The Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Mental Health Services (CMHS) is dedicated to improving behavioral health across the United States. A cornerstone of their efforts for American Indian and Alaska Native communities is the Circles of Care program. This initiative provides crucial infrastructure grants to support the development of community-based systems of care. Understanding this program is vital for anyone involved in or seeking to improve mental health services within these communities.
Initiated in 1998, the Circles of Care program was born from collaborative planning with tribal leaders, mental health professionals, and advocates within the American Indian and Alaska Native populations. Recognizing the unique needs and challenges faced by these communities, SAMHSA launched this program to foster self-determination in mental health service development. Notably, until the advent of the Native Connections program in 2014, Circles of Care stood as SAMHSA’s sole grant program exclusively dedicated to these communities, ensuring focused resources without competition from broader state or city initiatives.
Core Objectives of the Circles of Care Program
The Circles of Care program is strategically designed with two primary objectives:
- Planning and System of Care Model Development: The program empowers communities to strategically plan for and design their own community-based system of care models. These models are specifically tailored to address the mental health challenges faced by children and their families within their unique cultural context. This planning phase is critical for laying a solid foundation for effective and culturally sensitive services.
- Building Local Capacity and Infrastructure: Beyond planning, the program is committed to building tangible local capacity and infrastructure. This includes equipping tribal communities with the necessary tools and resources to successfully secure funding and support for the long-term implementation of their system of care models. This focus on sustainability ensures that communities are empowered to independently improve the mental health and overall wellness of their children, youth, and families for years to come.
How Circles of Care Grants Work
Circles of Care grants are structured to facilitate comprehensive change within communities. Grant funds are specifically designated to support:
- Infrastructure Planning and Development: Grantees utilize funds to build the foundational infrastructure required to support a robust system of care. This could include developing organizational frameworks, establishing collaborative partnerships, and creating the necessary administrative structures.
- Driving Systemic Change: The program aims to foster broad, systemic change in how mental health and related services are delivered. This involves moving away from fragmented approaches towards integrated, coordinated systems that are responsive to community needs.
- Local Capacity Building: A key focus is on enhancing local capacity. This encompasses training and workforce development, strengthening community resources, and fostering local expertise in mental health, substance abuse prevention, and wellness services. The ultimate goal is to empower communities to become self-sufficient in providing these vital supports for their children, youth, and families.
Furthermore, the Circles of Care program mandates specific operational principles for all grantees. These include:
- Cross-System Collaboration: Grantees are required to prioritize and implement strong cross-system collaboration. This means fostering partnerships between various sectors within the community, such as healthcare, education, social services, and juvenile justice, to ensure a holistic and integrated approach to care.
- Family, Youth, and Community Engagement: The program emphasizes the critical importance of including family members, youth themselves, and broader community resources in all stages of planning and implementation. This participatory approach ensures that the system of care is truly community-driven and responsive to the lived experiences of those it serves.
- Culturally Relevant Approaches: All program activities and system of care models must be grounded in culturally relevant approaches. This means respecting and integrating the unique cultural values, traditions, and beliefs of the community into the design and delivery of services. Cultural relevance is paramount to ensuring the effectiveness and acceptance of mental health supports within American Indian and Alaska Native communities.
It is important to note that Circles of Care grant funds are not intended for direct service provision. The program’s focus is upstream, on building sustainable infrastructure and capacity that will enable communities to deliver effective services over the long term.
Key Deliverables of the Circles of Care Program
To ensure accountability and progress, the Circles of Care program outlines specific deliverables that grantees are required to produce. These deliverables serve as building blocks for developing a comprehensive system of care model and include:
- Community Needs Assessment: A thorough assessment to identify the specific mental health needs and challenges within the community.
- Community Readiness Assessment: An evaluation of the community’s existing resources, strengths, and readiness to implement a system of care model.
- Community Resource/Asset Map: A detailed inventory of existing community resources and assets that can be leveraged to support the system of care.
- Social Marketing/Public Education Plan: A strategy to raise awareness about mental health issues, reduce stigma, and promote available services within the community.
- Process Evaluation: Ongoing monitoring and evaluation of the program’s implementation process to ensure it is being carried out as planned and to identify any necessary adjustments.
- Local Evaluation Plan: A plan to evaluate the impact and outcomes of the implemented system of care model within the community.
- System of Care Model (Blueprint): A comprehensive plan, often referred to as a “Blueprint,” outlining the specific components and structure of the community’s tailored system of care model.
- Implementation Plan: A detailed plan for putting the System of Care Model Blueprint into action, including a feasibility study to ensure its practicality and sustainability.
- Outcome Measurement Plan: A plan to measure the specific outcomes and impact of the implemented system of care model on the mental health and well-being of children, youth, and families in the community.
For grantees seeking guidance and resources, SAMHSA provides valuable tools such as “Planning a System of Care for American Indian and Alaska Native Communities: A Crosswalk.” This resource offers a comprehensive overview of the Circles of Care program and its step-by-step process, helping grantees navigate the program requirements effectively.
