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Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

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Page 1: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

Join the Anishnaabek Healing CirclePrepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery

October 22, 2014

Page 2: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

What is ATR

• ATR is a nationwide initiative of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Treatment (CSAT).

• The program provides vouchers to clients for the purchase of substance abuse clinical treatment and recovery support services.

Page 3: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

ATR Goals

The goals of the program are to:expand capacity, support client choice, and increase the array of services.

The Inter-Tribal Council of Michigan is the grantee for the program.ATR II started 10/2007 and ended

9/2010ATR III started 10/2010 and will end

3/2015ATR IV started 10/2014 and will end

9/2017

Page 4: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

Who are the Collaborators

Collaborating Tribes and Organizations

Bay Mills Indian Community Hannahville Indian Community Lac Vieux Desert Band of Lake Superior Chippewa

Indians Saginaw Chippewa Indian Tribe Grand Traverse Band of Ottawa/Chippewa Indians Sault Ste. Marie Tribe of Chippewa Indians Keweenaw Bay Indian Community Little Traverse Bay Bands of Odawa Little River Band of Ottawa Indians Pokagon Band of Potawatomi Nottawaseppi Huron Potawatomi Match-e-be-nash-she-wish Band of Potawatomi American Indian Health and Family Services

Page 5: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014
Page 6: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

Target Population

• Eligible clients are enrolled members of the collaborating tribes and members of other federally recognized, state recognized, and Canadian tribes residing in the project service area.

• Non-native family members and descendants are also eligible.

• The project will serve clients age 12 and older.

Page 7: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

Target Population

• The majority of clients, approximately 85%, will be American Indian.

• Descendents of tribal members are coded as American Indian on the GPRA and in the voucher system.

• The remaining 15% will family members of any cultural background.

Page 8: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

Target Numbers

• 3774clients over three years. • 1258 clients/year. • To accommodate continuity of care

and recidivism we estimate that as many 20% of the 5000 clients enrolled in ATR III will re-enroll at some time during the four year project period for the ATR IV.

Page 9: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

ATR III Resource Allocation

• All ATR III access centers have established financial caps based on client target numbers and GPRA follow-up completion goals.

• Caps will be adjusted quarterly based on progress toward recruitment and follow-up goals.

Page 10: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

ATR Client Registration and Placement Process

– Client is registered in the voucher system and assigned an ATR number.

– Voucher and GPRA number are the same.

– Client is screened (AUDIT/DAST/CRAFFT)

– GPRA is completed– Client is assigned to an Anishnaabek

Healing Circle Phase (Readiness Assessment)

– Clinical and/or recovery support assessment is complete if the client is in Phase II or III.

Page 11: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

ATR Client Voucher Process– Vouchers for access, care coordination,

follow-up and discharge are auto-generated by the system.

– Vouchers are requested based on the client needs.

– Referrals are made to tribal umbrella providers or Tier II providers as necessary based on client needs and choices.

– Vouchers are shared with Tier II providers as necessary.

Page 12: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

Client Process

All Clients– Services are provided and documented

in the client file. – Voucher transaction forms are

completed to facilitate billing for services.

– Documentation related to the transaction must be attached to or filed with the transaction form.

Page 13: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

Client ProcessAll Clients

– Receipts should be in the client file for ATR services purchased on behalf of the client.

– As you all know funds never go directly to the client for a purchase of clothing, food, etc.

– Voucher transactions are entered into the voucher system.

– ITC reviews and completes electronic audits on the files prior to payment.

– On-site file audits are completed by ITC randomly but with notice.

Page 14: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

Anishnaabek Healing Circle Phases

Readiness to Change and

Recovery Tasks

ATR Screening, Intake, GPRA

Phase I Pre-Treatment Readiness

Limited to motivational development and recovery

coaching

Phase II – Clinical Treatment

Full array of clinical and recovery support

services

Phase III – Aftercare Full array of recovery

support services

Page 15: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

Client Process

Phase I (Criteria=Positive Screen and willingness to participate in education or coaching.) • Motivational/educational services and

recovery coaching is provided.• Limited travel support and possibly some

other incentives that are tied to completion of motivational/educational services.

