and Associates and I will manage the logistical support for the Zoom session. At the bottom of your screen, you will find a series of icons. If you have questions throughout today's session, please use the chat function and we will address your questions either by chat or during the Q&A section at the end of the presentation. If you would like to speak aloud to ask your questions during the Q&A, please use the raise hand function under reactions. Finally, please be aware that today's session is being recorded. Closed captioning is available by clicking the CC function. If you need technical assistance during the session, please type the issue into the chat box and one of our techs will address it as soon as possible. Without further ado, I would like to introduce Courtney. Take it away. Thank you so much. Welcome. Hello, everyone. My name is Courtney Yarholer. I am Sac and Fox, Pawnee, Otoe, and Muskogee Creek. I live with my family in Moore, Oklahoma. And our original places that we reside and come from are Pawnee, Oklahoma, and Red Rock, and Okema. So it's my pleasure to be with you here today. I'll be serving as your facilitator. And we have an amazing presentation, amazing opportunity here to share some knowledge and wisdom and some dialogue together. And so with that, I'm also a training and technical assistance specialist with Kauffman and Associates. And that's just a little bit about me, but privileged and honored and blessed to work throughout Indian country for close to 18 years now. So but with that, let's, I'd like to turn it over to Terence LaFromboise, who's going to introduce our next speaker. Okay, Nick, so quick. Good morning. It's a good to be on this webinar, and to be a co-host with Courtney, and to be on this amazing team and to provide this opportunity for us to connect a little bit about myself. I come from the Blackfeet Reservation. I graduated a couple years back with my master's in social work with a focus in Indigenous trauma and resiliency. In my community, I do a lot of cultural preservation work and suicide prevention. Right now, I'm a technology transfer specialist with the ORN program and work for KAI, and also doing my licensed clinical social work in the community in the state of Montana. Just very blessed to introduce our cultural opener today. He comes with an extensive, amazing background in education, and the things he does and the things that he he says hold so much space. And I just want to introduce Dr. Aaron Payment. I just shared my morning Anishinaabemowin blessing in Anishinaabemowin, the language of my ancestors. I shared my name, Biwakajig, which means a place above my home territory where the spirits can talk directly through. My clans are bear and eagle. I am from Bala King, the place of the rapids, and a centuries-old gathering place for Native people. I also shared that I am Anishinaabe and have blood from all three of the three fires, Ojibwe, Odawa, and Potawatomi. I make sure to introduce all of my blood each time that I speak because I'm into trouble. I gave thanks to each of the directions and the teachings that we get from each, including the life cycles of new life in the eastern direction, which is represented by the new day, the southern direction, which represents our young people and entering the midday portion of our lives, the western direction, which represents adulthood, and then the northern direction, which represents our elderhood stage of life where we become wise. When we recognize our relationships in a medicine or spirit wheel, we see the connections between elders and the youth through a straight line and adults through our newborns through a straight line. This is the natural order in how Anishinaabe learn and some other tribes learn who we are and our responsibility to ourselves, each other, and to all of creation. I also gave thanks to Mother Earth, Aki, and Nibi, our waters. Water is life, which emphasizes the interdependence we have with the environment. We are part of, not separate from, our environment. When we recognize this, we approach our relationships with each other and with our very world with greater respect and care. An old blessing in my opening is, which is really a rhetorical question and a recommitment to each other. It asks, are you my relative? And it asks that not only you here today, but also our relatives that are our ancestors. Additionally, our main greeting of Ani is broken down to mean you and me together when we greet each other. This relational aspect depicts our responsibility toward one another. When we see the world from this perspective, we can't help but have more compassion and care as a matter of interdependence with each other. The Broken Promises Report and the consistently, and consistently the CDC data, have shown that American and Alaska Natives have the worst of the worst outcomes on social indices, including addictions, accidental overdoses, suicides, and ultimately lower life expectancy. Two years ago, the CDC showed a whopping seven-year drop in our American Indian life expectancy, which erases almost all the gains achieved since World War II. This is likely due to the pandemic and the ongoing epidemic of the opiate crisis and the fallout with fentanyl and other designer drugs that are killing our people. I am from a typical Native American family who has suffered from addiction. The opiate crisis is like nothing we've ever seen before. It is multiple times more potent than alcohol addiction. Fighting it has to be way more coordinated than anything we've tried before. We also have to see recovery beyond old conventions, including involving MAT and longer-term recovery and community supports to help our people rebuild our lives. As a people, we hold our spiritual center and our relations to one another as most sacred. Opiate addiction and other addictions it ushers in is like nothing we've seen before, as it becomes one's very center. It is all-encompassing. But our people deserve our compassion and our care and not our judgment. Therefore, the grace of God, go I, is the saying I often say, and I urge others to be grateful that you are not afflicted and reach out to support those who are. At KAI, we do work that matters and have rededicated our very approach to focus more directly on our behavioral health transformation with a historical trauma-informed approach and through compassion and care. Ché Miigwetch for listening, and I hope something that I said today connected with you and connects you with others in the work that you do. Ché Miigwetch. Thank you, Dr. Payment, for that opening, for starting us in a good way and grounding us. And, you know, our Indigenous people, our folks understood and understand the connection to spirit, the connection to all around us. And so we appreciate you for bringing us in and getting us started in a good way. I am blessed to have my grandma with us here today. I'm not here physically, but she's 94 years old. This week, she turned 94. And this week, she also told me, she said, pray about it and then let it happen, you know, so don't get in the way of it. So I want to thank you, Dr. Payment, because you've started us off in a good way. And so we know the rest is going to take care of itself. And so with that, I wanted to turn to our agenda, give a brief overview of our agenda today. We have, and while I'm going over the agenda, I want to thank Terrence for inviting everyone to share their introductions in the chat box. So that is there. So please, we see, I see some populating right now. So please continue to share with us who you are, where you're coming from. So with our agenda, the Opioid Response Network and Indigenous Communities Response Team, we're going to touch base on that. And we're going to go into growing our own, the presentation by Dr. Danica Love-Brown, Growing Our Own, Investing in Tribal Behavioral Health Workforce. We're going to have a share out, Caring for Our Relatives, and or a presentation here, again, Caring for Our Relatives share out. Then we'll go into our question and answers. And then we're going to touch base on how the ORN can help you. We will have a survey link and close out with our future webinar topics and our additional closing materials. But that's just a brief overview and a glimpse at what to expect in the next hour. So at this point, before we move on into our content, I'd like to turn it back over to our co-facilitator, Mr. Terrence LaFromboise to walk us through some housekeeping slides. Yes, thank you. I love what Courtney says, LaFromboise. Coming from Montana, living right next to the Canadian border, that's how they say my last name. I know in the States, we're just very English, and it's just LaFromboise. But I really like LaFromboise. Today, we're going to acknowledgement the funding for this initiative. As a part of the ORN network, this is brought to you by SAMHSA, and in part, the grant, SAMHSA, the views and expressed and written in the conference materials or publications, and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services, nor does mention of trade names, commercial practices, organizations imply endorsement by the U.S. government. Next slide, please. The opioid response network is in part due to the larger TOR grant and supporting TOR recipients and accessing and ORN assist states, tribes