Circles of Care TTA Cohorts: A History of Impact
The Circles of Care program has operated through various cohorts, each spanning three years and supporting a new group of grantees. These cohorts represent a rich history of impact and growth within American Indian and Alaska Native communities. Below is a listing of the cohorts and the grantees involved, showcasing the program’s extensive reach across diverse tribal communities:
Cohort 1: 1998–2001
- Cheyenne River Sioux Tribe, SD
- Choctaw Nation of Oklahoma, OK
- Fairbanks Native Association/Tanana Chiefs Conference, AK
- Feather River Tribal Health, CA
- First Nations Community Healthsource, NM
- In-Care Network, MT
- Inter-Tribal Council of Michigan, MI
- Oglala Lakota Tribe, SD
- Urban Indian Health Board, CA
Cohort 2: 2001–2004
- Blackfeet Nation, MT
- Central Council Tlingit and Haida Indian Tribes, AK
- Pascua Yaqui Tribe of Arizona, AZ
- Puyallup Tribal Health Authority, WA
- Salt River Pima-Maricopa Indian Community, AZ
- United Indian Involvement, CA
- Ute Indian Tribe, UT
Cohort 3: 2005–2008
- Cook Inlet Tribal Council, AK
- Denver Indian Family Resource Center, CO
- Muscogee (Creek) Nation, OK
- Native American Rehabilitation, OR
- Quileute Tribe, WA
- Sinte Gleska University, SD
- Tulsa Indian Health Care Resource Center, OK
Cohort 4: 2008–2011
- American Indian Center of Chicago, IL
- Crow Creek Sioux Tribe, SD
- San Felipe Pueblo, NM
- Karuk Tribe, CA
- Standing Rock Sioux Tribe, ND
- Nebraska Urban Indian Centers, NE
- Mashantucket Pequot Tribal Nation, CT
- American Indian Health and Family Services, MI
Cohort 5: 2011–2014
- American Indian Education Center, OH
- Boys and Girls Club, Northern Cheyenne Nation, MT
- Fresno American Indian Health Project, CA
- Native American Indian Center of Central Ohio, OH
- Tohono O’odham Community College, AZ
- Yellowhawk Tribal Health Center, OR
- Yurok Tribe, CA
Cohort 6: 2014–2017
- Hoh Tribe, WA
- Indian Health Center of Santa Clara Valley, CA
- Lower Brule Sioux Tribe, SD
- Makah Indian Tribe, WA
- Osage Nation, OK
- Quartz Valley Indian Reservation, CA
- Red Cliff Band of Lake Superior Chippewa, WI
- Seattle Indian Health Board, WA
- Tanana Chiefs Conference, AK
- Ute Mountain Ute Tribe, CO
Cohort 7: 2017–2020
- American Indian Health and Services, CA
- Eight Northern Indian Pueblos Council, Inc., NM
- Fallon Paiute Shoshone Tribes, NV
- Fort Peck Assiniboine and Sioux Tribes, MT
- Kansas Kickapoo Tribe, KS
- Maniilaq Health Center, AK
- Phoenix Native American Community Health Center, AZ
- Sacramento Native American Health Center, CA
- San Diego American Indian Health Center, CA
- Susanville Indian Rancheria, CA
- Toiyabe Indian Health Project, Inc., CA
- Winnebago Tribe of Nebraska, NE
- Yakama Nation, OR
Cohort 8: 2020–2023
- Alaska Native Tribal Health, AK
- Central Oklahoma American Indian Health Council, Inc., OK
- Comanche Nation, OK
- Confederated Salish and Kootenai Tribes, MT
- Confederated Tribes of Coos, Lower Umpqua, & Siuslaw Indians, OR
- Fort Defiance Indian Hospital Board, Inc., AZ
- Gerald L. Ignace Indian Health Center, WI
- Great Plains Tribal Leader’s Health Board, SD
- Iowa Tribe of Oklahoma, Inc., OK
- Lac Courte Oreilles, WI
- Native American Community Clinic, MN
- Oglala Sioux Tribal Council, SD
- Ohkay Owingeh, NM
- Pueblo of Nambe, NM
- Round Valley Health Center, Inc., CA
- San Carlos Apache Tribe, AZ
- Shingle Springs Band of Miwok Indians, CA
- South Dakota Urban Indian Health, Inc., SD
- Southern Plains Tribal Health Board Foundation, OK
- Swinomish Indian Tribal Community, WA
- United Indian Health Services, Inc., CA
- Wichita & Affiliated Tribes, OK
Cohort 9: 2023–2026
- Acorns to Oak Trees Restore the Village Project, CA
- ATC Circle of Care, AK
- Hopi Tribe, AZ
- Nebraska Circles of Care, NE
- Orange County Circles of Care Indigenous Project, CA
- Ponca Tribe System of Care, OK
- Red Road Youth Initiative, CA
- TMO Circle of Care Project, ND
This extensive list demonstrates the long-standing commitment of the Circles of Care program and its wide-reaching impact across numerous American Indian and Alaska Native communities. These cohorts represent a network of communities actively working to build stronger mental health systems for their children and families.
Connect with SAMHSA for More Information
For further inquiries or to learn more about the Circles of Care program, please reach out to:
Jeffrey M. Bedree
Public Health Advisor
Child, Adolescent & Family Branch
Center for Mental Health Services
Substance Abuse and Mental Health Services Administration
5600 Fishers Lane
Rockville, MD 20857
240-276-1181
[email protected]
Mr. Bedree serves as a primary point of contact for the program and can provide detailed information and guidance to interested individuals and communities.
