Mathiesen Memorial Health Clinic

MMHC'S COMMUNITY OPIOID INTERVENTION PILOT PROJECT - THE CHICKEN RANCH RANCHERIA OF ME-WUK IS A SMALL INDIAN TRIBE, RE-ORGANIZED ON DECEMBER 15, 1983. THE MATHIESEN MEMORIAL HEALTH CLINIC (MMHC) WAS FOUNDED IN 2007 AND FINANCED BY THE CHICKEN RANCH RANCHERIA. A HEALTH COMMISSION WAS FORMED AS A SUB-UNIT OF THE TRIBAL GOVERNMENT. MATHIESEN MEMORIAL HEALTH CLINIC IS STRUCTURED AS A TRIBAL HEALTH ORGANIZATION PER PL93- 638, VIA THE INDIAN SELF DETERMINATION ACT.MMHC?S SERVICE AREA IS LOCATED IN AND AROUND JAMESTOWN, CA, (ZIP 95327) AND EXPANDS INTO THE NORTH-EASTERN SIERRA FOOTHILLS (ZIP 95370). THE TARGET POPULATION IS THE CHICKEN RANCH RANCHERIA TRIBAL MEMBERSHIP OF 32 MEMBERS, 840 UNAFFILIATED NATIVE AMERICAN INDIANS WHO RESIDE IN TUOLUMNE COUNTY, AND AN ESTIMATED 350 NATIVE AMERICANS WHO LIVE OUTSIDE THE COUNTY IN MARIPOSA COUNTY AND CENTRAL VALLEY CITIES OF MODESTO, AND MERCED. BESIDES TRIBAL MEMBERS, MMHC?S TARGET POPULATION ALSO INCLUDES INDIVIDUALS AND FAMILIES THAT LIVE AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL. IN OUR SERVICE AREA THERE ARE AN ESTIMATE OF 35,335 TOTAL POPULATION OF WHICH 9, 821 LIVE AT OR BELOW 200% FPL, TWENTY-EIGHT PERCENT (28%). MMHC CURRENTLY HAS A SMALL MAT PROGRAM USING THE TRIBAL OPIOID RESPONSE GRANT FUNDS WE RECEIVED IN 2019. THIS MAT PROGRAM FUNCTIONS WITH FOUR MAT WAIVED PRIMARY CARE PROVIDERS, ONE MAT CARE COORDINATOR AND REFERRALS TO OUR BEHAVIORAL HEALTH SERVICES WHEN OPENINGS ARE AVAILABLE. MMHC OFFERS THE MEDICATION ASSISTANCE TREATMENT (MAT) TO ANY INDIVIDUAL (TRIBAL OR NON-TRIBAL) THAT SELF REFERS OR TO PATIENTS THAT ARE ASSESSED BY THE PRIMARY CARE PROVIDER NEEDING MAT SERVICES. MMHC?S PROGRAM NEEDS MORE RESOURCES TO ADDRESS THE OPIOID PROBLEMS IN OUR TARGET POPULATION AND IMPROVE ACCESS AND CAPACITY. WE WANT TO ENHANCE OUR CURRENT MAT PROGRAM WITH ADDITIONAL LICENSED ADDICTION PROFESSIONALS/S THERAPISTS AS WELL AS PROVIDE ALTERNATIVES TO OPIOID PAIN THERAPY.MMHC WOULD UTILIZE THE COIPP FUNDS TO ENHANCE OUR CURRENT MAT PROGRAM BY CREATING A COMPREHEN SIVE SUPPORT TEAM TO EMPOWER TRIBAL AND COMMUNITY FAMILIES IN ADDRESSING THE OPIOID CRISES. A TRIBAL TRADITIONAL/NATURAL HEALER WOULD BE RETAINED TO CONTRIBUTE TO A MUCH-NEEDED BODY OF KNOWLEDGE ON IMPROVING RECOVERY AND PROMOTING HEALING. THE TRIBAL COMMUNITY AND JAMESTOWN COMMUNITIES WILL NEED TO BE AWARE OF THE MAT/SUBSTANCE ABUSE PROGRAMS THAT ARE OFFERED BY MMHC. THUS, MMHC WILL ACTIVELY HAVE A PUBLIC AWARENESS AND EDUCATIONAL CAMPAIGN WHICH WOULD INCLUDE AN OUTREACH WORKER VISITING COMMUNITY MEMBERS AND ORGANIZATIONS AND PUBLIC BROADCAST ANNOUNCEMENTS. MMHC IS INVOLVED IN A REGIONAL COLLABORATION OF HEALTHCARE PARTNERS, COMMUNITY PARTNERS, AND PUBLIC SAFETY UNITED TO PROMOTE THE PREVENTION, TREATMENT, AND LONG-TERM RECOVERY OF HARMFUL OPIOID USE. THROUGH THESE RELATIONSHIPS, MMHC WILL BE ABLE TO INVOLVE PARTNERS IN COLLECTING COMMUNITY-REGION-WIDE DATA AND SUPPORT IMPROVING OUR COMMUNITIES.MMHC IS REQUESTING $500,000 OF COIPP FUNDS.

