting, and fishing experts. Having learned to live off the land and water where they resided, different tribes had their own languages, beliefs, customs, ceremonies, dress, et cetera. Many tribes functioned beyond the nuclear family. Aunties and uncles were considered additional mothers and fathers, and cousins were considered siblings. Value was placed on non-human things. Examples are the drumbeat is the heartbeat, the earth is our mother, and thunder is the ancestors. And then many of these lists still hold true today for many tribal people. And I'd like to discuss some of these in a little bit more detail. So tribal people knew how to grow crops that were indigenous to their part of the world. They knew how to hunt and fish effectively and efficiently, the animals and fish that would feed their people. It is a well-known fact that native people would use every part of the animal, the meat, the hide, the teeth, the bones, the tendons, et cetera. And they would only hunt what they would eat and or use. Thanks would then be given to creator and the animal for sacrificing its life. And the blood would be allowed to seep into the ground to nourish the soil. So when I say every part of the animal, even the blood was used to go back into the earth and help future crops. Oh, hold on, I went too fast. Okay. Each tribe also had their own customs, ceremonies, and traditions around marriages, childbirth, child rearing, rites of passage, changing of the seasons, and so on. Every tribe was unique and is still unique today. If you were to look at early pictures taken of tribal people across the Americas, you would see, for example, how unique traditional attire was. And you can even see that today at most powwows. There are an array of different types of dancers from Northern dancers to Southern dancers, each with their own distinct style of dance. You can also hear Northern drum groups and Southern drum groups, both with their own distinct sound and cadence. Each tribe was unique in the languages they spoke and still are, and the housing structures they lived in. Some tribes lived in teepees, others lived in wigwams, longhouses, adobe houses, wattle and daub houses, and so on. And this, by no means, covers all of the structures because I wouldn't have enough time for me to list completely, you know. Whenever I list things in this presentation, it's not an exhaustive list. It's just things that came to my mind. And so while this topic is very fascinating to me and I can spend all day talking about it, we'll now move into what life was like during colonization. So under this topic, we will cover forced relocation, forced assimilation, loss of culture, and the outcome. And colonization is the process by which European settlers populated regions of North, Central, and South America, as well as the islands of the Caribbean. This is also recognized as the time that various indigenous groups that inhabited these regions had their cultures replaced and often eradicated. Kill the Indian in him and save the man was a statement that was made by Richard Henry Pratt, who was the founder of Carlisle Indian Industrial School. So forced assimilation began around 1790 when the United States government created policies that gave them control over Native American people, which resulted in loss of language, loss of culture, loss of land, loss of customs. And these policies not only caused cultural distress, but were in violation of the U.S. Constitution. The United States government's Native American assimilation policies attempted to Americanize indigenous tribes through control of their schooling, religion, and customs, with a focus on immersion in Euro-American tradition. Nation's first president, George Washington, officially promoted civilization policies. He promoted a system for assimilation, which included impartial justice towards Native Americans, regulation of their land and promotion of commerce. Sale of Native land had to be approved by the United States under the Indian Intercourse Act, and Native Americans were only occupants of the land and not owners. It wouldn't be until 1924 when Native Americans won the right to full U.S. citizenship. However, that didn't guarantee them the right to vote. Many states found ways to deny Native Americans voting rights until 1975, when the Voting Rights Act was passed. Even then, some states continued to find ways to deny Natives the right to vote. Cultural disintegration. Native Americans were not allowed to practice their religion and were punished for holding ceremony. Many Native children were forced to attend boarding schools. Once their children had their hair cut and were punished for speaking their language. And of course, we all know that abuses of all kinds ran rampant in boarding schools. I once talked to an elder who stated that she would have her fingers hit with a ruler for speaking her native language at school. And this punishment was part of the reason why she didn't teach her children or grandchildren how to speak their language. And then the relocation of American Indians. And this flyer is an actual flyer from way back. So 1830, Andrew Jackson signs the Indian Removal Act, saying it would enable states to advance rapidly in population, wealth, and power. 