Principle 2

Invest in reciprocal learning and partnerships across tribes.

The 574 federally recognized tribes are receiving nearly $1.5 billion over the next 15 years (amount and length of time varies between the different settlements). Ultimately, these dollars may not be enough to fund the breadth of work needed to address the ongoing opioid crisis in tribal communities. Yet, the settlements do offer a unique opportunity to begin planning, enhancing, or creating new services for community members who use opioids, across a variety of sectors and to learn across tribal contexts. We have heard the desire to learn from shared challenges addressing the opioid crisis and successful efforts to overcome them. There is flexibility in the Approved Uses, and there is a desire from tribes and tribal health organizations to work together.

Collaboration, not competition.

– Indigenous Advisory Committee Member

How can tribes adopt this principle?

1. Maximize funding opportunities.

Consider supplementing existing funding opportunities through combining settlement dollars with other funding initiatives (e.g. Tiwahe Initiative, Native Collective Research Effort to Enhance Wellness (N CREW) Program, Federal state and local granting agencies, philanthropies, etc.) and, where possible, partner with states to access opioid litigation funding that states have dedicated for tribes/AI/AN communities and organizations (e.g. see example in Washington state). The Approved Uses have much flexibility compared to other grant-funded sources (e.g. federal grants that might restrict purchasing of certain harm reduction supplies or innovative cultural supports), which means there are opportunities for communities to respond to their unique needs.

2. Create partnerships for shared work.

As tribes create plans to spend the opioid settlements, working with existing knowledge systems can support the planning process. Tribal epidemiology centers, for example, have access to current data which can support planning and programming across and within regions. Considering the lack of available inpatient treatment services in some tribal communities, several tribes have been discussing the potential of pooling funds to create shared services. This approach may also reduce issues surrounding confidentiality, where community members do not wish to access treatment services in their home community due to stigma but may feel more comfortable accessing services in a shared space between communities.

3. Learn more about programs and services that other tribes have created to fund and share messaging.

Programs such as Didgwalic Wellness Center in the Swinomish Tribe offers a variety of substance-use related services, with innovative billing practices in which “funding comes directly from providing services for fees. Fees are billed to clients directly or to third party payers such as private health plans, Medicare, or Medicaid”. This integrated approach is currently being implemented in several tribes in the Pacific Northwest. The Indian Country ECHO: Substance Use Disorder ECHO Program offers an online platform to learn more about what other tribes are doing with their substance use programs, and can serve as an opportunity to share more about the work that your tribe is leading.

State and local jurisdictions will also be receiving funds from the opioid settlements, and there may be opportunities for Tribal Communities to work in collaborative or in alignment with regional programs. For further information on investment of the opioid dollars outside of the context of Tribal communities, please see the programs funded with state and local dollars as well as the Principles for the States.