H79TI088404

CHEROKEE NATION STRATEGIC TRIBAL INITIATIVE TO TREAT AND CURE HEPATITIS C VIRUS (STITCH) PROGRAM - USING A SAME-DAY TEST AND TREAT MODEL, THE CHEROKEE NATION STRATEGIC TRIBAL INITIATIVE TO TREAT AND CURE HCV (STITCH) PROGRAM AIMS TO ELIMINATE HCV FROM THE CHEROKEE NATION RESERVATION BY TESTING INDIVIDUALS AT HIGH-RISK OF INFECTION, INCLUDING INDIVIDUALS WITH HOUSING INSECURITIES, SUBSTANCE USE DISORDERS (SUDS), AND MENTAL HEALTH ILLNESSES. THERE IS AN ESTIMATED 2.4 MILLION INDIVIDUALS LIVING WITH CHRONIC HCV IN THE UNITED STATES (US). AMERICAN INDIAN/ALASKA NATIVE (AI/AN) INDIVIDUALS HAVE A HIGHER INCIDENCE RATE OF HCV INFECTION AND MORTALITY RATE COMPARED TO OTHER POPULATIONS. AI/AN PEOPLE, INCLUDING CHEROKEE PEOPLE, EXPERIENCE HIGHER PREVALENCE OF HOMELESSNESS, SUD, AND MENTAL ILLNESS, INCLUDING SEVERE MENTAL ILLNESS (SMI). BETWEEN OCTOBER 2012 AND JULY 2024, CHEROKEE NATION HEALTH SERVICES (CNHS) SCREENED APPROXIMATELY 87,000 UNIQUE PATIENTS FOR HCV INFECTION. AS OF APRIL 2025, OVER 2,000 PATIENTS HAD TESTED POSITIVE, WITH APPROXIMATELY 54% INITIATING TREATMENT. TO ACHIEVE HCV ELIMINATION IN CHEROKEE NATION, THERE REMAINS A CRITICAL NEED TO IDENTIFY AND SCREEN HARD-TO-REACH POPULATIONS AND TO STRENGTHEN ENGAGEMENT IN CARE AND TREATMENT INITIATION AMONG THOSE DIAGNOSED WITH HCV INFECTIONS WITHIN THE CHEROKEE NATION RESERVATION. SECONDARY GOALS ARE TO INCREASE THE DIAGNOSIS, TREATMENT, AND PREVENTION OF HIV AND SYPHILIS, AS WELL AS IMPROVING THE IDENTIFICATION AND MANAGEMENT OF SUD AND MENTAL HEALTH CONDITIONS, AMONG HIGH-RISK CITIZENS AND NON-CITIZENS OF TRIBAL NATIONS WITHIN THE CHEROKEE NATION RESERVATION. THE RESERVATION COVERS 14 TOTAL COUNTIES IN NORTHEAST OKLAHOMA, INCLUDING ALL OF SIX COUNTIES AND PARTS OF AN ADDITIONAL EIGHT COUNTIES. THIS PROGRAM AIMS TO INTEGRATE COMMUNITY-BASED APPROACHES WITH CLINICAL SERVICES TO SCREEN, DIAGNOSE, TREAT, AND PREVENT HCV ALONG WITH HIV, AND SYPHILIS INFECTIONS IN CHEROKEE NATION. THIS PROGRAM WILL PARTNER WITH COMMUNITY COALITIONS TO IDENTIFY LOCAL ORGANIZATIONS THAT SERVE HIGH-RISK POPULATIONS, INCLUDING INDIVIDUALS EXPERIENCING SUBSTANCE USE DISORDERS AND HOUSING INSTABILITY. WHEN INDIVIDUALS ENGAGE WITH THESE ORGANIZATIONS, THEY WILL BE INVITED TO RECEIVE TESTING FOR HCV USING RNA POINT-OF-CARE KITS AND HIV/SYPHILIS USING ANTIBODY-BASED POINT-OF-CARE KITS. INDIVIDUALS WHO TEST POSITIVE FOR HCV WILL BE SCHEDULED FOR A SAME DAY VISIT WITH A HEALTHCARE PROVIDER TO REVIEW RESULTS, DISCUSS NEXT STEPS, AND INITIATE TREATMENT AS APPROPRIATE. STAFF WILL FOLLOW STANDARD PROTOCOLS TO SUPPORT CARE CONTINUITY, INCLUDING CONTACTING PATIENTS VIA TELEPHONE AND MAIL FOR FOLLOW-UP APPOINTMENTS, REMINDERS AND RESCHEDULING AS NEEDED. ALL PATIENTS WILL ALSO RECEIVE A BEHAVIORAL HEALTH ASSESSMENT TO IDENTIFY AND ADDRESS ANY BEHAVIORAL HEALTH NEEDS AS INDICATED. AS PART OF THE CLINICAL SERVICES APPROACH, CNHS WILL PRIORITIZE INCREASING PROVIDER EDUCATION AND AWARENESS OF CURRENT HCV SCREENING AND TREATMENT GUIDELINES. FURTHER, CNHS WILL DEPLOY PATIENT NAVIGATORS TO SUPPORT PATIENTS THROUGH THE HCV/HIV/SYPHILIS AND BEHAVIORAL HEALTH CASCADE OF CARE. FINALLY, CNHS WILL USE INCENTIVE-BASED STRATEGIES – INTEGRATED ACROSS BOTH COMMUNITY AND CLINICAL SETTINGS - TO ENHANCE PATIENT ENGAGEMENT IN SCREENING AND HCV TREATMENT. THROUGHOUT THIS PROCESS, PROGRAM ACTIVITIES WILL BE CONTINUOUSLY EVALUATED TO GUIDE AND REFINE IMPLEMENTATION THROUGHOUT THE PROJECT PERIOD.