and urban native organizations, cities and communities, individuals by providing culturally responsive education and training to address the opioid crisis. We help enhance prevention and treatment recovery and harm reduction efforts by providing a cross-cultural connection and collaboration with in-state partners. We also provide no-cost training and consultation to help fill gaps as defined by all requesters. So, we listen and we provide whatever it is you're needing. Next slide, please. As a part of the ORN, I've seen some of the native brilliance that is being uplifted, and I think the big part of today's webinar is how are we supporting within organization and how are we connecting those cultural components, and a lot of what the ORN supports is that brilliance, that indigenous native brilliance. Within native communities, there are strengths and expert expertises that it's a shame that we're always looking outwardly when there's so much knowledge and investment internally, and ORN supports those spaces, along with the sovereignty that all tribes have and recognition that tribes want and need support, but at the same time, there's so much strength in recognizing our space and time. And again, we always look for local community leads. It's kind of how we lead our ORN effort support. So, next slide, please. Within the ORN, we have an indigenous community response teams, and these beautiful people have been an amazing support as I transitioned into TTS provider within TOR Region 3, and that is under HHS 5 and 8, and these are just big words, but all of us service different each territory and designed and designed a team lead by a regional technical transfer system, us, who is an expert in implementing evidence-based practices, ORN developed a response team to support requests specifically for TOR grantees and native communities. Next slide, please. And here is a quick map of our indigenous communities response teams region, and you see that regionally, we cover so much all over the United States and our neighboring islands, that Hawaii, it looks like we have Alaska, and each region is specific to a TTS. Next slide, please. And at the open response, we just want to really bring it back and together is recognizing that in community or together, we can make a difference. And I am going to hand it back to Courtney, who's going to introduce, oh, here is one of our ORN evaluation survey link. If you guys can scan the access code for a very brief survey, I've taken it. It is super brief. It also supports how we deliver and continue to support communities throughout the United States. Now I'm going to turn it back over to Courtney, who's going to introduce our amazing presenter today. Thank you, Terrence. Thank you for that good information. And I'm constantly just surprised and just kind of always in awe with how we can connect across the miles using Zoom and using these different resources that we have, and we can scan things with our phone. So it's always, I know I shouldn't be as surprised, but I'm constantly surprised. So it's my honor, it's my pleasure to introduce our presenter, one of our presenters here today that comes with so much experience, Dr. Donika Love-Brown. She was raised and born, born and raised in Northern New Mexico, and is a citizen of the Choctaw Nation of Oklahoma. She is KAI's Vice President for Behavioral Health Transformation. Dr. Love-Brown has worked as a mental health and substance use counselor, social worker, and youth advocate for 30 years. Over the years, her research has focused on indigenous ways of knowing and decolonizing methodologies to address historical trauma and health disparities and tribal communities. And she's also just a wonderful person. And so it's my pleasure, it's my honor to welcome and introduce Dr. Donika Brown. Thank you so much, Courtney. And thank you so much, Aaron, for your grounding today. Like so much of what you said, I think is woven into our presentation. And so I just appreciated grounding us in that way. I also want to acknowledge that some of what I'm going to be sharing today is out of conversations that I had at my previous job with Courtney. And so I might, I might call on Courtney to expound on things and primarily, this idea of sacred trust that we're going to kind of delve into today. So with that, if we can go to the next slide, we'll go ahead and get started. You know, so what I really want to talk about in reframing these ideas of workforce is, you know, as indigenous people of this continent, we are relational, we come from a relational worldview. And part of it is understanding and acknowledging that our lived experiences, you know, the hard experiences, as well as the good experience is ceremony, it is a sacred experience, that we as human beings are, are sacred. And this work is sacred, and that the ceremony initiates us into a sacred society of the remembered, a society that enabled, enables us to recognize when another might need support, might need family, might need community. And lived experience helps us to share kindness, patience, humility, and empathy. Generally, like when we sit in silence, and just being present with another person who might be suffering, and to help us find humor in the deepest hurts and pains. And lived experience helps us to create opportunities to connect. And it binds us in a sacred trust. Next slide. And we have a poll question, but I do believe we were, were we going to change the question? Oh, there we are. So while we're doing that question, I'm reminded I forgot to properly introduce myself. I apologize. Sometimes I get so excited about presentations, I lose my manners. So while we're doing that, I'm going to formally introduce myself. I'm Donika. Like Courtney shared, I'm a citizen of the Choctaw Nation of Oklahoma, and I was born and raised in northern New Mexico. And I have a history of doing clinical work as a mental health and substance use counselor, primarily with youth, Native youth, as well as adjudicated youth. And I've been doing that for a long time. And in my work, what I was really interested in doing in my dissertation was an understanding, not just kind of the impact of historical trauma on our people and health outcomes, but ancestral wisdom and knowledge. And so I really like to shift that narrative from pathology to focusing on our resilience and our beauty. So with that, do we want to share the responses to the poll question? So we see that there's, you know, there is a shortage of behavioral health providers. And then again, you know, part of it is because of clinical burnout, and lack of training. And well, reimbursement challenges, I think, has been an ongoing issue. I've been doing this for 30 years, and it's not changed. And then lived experience support. And for me, when we talk about this kind of support, it's around what we call self-care, community care, and spiritual care. And we'll talk a little bit about that as well. So with that, we'll go to the next slide. So in my previous position, I used to work at Northwest Portland Area Indian Health Board as a behavioral health projects director. And we did a lot of work within the tribes of the Pacific Northwest to talk about workforce development. And there was, what we were seeing really in 2020 was, you know, we've always, in 30 years, we've always had an issue with workforce. In these areas. But what we saw with the impacts of COVID, and specifically synthetic opioids like fentanyl, was, you know, these two issues kind of collided together, which created, I mean, what we're seeing is a public health crisis. And although we've kind of tended to move away from this idea that COVID is a pandemic, it's still an issue in our communities. And we're seeing waves of it. And it significantly impacted our communities, our tribal communities and the workforce. When we were working with some of the tribes in the Pacific Northwest during COVID, we saw a lot of the workforce just leave. And quite frankly, over the last few years, it's been reported to me by many tribes in the Pacific Northwest that the workforces that we do have is so stressed out and so burned out that it's been reported to me that some behavioral health providers have either attempted suicide or have taken their lives by suicide. And that's how critical it is. And part of it is because of this, this kind of this syndemic of these two, you know, public health crises, but also the fact that we just don't have the support that behavioral health providers that they need. And we're not providing particularly adequate support for people who have lived experiences and people who have lived experiences with mental health, with substance abuse, with trauma, you know, with incarceration, they have such an amazing insight and are able to provide such amazing work and support to people who are using drugs. And yet we're not supporting them substantially. And there's been a number of reports that have talked about this. HRSA provided a report that talked about, you know, substantial shortages of substance use counselors, marriage and family therapists, mental health counselors. And part of it is also needing to kind of expand the work that we're doing in this country to recruit and retrain and retain workers, but also we need to be better relatives to those workers. I think