60,000 indigenous people are forced west to Indian territory, to land that is unfamiliar and infertile, leaving them with little knowledge on how to survive. Part of this relocation became known as the Trail of Tears, resulting in around 15,000 deaths. The forced relocation would free up 25 million acres of land for white settlement. By 1840, almost all indigenous tribes had been forced west and the Indian Removal Act, therefore, had achieved its purpose. The bill enabled the federal government to negotiate with Southeastern Native American tribes for their ancestral lands in states such as Florida, Georgia, North Carolina, and Tennessee. And we'll watch a video here shortly about a tribe in California that experienced that as well. Some tribes, including the Cherokees, refused to leave their homes and were pushed out by the U.S. military between 1838 and 1839. Thousands of Native Americans died traveling thousands of miles through harsh weather toward unknown territory they were to call home. All of this historical trauma has led to systemic oppression. People that experience systemic oppression often experience substance use, obesity, high mortality rates, generational trauma, health inequity, lateral violence, and education inequality. So the effect of the historical trauma, generational trauma, stereotypes, health disparities, and health inequity. Unhealthy coping mechanisms have led to generational trauma. Trauma can leave a chemical mark on a person's genes, which is then passed down to subsequent generations. And that's from the New York Times. Focusing... Let's see here. Okay, sorry. Stereotypes. So, here are some of the stereotypes that Natives deal with. Native Americans are alcoholics. Native Americans get free money. Native Americans are lazy. Native Americans live on reservations. Native Americans are overly sensitive regarding history, teen mascots, and so on. Native Americans gamble and light casinos. Native Americans have the same or similar beliefs, customs, and traditions. So this graph shows how American Indian and Alaska Natives are dying from common diseases at younger ages than Caucasian people. And this all leads back to the historical trauma. If you notice the dips in the yellow and dark green lines, which represent American Indian and Alaska Native women and men, this dip signifies that on average, Indigenous people are dying younger. Health disparities show the difference in health outcomes for different groups within the population. One such disparity is that on average, American Indians die 12 to 13 years earlier than white Americans. Native people have higher death rates at most ages, but particularly at younger ages and higher mortality for most of the top leading causes of death. While it's easy to focus on the numbers, the statistics represent the symptoms of the problem rather than the cause. The specific reasons for health disparities are complex and represent where people live and the services available and accessible to them. Factors such as having a regular source of care, language, and communication barriers, lack of diversity in the health care workforce, high rates of poverty, lack of insurance coverage, discrimination against American Indians and Alaska Natives, and large distances from health care services have all added to the disparities that affect Native communities. So the ACES assessment, I'm sure a lot of you are familiar with the ACES assessment, is a study developed by Kaiser Permanente and Centers for Disease Control and Prevention, and they found that there's an association between adverse childhood experiences and health and social problems across the lifespan. It is therefore no surprise that Native people have higher mortality rates when considering ACES concepts. Health inequality, the American Indian and Alaska Native people have long experienced lower health status when compared with other Americans. Lower life expectancy and the disproportionate disease burden exist perhaps because of inadequate education, disproportionate poverty, discrimination in the delivery of health services, and cultural differences. These are broad quality of life issues rooted in economic adversity and poor social conditions. And that is from the Indian Health Service. So this video, this video is the tribe out of California I had mentioned earlier, and it discusses some of their historical trauma and the impacts and how they're overcoming it. So let's watch that now. This land was taken from us. It's like having a wife that was stolen from me. And you see her with somebody else walking. And she looks and she smiles and she still gives you love whenever you're out there. And in your heart, you feel like she's still yours, but she was stolen. Historical trauma has really bred a ground for disruption completely of a family system, of a parent role, of what safety looks like, even has changed what our social norms are. When termination happened and the lands were liquidated and members were paid out and then no longer considered a federally recognized Native American, so where did we go to lean on services? We went into the community to access health care services now or housing assistance or whatever it might be. I feel like our people have so many stories of what life was like during that time, the amount of racism that they went up against, the amount of inequity. There was a belief I think that ruminated around here that you had everything and look you just sold it away and now you want to depend on our resources and our services and bog our systems down. This could have all been avoided and what most people don't understand is that termination wasn't a choice of the Klamath tribes, that this was a federal policy placed upon them and so we had a large period of time where our people were hurting and they were hurting in really harsh ways. In this day and age we see the fallout of that exact thing. Our adverse childhood experience rates are significantly higher than the state average. We see tribal members come through the doors of our behavioral health clinic. For almost everybody that walks through that door they have lost a significant amount of family members, they have turned to alcohol and drugs as a way to cope. We do offer both Western and cultural relevant services to them. I think identity is one of the most important areas that we focus on is getting people to understand that you have a place and a