## ![](media/image1.jpeg){width="2.879861111111111in" height="0.5666666666666667in"}

######  October 2004

**What's In This Issue?**

**[Headquarters News]{.underline}:**

1\. Message *from DBH*

Director, Dr. Jon Perez

## 

## 2. State Systems Development Program 

## (SSDP VII) Conference

## 3. Circles of Care II Final Grantee Meeting

4\. BH Management

Information Systems

5\. BH Web Site launched May 2004

6\. Emerging Leader Program

## 7. HHS and Health Canada MOU: A collaborative effort to address Suicide, FASD Prevention, Interventions and other Health Issues among Indigenous People 

8\. Executive Staff Accomplishment and Projection Monthly Report --
Status (August 2004)

9\. Report: "Expanding Partnership To Meet Substance Abuse Prevention &
Treatment Challenges In American Indian & Alaska Native Communities"
Conference held June 8-10, 2004, in San Diego, California.

## ![](media/image2.png){width="6.995833333333334in" height="0.3375in"}

## 

## Message from Division Director, 

## Dr. Jon Perez

As I close in on two years in the position, I think I can say with some
conviction that the Division is making significant strides toward
supporting the Areas and the programs in ways which may not have been
possible over the past several years. As you can see from the newsletter
and the attachments, there is a great deal of work that has been done
and much ongoing work occurring now. There is much that still needs to
be done, but we are on the road now and making progress. Significant
partnerships, new initiatives, and new representation of programs are
all proceeding very well, in my opinion. We have a number of programs
and activities which you can read about here

and on the website, that are advancing. There are others, like
formalized recruitment approaches and regulatory changes, that are just
beginning. For example, on Wednesday, September 22, the Senate Committee
on Indians Affairs (S. 556) & the House Committee on Resources (H.R.
2440) marked-up and reported favorably their respective bills to amend
and extend the Indian Health Care Improvement Act (see the IHS website
for full information). Next week, the IHS Area Behavioral Health Branch
Directors, the Chief Medical Officer, Dr. Vanderwagen, and I will sit
down for two days to go over the current national and Area programs. We
will also use this time to set priorities and goals for the year. I will
share that information with you as soon as it is agreed upon and in
published format.

It is clear to me that ongoing communication between all of us is
critical as more programs come online, and as more activities are
undertaken both here and across our system. I urge you to keep us
informed about what you are doing and I will endeavor to do the same
from here. The newsletter is part of that communication process, as is
the new website. Wilbur Woodis, of our office, will be coordinating
information for both and I encourage you to share information with him
so that it can then be shared with our whole system. We are starting to
work together now as a larger team and the results are showing.

Please keep up the extraordinary work. It remains an honor to work with
all of you.

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## 

## State Systems Development Program (SSDP VII) Conference

 **[Hyatt Regency Crystal City, Virginia- August 11-13,
2004]{.underline}**

On August 11-13, 2004, SAMHSA's Center for Substance Abuse Treatment
(CSAT) Division of State and Community Assistance hosted their 7^th^
annual conference titled, "Innovations in Treatment." This conference
focused on five central tracks: 1) treatment issues, 2) recovery support
and faith based services, 3) implementation and sustainability of
evidence based practices, 4) workforce development and 5) addressing
homelessness.

This conference brought together state block grant programs for mental
health and substance abuse, researchers, state service providers, and
private sector service providers to present and discuss their innovative
local programs.

During plenary sessions, senior SAMHSA officials presented overviews of
SAMHSA's strategic prevention framework to substance abuse prevention
and charitable choice provisions and regulations. Department of Behavior
Health (DBH) staff attended this conference

and enjoyed an opportunity to attend breakout sessions that featured
national substance abuse treatment and prevention presentations. SSDP
VII conference also focused on best practices of service providers and
examples of collaboration efforts between state agencies and local
service providers.

According to SAMHSA officials, their State Incentive Grants program is
the backbone to assisting states and territories to promote partnership
development as well

as empowering communities to identify, coordinate, and orchestrate the
most effective prevention services for specific community needs.

State Systems Development Program (SSDP VII) Conference

August 11-13, 2004

Hyatt Regency

Crystal City, VA

For more information call DBH staff Clay Ward at

301-443-2038 or Gary Quinn at 301-443-9531

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## Circles of Care II Final Grantee Meeting

 **[Wyndham Hotel, Washington D.C August 19-20, 2004]{.underline}**

On August 19-20, 2004, SAMHSA's Center for Mental Health Services (CMHS)
in collaboration with IHS/Division of Behavioral Health, hosted a final
grantee meeting with the seven 2001 Circle of Care II American Indian
and Alaska Native Tribal grantees. These Circles of Care II grantees
developed unique system(s) of care programs (SOC) whose primary mission
was to design and assess culturally appropriate mental health service
models for American Indian/Alaska Native (AI/AN) children with serious
emotional disturbances (SED) and their families.