MMHC'S TOR 2024 PROJECT - MATHIESEN MEMORIAL HEALTH CLINIC’S (MMHC) SERVICE AREA IS LOCATED IN AND AROUND JAMESTOWN, CALIFORNIA, EXTENDING INTO THE NORTHEASTERN SIERRA FOOTHILLS (ZIP CODES 95327, 95370, 95305, 95372, 95379, 95383, 95346, 95335, 95310, 95321 & 95375 IN TUOLUMNE COUNTY AND 95228 IN CALAVERAS COUNTY; ALL INSIDE CONGRESSIONAL DISTRICT CA-005). THE TOTAL POPULATION WITHIN THIS LARGE RURAL AREA IS 58,274; OF WHICH 3,323 ARE VETERANS. THE GEOGRAPHIC BARRIERS INCLUDE OUR REMOTE/RURAL LOCATION, LOW-INCOME POPULATIONS, AND LIMITED ACCESS TO DIRECT MEDICAL SERVICES. THIS AREA IS ONE OF THE HISTORICALLY UNDERFUNDED INDIAN HEALTH SERVICE AREAS. THE POPULATION OF FOCUS IS THE CHICKEN RANCH RANCHERIA ME-WUK TRIBAL MEMBERSHIP OF 39 MEMBERS, 2152 UNAFFILIATED AMERICAN INDIANS RESIDING IN TUOLUMNE COUNTY, AND AN ESTIMATED 350 WHO LIVE OUTSIDE THE COUNTY. MMHC’S POPULATION OF FOCUS ALSO INCLUDES NON-TRIBAL INDIVIDUALS LIVING IN AND AROUND JAMESTOWN, SPECIFICALLY THE 13,234 INDIVIDUALS LIVING AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL, INCLUDING THOSE EXPERIENCING HOMELESSNESS. IN TUOLUMNE COUNTY THE RATE OF PEOPLE UNHOUSED IS 0.53 PER 100 PEOPLE. TUOLUMNE COUNTY EXCEEDED CALIFORNIA’S RATE IN EMERGENCY ROOM OVERDOSES (69.5/100K TO CA’S 54.88/100K), OPIOID RELATED OVERDOSE DEATHS (21.7/100K TO CA’S 18.6/100K) AND FENTANYL RELATED DEATHS (19.25/100K TO CA’S 16.59/100K). IN 2023, TUOLUMNE COUNTY SAW THE HIGHEST OVERDOSE DEATHS IN THE LAST 16 YEARS. MMHC WAS FORTUNATE TO HAVE BEGUN MEDICATION ASSISTANCE TREATMENT (MAT) AND SUBSTANCE USE COUNSELING SERVICES JUST PRIOR TO THE PANDEMIC, THANKS TO OUR FIRST TOR GRANT. AT FIRST, WE BEGAN SMALL WITH A FEW PATIENTS, BUT AS THE PANDEMIC RAGED, WE HAD SO MANY PATIENTS NEEDING HELP THAT WITHIN A YEAR WE HAD TO MOVE TO A NEW DEDICATED SPACE IN 2021, WE NOW CALL THAT OFFICE RED FEATHER CLINIC. AT THAT TIME, WE HAD 345% MORE PATIENTS THAN WE ORIGINALLY ANTICIPATED. ANOTHER 200% MORE IN 2023. THUS, WE RECENTLY OPENED A SECOND RED FEATHER CLINIC OFFICE THAT IS LOCATED JUST ACROSS THE PARKING LOT. IT HAS ROOM CAPACITY FOR ADDITIONAL PROVIDERS. OUR REQUEST FOR THE $250,000 EACH YEAR WILL GO TOWARDS KEEPING THE RED FEATHER CLINIC’S PROPERTIES IN OPERATION AND HIRING ADDITIONAL ADDICTION THERAPISTS TO ASSIST IN OUR EFFORTS TO COMBAT THE OPIOID AND FENTANYL CRISIS. WE ARE PLANNING SIGNIFICANT COMMUNITY OUTREACH EFFORTS WHERE WE WILL DISTRIBUTE PREVENTION AND HARM REDUCTION EDUCATION MATERIALS, AS WELL AS CONDUCT OVERDOSE TRAININGS AND DISTRIBUTE NARCAN. ADDITIONALLY, FOR OUR TRIBAL MEMBERS AND NON-TRIBAL PATIENTS, WE WILL OFFER NATIVE DRUM MAKING SESSIONS TO ENCOURAGE SPIRITUAL WELLBEING. PARTICIPANTS WILL LEARN NATIVE PRAYERS AND SONGS WHILE MAKING THEIR DRUMS AND THEN TAKE HOME TO USE TO FURTHER THEIR HEALING PROCESS. MMHC EXPECTS TO PROVIDE SERVICES TO AT LEAST 125 UNDUPLICATED INDIVIDUALS PER YEAR, A TOTAL OF 625 OVER THE FIVE YEARS AND TOUCH THE LIVES OF OVER 2500 INDIVIDUALS THROUGH OUR OUTREACH PROGRAM, DISTRIBUTING AT LEAST 1125 OVERDOSE KITS WITH NARCAN REDUCING OUR COUNTY’S DRUG OVERDOSE DEATHS.