space within this tribe that there is a responsibility that can give value to your life. Fire I think has always been a big part of who we are whether it was just sustenance and to survive or that burning spirit that you have inside of yourself that there's a belief that you always have to be feeding that spirit just like a fire you always have to keep it burning. As a behavioral health program we have to think in those terms, in those traditional ways of thinking. We have to know that when a fire exists that we're responsible for continually kindling it. We don't always want to be seen as the traumatized Indians. We want to be seen as resilient Indians, powerful people connected to our homeland, practicing our traditions and our cultures, separating ourselves apart from just the norm and being very concrete in who we are as tribal people. Place matters because it affects us every day. How could you not walk and see your love being controlled by somebody else and it not affect you every day? You restore that relationship and you restore health. So, this video is a good segue into our next topic of Native resilience and how our Native people have worked to overcome historical trauma. So in this next part, we will cover tribal sovereignty, reclamation, finding our way back, and tribal programs rooted in resilience. Tribal sovereignty, indigenous concepts and practices of self-governance long predated European colonization in the Americas. Sovereignty means many different things to many different tribes. This is because each tribe is unique and autonomous. Long before there was a United States of America, tribes governed themselves, provided for their people, and negotiated treaties with other nations such as England, France, and Spain. When tribes signed treaties with the U.S., they were guaranteed the right to continue governing themselves. This means that their sovereign rights are retained and not granted. Reclamation, land, tribes are working to protect treaty rights and protect sacred sites. There are language preservation programs in tribes now. People continue to practice ceremony and also their traditions, customs, and cultural practices. Finding our way back, many tribes, if not most, are making efforts to get back to the old traditional way of doing things. This includes bringing in elders to share their wisdom on things such as songs, farming, hunting, sewing, basket weaving, healing practices, food preparation, and child rearing. I know I was at a conference recently in Montana where a nutrition program was teaching children how to hunt food and how to do it the right way. And like I said earlier about using all parts of the animal and learning how to cook the food after they kill the animal, and that's just one example of many. And so now we're going to look at ACEs through a different lens, resilience building. When people are willing and able to process their experiences of adversity, trauma, and pain, they tend to be able to deal with life's twists and turns with more resilience. And resilience factors born out of ACE concepts can actually help people improve their lives. So anytime I have administered the ACEs questionnaire with clients that I had, I always make sure that I follow it up with the resilience questionnaire. The resilience questionnaire, for those unfamiliar, is a questionnaire that asks questions similar to the ACEs questionnaire. It's questions such as, I believe that my mother and father loved me when I was little. When I was a child, neighbors or my friends' parents seemed to like me. And another example, someone in my family cared about how I was doing in school. So it's a good way for people to also realize how resilient they are, the strengths they have, because the ACEs questionnaire can be a little bit heavy and can be hard for people once they see what their score is. So the resilience questionnaire, I definitely would encourage people to use that when you can. So some tribal programs rooted in resilience, the Missing and Murdered Indigenous Women Movement, traditional food and nutrition programs, substance use programs, tribal walks and runs, powwows, exercise programs, boys and girls clubs, maternal child wellness programs, and then cultural programs, traditional gardening, beading, sewing, drum making, and language. So now we're going to move into prevention rooted in culture. When planning programming, it's important to consider getting input from various sources, programs and stakeholders, and that can include elders. Well, it's really important to include elders, but also important to include youth, council members, program leadership, program participants, and then community members in general. It's important to brainstorm activities that your program can provide that will draw people in, and every tribe is unique. So these are just some examples. It will look different for every tribe, but storytelling, culture nights, talking circles, beading classes, family fun nights. I know a lot of tribes are doing family fun nights for substance use programs. So it's a where people are getting together and everybody's sober, and so those can be good. Singing and drumming, traditional food tastings, drum making, where little kits are provided, and then also regalia making. And then make sure and consider indigenizing program materials and activities so they feel more familiar and personal, whether that be posters that are posted around the schools, curriculum, any presentations that are given, and programming. And there are ways to to take things that are non-native and make them native just with art or wording so that it feels more personalized. And then connection is the correction, and I have a mentor that says this often. So work to connect community members and youth to the land, the culture, family, traditions, and spirituality. This