This meeting allowed grantees to present their programs (from beginning
to end) and from these presentations, seven AI/AN tribal communities
outlined how each one identified, assessed, designed, developed, and
implemented culturally and linguistic appropriate mental health services
for their tribal communities. The seven AI/grantees were Blackfeet
Nation in Montana, Central Council, Tlingit and Haida Indian Tribes in
Alaska, Pascua Yaqui Tribe in Arizona, Puyallup Tribal Health

in Washington, Salt River Pima-Maricopa Indian Community in Arizona,
United American Indian Involvement, Inc. (UAII) in Los Angeles County,
California, and Ute Indian Tribe in Utah.

The grantee PowerPoint presentations highlighted the strengths of their
unique programs as well as common themes shared by all seven grantees.
The richness of culture specific to each AI/AN community was

integrated throughout each grantee's program and also very evident was
how each grantee included tribal community when designing a mission
statement to

guide their programs. The result in seven AI/AN communities was capacity
building, empowerment, community investment and most important, a

culturally appropriate mental health service model

for that specific community.

Senior SAMSHA officials provided support and praise

for the hard and dedicated work by these seven grantees, and best of
all, an announcement about future funding (\$2.5 million dollars) for
third round Circles of Care grantees.

Circles of Care II Final Grantee Meeting

August 19-20, 2004

Wyndham Hotel

Washington, D.C.

For more information call Jill Erickson at

301-443-3129 or Tammy Clay at 301-443-0104

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## 

## Behavioral Health Management Information System

**(Behavioral Health GUI**

**Client-centered Development and Deployment)**

Behavioral health providers are trained to listen to

"client narratives" (their own story in their own words),

to "start where the client is", to focus on strengths

rather than deficits, and to develop solutions to

problems in true partnership with our clients. We

have applied this "client-centered" philosophy in

the development, deployment and support of the behavioral health
applications as well.

Every phase of software development for the

Behavioral Health GUI was influenced by the

eventual users -- our clients. Building on the strengths

of existing RPMS applications, behavioral health providers created the
requirements for the application,

and clinicians worked side by side with developers to make certain these
requirements were correctly interpreted. A user-centered design process
was

informed by on-site observations, interviews, and

usability testing. Training activities were uniquely

tailored according to the needs of the Areas, and recommendations of
attendees were immediately incorporated in order to improve the training

experience for others. Throughout the process

the BH GUI project plan remained dynamic,

changing as needed to reflect user priorities

and industry standards.

**BH GUI Released**

ITSC released the much-anticipated Behavioral Health GUI (BPC v1.4) in
January 2004. BH GUI is the Windows-based graphical user interface to
the very

robust and widely deployed Behavioral Health System (BHS v3.0). BH GUI
and BHS v3.0 are interim application releases on the development path of
a

fully integrated, electronic behavioral health

application. Patch 1 of BH GUI and patch 2 of

BHS v3.0 will be released early this summer.

The patches include minor modifications to enhance usability as well as
several changes and new features designed to increase security and
privacy to facilitate compliance with HIPAA. In addition, BHS v3.0

also includes the domestic violence screening exam

code.

BH GUI is a component of the IHS Patient Chart which was initially
released in 2001. With the deployment

of the BH GUI behavioral health providers can now take advantage of the
benefits of integration with multiple RPMS applications in the
user-friendly environment offered by Patient Chart. Unique to the BH tab
in

Patient Chart is the ability to enter clinical notes,

record treatment plans and reviews, and document

group encounters and administrative activities.

Other features include a suicide surveillance tool

designed to assist BH programs in the reporting and tracking of
incidents of suicide. The GUI facilitates

direct provider entry of clinical information, rather

than data entry, and providers have commented

frequently on the ease of clinical documentation

in the new application.

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## New Behavioral Health Website to be launched May 2004

The Division of Behavioral website is available on the IHS Intranet and
Internet. The updated site replaces

the original site which was launched in 1996. There

are many new features on the site including sections

for:

-   Programs, Publications, and Links;

-   Statistics, Charts and Questions;

-   Meetings, Workshops and Mailings;

-   Jobs, Scholarships and Loans;

-   Administration

The key element to the new site is the Administration feature, which
will allow Division staff and Area folks a Login Access to update
outdated information and make necessary changes in real time as
appropriate. Please consider the site an interactive forum for Division
and Area staff. Since program information changes frequently, routine
communication will be required in order to keep the site updated as best
as possible. The Division of Behavioral Health staff is excited and will

be contacting I/T/U programs to help improve and launch this updated
site.

