Join the Anishnaabek Healing CirclePrepared by: Cora Gravelle, Client Access & Outreach Coordinator, Eva L. Petoskey, M.S. Director, Terri Tavenner, ATR Associate

Director, Anishnaabek Healing Circle Assess to Recovery March, 29,2011

Anishnaabek Healing CircleAccess to RecoveryATR & the Military

Veterans, Active Military, National Guard:

How can we work together to help active

duty, returning servicemen and service-women, and veterans who are Native American, to access treatment and recovery resources?

ATR and the Military

Goal: to introduce ATR as a referral source and resource to the military.

What is ATR?• Access to Recovery – ATR – is a

nationwide initiative of the Substance Abuse & Mental Health Services Administration (SAMHSA) Center for Substance Abuse Treatment (CSAT).

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

What is ATR?

The Anishnaabek Healing Circle ATR is designed to support healing and recovery from addiction among the Michigan tribal population.

The Inter-Tribal Council of Michigan is the grantee for the program.

ATR Goals

The goals of the program are to:expand capacity to serve Native

Americans,support client choice, and increase the array of services.

The Inter-Tribal Council and 12 tribes are collaborating partners in ATR:

ATR II started 10/2007 and ended 9/2010

ATR III started 10/2010 and will end 9/2014

Who are the CollaboratorsCollaborating 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

ATR Provider Network• Tier 1 Providers are tribal behavioral

programs. Tribes provide access and care coordination and are the entry point into ATR for a client.

• Tier 1 Tribal Providers offer an array of services under the tribal umbrella.

• Tier 2 non-Tribal Providers are clinical treatment and recovery support organizations who share vouchers and provide services.

Clinical TreatmentProgram Qualifications

• Organizations will be licensed by the State of Michigan or under Tribal Codes for the services they are providing.

• Clinical staff will be licensed, registered or certified in their specialty. Substance Abuse counselors must meet Tribal, Indian Health Services, Michigan or the IC & RC certification standards. Appropriate certifications include CADC I, CAD-II, or CADC-III from UMICAD (www.umicad.org) or the CAC-M, CAC-R, or CAAC from MCBAP (www.mcbap.com). For other specialties the appropriate Tribal or Michigan standards will apply.

Recovery Support Staff Qualifications

Cultural resource people must be recognized and sanctioned by their Tribal communities.

Faith-based resource people/programs will be recognized and sanctioned by their respective faith communities. If required by Tribal or State law or policy, organizations and individuals

will be licensed by the State of Michigan or under Tribal Codes for the services they are providing.

If an individual service provider has less than one year of experience working with ATR Tribal clients, he/she must provide documentation of at least six hours of cultural competence training dealing specifically with Michigan Tribal history and culture. This documentation must be submitted to ITC within 60 days of becoming an approved provider

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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.

• All clients must have a current or past problem with alcohol or other drug abuse.

• The project will serve clients age 12 and older.

• 8752 clients over four years. • 2188 clients/year.

ATR III Enhancements

• Expand age range to include 12-13 year olds.

• Enhance care coordination for ATR.• Enhance cultural interventions/grassroots

community engagement.• Enhance provider recruitment and

selection.• Expand services to urban Indian

population in Michigan.

ATR III Enhancements

• Expand outreach to under-served Native American populations, such as the Active Military Service, Veterans, Prison re-entry, homeless and hard to reach populations.

ATR III Resource Allocation• ATR III funding is a payor of last

resort. Insurances or Veterans benefits will be used first.

• ATR is a supplement and can add/ enhance what VA already has to offer.

• ATR III can be a new Referral Source for the VA.

ATR III Resource Allocation• ATR III has a new approach to

placement of client (Phases) that encourages clients to progress toward full engagement in treatment and/or recovery.

• ATR III vouchers have been restructured to create a match with the recovery support assessment and service options.

ATR Client Registration and Placement Process

– Client is registered at one of the Tribal Access centers.

– Client is screened (AUDIT/DAST/CRAFFT) and if eligible, is assigned a unique Client ID # that never changes.

– GPRA is completed.– Client is assigned to an Anishnaabek

Healing Circle Phase.– Clinical and/or recovery support

assessment is completed if the client is in Phase II or III.

Client Choice– It is the client’s choice of what provider

they will use as long as the provider is in the ATR Network, is accessible, and provides the level of care the client needs, based on assessment.

– The Tribal Access Center provides Care Coordination and will stay with the Client throughout the ATR process.

– The Care Coordinator helps the client navigate the system and find providers that match the client’s treatment and recovery plan.

Anishnaabek Healing Circle Phases

Readiness to Change

and Recovery

Tasks

ATR Screening, Intake, GPRA

Phase I Pre-Treatment ReadinessLimited 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

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Phase I (New for ATR III)

Phase II Phase III

Criteria=Positive Screen and willingness to participate in education or coaching.

Criteria=Positive screen and willingness to complete a clinical assessment and enter treatment.