can make all the difference. And many tribes are already working toward getting their tribal people more closely connected to the culture. But this need for connection is in the very fiber of our being, and this is across cultures. So I know that in the past when I worked with clients who aren't connected to anything, it's harder for them to get into recovery because it almost feels to them as though they're drifting. And so it's good to kind of anchor them to something, whether that be a cultural program or just mindful walks where they're connecting with the earth and nature, what they're hearing, what they're seeing, what they're feeling. So that is super important. And I think we are going to move into questions now. I know that this is the end of my part of the presentation. I know I just grazed the surface of a huge topic in a very short amount of time. So I just want to say that I appreciate your time and being here, and I'll be happy to try and answer questions the best that I can. There are a couple of questions in the chat, Kelly. It looks like people are wanting to know where they can find the resilience survey. OK, I will drop it in the chat. Awesome. Thank you. Yeah, I think if you go to that website underneath that resilience questionnaire, where it says resilience questionnaire pdf, I think if you go to that website it should be. I thought that that was going to be a direct link, but it looks like it's not. I know if you type in the resilience questionnaire and then ACES after that, it will come up. There we go, I just sent the link. Thank you, Kelly. Any other questions? Looks like we have one in the chat. How can Angelos best talk about native culture to natives and do so in an impactful way? I think a good way to do that is to talk to a native elder in your community. I would, because like I said, every tribe is unique, and it would depend on place where you're at, and it might even be good to have an elder or somebody there that is knowledgeable about the local tribal community, so they can answer questions if people were to ask questions that you're unsure of how to answer. So I would say bringing in somebody to either mentor you or be there during those discussions. I have another question here. I'm particularly interested in the prevention aspect. Would you have any resources, including studies, to cite on culture as prevention? I'm part of a team working with culture as prevention, but very interested in the ORF perspectives and resources. Yeah, so there is curriculum. There are posters that have been made that are indigenized. The best way to do that would probably be to submit a TA request through the ORN. It's an easy process. It's totally free, and then once you get connected to your TA provider, they can send you all of those materials, but yes, there are many. It would just depend on exactly what your need is. And we'll discuss here in a little bit about how to submit a TA request. I see another question about the MSW ITR program. Is my information on one of these slides? I'm not exactly sure, but. I don't think so, Kelly. OK. Oh, sorry, that was a direct message. Sorry, Evelyn, I will get back to you on that. I have another one here. As someone who's not Native but works in a tribal community, how would you recommend for myself to be more involved in the community but also maintain respect for the culture? It's a great question. I think that it's always important to ask. I know that a lot of activities or community events are open to the public, but I think that just talking to somebody that has knowledge about what's appropriate or what activities would be appropriate to attend, I think that that would be good. It shows support. And yeah, and also respect for the culture. I would just ask somebody in the community about what they think would be appropriate. I know that there are just different protocols for different tribes, so I would ask somebody that you feel like would know the answers to your questions. It's always good to ask if you're unsure. Find that person that you've built rapport with and then ask them all the questions. Thank you so much, Kelly. Do we have any last minute questions for Kelly? I think that might be it. And you feel free to continue to add your questions to the chat as we go through the rest of the presentation, and Kelly can continue to answer them there as well. All right, Chelsea, I'll just hand it over to you. Thank you. Thank you, Kelly. Chelsea, before you jump in, Michelle mentioned that SAMHSA has the free culture card resource for download when working with American Indian and Alaskan Native communities, which was developed by American Indian and Alaskan Native communities, so I just wanted to point that out. She did put that in the chat, and they have the link there. So please be sure to look into that if you're looking for another resource on working with American Indian and Alaskan Native communities. Thank you, Leah. And I see that other question there about ordering culture cards. I don't know, Michelle, if you know what that process is or if people can order those online. So we used to have this incredible folding device. It was really amazing. Some of you may remember that. We no longer manufacture that, which is unfortunate, but you can download them and make copies. OK, I think I have the whole thing. All right, well, thank you all. Thank you so much, Kelly, for a wonderful presentation. And like I mentioned, please continue to add your questions to the chat. I think up next is Emily, and she'll talk some more about some TA requests that we've received recently. Hi, everyone. Can you hear me OK? Yes, so for those of you who don't know me, I'm Emily Mothberg, and I am a technology transfer specialist, or TTS, for the Northwest region of the Orange Indigenous Communities Response Team. So that