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Emerging Leader Program: Meet Mr. Quinn, Mr. Ward and Ms. Teresa A.
Sappier

*[Mr. Gary M. Quinn]{.underline}*

Gary: "I received my MSW from Arizona State University and I am a member
of the Tohono O'odham Nation with primary residence in Tucson, Arizona.
My social work experience includes working with: non-Indian seniors and
related aging concerns, adolescents held in county and state juvenile
correctional facilities, teaching transitional skills to women and men
held in state correctional facilities, case management for students with
disabilities at the University of Arizona, volunteer ombudsman with the
Pima Council on Aging, an internship with a Native American skilled
nursing

facility, and grant writing with Graffiti Abatement in Tucson.. Over the
next two years of my IHS Emerging Leaders Program assignment, I
excitedly look forward

to guidance and training from my supervisors and co-workers here at IHS
HQ. Most of all, I anticipate unlimited enriching opportunities to work
with Native American people across the country."

*[Teresa A. Sappier, P.A., M.A.]{.underline}*

Teresa Sappier, a member of the Penobscot Nation of Maine and a second
year OS/ Emerging Leader Program in the IHS Office of Public
Health/Division of

Behavioral Health, has returned to IHS after a year of DHHS agency
rotations. Ms. Sappier committed her

first year to working with federal agencies that serve Tribes and Tribal
Organizations and brings that

experience back to IHS along with the networks she developed.  Ms.
Sappier's interest in Behavioral Health

is the result of her work with Alaska Native and

American Indian (AI/AN) Tribes in Maine, New

Mexico, Arizona and Alaska. She has worked in the

areas of health, social work and education. While

working in Alaska, Ms. Sappier became interested in AI/AN traditional
medicine.

For the second year of her program, Teresa will be working with the Dr.
Jon Perez and the staff in the Behavioral Division. Teresa's specific
assignment will

be working on gathering information on the 31 initiatives for which the
Division of Behavioral Health is responsible. Eventually, the
information will be placed

on the Behavioral Health website. 

*[Mr. D. Clay Ward]{.underline}*

Clay is a proud member of the Choctaw Nation of Oklahoma and was born
and raised in Broken Bow, Oklahoma. Clay has a Masters of Science in
Human Resources and Bachelor of Arts in Criminal Justice and is a
Certified Alcohol and Drug Counselor with ten years experience in the
substance abuse and mental health field. Clay has worked at Rolling
Hills Hospital (a private psychiatric inpatient hospital in Ada, OK),
Native American Center of Recovery (Shawnee, OK), and the Oklahoma City
Indian Clinic.

Most recently, Clay was the Health Services Manager for the Pueblo of
Jemez for approximately two years before being selected in July of 2004
to the Emerging Leaders Program in Washington D.C.

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## 

## HHS and Health Canada MOU: A collaborative effort to address Suicide, FASD Prevention/Interventions and other Health Issues among Indigenous People 

**[IHS Director's General Staff Meeting,]{.underline}**

**[Reyes Conference Room,]{.underline}**

**[Rockville, MD]{.underline}**

**[September 2, 2004]{.underline}**

On September 2, 2004, during September's IHS General Staff meeting,
Department of Behavior Health (DBH) had an opportunity to highlight one
of DBH's prevention/intervention projects. Tamara Clay, IHS/DBH Public
Health Advisor, presented an overview of this collaborative effort with
Canada to focus on sharing prevention and intervention practices with
Indigenous People from both countries. Ms. Clay provided a historical
background and current project status of this Memorandum of
Understanding (MOU) with Canada. This MOU's primary purpose is "To share
knowledge through an agreed upon annual schedule of work which may
include the exchange of information and personnel, the conducting of
workshops, conferences, seminars and meetings."

For more information regarding Ms. Clay's Power Point presentation,
click here.

(HHS_CANADA_MOU.PPT)

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height="1.3736111111111111in"}

**Executive Staff Accomplishment and Projection Monthly Report --
Status**

**(August 2004)**

***DBH/IHS Participation in the DHHS Office of the Secretary's***

***Office of Disability's Young Adult Initiative Policy Academy***

The President's New Freedom Initiative (NFI), Executive Order 13217,
requires the Federal Government to assist States and localities
(including Tribes) in swiftly implementing the Olmstead decision "to
help ensure that all Americans have the opportunity to live close to
their families and friends, to live more independently, to engage in
productive employment, and to participate in community life." To address
the comprehensive service needs of young adults (ages 16-30) with
disabilities[^1], the Department of Health and Human Services (HHS)
Office of Disability (OD) is facilitating the development and
implementation of a comprehensive Fiscal Year 2005 initiative with
participating HHS agencies and Offices. The Young Adult Initiative will
utilize a policy academy planning approach to provide technical
assistance to participating States and Tribes to ensure increased
independence and self-sufficiency and improved outcomes in health and
human services, education, employment, housing, and transportation for
young adults with disabilities. In an IAA signed in August between IHS
and DHHS OD, the National Indian Health Board was identified as the
agency to directly support and assist IHS and OD to provide contract TA
services for the academy in Indian Country. The academy will address
systems integration infrastructure development/enhancement that builds
capacity to support young adults' with disabilities transition to
independence and adulthood. Two policy academies, with approximately 12
States and 4 Tribes participating, will convene in Washington D.C.,
during the year 2005 and 2006, and activities (i.e. post academy
evaluations) will continue into 2007.