• Each tribal collaborator will need to develop a plan for providing Phase.

• This phase is designed for facilitate larger scale community outreach.

Page 16: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

Client Process

• Phase II (Criteria=Positive screen and willingness to complete a clinical assessment and enter treatment.)• Clinical treatment services• Recovery Support Services• Motivational services

Page 17: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

Client Process

• Phase III (Criteria= Willingness to continue to work on recovery tasks appropriate for the level of recovery.) (Early, Middle, Late)• Recovery Support Services• Motivational services

Page 18: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

Client ProcessAll Clients• Client GPRA Follow-

up • Client GPRA

Discharge • Access Center • Care Coordination Phase I• Motivational

Development and Readiness

• Peer Support & Relapse Prevention

• Transportation

Phase II & III• Brief Intervention **• Outpatient **• Intensive Outpatient

**• Residential Treatment

**• Sub-acute Detox **• Medical Services • Housing Support

Services Transitional Living Facilities

• Employment & Education Peer Support & Relapse Prevention

• Motivational Development and Readiness

• Peer Support & Relapse Prevention

• Family & Parenting Support

• Basic Needs• Legal Support• Health & Global

Wellness• Spiritual

Support/Cultural Support

• Transportation• Mental Health

Services/Co-occurring

Page 19: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

Recovery Coach Institute

• Two Anishnaabek Healing Circle Recovery Coach Institute have been held to train local recovery coaches, recovery coach supervisors and ATR liaisons.

• Seventy couches and supervisors from the tribes in Michigan have been trained.

• The training has been approved to meet all of the educational requirements for the Certified Peer Recovery Mentor - Michigan.

Page 20: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014
Page 21: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

Tribal Feedback

Benefits● Client Choice● Client Empowerment● Client Responsibility● Reduction of Stress/Barriers● Inclusion of cultural values/ceremonies for

healing● Holistic care● Recovery Support Services-continuum of care● Identification and reinforcement for long term

sobriety● Quarterly BH meetings with State Tribal BH-

support● Quality leadership and development with ATR

Directors

Page 22: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

Tribal Feedback

Enhancement of Recovery Services● Transportation● Special Need Fund● Alcohol Drug testing● Acupuncture● Physical Fitness & Well-being● Traditional Healing Services● Housing support● Medical Care ●Alcohol/Drug Free Social Activities

Page 23: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

Monitoring of Service Array

Access Clinical Recovery Support

0%

10%

20%

30%

40%

50%

60%

70%

14%

57%

29%

13%

58%

29%

15%

35%

50%

ATR IIATR IIIGoal

Page 24: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

ATR is Effective

ATR II client outcomes (N=2984). Improvements in abstinence, no arrests, no HBSC and socially connectedness were statistically significant (p<.001).

Abstinent

No Arrests

Employed/In School

HBS Consequences

Social Connect

Stable housing

0.00% 20.00% 40.00% 60.00% 80.00% 100.00%

52%

92%

55%

84%

77%

77%

67%

97%

57%

91%

90%

79%

30%

5%

4%

8%

17%

3%

ATR II Intake, Follow-up, and Change on Key Indicators

Change At 6 Months At Intake

Page 25: Join the Anishnaabek Healing Circle Prepared by: Eva L. Petoskey, M.S. Director, Anishnaabek Healing Circle Assess to Recovery October 22, 2014

• Access to Recovery• Anishnaabek Healing Circle• 2956 Ashmun, Suite A• Sault Ste. Marie MI 49783• (906) 632-6896• www.atrhealingcircle.com

Staff • Eva Petoskey, Director (231-357-4886) [email protected] • Terri Tavenner, Associate Director [email protected] • Connie DePlonty, Voucher Coordinator [email protected] • Cora Gravelle, Call In Center Client Access & Outreach [email protected] • Sheila Hammock, Call In Center Client Access & Follow-up [email protected]

Produced by the Inter-Tribal Council of Michigan with Access to Recovery (ATR) Anishnaabek Healing Circle Grant (1H79TI025514) funds from the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Administration (SAMHSA), U.S. Department of Health & Human Services (HHS). Content is solely the responsibility of the authors and does not necessarily represent the official views of the agency.