one of the things that we neglect to think about or understand kind of on federal levels, but we intimately understand in our own communities is that, you know, we want to recruit and retain a workforce that live and are part of our community. But consequently, you know, we as providers are also dealing with the same struggles that we're working with. And so we have this additional burden that we carry that is not really being addressed in the support aspect of developing and retaining an appropriate workforce. Next slide. And so, you know, we've been talking a lot about over goodness, you know, 20 years about growing our own and improving staffing and growing knowledge and thinking innovatively in these areas and providing the health and well-being of tribal citizens doesn't solely rely on simply bringing in more doctors or people from outside of the state. It also relies on bringing people from outside of their communities into working as professionals in Indian country. And we need to create an educational and employment pathway that improves a community member's likelihood of entering a health-related field and can help reinforce a community-driven response. So responding to like the opioid crisis in tribal communities, holistically, this requires training opportunities and creating community-based professional wage earning jobs and workforce development challenges facing tribal governments and native organizations are multifaceted. There are feasible ways to overcome these hurdles. In fact, a growing number of tribal nations are constructing effective solutions to overcome them by developing responses that includes improving staffing. So, you know, reaching out to community members and providing, you know, adequate training and support for them and recruiting people to come into those positions. You know, seeking additional funding and restructuring staffing profiles to increase staffing levels and ensure adequate workforce to implement this work that we need to do. And growing knowledge. I think one of the other things that I heard a lot in tribal communities was it wasn't just the workforce as far as like chemical dependency counselors and mental health workers, but there's a lack of clinical supervisors. And there's a lack of clinical supervisors in general, but there's an even more impact is the lack of culturally competent clinical supervisors and then consequently even fewer clinical supervisors who are part of the community who were trained to do the work from their communities with their communities. And so growing knowledge and developing training that's specific to tribal communities and providing that training and creating a comprehensive, you know, training and understanding of how all these impacts help us and doing it within a way that's culturally competent. And thinking innovatively, we really need to, I think, think outside the box and provide staff, you know, designated wellness time and stress management support and promoting retention and avoiding burnout. You know, I've seen, you know, organizations that have on top of their culture, their annual leave, they have cultural leave so people can engage in their cultural activities and have time to do that. We also have seen policies where organizations have dedicated wellness time and they have staff who come together and provide cultural activities or wellness activities together so it also builds up that time. So on top of your like daily lunch break and your 15 minute breaks, you get an additional 30 minutes to do wellness and creating innovative ways to engage health and wellness in that and encouraging staff to have a work-life balance. I think in this Western society, we've really pushed towards this productivity where we are kind of expected to work, you know, 60 hours a week, especially if you're like a salaried employee. And what we really need to do is really move towards having a more, you know, balanced experience and encouraging work-life balance for our people and for our workforce. Next slide. So part of that is really also kind of understanding these different worldviews, right? In the Western world, we have these very linear worldviews where, you know, it's always kind of asking why, there's a cause and effect, time and clock are kind of oriented around linear time, you know, coming from this very medical model. You know, a lot of times in a lot of tribal communities too in the Western world, we have these very strict mandates around, you know, our relationships and behavior and things like that, but in our indigenous communities, we're relational, right? And so we ask questions about how and what, you know, and thinking about the cause of things in a different way and that it's more fluid and moving. The focus is on the group, not on the individual. In the Western world, healing is really mandated to kind of an individual experience where in indigenous worldviews, it's a collective experience. We heal together. So it's much more community-based and it's sharing and there's a generosity that's part of that. And children are protected and viewed as precious and they're engaged in the communities in different ways. And we remember that when we heal in this lifetime, when we heal in this space, in this time, we not only heal, you know, the future generations, we also heal our ancestors. And so it's not just this linear experience. Elders are respected and esteemed and not just elders, but knowledge keepers. You know, we have a whole burgeoning group of younger people who are reclaiming their culture, reclaiming their language. You know, I think about Terrence, you know, he is a knowledge keeper. And although he might not be an elder in age, like he holds a lot of wisdom. And so, you know, again, thinking outside of that box about who are our knowledge bearers. And all of this is connected to our spirituality. In the Western world, there's actually, you're not supposed to even talk about spirituality. In our world, it's centered, healing is centered in our connection to spirit, in our connection to something outside of ourselves. And it's kinship based, you know, we have relatives that are not our blood relatives, we have relatives who, you know, who step into these roles. When I was 16 and struggling, it was my kinship aunties who stepped in and took care of me. And also disciplined me and so creating kind of these anti societies or these other relations to help support this. Next slide. And so, you know, coming back to this relational worldview is that, you know, we want to think about balance. In the Western world, health is viewed as the absence of disease, which I always think is really interesting. That's the APA definition of health. And so we don't really think, you know, many tribal languages, there's not even a word for health. We have words for being in balance, we have words for being connected, we have words for being, you know, in wellness, but there's not a lot of words for health in the Western context. And so balance is a big part of that. And not just, you know, Aaron kind of talked about those medicine wheels that, you know, but this is not just the physical, mental, emotional, and spiritual. Our relational worldview also connects us to, you know, our relationship with our ancestors, with ancestral wisdom and knowledge. And that's generally passed down through our creation stories and in our songs and our dances and, you know, and the way that we interact with our elders. It's interconnected, and we're also in relationship with Mother Earth and all creation and that we're not separate from it, we're not above it. We're in relationship with it. And then at the center of it all is, I think one of the main things for me is understanding that we're all sacred. And that when we understand, not that we know it in our brain, but that we understand it in our heart, we're going to navigate the world in a very different way. And when Courtney and I started talking about this idea of sacred trust, that was really kind of, for me, the core message from that is that as us as providers, this is a sacred trust. This work we do is sacred. When we're talking about someone's pain, when we're talking with someone about their darkest wounds, their deepest pains, their suffering, their struggles, that is sacred. That is sacred work. And as workforce, as providers, when we acknowledge that, it shifts the energy that we have in relationship with the people that we're serving. It also shifts the way that the people we're serving also see themselves in the world. They're not just clients, they're not just patients. They understand that they're part of humanity and that we're in relationship with each other. And so this provides a model for who we are as individuals to be in relationship and in balance. And it's not just simply an absence of disease. We have a lot of our relatives who are sick. They have chronic illnesses, but they're still living good and healthy and well-balanced lives. And that we can create a balance to produce a strong, positive sense of self and well-being. And that really when we're looking at this, we're looking at an imbalance, which can then cause symptoms of illness, substance use, difficulty in maintaining relationships, and a sense of disconnection. Gabor Mate talks a lot about this connection between