Type: Intergovernmental/Partnering Reporter: Tammy Clay    Phone:
(301)443-0104

Contact: Tammy Clay    Phone: (301)443-0104

***DBH/IHS and Center for Medicaid and Medicare Services (CMS)***

Representatives of the IHS Division of Behavioral Health are continuing
to meet with representatives of the Center for Medicaid and Medicare
Services (CMS) to implement a "Medicaid Demonstration Project Proposal
for the Indian Health Service/Youth Regional Treatment Centers (YRTCs)".
The proposal will improve access to and quality of culturally
appropriate alcohol and substance abuse treatment to Medicaid eligible
AI/A youth seeking care at YRTCs. The proposed project is designed to
run for five years and will replace the current system which requires
each YRTC to independently negotiate with each patient's home state. In
addition, the project will provide YRTCs with a daily rate payment
structure, replacing the fee-for-service payment system currently used
by several YRTCs; creating a more accurate daily rate payment structure.
Next meeting between agencies is scheduled for September 3, at CMS in
Baltimore.

Type: Intergovernmental/Partnering Reporter: Tammy Clay    Phone:
(301)443-0104

Contact: Tammy Clay    Phone: (301)443-0104

***IHS/BIA***

A family violence workgroup is planning a handbook on family violence in
Indian Country. Our last conference call was July 29^th^. Our next
conference call meeting will be scheduled for September 8^th^. We have
developed a list of issues which might be included in the handbook. We
hope to have a brief concept paper that we can discuss by our next
conference call.

We will be continuing our contacts with the BIA regarding a revision of
the BIA/IHS MOU on Child Protection Teams and other child protection
matters.

A child protection handbook is due to be completed and ready for
distribution by about mid-September. We plan to distribute this to
various groups and individuals who may have need of the handbook.

Type: Intergovernmental partnership

Reporter: Ramona Williams (301)443-1539

Contact: Ramona Williams (301)443-1539

***DBH/IHS and Health Canada Activities***

***(Pertaining to the Behavioral Health Component of the Memorandum of
Understanding between Health Canada of the Government of Canada and the
Health and Human Services of the Government of the USA)***

The common objective of the IHS and Canada MOU is to raise the health
status of American Indians and Alaska Natives in the U.S. and the First
Nation and Inuit people in Canada. Representatives from the IHS and
Canada's two working groups, the AD Hoc Working Group on Fetal Alcohol
Spectrum Disorder and the Suicide Prevention Working Group, continue to
have monthly conference calls to address their respective agendas. The
members of the workgroups are working towards improving approaches to
health issues, identifying and reinforcing best practices, and sharing
knowledge and learning as they pertain to the health and wellness of the
Indigenous peoples of North America. Each working group is currently
working on two specific areas: 1.) creating individual scans by
collecting comprehensive information on suicide prevention and
intervention programs or FASD prevention and intervention programs
utilized among Indigenous peoples in the US and Canada, and 2.) creating
a website as a central repository to store the information, and use
digital technology to link the workgroup for ongoing long term
communication and information sharing.

Two face-to-face meetings are currently scheduled, one each for FASD and
Suicide working groups, in Ottawa, Canada in October. Final Agency
authorizations and travel approvals are being sought at this writing.
These meetings are the reciprocal ones for previously held meetings in
the United States earlier this year.

Type: International/Partnering

Reporter: Tammy Clay    Phone: (301)443-0104

Contact: Tammy Clay    Phone: (301)443-0104

**AmeriCorps/SSA/CMS/IHS: Serving Rural Communities**

The Social Security Administration (SSA), Centers for Medicare/Medicaid
Services (CMS), Indian Health Service (IHS) SSA, CMS, and IHS are
engaged in various outreach activities designed to identify and educate
American Indians and Alaska Natives (AI/ANs), who may be eligible, about
SSA and CMS programs. A particular focus of the education and outreach
activities has been in rural areas, specifically Native American
Communities and reservations. These areas, by virtue of being remote,
have limited access to government services, e.g., health, and in several
locations have little or no telephone connectivity.

Responding to the need for SSA and CMS program information and services,
SSA and CMS have piloted education and outreach demonstration programs
on several Indian reservations. The demonstrations involve the
collaborative education of social service workers and community health
representatives who frequently come in contact with those potentially
eligible for benefits. Equipped with a basic knowledge of program
eligibility, they are readily able to identify and refer applicants to
Social Security and State Medicaid offices as appropriate.

In the course of engaging other federal agencies in a Minnesota outreach
project (April 2000), SSA was referred to AmeriCorps, a program of the
Corporation for National & Community Service (CNCS). Since that time,
SSA and CNCS representatives have collaborated on ways in which both can
work together in service to citizens.

