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Strategies That Peak How States Include Tribes in Planning Building FASD State Systems Colorado Springs, CO May 7, 2008 Panel Members Candace Shelton, M.S., LISAC SAMHSA FASD Center for Excellence Lorena Burris, PhD Research Associate Center on Child Abuse and Neglect

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strategies that peak how states include tribes in planning

Strategies That Peak How States Include Tribes in Planning

Building FASD State Systems

Colorado Springs, CO

May 7, 2008

panel members
Panel Members
  • Candace Shelton, M.S., LISAC

SAMHSA FASD Center for Excellence

  • Lorena Burris, PhD

Research Associate Center on Child Abuse and Neglect

Oklahoma University Health Sciences Center

  • Suzie Kuerschner, MEd

FASD Consultant

what is indian country
What is Indian Country?

Candace Shelton, M.S., LISAC

Senior Native American Specialist

SAMHSA FASD Center for Excellence

(520) 881-8182

what is indian country4

Legally Defined as:

  • All land within the limits of any Indian reservation under the jurisdiction of the U.S. Government.
  • All dependent Indian communities within the borders of the United States.
  • All Indian allotments, the Indian titles to which have not been extinguished.

(Title 18, U.S. Code, section 1151)

american indian alaskan native population
American Indian/Alaskan Native Population
  • 562 Federally Recognized Tribes
  • 229 Alaska Native Entities

(Federal Register, April 2008)

  • 69 States Recognized Tribes

(Santa Clara Law Review, 2007)

  • 160 Federally Non-Recognized Tribes

(500Nations, 2008)

american indian alaskan native population7
American Indian/Alaskan Native Population
  • Approximately 2.5 million self-identified AI/AN in the 2000 Census
  • Approximately 4.1 million AI/AN identified as one or in combination with one or more races
  • 38% of the AI/AN population is under the age of 18
  • 63% of AI/AN reside in urban areas, 37 % of AI/AN reside in rural areas

Indian Country is NOT all the same

Hopi different than the Seminole

Eastern Band of Cherokee different then Zuni

Inupaiq (Barrow) different than the Haida (Masset)

ai an cultural practices
AI/AN Cultural Practices
  • Preservation of cultural identity
  • Strong cultural foundations
  • Respect for elders
  • Value placed on children
  • Extended family structure
  • Interdependence of family relationships
  • Use of humor
diversity in cultural values
Diversity in Cultural Values


Sharing Saving

Cooperation Competition

Being Doing

Group Individual

Harmony with Nature Mastery over Nature

Present Future

Respect for Elders Value Youth

community challenges
Community Challenges
  • Domestic Violence
  • Child Abuse and Neglect
  • Substance Abuse
  • Mental Disorders
  • Violent Deaths (Unintentional)
  • Suicide
external barriers
External Barriers

Outside assistance introduced to Indian Country:

  • Lack of cultural knowledge and sensitivity
  • Language barriers
  • Distrust
  • Attitude of superiority; prejudice
  • Time-limited services
  • Questionable quality of services offered
internal barriers
Internal Barriers

Obstacles that deter tribal members from seeking assistance:

  • Lack of consistency
  • Lack of professionals with specialized training
  • Territoriality
  • Confidentiality
  • Tribal/agency politics
additional barriers in indian country
Additional Barriers in Indian Country
  • Living in isolated areas
  • Limited services available
  • Excessive paperwork to receive services
  • Waiting for service delivery
  • Stigma-shamefulness/disgrace
  • Substance abuse
  • Resistance to change
primary prevention
Primary Prevention
  • Directed at the general population
  • Involves raising awareness and providing education


- Safe Start Programs

- Boys and Girls Clubs in Indian Country

secondary prevention
Secondary Prevention
  • Activities directed toward high risk groups
  • Take Action to prevent or minimize harm


- Early Head Start/Head Start

- Home Visitation Programs

        • Healthy Families America
tertiary prevention
Tertiary Prevention
  • Focuses on reducing problematic behavior
  • Involves treating the problem to lessen its effects


- Wellbriety/WhiteBison

- Circles of Care - SAMHSA

strategies for connecting with tribes
Strategies for Connecting with Tribes
  • Outside agencies:

1. Establish Trust with the community

2. Be Respectful

3. Beware of Cultural Trespassing

4. WAIT until assistance is requested


Strategies for Connecting with Tribes

  • Within the Indian community:
  • Obtain support from community leaders
  • Get to know the Tribe
  • Introduce new programs and providers to community members
  • Address the younger population
  • Utilize the tribal elders
working with child maltreatment in indian country

Working with Child Maltreatment in Indian Country

Lorena Burris, PhD

Center on Child Abuse and Neglect

Oklahoma University Health Sciences Center

federal indian policy
Federal Indian Policy
  • U. S. Government made treaties with Independent

Tribal Nations; in 1870’s federal laws were enacted

to extend the trust obligations with tribes.