Cherokee Nation

SAMHSA WAS GIVEN THE AUTHORITY TO ADDRESS PRIORITY SUBSTANCE ABUSE TREATMENT, PREVENTION AND MENTAL HEALTH NEEDS OF REGIONAL AND NATIONAL SIGNIFICANCE THROUGH ASSISTANCE (GRANTS AND COOPERATIVE AGREEMENTS) TO STATES, POLITICAL SUBDIVISIONS OF STATES, INDIAN TRIBES AND TRIBAL ORGANIZATIONS, AND OTHER PUBLIC OR NONPROFIT PRIVATE ENTITIES. UNDER THESE SECTIONS, CSAT, CMHS AND CSAP SEEK TO EXPAND THE AVAILABILITY OF EFFECTIVE SUBSTANCE ABUSE TREATMENT AND RECOVERY SERVICES AVAILABLE TO AMERICANS TO IMPROVE THE LIVES OF THOSE AFFECTED BY ALCOHOL AND DRUG ADDITIONS, AND TO REDUCE THE IMPACT OF ALCOHOL AND DRUG ABUSE ON INDIVIDUALS, FAMILIES, COMMUNITIES AND SOCIETIES AND TO ADDRESS PRIORITY MENTAL HEALTH NEEDS OF REGIONAL AND NATIONAL SIGNIFICANCE AND ASSIST CHILDREN IN DEALING WITH VIOLENCE AND TRAUMATIC EVENTS THROUGH BY FUNDING GRANT AND COOPERATIVE AGREEMENT PROJECTS. GRANTS AND COOPERATIVE AGREEMENTS MAY BE FOR (1) KNOWLEDGE AND DEVELOPMENT AND APPLICATION PROJECTS FOR TREATMENT AND REHABILITATION AND THE CONDUCT OR SUPPORT OF EVALUATIONS OF SUCH PROJECTS, (2) TRAINING AND TECHNICAL ASSISTANCE, (3) TARGETED CAPACITY RESPONSE PROGRAMS (4) SYSTEMS CHANGE GRANTS INCLUDING STATEWIDE FAMILY NETWORK GRANTS AND CLIENT-ORIENTED AND CONSUMER RUN SELF-HELP ACTIVITIES AND (5) PROGRAMS TO FOSTER HEALTH AND DEVELOPMENT OF CHILDREN, (6) COORDINATION AND INTEGRATION OF PRIMARY CARE SERVICES INTO PUBLICLY-FUNDED COMMUNITY MENTAL HEALTH CENTERS AND OTHER COMMUNITY-BASED BEHAVIORAL HEALTH SETTINGS

93.243 - Substance Abuse and Mental Health Services Projects of Regional and National Significance

Division of Grants Management [HHS - SAMHSA]

Tahlequah, Oklahoma 744645492 United States

Single Zip Code

Hepatitis C Elimination Initiative Pilot (TI-25-005)

Amendment Since initial award the total obligations have increased 258% from $2,092,456 to $7,499,842.