Criteria= Willingness to continue to work on recovery tasks appropriate for the level of recovery.

•Motivational Services •Educational services•Recovery coaching

•Clinical treatment services•Recovery Support Services•Motivational services

•Recovery Support Services•Motivational services

•Community outreach•Engagement of clients

Very early recovery Early, Middle, Late Recovery

Thinking about Recovery

Maybe Engaged in Recovery

Engaged in Recovery

ATR III Phases

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Voucher Structure Vouchers

Phase I Vouchers Phase II Phase III

Client GPRA Follow-up**Auto Auto Auto

Client GPRA Discharge**Auto Auto Auto

Access Center**Auto Auto Auto

Motivational Development and ReadinessAvailable Available Available

Care Coordination Voucher** Auto Auto Auto

Brief InterventionNot Available Available Not Available

OutpatientNot Available Available Not Available

Intensive OutpatientNot Available Available Not Available

Residential Treatment (Max 30 days)Not Available Available Not Available

Sub-acute Detox (Max 3 days)Not Available Available Not Available

Medical ServicesNot Available Available Available

Housing Support ServicesNot Available Available Available

Transitional Living Facilities Not Available Available Available

Employment and EducationNot Available Available Available

Peer Support & Relapse PreventionAvailable Available Available

Family & Parenting Support Not Available Available Available

Financial/Basic Needs Not Available Available Available

Legal Support Not Available Available Available

Health & Global Wellness Not Available Available Available

Spiritual / Cultural Support Not Available Available Available

TransportationAvailable Available Available

Mental Health Services / Co-OccurringNot Available Available Available

What Makes the Anishnaabek Healing Circle

Unique• We offer culturally-based recovery

support to Native Americans & their families.

• We work with the client before and after clinical treatment to attain and then to maintain long-term sobriety.

• We offer care coordination to support a substance abuse free lifestyle.

• We recognize recovery as a life-long journey.

ATR II Clients by Age Group

10 to 12 yrs 0% 13 to 17 yrs

9%

18 to 24 yrs17%

25 to 34 yrs23%

35 to 44 yrs20%

45 to 54 yrs16%

55 to 64 yrs9%

65 yrs+6%

ATR II Unduplicated Clients by Age Group, n=5,288

ATR II Gender

47%

53%

ATR II Gender of Unduplicated Clients, n=5,288

MaleFemale

10 to 12 yrs

13 to 17 yrs

18 to 24 yrs

25 to 34 yrs

35 to 44 yrs

45 to 54 yrs

55 to 64 yrs

65 yrs+

020

040

060

080

010

0012

0014

00

1

246

468

573

493

383

189

125

0

227

416

626

580

477

289

194

Unduplicated ATR II clients, Age group by gender, n=5,288

MaleFemale

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ATR II Outcomes

Abstinent

No Arrests

Employed/In School

HBS Consequences

Social Connect

Stable housing

0.00%

10.00

%

20.00

%

30.00

%

40.00

%

50.00

%

60.00

%

70.00

%

80.00

%

90.00

%

100.0

0%

52.00%

92.00%

54.70%

83.90%

76.70%

77.00%

67.40%

96.50%

57.00%

90.60%

90.00%

79.30%

29.6%

4.9%

4.2%

8.0%

17.3%

3.0%

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

ChangeAt 6 MonthsAt Intake

ATR III Targets

KEWEENAW BAY INDIAN COMMUNITY

SAGINAW CHIPPEWA TRIBE

SAULT TRIBE OF CHIPPEWA INDIANS

LITTLE TRAVERSE BAY BANDS

BAY MILLS INDIAN COMMUNITY

HANNAHVILLE INDIAN COMMUNITY

GRAND TRAVERSE BAND

POKAGON BAND

LAC VIEUX DESERT

LITTLE RIVER BAND

NHBP

MATCH-E-NASH-SHE-WISH POTAWATOMI TRIBE

American Indian Health and Family Services

0 50 100 150 200 250 300 350

320

320

260

200

160

160

260

160

4060

160

40

60

ATR III Annual Client Target Numbers

Clients

ATR & the VA• We would like to be a referral source

to Native American veterans in Michigan.

• We would like to find ways to work together and explore options to serve vets.

• Miigwetch (thank you) for your time and interest.

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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) epetoskey@centurytel.net Terri Tavenner, Associate Director ttav@itcmi.org Donelda Harper, Training & Audit Specialist dharper@itcmi.org Lori McDonald, GPRA & Media Specialist lorimac@itcmi.org Aagii Clement, Provider Liaison Specialist aclement@itcmi.org Connie DePlonty, Voucher Coordinator connied@itcmi.org Cora Gravelle, Call In Center Client Access & Outreach cora@itcmi.org Sheila Hammock, Call In Center Client Access & Follow-up shammock@itcmi.org

Produced by the Inter-Tribal Council of Michigan with Access to Recovery (ATR) Anishnaabek Healing Circle Grant (1 H79 TI023118-01) 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.