MMHC TRIBAL OPIOID RESPONSE PROJECT III (2022 TOR) - MATHIESEN MEMORIAL HEALTH CLINIC (MMHC) SERVICE AREA IS LOCATED IN AND AROUND JAMESTOWN, CALIFORNIA, (ZIP CODE 95327) AND EXPANDS INTO THE NORTH-EASTERN SIERRA FOOTHILLS (ZIP CODE 95370) IN TUOLUMNE COUNTY. THIS COMMUNITY HAS BEEN GREATLY AFFECTED BY THE ECONOMIC DOWNTURN TO THE COVID PANDEMIC. WE ARE SEEING AND EXPERIENCE AN INFLUX USE OF ILLICIT DRUGS AND OVERINDULGENCE OF OPIOIDS RESULTING IN HIGH NUMBERS OF OVERDOSES IN OUR EMERGENCY DEPARTMENTS. MMHC WAS FORTUNATE TO HAD BEGUN PROVIDING MEDICATION ASSISTANCE TREATMENT (MAT) AND SUBSTANCE USE COUNSELING SERVICES JUST PRIOR TO THE PANDEMIC, THANKS TO OUR FIRST TOR GRANT. AT FIRST, WE BEGAN A SMALL PROGRAM WITH A FEW PATIENTS. AS THE PANDEMIC RAGED, WE BEGAN CARING FOR A HIGHER NUMBER OF PATIENTS THAN ANTICIPATED. WITHIN A YEAR WE HAD TO MOVE OUR MAT SERVICES TO A LARGER DEDICATED SPACE, WHICH WE NOW CALL THE RED FEATHER CLINIC. BY THE END OF LAST YEAR, WE HAD 345% MORE PATIENTS THAN WE ORIGINALLY ANTICIPATED. THUS, MMHC WILL NEED TO CONTINUE TO BE A STRONG SOURCE OF CARE FOR OUR TRIBAL MEMBERS AND COMMUNITY AT LARGE. MMHC WILL CONTINUE TO ENHANCE AND EXPAND OUR EXISTING MAT AND SUBSTANCE USE COUNSELING PROGRAM PROVIDED BY HIGHLY EXPERIENCED AND PASSIONATE STAFF. OVER THE NEXT YEAR WE EXPECT TO CARE FOR 180 NEW PATIENTS AND 40 THE FOLLOWING YEAR. WE HAVE BEEN OUTREACHING TO SCHOOLS AND NOTICED THE NEED FOR A YOUTH TREATMENT PROGRAM, WHICH THERE ARE NONE IN OUR AREA. OUR PLAN WITH THE 2022 TOR FUNDING IS TO BEGIN A MORE AGGRESSIVE OUTREACH CAMPAIGN, SEEKING AND EDUCATING YOUTH ON DRUG USE AND PREVENTION OF OVERDOSE. WE PLAN TO DO 10 EDUCATIONAL COMMUNITY EVENTS; AT WHICH TIME WE WILL DISTRIBUTE OVERDOSE KITS CONTAINING NALOXONE. OVER THE TWO YEARS WE HOPE TO DISTRIBUTE AT LEAST 500. MMHC'S MAT/SUD COUNSELORS HAVE TAKEN BASIC TRAINING IN CONTINGENCY MANAGEMENT THIS LAST YEAR. ALL AGREE IT IS A PROMISING CARE MODALITY FOR POSITIVE REINFORCEMENT WHICH WILL SUPPORT PATHWAYS TO RECOVERY. THIS NEXT YEAR, WITH THE TOR FUNDING, MMHC WILL DEVELOP A CONTINGENCY MANAGEMENT