trauma and substance misuse, as well as other conditions. And it's not trauma that leads to addiction. It's trauma creates a sense of disconnection. It disassociates us from our relatives, from our world, from our sense of self and balance. And so what we're now talking about a lot is connectedness. And I'm hoping that Katie Hunsberger talks about this in her dissertation. She's talking about connectedness in relative to education of workforce, of behavioral health providers, and the connection between teachers and learners and elders, and all of these things, and building a support for learners to be feel more connected. Next slide. And so a lot of what we talk about as providers is that we just want to be a good relative. And being a good relative in our world is, you know, really that everyone is meant to have family. That connection strengthens us and connection serves as an anchor and grounds us. We know who we are in the world. We know our role when we're in connection with our ancestors, with the land, with the tribe, with our community. It fosters a sense of belonging. And in this society, like, there's an epidemic of loneliness. And I think COVID really impacted that as well when we were having to socially isolate. And so consequently, you know, we need to garner a sense of belonging. And being connected to our culture and cultural ties promotes cultural reproduction. When we feel, you know, safe in those spaces and, you know, to feel like we've been understood. And I'm not talking about just clients. We as human beings, you know, need to feel connected and centered. And for me, I think when we really understand the sacredness of this work, we can shift to back to this place of compassion, care, and kindness. I learned more about my humanity in working with adolescents who use drugs. I learned more about patience. I learned more about love and compassion and being in relationship from those kids. And so when we think about when we feel safe and supported, what does that feel like? And Courtney and I, we did some focus groups where we met with people who are service users of mental health and we asked that question. And that was the only question we asked during the whole focus group was, what does it feel, when did you feel safe and supported? And it just was this beautiful experience of them sharing about their experiences, looking at it from that perspective. Next slide. And so there's been a lot of work really thinking about and talking about connectedness. And Jessica Ulrich is a friend and a colleague and a sister, and she's really been doing a lot of work. And Dr. Melissa Walls and Melissa Lewis, myself, Katie Hunsberger, we've been really talking a lot about connectedness and connectedness really to our culture. And what we're starting to understand is that when people are connected and feel connected, that they're healthier. That's the bottom line. But when we talk about cultural connectedness, this is this kind of very ambiguous idea of cultural connectedness. And what we're trying to do is understand what are the mechanisms of culture and connectedness that motivate people to shift their worldview and shift the way they're navigating the world. So for us, what we've been talking about, we've been working with Johns Hopkins, the Center for Indigenous Health, is looking at cultural connectedness. And specifically, we've been talking about ancestral connectedness, land connectedness, cultural connectedness, and community connectedness. And we're working on developing a measure so that we can look at that and think about it in a different way. But what we know is when you think about why does treatment work, treatment modalities are just treatment modalities. It's kind of just words on paper. What works about treatment is connectedness. It's that therapeutic alliance that we have with our clients that generates connectedness. And it's that connectedness that's healing. That's why 12-step groups are really effective for many people. It's not necessarily the model of the 12-step, it's being in space with people who have shared experiences as you and building that network of support and connectedness. And so it's really an exciting part. And this is really an indigenous framework for understanding. Next slide. And so we talk a lot about our knowledge keepers and prayer. And this is a picture of Eduardo Duran and a lot of the work that I like kind of lean to is really from him. And he has been a really good ancestor to me and a really good ancestor to a lot of people. And one of the things that he talks about is that this work we do is prayer. When people are telling their stories, that's an act of prayer. And he talks about historical trauma as a soul wound. And that all of these conditions that impact us like suicide and substance misuse and cancer and diabetes all have a spirit. And that there's natural law and that we should be offering gratitude and learning to each other in this work. And that there's these spirits that we need to kind of like go into treaty with, which can be really, really scary. To go into treaty with the spirit of alcohol can be a really scary thing. And that's why we have providers who do that. And then we have a lot of other ancestors, Maria Braveheart Yellow Horse. There's just so many. And now there's new knowledge coming up from new folks like Katie Huntsberger. And I'm excited to have her present. Next slide. And so the current trends in workforce development is really, I don't even like the idea of current trends. The trends that we're reclaiming are these ideas of remembering and reminding and focusing on our indigenous strengths and resiliencies. And even moving beyond this idea of resiliency, it's moving to this idea of thrivance that we are thriving despite so much pain and so much struggling. You know, we want to grow our own. We want to build the capacity of those who are working and living in our own communities and valuing knowledge keepers and recognizing the parallels of what we've always known to what we now know. Even this idea of like the epigenetic transfer of historical trauma, which is new knowledge. My grandfather used to tell me the memories of your ancestors are passed down on your blood. He was talking about epigenetic transfer of knowledge. So not just trauma, but ancestral wisdom. And coming through, and now we're seeing this resurgence of amazing, beautiful art and fashion and shows. Reservation dogs was just an amazing representation of our lives in a contemporary way. But we still need to protect some of our, you know, the laws and protect the Indian Child Welfare Act and protect sovereignty. And, you know, these things are constantly under attack. And so we need to protect that. And then, you know, acknowledging the harm that colonization has had on us. And, you know, our beloved Holly Echo Hawk always talks about native psychological brilliance. This is an important concept that we always center our brilliance versus our pathologies. Next slide. And that, you know, we need to kind of, for me, really changed the way we think about leadership. You know, for me, I try to think about leadership as less hierarchical and more horizontal and circular. And so for me, in the way that I try to be a good leader, even when I was a licensed clinical social worker and providing clinical supervision to, you know, the pride providers that I was working with, you know, an important part of this is really that we are human beings. And we have lots of things that happen to us. And that if we're in a relational, coming from a relational worldview, that our leadership acknowledges that. And that we support work-life balance and that we support self and community care. And that we develop models of supervision that navigate being in both worlds. And that's what Courtney and I were really talking about was like the sacred place where we're navigating the space in between. You know, we're mandated by federal law to use certain assessments and measures and reporting and all of these things. We don't have a choice in that if we wanna get paid and have our accreditation. But we do have to acknowledge the relational worldview of the people we work with. So we as leaders are navigating the space in between these worldviews. And that if supervisors are coming from outside of our communities, we really need to provide cultural consultation to them. And I think some of the most harmful things that I've seen came from, you know, very well-intentioned clinical supervisors who were coming into communities and not understanding that. And that, you know, the reality of it is is that we do have dual relationships. And so we have a higher responsibility to navigate that. And so, because we live and come from our own communities, I mean, the country's small, right? So we many times are working with people that we have relationships with. And so we don't have a choice with that. Many times we're the only providers. So we have to navigate these dual relationships in a way that is relational. And, you know, celebration and acknowledging and praise and, you know, supporting. We need to pay our providers what they're worth, which is a lot more than what they're getting paid. And in treatment fields, you know, counselors and mental health providers and chemical dependency counselors