  • Early Federal Indian Policy was to assimilate

American Indians

  • Assimilation of American Indian children included :
        • boarding schools
        • adoption by non-Indian families
federal indian statutes
Federal Indian Statutes
  • 1953 Public Law 83-280; Amended in 1968
  • 1976 Indian Health Care Improvement Act P.L. 94-437; Reauthorized in 2008
  • 1978 Indian Child Welfare Act
  • 1989 Office for Victims of Crime/Victim’s Assistance in Indian Country (VAIC)
  • 1990 P.L.101-630 The Indian Child Protection and Family Violence Prevention; Reauthorized in 2003
violence in indian country
Violence in Indian Country

Child abuse & neglect:

1 substantiated report of a child victim of abuse or neglect for every 30 American Indian children age 14 or younger

(U.S. Bureau of Justice, 1995)

Rate of victimization for American Indian children was 15.9 cases per 1000 children. Rate of victimization was 12.1 per 1,000 children in the population. (NCANDS 2006)

violence in indian country24
Violence in Indian Country
  • Violence Against Women Act (2005)

- Tribal Title (Title IX) included AI/AN women

- AI/AN women 2.5 times more likely to be raped or

sexually assaulted (Amnesty International, 2007)

  • Domestic Violence/Intimate Partner Violence

Less likely to be reported in Indian Country

      • Due no or slow response from tribal police
      • Failure to prosecution
  • Domestic/Family Violence and Child Abuse
jurisdiction in indian country
Jurisdiction in Indian Country
  • Factors that determine jurisdiction
    • Whether the victim is:
      • Indian or Non-Indian
      • Victimless
    • Whether the offender is:
      • Indian or Non-Indian
    • Whether the offense occurred on tribal land or not
    • Whether or not Public Law 280 (or other relevant federal laws apply)
reporting child abuse neglect in indian country
Reporting Child Abuse & Neglect in Indian Country
  • Federal Jurisdiction: for violation of federal offense (major crimes)
      • Local law enforcement agency
      • Local child protective services agency
      • BIA Child Abuse Hotline 1-800-633-5155
  • State Jurisdiction: when under PL 280 follow state or state-tribe agreement exists
      • Child protective services agency
      • Law Enforcement agency
      • Child Abuse Hotline
  • Tribal Jurisdiction: committed on tribal land
      • Child protective services agency
      • Local law enforcement agency
      • Federal Bureau of Investigation
Suzie Kuerschner, MEdFASD ConsultantPortland, Oregon(503) 622-3973suziekuerschner@Gmail.comNPIHB(503) 228-4185

Building Sustainable State Systems& Collaborative Circles of CareforTribal and StateF.A.S.D. Service Integration


planning goals
Planning Goals
  • Facilitate integrated service delivery

from a family focused, Collaborative Circle of Care

model that insures culturally congruent and

developmentally appropriate case coordination

  • Facilitate community design of systems to include

mentors, natural helpers and elders that can

increase the frequency and duration of support


provider partnerships
Provider Partnerships

State, county and tribal systems model multi-disciplinary trust, promoting a climate conducive to positive collaborative relationships with families


creating and facilitating collaborative community and provider systems
Creating and Facilitating Collaborative Community and Provider Systems

 Non-stigmatic delivery of services

 Dynamics and integration of professional and community member volunteers

 Identification and list of community specific

resources … inclusive of providers, natural

helpers and elders



Behavioral Health Service Components



Substance Abuse


Family Support,

Advocacy, and

Care Coordination

Mental Health


Substance Abuse




Considering Diversity Factors in Integrated Behavioral Health Service Delivery

Norms for Maintaining Family, Friendship, and Professional Relationships

Degree of Assimilation and Acculturation

Child Nurturance and Discipline Approaches

Diversity Factors to Consider When Implementing Integrated Behavioral Health Services

Language and Dialect Differences and Similarities

Neighborhood and Community Resources

History of Societal Oppression, Resulting in Mistrust (including ethnic, gay, lesbian and bisexual oppression)

Generational Differences Regarding Cultural Practices

Economic Class Differences

Social Mores and Religious Values and Beliefs



1) Providers are educated about child development; consequences of organic brain damage; components of behavioral health; parenting stressors and family life issues



2) Families feel equal in service relationships. Delivery is not “done to” but “designed with” and participation in their lives is understood as a privilege by providers



3) Case coordination reflects family focus

and utilizes forms and delivery strategies

that respect this focus and conform to laws

of confidentiality



4) Sustainable behavioral change is understood as the result of both skill acquisition and habituation over time



5) Providers are knowledgeable about the special parenting challenges of parents who themselves have special needs


State, County & Tribal SystemsIntegrate Traditional Knowledgeand Clinical Best PracticeBuilding on Existing Structures:


 Health
  • Public Health
  • Tribal Health Services
  • Behavioral Health

◦ state, county and tribal


 Education
  • Early Intervention/I.F.S.P. Planning
  • Early Childhood Education/Headstart
  • Elementary Middle & Secondary School/I.E.P. Planning

◦ Tribal and public education

Post Secondary College Support


 Justice
  • Assist arrested individuals in understanding court procedures
  • Assist courts and judges with appropriate sentencing guidelines


employment living
 Employment & Living
  • Vocational education
  • Career development
  • Housing



Potential Forms


Possible Templates


Task Force Team Members



To move forward in healing

we must remember

that as Native people

we do not live in our communities

but our communities live in us.

Then and only then

do we really realize what collects our

choices and directs our decisions