title, TTS, it sounds fancy, but it means that I coordinate requests and ensure that they stay on track through completion. So I'm going to share about the details and process for a prevention-related request that was recently completed through the Northwest region of the Oran. So this specific request came in from the chemical dependency clinical manager position at a tribal health clinic. This clinic provides a full range of health care services and is a level one outpatient treatment provider. The request was submitted in response to an increase in overdoses in their community, including the loss of one community member. So Chelsea and I met with this requester to talk through what they were thinking and looking for. And based on this conversation, we outlined a goal, which was to build capacity among staff in the community to prevent substance misuse and overdose. So to accomplish this goal, the Oran assisted the requester in providing an in-person educational event that was open to all of their community members, including clinic staff. And the tribe provided a free meal at the start of the event. And this was followed by a prevention-focused presentation from an Oran consultant. Other community partners, including local law enforcement, also participated by sharing about current trends in their area, answering questions, and providing a demonstration with their fentanyl detecting canine. Additionally, Narcan administration information was shared. And the tribal clinic was able to distribute Narcan to any attendees who wanted it. So that gives a bit of an overview of what that request was and the end results. Next slide. So now I'm going to take a step back and share a bit more about the step-by-step process of how this request was completed on the Oran side so everyone can have an idea of what to expect when submitting a request. So first, the requester submitted their request on the Oran website. After the request was received by the TTS Duo, which in this case was Chelsea and I, the requester was contacted through email to set up a time for what we call a determination of need meeting. In that meeting, we talk in depth about what the requester is thinking and looking for and get some information about the background and their organization and anything else that's relevant. And after this meeting, the TTS identified and recruited an appropriate consultant based on the specific needs of the requester. And once an available and appropriate consultant was identified, the TTS set up a meeting with both the requester and the consultant to create a plan for moving forward. After that meeting, the consultant then created a presentation based on the goals and needs of the requester. And once the consultant finished creating that presentation, it was vetted by the Oran Indigenous Communities workgroup. So this workgroup reviews and vets all presentations delivered to Indigenous communities to ensure cultural appropriateness and responsiveness. So once the presentation was vetted, the requester met one more time with the TTS and consultant to finalize event logistics and details. And finally, the consultant traveled to the community to deliver the presentation. And next slide. So as I mentioned before, the event started out with a community meal provided by the tribe. One caveat is that the Oran cannot pay for food, just pointing that out. But that was followed by our Oran consultant as the keynote speaker. And after that, the community partners also shared education and answered questions. And the keynote presentation provided by our Oran consultant covered several topics, including data around the impact of the opioid crisis, stigma, culture as prevention, and also recovery and hope. And one of the most impactful pieces of this particular presentation was the consultant sharing of her own personal story. Next slide. And to share a bit more about the consultant who served on this request, her name is Sarah Quijano. And she is a citizen of the Cow Creek Band of Umpqua tribe with Cree, Kalapuya, and Cow Creek ancestry. She lives with her family on her people's traditional homelands in the Umpqua Valley of Oregon. In addition to being an opioid response network consultant, she works as an alcohol and drug counselor, teaches at Fulton State University, and has been certified in Native youth prevention programming. She herself lost an adult child to fentanyl poisoning, which has fueled her passion for spreading awareness about fentanyl and supporting other prevention initiatives in her area. And she's just one example of our large pool of consultants. Next slide. And I believe now I'm going to pass it over to Chelsea to talk a bit about a different request. Thank you, Emily. Yes, I'm going to talk a little bit about the second request we have up here. This was submitted by the recovery support coordinator for this program. They have a very well-established clinic that includes primary care, MAT, and recovery services. This was also a request that Emily and I received up in the Northwest region. They, like many of our grantees and requesters, have seen an increase in fentanyl use in their community. They are located off of a major highway, and they've seen an increase in drug trafficking in their community as well. So that is originally why they reached out to the ORN. The TA goal for this is to build capacity among the community to prevent OUD and OUD-related overdoses. Some of the training details, we will be providing two presentations for their opioid education day for their community. This will take place in person in their community. Those two separate ORN presentation topics will be OUD 101 and culture as prevention. We are estimating approximately 150 people will attend this event, so it will be a large community event. The audience will be community members as well as