and behavioral health aides are just not compensated at a wage level that they should be, in my opinion. Next slide. And so I think one of the things that we worked on, I worked on when I was at Northwest Portland is we developed a community or behavioral health aid project and I helped develop the standards and procedures for that. And then I worked with a number of partners to develop the curriculum. And then I had the honor of being able to teach that curriculum to our first cohort of behavioral health aides. And so Katie Huntsberger, and we can introduce her in a minute, but I'm just gonna say, she's just so amazing. And she is the student support person for this project. So she recruits students from tribal communities and then she really kind of helps build them up to become amazing providers in our community. So we wanted to provide this kind of community share out to talk about the specific nuances of this behavioral health aid program. So I will, you know, open it up and pass it on to Katie. Hello, before Katie joins us, this is Courtney. And so I'm gonna, I would like to have a introduction. Thank you, Courtney. Yeah, yeah. But it's exciting. It really is. It's exciting. And you know, you even hesitate to say the term work, right? But it's exciting opportunity that we have to connect and to share and to live together in this way. And so I'm real excited to hear what Katie has to share. So relatives, I would like to introduce Miss Katie Huntsberger I believe I'm saying your name, right? Great. She is a member of the Fort McDowell, Yavapai Nation. Her homelands are the areas around and within the Sedona Desert. Katie has worked closely with indigenous peoples in various parts of the world for the last 10 years. She is co-deputy chair for Caring and Living as Neighbors based in Sydney, Australia, and currently works at the Northwest Portland Area Indian Health Board as the behavioral health aid program manager. Katie strives to weave in indigenous frameworks, indigenized frameworks and theories to decolonize minds and create systems of care for our future generations. It's just a fantastic time to be alive and hear from and learn from and grow with wonderful people such as Katie. So ladies and our relatives, Katie. Thank you so much, Courtney, for that introduction. Mahamganuwa Niyamulich Katie Huntsberger. Hello and good day. My name is Katie. I use she, her pronouns. I work with the tribal community health provider program as the behavioral health aid program manager. I was hired for this role in 2020 as the BHA student support coordinator. I'm here to talk about the creation, implementation and evolution of the BHA education program. It's been so special being a piece of this puzzle and I'm excited to share with you all this program that steers in the direction of decolonized approaches to education that really emphasize indigenous ways of being, which are vital frameworks that are so needed in the behavioral health fields for our tribal communities. So if we can move to the first slide. Next slide, please. Awesome. So the BHA education program was originally developed and implemented in Alaska in the 90s through the Alaska Native Tribal Health Consortium, ANTHC. Health aides are going through the program at various levels where they're working to provide culturally tailored village-based care to their communities. Alaska created invaluable standards of procedures, bylaws and past legislation that allows their health aides to pursue schooling, go through the Alaska Certification Board to be certified as BHAs, community health aides and dental health aides, then work for their village and behavioral health departments billing for their services. ANTHC success has been widely recognized and the Portland area is the first in the lower 48 to manifest a Northwest version of the BHA program. Through Alaska's programming, as well as ours in the Northwest, the creation of the program is rooted in the guidance, expertise, input and voices of tribal communities and leaders. In 2018, the health board created a BHA advisory work group consisting of ANTHC reps, higher education institutions, clinical supervisors, program directors, behavioral health staff and elders who became key players in the structure of the Northwest BHA program. This advisory work group met once a month and was a space for them to come together to discuss potential education sites, the curriculum, sustainability, what this program would look like for tribal communities. Experts in the field from various Northwest states and tribal representation came together to discuss what was so very much needed, which were holistic methods that prioritized indigenous ways of knowing and being able to help our communities heal from substance misuse and behavioral health crises. Keep in mind, this is before 2020 when that amplified even more. So similar to community-based participatory research methods, this process emphasized the importance of building respectful, reciprocal and trusting relationships with tribal communities to fully understand their unique needs. It was truly a way of embracing tribal self-determination by listening to what tribes were in need of and then tailoring aspects of the program to meet those needs. So whether it be through job descriptions, recruitment, funding, technical assistance, meeting with tribal council, you name it, it was a time and space for everyone to have a seat at the table and help put those building blocks together. Once those relationships were established and protocol was met and that trust in one another was created, then the program creation began. In 2020, when I was hired, the BHA Advisory Work Group had created essential work and huge strides. And the Northwest Portland Area Indian Health Board had solidified two critical relationships with academic institutions who were going to house the BHA program, which we'll talk about a little bit more later. And the BHA Advisory Work Group has now, who met from 2018 to 2022, has now been formalized into the Behavioral Health Academic Review Committee, the BARC, consisting of experts in various regions who are deeply in the fields of behavioral health and are a part of the development. Overall, I always like to think of the program as a human. In its womb, people and elders were dreaming of what it would grow into, what they would be like, how they would make people feel. It was all the dream work that was being poured into the plans that would take action once they were birthed. Then the program was in its baby phase, where we were all still learning the ins and outs together, the ups and downs, learning as we went along, and often through trial and error. It was a lot of reading, relearning, took a lot of patience. But now the program is almost four years old. It's in its toddler era and growing quicker than expected. Stories, lessons, ideas are endlessly being communicated. It truly took a community to raise it, to care for it, to love it into what it is today. And that's the most special part about this program to me, is that it was birthed in love and raised in a collective consciousness of healing. Next slide. Thank you. So this is a map of our journey. It's been a long one. Every piece of it has been very mindful. I feel like at this point, people are wondering what is a BHA? We've talked about it, but what is it? So a BHA is a counselor, a health educator, an advocate. They help address individual and community-based behavioral health needs, including those related to alcohol, drug, and tobacco misuse. They help address mental health problems such as grief, depression, and suicide. And they seek to achieve balance in the community by integrating their sensitivity to cultural needs with specialized training in behavioral health concerns and treatment. They're a homegrown collective of natural healers, advocates, holistic caregivers. They're aunties, grandmothers, uncles, dads who are rooted in their communities and are aware of the behavioral health needs specific to their community. So oftentimes, BHAs have lived experiences and are typically first-generation non-traditional students, meaning that they're the first to go to college. Maybe they're pursuing school later in life. They didn't have the opportunity to pursue a degree, and now they're going back into it. Some similar roles are peer recovery mentors, peer support specialists, traditional health workers, CHRs. Current BHAs even start as front desk receptionists for their behavioral health department. Some are working within tribal schools with youth. Some are in elder programming, promoting cultural arts therapy, and some are unemployed or seeking internships. So the current pool of BHAs is very broad. Their scope of work depends on the level that they're at, but some of the services that they provide include case management, referrals, early intervention, crisis intervention, postvention, health education, screening assessment, and community prevention activities. So when we look at the top right here, the BHA education program, you'll see that on this road, Northwest Indian College and Heritage University are the two higher education institutions who are housing this program. Northwest Indian College is a tribal college based in Bellingham, Washington. Their BHA program originally came through