The activities conducted through the SSA/CMS/IHS initiatives are
consistent with AmeriCorps\*VISTA services provided to communities
(e.g., community outreach and education, coordination of health services
and information, etc.). Thus, the goals of the SSA/CMS/IHS pilot
project, and the charter of CNCS interest in outreach can be mutually
supportive.

*Project Outline*

-   Workforce and Asset Development (e.g., job skills, entrepreneur
    education, microenterprise development, financial asset development)

-   Education (e.g., telemedicine, student engagement/retention, citizen
    education)

-   Technology (e.g., access, coordination, education, security)

-   Leveraging Existing Resources (e.g., accessing existing
    benefits/programs, facilitating community organization, volunteer
    generation)

Type: Intergovernmental/Partnering Reporter: Wilbur Woodis     Phone:
(301)443-6581

Contact: Wilbur Woodis     Phone: (301)443-6581

***Federal American Indian and Alaskan Native Intra- and Interagency
Work Group on Alcohol and Substance Abuse***

The Indian Alcohol and Substance Abuse Prevention and Treatment Act (PL
99-570), as amended, indicates that Congress' intent, in establishing
the law and the Division of Alcohol and Substance Abuse Prevention
(DASAP) within the Bureau of Indian Affairs, was to facilitate:

-   Developing a comprehensive, coordinated attack upon the illegal
    narcotics traffic in Indian country and the deleterious impact of
    alcohol and substance abuse upon Indian tribes and their members,

-   Providing guidance to those Federal agencies responsible for Indian
    programs to identify and focus existing programs and resources upon
    the problem,

-   Opportunities for Indian tribes to develop and implement a
    coordinated program for the prevention and treatment of alcohol and
    substance abuse at the local level, and

-   Supplementing existing programs to further this intent.

DASAP fulfills Congress' intent, in part, through the Federal American
Indian and Alaskan Native Interagency Work Group on Alcohol and
Substance Abuse, commonly referred to as the Federal Interagency Work
Group or IAWG.

We hope the IAWG members and other interested persons will work closely
with DASAP in pursuing this admirable goal. In doing so, DASAP expects
to enhance the quality of life in Indian communities and reduce the
deleterious impact of alcohol and substance abuse upon individual
Indians, their families, their employers, their community, and their
tribe.

Next Scheduled meeting Thursday September 23, 2004

Type: Meetings Reporter: Wilbur Woodis     Phone: (301)443-6581

Contact: Wilbur Woodis     Phone: (301)443-6581

***Behavioral Health Management Information System (BHMIS)***

Continue with Bi-weekly conference calls addressing the BHMIS
integration project. The FY 05 project SOW has been submitted and the FY
06 Project Plan is also being finalized. The primary goal is toward an
integrated Patient Chart complete with a Graphical User Interface (GUI)
from end, basically providers working with a Windows application. The
following is a summary of iterative activities by workgroup-

BH Export process continues with Mike Gomez ITSC Albuquerque as lead on
this issue. Currently the Indian Health Performance Evaluation (IHPES)
team is working on protocols of sites exporting a Mumps global to the
NPIRS server verses converting to a BXP format prior to exporting until
Raymond Willie ITSC Albuquerque providing TA on the BXP formatting
process completes BXP.

TRAINING & MARKETING

Portland Area -- September 14^th^ & 15^th^

Phoenix Area -- October 13^th^ & 14^th^

Type: Conference/Meeting

Reporter: Wilbur Woodis    Phone: (301)443-6581

Contact: Wilbur Woodis     Phone: (301)443-6581

***Behavioral Health Web Site***

Continue populating the upgraded and updated Division of Behavioral
Health Web Site, adhering to the IHS-Specific Implementation Guidelines
for Section 508 Standard (m) which states, \"When a web page requires
that an applet, plug-in or other application be present on the client
system to interpret page content, the page must provide a link to a
plug-in or applet that complies with 1194.21 (a) through (i)". The
intent of this standard is to ensure that all documents, regardless of
the format, are accessible to all users, whether they are people with
disabilities, those using older browsing technology, or those with slow
Internet connections.

Type: Conference/Meeting

Reporter: Wilbur Woodis    Phone: (301)443-6581

Contact: Wilbur Woodis     Phone: (301)443-6581

***Suicide Prevention Committee***

The IHS Suicide Prevention Committee will be meeting the last week of
September to define goals and objectives for IHS to follow in suicide
prevention efforts. Meeting dates are September 28^th^ and 29^th^. Up to
date information will be placed on the IHS Behavioral Health website.

Reporter:  Marlene EchoHawk, Ph.D.

Telephone (301) 443-2589

Contact:   Marlene EchoHawk, Ph.D.

Telephone (301) 443-2589

 

  

IHS will be working in collaboration with NIH/NIMH in a conference to
foster research.  The conference will be in Philadelphia, PA on
September 9th & 10.  The conference is entitled \"Pragmatic
Consideration of Culture in Preventing Suicide\".

