Outpatient Program for Little Earth

Dr. Laurelle Myhra, left, with healthcare consultant Adam Fairbanks and Jolene Jones, president of Little Earth Residents Association, at the Native American Community Clinic in Minneapolis. (Photo by Lee Egerstrom.)

By Lee Egerstrom

Three Native American organizations have teamed up to launch a new Intensive Outpatient Program (IOP) to help drug abusers and their families in the Little Earth of United Tribes community in Minneapolis.

Beginning in October, Little Earth residents will be eligible for outpatient treatment and support from health and behavioral specialists at the nearby Native American Community Clinic (NACC), 1213 E. Franklin Ave.

This collaborative program is supported by the Red Lake Nation, the Northern Minnesota band of Ojibwe that is developing Mino-Bimaadiziwin (“The Good Life”), a large housing and mixed use project near Little Earth and the American Indian Cultural Corridor in south Minneapolis.

“This is the ‘next level,’ the ongoing step for recovery and treatment that our community needs,” said Jolene Jones, president of the Little Earth Residents Association (LERA) that manages the rental housing in the Little Earth complex, 2495 18th Ave. S.

Dr. Laurelle Myhra, director of behavioral health at NACC, said substance use disorder treatment is crucial for the health of American Indians. “Native Americans are six times more likely to die of opioid drug overdoses than the dominant Minnesota population,” she said.

Americans in general now recognize that all segments of society are facing an opioid crisis from use of heroin, synthetic variants and related, prescribed pain killers such as oxycodone, hydrocodone, codeine and morphine.

While widespread now, use of these drugs hit Native Americans earlier than most communities. And it wasn’t just within the urban areas, said Adam Fairbanks, of EI-Consultants of Robbinsdale, a consulant for the Red Lake Tribal Council who forged linkages among Red Lake, NACC and Little Earth.

EI-Consultants works with tribal organizations to establish and operate chemical dependency and mental healthcare facilities, primarily in Minnesota.

Fairbanks, Myhra and Jones are all “Native Americans.” That identity is becoming preferred by groups such as Little Earth with diverse tribal backgrounds and by groups working to link urban Indians and descendants who may not be enrolled members of different tribes, Jones said.

he crisis in her own backyard became painfully evident in 2009 when the Little Earth community had “11 or 12 OD (overdose) calls within a 20 minute period.

“The paramedics didn’t know where to begin,” Jones said. “They said they had never seen anything like that before.”

At that point the EMT paramedics “were our first line of defense. We had to do something,” she said.

Little Earth has a population at about 1,000 residents housed in 212 rental properties ranging from efficiencies to five-bedroom homes. Children account for half the population and half of them are under the age of 10, Jones said.

Faced with problems and threats to children, Little Earth started prevention and emergency response efforts. About two of every three housing units now have Narcan, the drug also known as Naloxone, used to treat people with an opioid overdose. Little Earth has a specialist who residents may call to administer the drug.

Deaths from overdoses have stopped but Little Earth still has occasional problems with shootings and violence, usually by “visitors,” such as drug dealers, who stop by “because we are still a market,” Jones said.

Problems persist across Minnesota’s 11 tribal communities and in urban centers. The Minnesota Health Department, in a background document “The Opioid Epidemic in Minnesota,” states there is an urgent need for program assistance within American Indian communities.

American Indians made up an estimated 1.1 percent of the state’s population in 2015 Census Bureau data but accounted for 15.8 percent of those entering treatment for opioid abuse.

American Indian communities in Minnesota had drug overdose death rates nearly five times higher than white Minnesotans from 1999 to 2014 and were 8.7 times more likely to be diagnosed with maternal opiate dependency or abuse during pregnancy compared to non-Hispanic whites, the health department found. Infants were 7.4 times more likely to be born with neonatal abstinence syndrome (NAS) – now called Neonatal Opioid Withdrawal Syndrome.

That’s where the new Intensive Outpatient Program comes into play. In materials being prepared for the launch of the IOP, Myhra notes that health organizations have various programs for outpatient services. What NACC is establishing with Little Earth, however, combines culturally sensitive, trauma-focused harm reduction and a family systems approach.

This will operate for 12 weeks, five days a week at NACC, opening with a prayer and cultural teachings by a Little Earth elder in residence. Substance use disorder classes will be led by a clinical supervisor and peer recovery coaches.

While some trained positions are still being filled, the program calls for mental health and public health education classes led by behavioral health and community health workers and providers.

Part of the program will allow family members to participate with the IOP patient and attend large group cultural teaching, substance abuse and behavioral health education classes, and in small group sessions to process information.

Myhra said the legal name for the program is NACC Tribal Health and is seeking suggestions for a Dakota or Ojibwe name for use in public. Limited services will begin in September but will begin officially on Oct. 1.

It will be open to Little Earth residents, Native Americans throughout the metro area, enrolled members and descendants of tribes, and because NACC is a Federally Qualified Health Center (FQHC), it will also serve non-Native family and community members.
“There’s a lot of healing that needs to be done,” Little Earth’s Jones said.

This next step, as she calls it, is consistent with the community’s efforts to address health disparities in the American Indian community. Among other programs, Little Earth operates an urban farm to promote healthy cooking and eating, farming education, healthy living and physical exercise through gardening.

It also has youth development programs, education and employment services, a joint family program called Omniciye (Lakota for “coming together for a common purpose”) with Hennepin County, character and leadership development, health and life skills, diabetes prevention and a “Wellbriety” program promoting wellness, sobriety and drug free families for Little Earth residents and the surrounding community.

Meanwhile, NACC stresses the integration of mind and spirit with its medical and dental healthcare services. Behavioral health providers are available daily at its Franklin Avenue medical clinic for diagnosis and health and wellness planning.

These services cover a range of mental health and emotional problems such as grief and loss, depression, anxiety and substance use disorder where outpatients can be helped through counseling services.

For more information, the NACC website is at: nacc-healthcare.org; the Little Earth website is at: www.littleearth.org; EI-Consultants services for Native communities are explained at: www.ei-consultants.com; and Red Lake Nation news and information can be found at: www.redlakenation.org.

MN Health Department drug abuse statistics can be viewed at the website: https://mn.gov/dhs/assets/federal-opioid-briefing_tcm1053-336378.pdf.