Strategy for Tribal Behavioral Health Department

Catawba Indian Nation


Located in South Carolina, the Catawba Indian Nation has over 3,300 enrolled members. As of early 2023, the Indian Health Service was operating a small service unit there that provided referral services for tribal members. The Tribe operated a small, grant-funded behavioral health department and was engaging in discussions with the IHS to assume control of health services through what’s known as a 638 contract. To aid in these discussions, KAI helped develop a strategic plan.


The challenges to effective behavioral health services in the Catawba Nation are substantial, including a lack of community-based sober living and transitional housing options, the limited scope of IHS services, a lack of culturally grounded services, and a reluctance to seek care due to tribal members’ prior experiences of cultural insensitivity at local treatment centers and sober living residences.


KAI conducted an exhaustive needs assessment which included interviews with key stakeholders, a community gathering with tribal members, and review of epidemiological data. The community gathering provided an opportunity for tribal members with lived experience to describe the issues they encounter when seeking care at inpatient rehab and returning home from treatment. KAI then facilitated a strategic planning retreat with leadership from the grant-funded behavioral health programs and tribal council to build consensus for the behavioral-health strategy.


A comprehensive strategic plan for behavioral health was developed and submitted to tribal council for approval.