Reporter:  Marlene EchoHawk, Ph.D.

\(301\) 443-2589

Contact:   Marlene EchoHawk, Ph.D.

\(301\) 443-2589

 

***State of New Mexico Legislation for Prescriptive Privileging for
Psychologists***

Jon Perez, DBH Director, will be meeting with members of the New Mexico
Board of Psychology and participate in public hearings in Albuquerque,
NM, September 16 and 17 for regulations specific to the legislation
enabling psychologists to prescribe certain psychotropic medications.
The state of New Mexico passed legislation providing for psychologists
with a highly specific curriculum and clinical mentorship to begin
prescribing collaboratively with licensed physicians. The Regulations
have been open for public comment and the final hearings are being held
on the above date.

Reporter: Jon Perez (301) 443-2026

Contact: Jon Perez (301) 443-2026

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[Accomplishments]{.underline}

***National Institute of Mental Health/IHS***

***Suicide Among Indigenous Peoples in the Americas Conference***

NIMH has agreed to support a collaborative 5 year research, service, and
program initiative to address suicide among Indigenous People. Over a
several month period, IHS and NIMH staff collaborated to develop a
proposal for NIMH to work directly with IHS to further research about
and interventions for suicide among native peoples as a distinct
research and service group. Grayson Norquist, NIMH Director for the
Division of Services and Intervention Research, approved the
collaboration and authorized NIMH to move forward with IHS on the
programming in August. The first major effort will be a conference
sponsored by NIMH in March/ April 05 timeframe. Tentatively entitled
"Suicide Among Indigenous Peoples in the Americas" it is being designed
to kick off the multiyear effort to more appropriately understand and
address suicide among indigenous populations, beginning with the United
States, Canada, Native Hawaiians, and Pacific Islanders. This is a
direct outgrowth of the ongoing work between IHS and First Nations Inuit
Health Branch in support of the DHHS/Health Canada MOU. It brings the
resources and convening resources of NIMH directly to support increased
programs specific to native populations.

Reporter: Jon Perez (301) 443-2026

Contact: Jon Perez, (301) 443-2026

***IHS/SAMHSA Suicide Prevention Resource Initiative***

An IAA between IHS and SAMHSA to support the development and management
of a national suicide prevention resource and response program was
approved and \$200,000 transferred from CMHS to IHS for the purpose of
supporting an effort to train 12 individuals---one from each IHS
Area---in community suicide prevention assistance and mobilization, who
will then be available nationally to support communities in crisis or
involved in suicide cluster events. Additionally, the funds will be used
to develop an online community response "toolkit" that will serve as a
resource for communities in crisis and include information on suicide
responses and community mobilization that can be downloaded from the IHS
DBH website. This effort is a collaboration between CMHS, IHS
Headquarters, Aberdeen and Albuquerque Areas, to develop and implement
the program. It is expected that, if the program is successful, there
will be continued funding via CMHS for a multiyear period.

Reporter: Jon Perez (301) 443 2026 Contact: Jon Perez (302) 443-2026

***Behavioral Health Management Information System (BHMIS)***

Brian Sheff and Wendy Wisdom (BHMIS Workgroup Members presented at the
Aberdeen Area Alcohol and Substance Abuse Directors Meeting Conference
in Spearfish, SD. The BHMIS initiative received a very positive response
with approximately 22-24 independent tribes attending. In the recent
past, many tribes went to Commercial Off The Shelf (COTS) products
because of a perceived shortfall in technical support from the IHS. Many
were encouraged by the new emphasis on the current BHMIS and ITSC
support. Many would prefer the GUI but may not have the technical
abilities to use the GUI. Primarily due to having no T1 lines, lack of
support from Aberdeen Area, especially related to RPMS Access. Many
participants like the BH GUI but are hindered by not having a T1 line.

Phoenix Area Behavioral Health Conference -- Wendy Wisdom attended and
presented the BHMIS software and database.

Scope of Work was submitted to Art Gonzales for FY05 Training and
Integrated Behavioral Health development and enhancement activities. The
Project Plan for FY 06 was also revised.

TRAINING & MARKETING

-   Desert Visions Pre-implementation visit July 13^th^

-   Alaska Area July 13^th^ & 14^th^

-   Billings Area (2 sessions) July 27^th^ -- 30^th^

-   Albuquerque Area -- August 12^th^ & 13^th^

    OTHER

-   ITSC Technology Conference (August 23-27, 2004), Denise Grenier
    discussed the BHMIS project.

-   Western Urban Data Meeting (August, 03, 2004), Mike Gomez discussed
    the BH GUI reporting.

-   Tribal Crime Data Training (August 30 - September 1, 2004) at the
    Hilton Albuquerque, NM. Wilbur Woodis discussed the BHMIS project.