IMPLEMENTATION PLAN, AND TAKE THE GUIDED STEPS IN PROVIDING THE EVIDENCE-BASED PROGRAM THAT INCLUDES PROTOCOLS, STAFF TRAINING, DEVELOPING TRACKING A SYSTEM FOR INCENTIVES, PATIENT EDUCATION AND EVALUATION PLAN. WE HOPE TO HAVE THE PROGRAM AVAILABLE MID-YEAR. MMHC IS COMMITTED TO DELIVERING BEST PRACTICES, EVIDENCE BASED AND TRAUMA-INFORMED CARE FOR OUR CLIENTS DIAGNOSED WITH OPIOID USE/SUBSTANCE USE DISORDERS. WE HAVE DEDICATED INDIVIDUALS THAT PROVIDE NEEDED SERVICES AND ARE OPEN TO ANYONE IN NEED, NO MATTER HOW THEY ENTER: SELF-REFERRED, WALK-IN OR REFERRAL. THUS, WE NEED TO ADD AN ADDITION CERTIFIED SUBSTANCE USE COUNSELOR TO OUR FAMILY OF CLINICIANS. WITH THIS FUNDING WE WOULD IMMEDIATELY BEGIN THE RECRUITMENT. SERVICE AREA: MMHC’S SERVICE AREA IS THE CITY OF JAMESTOWN, A NATIONAL DESIGNATED HISTORIC TOWN LOCATED IN WESTERN TUOLUMNE COUNTY, CALIFORNIA, AND THE SURROUNDING AREA. JAMESTOWN IS A RURAL AND SOMEWHAT REMOTE AREA WITH MINIMAL SERVICES LOCATED IN THE SIERRA NEVADA MOUNTAIN FOOTHILLS. TARGET POPULATION: THE TARGET POPULATION IS THE CHICKEN RANCH RANCHERIA TRIBAL MEMBERSHIP OF 32 MEMBERS, 840 UNAFFILIATED NATIVE AMERICAN INDIANS WHO RESIDE IN TUOLUMNE COUNTY, AND THE LOW-INCOME POPULATION THAT RESIDE IN AND AROUND JAMESTOWN. EXPECTED OUTCOMES: MMHC EXPECT OUTCOMES ARE: 1) PROVIDE 220 PATIENTS IN THE TWO YEARS 2) HIRE ANOTHER PART TIME SUBSTANCE ABUSE COUNSELOR; 3) INCREASE OUTREACH TO HIGH-RISK YOUTH PROVING CARE TO AT LEAST 20 TEENS, AND 4) DEVELOP AND IMPLEMENT A CONTINGENCY MANAGEMENT PROGRAM.

SUPPORTING TRIBAL PUBLIC HEALTH CAPACITY IN CORONAVIRUS PREPAREDNESS AND RESPONSE ? 2020

MMHC TRIBAL OPIOID RESPONSE PROJECT 2

TRIBAL OPIOID RESPONSE PROJECT

FOUNDATIONAL WORK TOWARDS THE DELIVERY OF PATIENT- AND FAMILY CENTERED CARE

ALLOW OUR CLINIC TO IMPLEMENT A THIRD-PARTY STUDY OF OUR CURRENT WORK-FLOW PROCESS AND UTILIZE A UPDATED DICTATION SYSTEM FOR ALL LEVELS OF OUR PROVIDERS AND SUPPORT STAFF.

IMPROVEMENT OF MEDICAL PATIENT FLOW VIA ELECTRONIC MEDICAL RECORD AND BETTER STAFF FUNCTIONS

COMMUNITY FACILITY DISASTER TECHNICAL ASSISTANCE AND TRAINING GRANTS