their chemical dependency program. So a lot of the courses are dependent or kind of created through that chemical dependency ATA degree. So some of their courses are crisis management, multicultural counseling, stress management, a supervised practicum, chemical dependency, relapse prevention. Northwest Indian College is a predominantly online learning, so that offers a lot of flexibility for students to pursue online learning through Northwest Indian College, which makes it very accessible. And we also have Heritage University located on the Yakama Nation in Toppenish, Washington. Their program stemmed through their social work degree. So some of their courses align more in like ethics and practice, SUD, human behavior on the social environment, social justice and diverse population and BHA seminars. Both programs have BHA coursework that are grounded in those kind of holistic approaches to care. Partnerships with Heritage and Northwest Indian College have been extremely invaluable. There are BHA faculty at each institution that our team meets with regularly to monitor the status of the student, provide updates on the curriculum, meet with the professors, monitor progress, look at some of the grades to make sure if students are falling behind that we can create an action plan or provide a tutor to make sure that they pass the class. These partnerships are extremely important to provide that student insight. Success of the program also relies on the local or Northwest tribal communities who can identify people in their communities or working within their departments who can join the program, and having that tribal support is extremely important. Most of the BHAs are working full time, are parents or grandmothers, and also pursuing school full time. So as you can imagine, they're wearing mini hats and having that tribal support within their departments is crucial because oftentimes some of these courses take place while they're in the workplace from like one to two, you know, depending on the part of the day. A lot of the classes do take place while they're working, but we solidify that tribal partnership through MOUs where the health board and the student and the tribe kind of signs this training support agreement that they're aware that this employee is going to pursue school, that they're really learning things that are directly involved into their day to day work. I think a great example of this is the Yakama Nation. They currently have the largest pool of behavioral health aides, I think around 12 and that's growing. Yakama Nation and Heritage University really established a strong partnership to build workforce development and it's been working really well in their favor. Next slide, please. BHA courses are uniquely designed for students to utilize tribal traditional tools as well as some Western forms of health care to create care plans, assessment and services for families, youth, elders who are impacted by mental health disorders. All BHA required courses are grounded in holistic and indigenous approaches to health care. The BHA educational philosophy model includes identity, history, self-direction and leadership, cultural competency, language and relationality. This model promotes our vision of creating diverse, unique and culturally responsive programming for Native students working to spread wellness in their communities. And so by opening the traditional framework of Western knowledge to indigenous science and tradition, it becomes possible to understand the world in a far more complete and comprehensive manner. We have witnessed the retention of our BHA trainee cohorts as they are experiencing learning in indigenous education environments that reflect a relational worldview. And the integration of tribal pedagogy with traditional ways of learning to then complete these programs to better prepare them to work and implement tribal-based practices in their delivery of care. And this all really stems through the six R's in higher education being respect, relationship, representation, relevance, responsibility and reciprocity. So we are very lucky to have found two academic institutions who value these worldviews and implement it within their within their teachings. Next slide, please. So these are some of the textbooks that the students, the BHAs are receiving throughout their coursework. I think as we know, health intervention initiatives centered within indigenous knowledge frameworks are highly effective in counteracting the destructive effects of Western diets and lifestyles on Native communities. And these emerging models of indigenous knowledge and education are very promising because by integrating these traditional indigenous practices, as Donika was talking about earlier, these pedagogical models that are inclusive of our ways of knowing students are more likely to relate to the material to understand these texts that aren't so standardized and quantitative and, you know, kind of dehumanizing. It really centers texts that honors these ways of knowing. In fall 2021, Native American students made up 0.7% of all post-secondary enrollment. Since fall 2010, Native enrollment has declined from 196,000 to 121,000. That's almost a 38% decrease. Undergraduate enrollment declined from 179,000 to 170,000. That's an almost 40% decrease. Those students who do pursue post-secondary education face systemic barriers and access to education. Financial struggles and costs of college are overwhelming. Only 36.2% of indigenous students who enrolled at four-year colleges and universities in 2014 completed their degree in six years compared to 60% of all other students of other races and ethnicities. I'm not a fan of talking about the deficits, but it's important to understand the relationships between higher education and Native peoples in this country. It is truly an epidemic that predominantly white institutions have continued to ignore. But Native people are embracing our own self-determination and tribes are flexing those tribal sovereignty muscles to create pathways for Native people to pursue schooling. So college affordability, cultural relevancy, inclusivity, community, and familial support, therefore, are extremely important aspects that make students successful. Through the funding we've secured for this program, we're able to provide a stipend scholarship of $12,500 so that students can earn while they learn. And I also help pay for their tuition, reimburse them for books and supply costs, and provide tutor support. So all of these things that seem so little to the average person pursuing higher education are extremely large barriers for Native students. And so we really try to address that through this program. Next slide, please. Higher education for me at times was a pretty negative experience because I was in a predominantly white institution where I felt like the campus climate was at times culturally hostile, which led to feelings of lack of belonging, imposter syndrome, and even hesitancy to even continue throughout school. I was surrounded by Native mascots, stereotypes, and often really felt that I was that 0.1% on campus. And I really love the BHA program because it's grounded in Indigenous paradigms at institutions that value culturally responsive programming in order to keep retention for their students. My current dissertation work is looking at the lack of relationality and cultural connectedness that is the harsh reality of Native students who go to predominantly white institutions. Without systems in place, Native students have continuously been pushed out of these spaces of learning and often have to battle the systemic monsters that are alive and well on college campuses throughout this country. For these reasons, we really try to meet the students where they're at so we have a deeper understanding of what their needs are, if they have any IEPs in the past, if they're living with a disability, if they are in recovery. So we have that relationality and trust building at the center of the programming. And by seeping in these relational and cultural practices with the students, I feel like it allows them to move forward in a way that is deeply embedded in those approaches. They're not just learning it, they're living it and breathing it daily and some BHAs have opened up to me saying that they feel the mounting pressure to be a part of this healing movement, but it's not a job. As Courtney had mentioned, it's community care and reciprocity. And so through the BHA education program, we really try to adjust the needs holistically through cultural competence, trauma-informed care, having a deep understanding of intergenerational trauma, and the students not only learning about it, but having activities and assignments in their class where they're deeply thinking about their own intergenerational trauma. Kind of like heal the healers training, but through coursework, where they can understand how this has impacted their work so that they can be healed and provide that healing to those that they work with. This program speaks openly about these issues in order to create effective treatment plans that recognize the importance of utilizing culture as medicine, as prevention, that these approaches declare include key aspects of spirituality, culture, traditions, connectedness, as Donika was