Type: Conference/Meeting

Reporter: Wilbur Woodis    Phone: (301)443-6581

Contact: Wilbur Woodis     Phone: (301)443-6581

***Behavioral Health Web Site***

The DBH web site content was updated Thursday July 22, 2004 with over 50
new items added to the site.

Type: Conference/Meeting

Reporter: Wilbur Woodis    Phone: (301)443-6581

Contact: Wilbur Woodis     Phone: (301)443-6581

***Mental Health and Community Safety Initiatives***

The Mental Health and Community Safety Initiatives grants have been
reviewed and approved for continuance for the next fiscal year.

The technical assistance period of performance has been extended in the
contract with the National Child Welfare Association (NICWA). The
extension is through December 2004. NICWA will be continuing the
technical assistance provided to the Community Mental Health Initiative
Grants.

The Interagency Agreement with DOJ is continuing and the Agreement
Modification completed. This will provide for continuance of the Child
Specialist services for abused American Indian children being provided
in the Billings Area.

The contract for the Making Medicine Project has been completed and will
be continued for the upcoming FY. The Making Medicine Project will
continue the "train the trainer" training for various tribal/urban and
IHS staff involved with American Indian/Alaska Native child abuse and
neglect issues.

Type: Intergovernmental partnership

Reporter: Ramona Williams (301)443-1539

Contact: Ramona Williams (301)443-1539

![](media/image8.png){width="0.6236111111111111in"
height="0.4673611111111111in"}![](media/image9.png){width="0.6236111111111111in"
height="0.4583333333333333in"}

**[Report]{.underline}: "Expanding Partnership To Meet Substance Abuse
Prevention & Treatment Challenges In American Indian & Alaska Native
Communities" Conference held June 8-10, 2004, in San Diego,
California.**

"On June 25-26, 2003 The Indian Health Service (IHS) and the Substance
Abuse and Mental Health Services Administration (SAMHSA) sponsored a
conference entitled "Building Partnerships to Meet Substance Abuse
Prevention & Treatment Challenges in American Indian & Alaska Native
Communities". The conference was held at the Catamaran Resort Hotel in
San Diego, California and drew 262 participants from throughout the
nation. The event proved to be such a success the sponsors agreed to
sponsor the conference as an annual event and incorporate suggestions
and learning from the previous year. The goal was to continue to improve
the format and content of each conference.

On June 8-10, 2004 IHS and SAMHSA joined together to co-sponsor the
IHS/SAMHSA and the National Behavioral Health Conference in San Diego,
California. The addition of IHS National Behavioral Health Conference
gave credence to the new theme of the conference "Expanding Partnerships
to Meet Substance Abuse Prevention & Treatment Challenges in American
Indian & Alaska Native Communities." Approximately 400 participants from
the United States, Canada, Australia and New Zealand attended this event
giving it a distinctive international and cultural spirit. The
conference agenda was expanded to 55 workshops, an increase of 39
workshops from the previous year. The following is an overview of the
conference proceedings." (Pp. 8)

**To view entire 64 page report see attached \*.PDF file (San diego
report.pdf)or visit KAI's website at:**
[www.kauffmaninc.com](http://www.kauffmaninc.com/)

![](media/image3.png){width="2.9993055555555554in"
height="0.2604166666666667in"}

For additional information, visit these websites:

-IHS Division of Behavioral Health Website:
<http://wwww.ihs.gov/medicalprograms/behavioral/>

-First Nations and Inuit Health Branch Website:
<http://www.hc-sc.gc.ca/fnihb-dgspni/fnihb/index.htm>

-Health Canada Website: <http://www.hc-sc.gc.ca/english/index.html>

For more information call Tammy Clay/IHS/DBH at 301-443-0104

![](media/image5.png){width="3.225in" height="0.5756944444444444in"}

(**MIS** continued from pg 3)

**The Training and Deployment Experience**

Graphical user interfaces by their nature are more intuitive and
user-friendly. This fact has been confirmed by feedback from users
during early deployment of BH GUI*.* However, learning, implementing and
supporting a new application, like any change effort, can produce
anxiety, fear and sometimes resistance. We discovered during the first
BH GUI training that while the students (including clinicians, program
managers, data entry and IT staff) appeared to accept and learn the GUI
more easily than the typical RPMS roll and scroll application, the pain
associated with learning a new application --with change, in other words
-- was still present. There were also those students who were reluctant
to leave behind that application with which they were familiar and had
finally mastered -- the once-dreaded "roll and scroll".

The RPMS BH applications are intended for use by widely divergent IHS,
tribal and urban behavioral health programs. The users are comprised of
mental health, social work, and alcohol and substance abuse
professionals and paraprofessionals, all with varying degrees of
computer literacy and comfort levels. The programs and facilities are
equally diverse with stand-alone, tribally run outpatient mental health
clinics, urban residential alcohol and substance abuse treatment
facilities, clinic- and hospital-based social work departments and
everything in between. As we developed and presented training on the BH
GUI, we discovered a number of ways to make the experience more relevant
and appropriate for attendees.

