In This Issue:

• #CrisisTalk: Dr. Warrior on How States Need to Include American Indians in Their 988 Plans
• State Spotlight: State of Alaska Collaboration with Alaskan Native Tribes
• NASMHPD Thanks Fran Silvestri, Retiring President and CEO of the IIMHL
• HHS Issues Revised Reporting Requirements and Timeline for Recipients of Provider Relief Fund Payments
• MACPAC's June 2021 Report to Congress on Medicaid and CHIP
• Supreme Court Tosses Lawsuit Challenging Affordable Care Act
• Request for Comment: FCC Proposes Requiring Texting to 988
• Legal Issues and Crisis Services Resource
• New Programs from the Disaster Distress Helpline
• North Carolina Collaborative for Ongoing Recovery through Employment
• SAMHSA Hiring for Several Positions

• SAMHSA-Sponsored Webinar: Alternatives to Police Response for People in Mental Health Crisis - Ideas, Barriers and Ways to Work to a Solution
• SAMHSA-Sponsored Webinar: Increasing Cultural Competency in Mental Health Care Settings

• Emergency Department Visits for Suspected Suicide Attempts Among Persons Aged 12–25 Years Before and During the COVID-19 Pandemic
• Mental Health Among Parents of Children Aged <18 Years and Unpaid Caregivers of Adults During the COVID-19 Pandemic
• HHS Launches Hotline to Improve Access to COVID-19 Vaccines for People with Disabilities
• In Mental Health Crises, a 911 Call Now Brings a Mixed Team of Helpers — And Maybe No Cops
• Bill Would Permanently Expand Telehealth Services
• Child Mental Health Crisis Needs Attention, AMA Delegates Say
• America's Physician Shortage Could Top 139,000 by 2033
• Persistent Insomnia Since Childhood Linked with Mood, Anxiety Disorders in Adults

• Position Statement on the Routine Administration of CBTp as the Standard of Care for Individuals Seeking Treatment for Psychosis
• 988 Model Legislation Available
• Telehealth for the Treatment of SMI and SUD
• Systems of Care: To Infinity and Beyond
• SAMHSA DTAC Research Bulletin: A Preliminary Look at the Mental Health and Substance Use-related Effects of the COVID-19 Pandemic
• COVID-19 Vaccine Resources
• EPINET
• SMI Adviser
• IPS Employment Center
• Crisis Services: Meeting Needs, Saving Lives
• COVID-19 Information for SAMHSA Grant Recipients
• 2020 Technical Assistance Coalition Working Papers
• EIP Resource Center

State Spotlight: State of Alaska Collaboration with Alaskan Native Tribes

In Alaska, there are 17 tribal regions in which there are a total of 229 federally recognized Tribes comprising Alaska’s tribal health system, with behavioral health providers located in all but two of the 17 regions. Ten of the 17 behavioral health providers are also community health centers, providing a tremendous opportunity for integration of physical and behavioral health services. One of Alaska’s strongest assets for improving the behavioral health of all Alaskans is the tribal health system. Tribal health organizations leverage Indian Health Service funding with state grants, third party billing revenue, Alaska Medicaid billing revenue, and other funds to provide an array of behavioral health services and supports.

In remote villages/communities throughout Alaska, particularly those without access to the road system, prevalence rates and behavioral health needs are quite high and quickly overload available provider capacity. The need to seek acute treatment services located outside of a community is the norm, exacerbating an existing disconnect between culture and treatment. Outpatient services are few and far between and crisis response and transportation services are extremely costly. Adding to this challenge are the limited supports for patients returning to the community, with discharge plans developed in urban, acute-care settings that do not reflect village/community realities.

The State of Alaska consistently and regularly engages with Alaska Native tribes through the Government-to-Government consultation process, affirmed by Executive Order in 2000 and through Presidential Memoranda in 1994, 2004, and 2009.

State of Alaska representatives regularly participate in Alaska Tribal Health System (ATHS) meetings, ensuring attendance in the biannual Alaska Native Health Board MEGA Meetings, the Tribal Behavioral Health Director (TBHD) Quarterly Meetings, and the quarterly State Tribal Medicaid Task Force (MTF) Meetings.  These meetings ensure tribal engagement and collaboration is ongoing and routine. The state remains open to tribal BH directors to schedule extra time during the already established TBHD meetings to discuss specific inquiry or concerns.

As part of the MEGA and MTF meetings the Division of Behavioral Health (the division) and tribal partners maintain open, direct conversation on the status of the implementation of the Alaska 1115 Medicaid Demonstration Waiver for substance use and behavioral health treatment services and the implementation of claims processing through the Administrative Services Organization.  As the pandemic begins to wane, the division and tribal partners maintained open dialogue about the successes and challenges in serving behavioral health clients during the pandemic.  The focus and expressed interest of our tribal partners has been heavily directed on the benefits and continued need for telehealth flexibilities beyond the end of the public health emergency.  Providers have noted rural and remote regions have been positively impacted by the increased access telehealth has afforded communities that are off the road system and accessible only by plane or boat. 

The Alaska Native Health Board (ANHB), established in 1968, is recognized as the statewide voice on Alaska Native health issues. The mission of ANHB is to promote the spiritual, physical, mental, social, and cultural well-being and pride of Alaska Native people. ANHB is a 26-member board entity, consisting of one elected or selected representative of the Board of Directors or health committees of Alaska’s Native regional health organizations and independent tribal public Law 93-638 compactors/contractors. The tribal health directors of the regional health organizations serve as technical advisors to ANHB. The Association of Tribal Health Directors (ATHD) and the board of directors meet quarterly. These meetings serve as a forum for discussion of health issues affecting all of Alaska’s regions. Issues are identified, ranked and strategies are developed. Thru this process ANHB prepares an annual set of state and federal priorities.

The robust partnership with Alaska Native Tribes is largely a result of the sophisticated structure built by Alaska tribal health organizations. Tribal health care changed dramatically in Alaska when in 1998 Alaska Area Native Health Service signed a contract transferring statewide services to the Alaska Native Tribal Health Consortium (ANTHC).

The ANTHC is the largest, most comprehensive tribal health organization in the United States, and Alaska’s second-largest health employer with more than 3,000 employees offering an array of health services to people around the nation’s largest state.

The state honors the special government to government relationship with the tribes, recognizes the essential role that tribal health organizations play in delivering care to Alaskans across our vast state, and maintains the commitment to work with tribes to improve health outcomes for all Alaskans.