providers, and this will be taking place in March of 2024. They did submit this request to us in October, and so that gave us plenty of time to plan this large in-person event. Next slide. TA process to date, so our requester submitted an ORN TA request online. This then came directly to Emily and I. We met with the requester to complete what we call the determination of needs call. During the Dawn call, the requester brought up many topics that she thought we could help support her with. She was thinking we could help support with policies and procedures for their MAT clinic, guidance around spending opioid settlement funds, and trainings for providers and community members. So during this Dawn call, we shared a lot more information with her about the ORN and how we can help support her. She was then able to take that information back to her leadership team. They had a conversation and decided which requests and topics they wanted to prioritize given their team's capacity. So their team did decide to move forward with the community training. We met with our requester again to gather more information about specifics of the training, logistics, and really hone in on what topics they wanted to focus on. After that, Emily and I had enough information to reach out to ORN consultants. So we were able to find a consultant who was willing and able to serve on this request with us. And I will tell you a little more about her in just a moment here. We met with our consultant. We debriefed the request with her and provided her an update at where we were in the TA process. We were also able to answer any questions that she had about traveling, to be there in person for this event. We then had a meeting with our requester and our consultant so that they could meet, really begin building that rapport and start having discussions about what those presentations would end up looking like in March. That is where we are at right now in this process. Over the next couple of months between now and March, we will be meeting with our consultant and our requester a handful more times to really make sure that the presentation is all set and ready to go by March. Next slide, please. Event agenda. So this was created by our requester. This is what their team wanted their event day to look like. So these two sessions that you see in bold will be presented by our ORN consultant. The rest of the events will be presented and organized by their program staff. So it's important to mention here, I think that every event day we do does look very different depending on what our requesters are wanting and needing. As you can see, this event agenda is very different than the one that Emily just shared for the other request. Next slide, please. Okay, so I do want to share a little bit about our consultant who is serving on this request with us. Heather Momberg has a doctor of nursing practice degree. She is also currently working with the ORN as a regional coordinator in the Southwest region. So she is a colleague of ours. Heather has over a decade of healthcare experience. She started her career as a labor and delivery nurse, and that's where she was really inspired to advocate for access to MAT for pregnant women and families. Heather has since helped implement and run MAT programs for tribes in Montana and California. So she has really great experience working with native communities. And as you can see, she's just a really great fit for this community day event that we're planning. So we will meet with her a couple more times between now and March, and then we will do the presentations the middle of March. And that is all that Emily and I have right now. So if you have any specific questions about these two requests, please feel free to add them to the chat, and we'd be happy to answer any of those. Great, I see Carrie answered. Paula did have a question about living in a rural area, Klamath Falls, Oregon. So she was wondering if ORN would be able to provide training and technical assistance out there, so. Yes, yes, Paula, we would be able to. So feel free. I'm gonna talk in the next slide or two about submitting a request. I'm also very familiar with Klamath Falls. I have a grandmother there, so. But yes, we would be happy to help you with anything you're thinking about. All right, any other questions? Okay, I think we can move on to the next slide, please, Kelly. All right, and with that, we are at the end of our session today. So thank you all so much for joining. Our next session will be December 21st, 2023. The link is here in the chat. Thank you, Emily. All webinar recordings will be available at opioidresponsenetwork.org slash TOR within two weeks. We will also be sending out emails to register for that next session as we did for this one. So do keep an eye out for those. Next slide, please. To ask questions or to submit a request for a TA, please visit the opioidresponsenetwork.org. Up in the right-hand corner, there is a Submit a Request button. So you will go ahead and click on that button, submit the form, and it will go straight to your TTS in your region. You can also email ORN at AAAP.org with any questions, or if you need help accessing that website. Next slide, please. All right, and then this brings us to our evaluation survey link. Please do take a minute to complete this. If you have time, you can scan the QR code here, or Emily has added this to the chat as well. Thank you, Emily. And with that, I want to thank you all so much for joining us this morning or this afternoon, depending on where you are. And we really look forward to seeing you in December. I hope you all have a great rest of the week. Thank you.

Tribal Opioid Response

Native trauma

resilience

prevention

historical trauma

health disparities

cultural practices

spirituality

substance use programs

Native communities