Discipline-specific data entry scenarios and exercises were developed
with input from clinicians in the field. Self-paced tools for
independent learning were designed and distributed widely to support
learning outside of the classroom. Training sessions for specific user
groups, such as residential alcohol and substance abuse treatment center
clinicians and staff, were especially well received and successful. A
standard of a minimum of two trainers per 20 students, one being a
clinician, was established. The time and energy invested in making
frequent changes to training materials and agendas, and in post-session
debriefings and analysis of training evaluations, was clearly well
spent.

**Plans for Future Development and Deployment**

Users have tasked us with the development or inclusion of an improved,
comprehensive treatment plan module in the BH GUI. This is a priority of
future development efforts. Programming is underway now for enhanced
group functionality, and work continues toward importing the BH GUI into
the IHS Electronic Health Record. While Patient Chart has always been
considered an easy-to-use, easy-to-deploy application, implementation of
the BH GUI does require a different process than BHS v3.0. Changes to
deployment plans include increasing the number of on-site implementation
visits as an adjunct to Area training. Also at the request of users, we
are hoping to be able to offer on-line training soon and are pursuing
continuing education credit for training from the IHS Clinical Support
Center.

We are extremely grateful to our clients -- the users, potential users
and the Division of Behavioral Health -- for partnering with us in the
development and deployment process of the BH applications. Behavioral
health providers know that it is the client who holds the answers.

Submitted by:

Denise Grenier, MSW, LCSW, Clinical Lead, IHS Information Technology
Support Center, Tucson, Arizona

![](media/image8.png){width="1.8444444444444446in"
height="1.3854166666666667in"}

Throughout FY 2004 and into FY 2005, IHS is working with other DHHS
workgroups to address technical assistance, and improving effective and
appropriate community services for individuals with disabilities, in
many areas of health (i.e. elder care and diabetes). IHS also
continuously collaborates with other intradepartmental agencies to
formulate methods to work with states and Tribes in order to identify
and access potential sources of funding and to implement best practices
particularly as they apply to the AI/AN population with disabilities.

![](media/image10.png){width="3.323611111111111in"
height="0.4166666666666667in"}

For more information see the following websites:

<http://www.ihs.gov/medicalprograms/eldercare/Long_Term_Care.asp>

[http://www.ihs.gov/medical
programs/eldercare/Resources_For_Professionals.asp](http://www.ihs.gov/medical programs/eldercare/Resources_For_Professionals.asp)

<http://www.healthpolicy.ucla.edu/pubs/publication.asp?pubID=79>

<http://www.os.dhhs.gov/aging/index.shtml>

![](media/image9.png){width="1.0673611111111112in"
height="0.7944444444444444in"}

All newsletter stories were written by Behavioral Health Staff, unless
otherwise noted. Thank you for your hard work and to those in the field
who submitted stories.

Dr. Jon Perez, Director

[JPerez@hqe.ihs.gov](mailto:Jperez@na.ihs.gov)

Frank Canizales

[FCanizal@hqe.ihs.gov](mailto:FCanizal@na.ihs.gov)

Shelly Carter

[SCarter@hqe.ihs.gov](mailto:SCarter@na.ihs.gov)

Tamara Clay

[TClay@hqe.ihs.gov](mailto:TClay@na.ihs.gov)

Marlene Echohawk

[MEchohaw@hqe.ihs.gov](mailto:MEchohaw@na.ihs.gov)

Colleen Good Bear

[CGoodbea@hqe.ihs.gov](mailto:CGoodbea@na.ihs.gov)

Michele Muir

<Muirm@hqe.ihs.gov>

Gary M. Quinn ELP Intern

Gquinn[\@hqe.ihs.gov](mailto:WWoodis@hqe.ihs.gov)

D. Clay Ward ELP Intern

<Dward@hqe.ihs.gov>

Teresa A. Sappier ELP Intern

<Tsappier@hqe.ihs.gov>

Ramona Williams

<RdWillia@hqe.ihs.gov>

Wilbur Woodis

[WWoodis@hqe.ihs.gov](mailto:WWoodis@na.ihs.gov)

Graphics Provided By:

GRAPHICS by ANDAHATEY

<http://members.aol.com/Andahatey/index.html>

Greasy Grass Native American Graphics & Old West Graphics

<http://thegreasygrass.com/>

Poison's Icons

<http://members.aol.com/poison64/>

Rina's Graphics

<http://www.geocities.com/Athens/Styx/2331/rinagraphics.htm>

For more information about the DBH Newsletter, or to send information to
be included in the next issue e-mail or call:

Division of Behavioral Health: (301) 443-2038

<behavioralhealthprogram@na.ihs.gov>

![](media/image11.wmf){width="1.4770833333333333in"
height="0.3194444444444444in"}

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