talking about, which are all at the center of Native wellness and identity. So we really encourage the students to use their tribal traditional tools. I love the picture on the right, because a lot of these tools involve dream work. It revolves around healing. It's around storytelling. And a lot of the projects that BHAs have honor these tribal traditional tools where students can implement them into their coursework and their essays and their presentations. And another piece of the program is emphasizing self-care, because sometimes, as we mentioned, the BHAs have lived experience. So sometimes some of the coursework can be triggering. It can take them back into places where maybe it was a little hard for them. So one of the very first assignments that BHAs have is creating a self-care plan and really thinking about how they, you know, using the relational worldview model, the medicine wheel to figure out how they can balance school, life, work, being full-time this and full-time that. And it really can stretch some BHAs in different directions. But we really try to emphasize for the students to take care of their garden and to water the seeds that they need to make sure that they don't reach burnout. Next slide, please. Mentorship is a huge piece of the program that we've implemented. It provides relational and kinship approaches to ensuring that students have an elder and a mentor. It helps not only their academic outcomes, but their health outcomes and their social relationships. And providing an elder mentor at the health board has been through the Indian Country Echo platform. This is a plug if you're ever wanting to join. It's every month. You can go to IndianCountryEcho.com. And the Northwest Elders, Knowledge Holders, and Culture Keepers Echo was designed for behavioral health aides. It's now opened up to all health aides. Anyone can join. It's a space where BHAs can ask for support through elders, through mentors to connect with community, build a community of support. And, yeah, honor the storytelling. And BHAs could submit a case didactic form if they're having trouble with a client or they're seeking guidance. So if you are ever interested in attending these, I believe they're every second Tuesday of the month from 12 to 130. But I did want to mention that that elder and mentorship is a piece of the BHA program. And they often have times to connect throughout the year with one another. Next slide, please. So these are some pictures of BHAs. They are active agents in the development of the program. Our team does site visits to the schools. We meet with clinical supervisors in person. We meet with tribal council if they're needing some technical assistance. We build relationality through one-on-one check-ins monthly where I meet with the student and their clinical supervisor, especially the first year when they're in the program to ensure retention, making sure that they have many layers of support with their elder, with me, to make sure that they have what they need to be successful. The top right picture, you'll see the tipi, which is on campus at Heritage University where we start their BHA seminar. They start class. And it really is a beautiful, it's a two-hour class. And it starts a ceremony in the tipi where you go around and smudge. And students are really talking about what is weighing on them, what they're happy about. But they do that at the start of each class. And it is really a grounding, emotional way to start. But once that work is done, it's so much easier to leave it in there, go to the class, and then pursue the coursework. The bottom left is the National Tribal Opioid Summit last year. The BHAs and elders had a specialized track throughout that where they had Dallas Gold Tooth come in. And they were also creating smudge bundles for some of the participants of the program. It was a pretty emotional and heavy day. But we like to provide opportunities for both cohorts, all cohorts, and students from each institution come together and get to know one another. Next slide, which I believe is my last slide. Just to wrap this up. This far, the Northwest Portland Area Indian Health Board, Heritage University, and Northwest Indian College have recruited over 55 behavioral health aid trainees since 2021. I'm happy to say that we have high attrition and retention rates. Twenty-nine students are currently in school. And we are looking to recruit our fourth cohort in 2025. Three students have been nationally certified through the Alaska Certification Board. Nine students have stepped out. And three students have taken a break from the program but are coming back when the time is right for them. Over 15 tribes have sponsored, supported, and assisted the VHM behavioral health employees in pursuing the two-year program. Yakima Nation has supported over a dozen students who received training, education, and certification. This has expanded workforce development in the Northwest area in a vital time of need. BHA careers and job placements have also been put in place by several tribes. So, BHAs are existing in current tribal departments. As of April 2024 and this month, 12 behavioral health aides, the very first cohort, have completed their training, have graduated. I was able to attend both of those graduation ceremonies and it was really beautiful and coming full circle. All of this work has been done through a grant provided by HRSA, an opioid-impacted family support program grant. We have just applied for our next four-year round of funding. So, please cross your fingers for us so we can continue to keep doing this important work and spreading and recruiting students and providing support for tribes. CHAP expansion is spreading throughout Indigenous country, creating opportunities to expand recruitment to other tribal areas such as Montana, Arizona, and Oklahoma. All in all, I think being a good relative is at the core of what I try to bring to this program as a Native student with my own lived experiences with mental health and substance misuse. I knew from the get-go that sacred trust that was needed in order to be successful at providing student support. Not being so formal, acknowledging who they are and where they come from, traveling to tribes as much as possible to meet in person, and being relatable to their experiences. It's meeting their kids, it's talking about their experiences with domestic violence, with foster care, and other barriers faced, forced upon them through systemic barriers that exist in this country. And it's being open to talking about how intergenerational trauma has impacted us. This part of my career has transformed my life. This work has grounded me in connectedness and relationality. It's led me to my dissertation work. It's allowed me to meet a lot of mentors such as Donika and those that I work with. And I feel so honored to be one of the many building blocks of this program. So, with that, I would like to say, Unigam, thank you for listening and sharing space today. Wonderful. Thank you so much for sharing, Katie. Thank you. Your experience is tremendous. It's wonderful. And like you said, it's in the toddler stage, so there's still much more growing. And I love how you shared that it was birthed and loved and raised in a conscious community. So, thank you so much for sharing. We want to take a few minutes to go to questions and answers. So, if anyone has any questions, please put them in the chat box, the Q&A box. Raise your hand. We have a team here. We're working together to monitor and ensure that we get everyone's questions. I am keeping an eye on the time. So, right now, we're going to leave about five minutes. So, I just wanted to put that out there. But are there any questions? Either Danica or Katie? And while you're thinking about your question, Chelsea, I believe we had maybe a couple of questions come through or something. Is there one that maybe you could put into the chat box? Let's see, what will the future of BHAs and BHA programming look like for Indigenous country? So what is that vision, all right? What does that look like for us? What is it, if we were to dream that up, and what does that vision look like? So that's a great question. Katie or Dr. Brown? Well, for me, you know, the big vision is that we have healthy, happy communities, right? And that we build up our, you know, our own infrastructure outside of kind of Western ideas. And, you know, and right now it's like we have to be in relationship. So we do the best we can. I'll say though, and Katie can probably speak to this more, there's so much interest across Indian country for this model. The NPIHB is in conversation with the Navajo Nation. They've been in conversation with other tribal communities in Montana, at Blackfeet, and the Cherokee Nation. So they're ongoing conversations. And so, you know, this was kind of a call to action that the board developed this program for the lower 48, because they've been doing this work in Alaska for a long time. And, you know, and so with huge amounts of success. And so it's, I think it's just a model that can be really effective in developing that workforce. So there's a lot of interest. And like I said, I just imagine this toddler, and that's what it feels like, because we were like, our theme throughout this whole experience was, we were