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

2. 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.

3. 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 9/2010  ATR III started 10/2010 and will end 3/2015  ATR IV started 10/2014 and will end 9/2017

4. 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

6. 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.

7. 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.

8. 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.

9. 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.

10. 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.

11. 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.

12. 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.

13. Client Process All 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.

14. 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

15. 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.

16. 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

17. 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

18. Client Process All 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

19. 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.

21. 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

22. 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

23. Monitoring of Service Array

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

25. 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.netepetoskey@centurytel.net Terri Tavenner, Associate Director ttav@itcmi.orgttav@itcmi.org Connie DePlonty, Voucher Coordinator connied@itcmi.orgconnied@itcmi.org Cora Gravelle, Call In Center Client Access & Outreach cora@itcmi.orgcora@itcmi.org Sheila Hammock, Call In Center Client Access & Follow-up shammock@itcmi.orgshammock@itcmi.org 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.