building the canoe while we were paddling. So we were literally creating the curriculum, and recruiting students and training students all while we were still developing all of this, because the need was so great. We didn't, we just couldn't stop to develop the program, to wait and then implement it. There was just so much need. So we were paddling the canoe while we were building the canoe at the same time. Yeah, yeah. And that's what, that's a lesson right there. So thank you so much for sharing. I can just add in two different pieces, I feel like, for the future of the program. I think at a more formal level, there's still a lot of work being passed with legislation and policies for Oregon, Idaho, and Washington. So that the Portland Area CHAP Certification Board, which is this whole other layer of the program, will be able to certify behavioral health aides through that certification board, where they receive that national certification, where tribes are implementing the billing codes, and all of those requirements. So in the end, after the two years, after the BHAs have completed all of their things that are required for certification, that they're able to bill for Medicaid reimbursement. And that provides sustainability in itself right there. Yeah. And go ahead, Donna. Well, what I'll also add is, you know, I've been teaching social work and human service courses for 20 years in a master's level. And this training is much more rigorous than any other certification trainings that I've ever done. It's more thoughtful, it's intentional. And those BHA students quite, in my opinion, are more qualified to do this work than I would even argue an MSW. And so I just want to reiterate, because there's still this like sentiment, and in my opinion, is kind of based in this racist idea that we're not really smart enough to actually be doing these certifications and accreditations ourselves, when in reality, it's much more intense, it's hard, it's rigorous, and much more impactful, I think, in the long run. And in the time that I was teaching these courses with the BHA, the students were, there were struggles, a lot of it was really around technology more than anything, which I can sympathize with, because I'm technology challenged, but the engagement of the students was much more engaging than in other coursework that I've taught at different levels. I just want to add that. It's really an intense program, because they're living and working at the same time that they're training. Wow. So I'm hearing it's relational. Yes. The part of what I think it also makes it so effective is that you're not stopping what you're doing, going to a program, getting trained, and then going back to your community. It's this, you know, kinetic learning where you're learning and doing at the same time. So the integration of knowledge is much more purposeful, right? And then on top of it, you're getting the secondary education with elders and knowledge people, knowledge keepers. You don't get that anywhere. And those knowledge keepers, man, they're amazing. I would encourage you, if you can, to join the elders and knowledge keepers that go, because it's really a really beautiful space. Wonderful. Thank you for that invitation, invitation, Donika. And just kind of quick, very quickly, because I'm also monitoring the time, but that leads into one of the questions that I see in the chat box around technical assistance, accessing, is there technical assistance that can be accessed to help develop a BHA program in the communities that we serve? So what are some of those resources? And maybe there's some ideas or something that we can speak to around that. There is, I will say, another plug through the Indian Country ECHO platform, as well as the Northwest Elders ECHO, there is a CHAP ECHO learning collaborative, and I can put that link in the chat, but that meets every two to three months. And it really is talking about not only BHAs, but dental health aides, community health aides, and CHRs, and really has been going through each, every other month, what the implementation look like, learnings for tribal communities. If people are out of area who are trying to start an advisory work group to begin the process, I would say the CHAP ECHO learning collaborative is a great opportunity. We also have our website, TCHPP.org, and I can also put that in the chat, but that has a contact page where you can look at our team members and reach out to someone on our team. We have had a lot of technical assistance inquiries, because as we've mentioned, the program is growing. I know Montana and I feel like Arizona are starting to, you know, in their advisory work group collaboration phase to build a certification board and create training programs. So right now, as toddlers, yes, we're getting a lot of, you know, of these requests, and we're happy to help, because we definitely, as I said, learned through trial and error, but learned some really critical lessons. Thank you. Thank you so much. Thank you so much for sharing those invitations. So again, we appreciate your knowledge and sharing that wisdom. So, but at this time, we're going to, I'm looking at the time, I want to be respectful of everyone's time, but we have a few more things that we need to cover, so I'm going to turn it over to Terrence. Yes, next slide, please, after the Q&A. And I think this ties perfectly into a little bit of that TA, and those specifically there are parameters that ORN has to be guidelined under. There are specifics that we can provide within the ORN for free, as mentioned in the earlier slides, that training around trauma-informed care practices. Consultation and creating job descriptions and policy documents. Now, consultation, we can't create those for you, but we can provide high-level expertise to come in, and to provide knowledge, and formats, and templates, and all those things that could guide us. Stigma training for tribal communities and workforces, huge, especially in spaces of what we're doing today, when we're looking at building connection with others, we have to build that connection with ourselves. And in order to do that, we have to build competency, and ORN can support in providing those spaces. Providing tribal educational resources and training for staff. Sharing practices for building tribal community-centered support, which is important when we're looking at being a good relative and supporting community, while also supporting ourselves. Training around staff retention and ways to mitigate staff burnout, which is the big part of connection is the correction, and if you want to create a balanced person connection. And next slide. And the opioid response is here to help. I can't stress enough that the ORN is a resource for no-cost education, training, and consultation to enhance efforts addressing opioid and stimulant use disorders within our Indigenous spaces, communities, families. ORN has consultants in every state and territory to deploy across prevention, treatment, recovery, and harm reduction. Share your needs via submit a request. Form at the opioidresponsenetwork.org. We will get back to you within one business day within your regional point person. We'll be in touch to learn more. And it's shared in the chat. Again, this submit a request is so easy. With that, I want to turn it back over to Courtney. Wonderful. Thank you so much. So just to kind of wrap it up in our last minute here, we have a few more slides as we plan for our July webinar, Bridge Housing, Critical Need for Native Recovery. So here's the registration link. So please utilize your phone and your technology and join us on that day on July 25th for our next webinar. Next slide, please. In addition, we have additional future webinar topics in August. We mentioned July 25th. And then on August 29th, we'll have Engaging Tribal Leaders, Linking SUD Services and Tribal Economic Development. So really linking those opportunities and those strengths within our communities. And September 26th, Whole Native SUD Treatment Care Examples. And so again, look forward to seeing you and join us at those times. And I believe we have one more slide with some important information that we want to share. And as always, we want to continue to improve and bring you quality time together. And so we ask for your feedback, your gift of feedback, and your gift of what you thought about this session and what you took away and how we can improve. So if you could please click the link here or scan the QR code and let us know, we would greatly appreciate that gift. So we've reached our time. I want to quickly thank our co-facilitator, Terrence, our presenters, Dr. Payment for starting us off in a good way and it carried us through. And we hope that those blessings continue to go with each and every one of you. I want to thank all of you for showing today and your support and the great work that you do in showing up for the families and relatives in your communities. But with that, I just want to say thank you and blessings to all. Thank you.

culturally competent workforce

indigenous communities

mental health

historical trauma

relational worldview

self-care

sacred trust

indigenous strengths

cultural heritage

supportive leadership

community connections

healing environments

behavioral health training