Transcript Slide 1

Anishnaabek Healing Circle
Access to Recovery
AN EFFECTIVE AND INNOVATIVE ROSC MODEL
September 2013
Prepared by:
Eva L. Petoskey, MS Director
Terri Tavenner, Associate Director
Inter-Tribal Council of Michigan
 The Inter-Tribal Council of Michigan (ITC) is a
consortium of the federally recognized tribes in
Michigan.
 The ITC has collaborated with the Michigan tribes on
a wide range of health and human service initiatives
over the past 40 years.
 The elected tribal Chairpersons from
the consortium tribes serve as the
ITC
Board of Directors.
What is Access to Recovery and
the Anishnaabek Healing Circle?
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.
ATR Goals
The goals of the ATR program are to:
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expand capacity of treatment & recovery support services,
support client choice,
and increase the array of services
The Inter-Tribal Council of Michigan is the grantee
for the program.
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ATR II started 10/2007 and ended 9/2010
ATR III started 10/2010 and will end 9/2014
Target Population
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Enrolled members of Michigan tribes and other federally
recognized, state recognized, and Canadian tribes residing in
the project service area, age 12+. Non-native family members
and descendants are also eligible.
All clients must have a current or past problem with alcohol
or other drug abuse.
 Anishnaabek Healing Circle ATR II: (5228 clients)
 Anishnaabek Healing Circle ATR III: (8752 target)
Who are the Collaborators?
Collaborating Tribes and Organizations
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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
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The Recovery Movement
As Anishnaabek we have endured a
remarkable journey over time
carrying the seeds of healing deep in
our hearts.
The grief and trauma resulting from boarding schools,
rapid cultural change, lack of economic opportunity,
and loss of land have contributed to the high rates of
substance abuse and mental health problems
experienced by the Anishnaabek families and
communities today.
Tribal Initiatives
The seeds of healing have grown into a
strong recovery movement with
committed people.
Tribal governments have created behavioral health
departments along with policies and procedures to
guide the delivery of services including indigenous
healing services that are integrated with western
approaches.
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The
Anishnaabek
Healing Circle
ATR has been
able to
effectively
access funding
to support this
tribal vision for
healing.
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Jingle dress
dancers, dance for
healing.
Anishnaabek
people of
Michigan.
(Odawa,
Potawatomi, and
Ojibwa)
Working with multiple tribes has
challenges. There are multiple ways to
collaborate. A shared vision is key to
success.
Tribal Behavioral Health Communication Network
Vision Statement: “The spiritual strength of our
ancestors will live in the hearts of our people.”
The Communication Network
is a group of tribal behavioral
health stakeholders. The group
has been meeting for 30+ years.
“To advocate for and facilitate the
Behavioral Health
development of indigenous
Communication
Network Mission methods for the prevention and
treatment of substance abuse and
Statement:
mental health problems based on
Anishnaabek values of Love,
Respect, Honesty, Bravery,
Humility, Truthfulness, and
Wisdom; and to evaluate these
methods based on indigenous
indicators.”
Winter Teaching Lodge
Behavioral Health Cultural Service
Expansion with ATR
Saginaw Chippewa Tribe
Behavioral Health Residential, Outpatient and
Recovery Support Services
Tribal Recovery Oriented Systems of Care
 Shifting the model of intervention from acute care
of individuals to a sustained recovery management
approach relies on partnerships with individuals,
families and communities. White & Sanders
(2004).
 ATR II started the “process” of integrating services
into a ROSC. ATR III continues that process by
identifying key elements to integration.
Anishnaabek Healing Circle Phases
ATR Screening,
Intake, GPRA
Phase III –
Aftercare
Full array of
recovery support
services
Readiness to
Change and
Recovery
Tasks
Phase II – Clinical
Treatment
Full array of clinical
and recovery
support services
Phase I PreTreatment Readiness
Limited to
motivational
development and
recovery coaching
ATR III Phases
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Phase I (New for ATR Phase II
III)
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
•Recovery Coaching
•Community outreach
•Engagement of clients
Very early recovery
Early, Middle, Late
Recovery
Thinking about Recovery
Maybe Engaged in
Recovery
Engaged in Recovery
Voucher Structure
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Vouchers
Client GPRA Follow-up**
Client GPRA Discharge**
Access Center**
Motivational Development and Readiness
Care Coordination Voucher**
Brief Intervention
Outpatient
Intensive Outpatient
Residential Treatment (Max 30 days)
Sub-acute Detox (Max 3 days)
Medical Services
Housing Support Services
Transitional Living Facilities
Employment and Education
Peer Support & Relapse Prevention
Family & Parenting Support
Financial/Basic Needs
Legal Support
Health & Global Wellness
Spiritual / Cultural Support
Transportation
Mental Health Services / Co-Occurring
Phase I
Vouchers
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Phase II
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Phase III
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The Tribal Umbrella
 Every tribe has programs: every program and
department is part of the circle of recovery for an
individual.
 Whatever (and whoever) the individual needs to
support their recovery is whatever (and whoever)
should be integrated into the circle of recovery.
 Build on what already exists.
Track 1: Recovery Coaching
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Strategies
 Research materials and adopt/modify/develop a curriculum
for Recovery Coach training
 Develop a Cultural Competency Module specific to the needs
of the Anishnaabek People of the Three Fires (the target
population for ATR). Utilize the module in the RC
curriculum and to train ATR network providers
 Conduct an Anishnaabek Recovery Coach Institute to train
the first cohort of recovery coaches from Michigan tribes.
 Conduct a training for RC supervisors that includes “how to”
integration of non-clinical approaches to recovery
management
Track 2: A Recovery-Oriented System of Care
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 Identify program qualities that will support a ROSC
 Identify program qualities that will support
Recovery Coaching
 Develop a strategic plan to obtain “buy-in” from
tribal behavioral health and health administrations
to implement a ROSC in each of 12 tribes in
Michigan
 Implement the strategic plan to parallel the timeline
for certification of the first cohort of Recovery
Coaches
Outcomes:
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 Trained Recovery Coaches within each tribal community,
who are from each tribal community, who can provide ATR
billable recovery management services to the target
population.
 A Recovery Oriented System of Care that includes
programs, people and resources, with the consumer at the
center of the circle.
Recovery Coach Institute
 The first Anishnaabek Healing Circle Recovery Coach
Institute was held June 4-8, 2012 to train local recovery
coaches, recovery coach supervisors and ATR liaisons.
 Fourteen peer recovery coaches from 8 tribes in Michigan
and one in South Dakota completed the training, as did 13
supervisors and ATR tribal liaisons.
 Trainers came from the Detroit Recovery Program, from
Michigan tribal communities and ITC/ATR staff.
Module 1: How to Be a Recovery Coach
 What is a Recovery Coach?
 What Do They Do?
 Strengths-based Recovery Management; Skill
Building for the Recovery Coach
 Fitting the Recovery Coach into the Anishnaabek
Healing Circle ATR
Module 2: How to Supervise the Peer Recovery
Coach
 What makes supervising peer recovery coaches
different than clinical staff?
 Role of supervision to recovery coaching
 Forming a learning community for Recovery Coach
supervisors
Module 3: The ATR Tribal Liaison’s Role in
Developing a ROSC
 Pulling it all together: Using ATR reimbursements
to fund recovery activities and expand ATR options
for consumers;
 developing tribal umbrellas;
 budgeting ATR recovery support activities;
 using recovery coaches as independent contractors
The first cohort of peer recovery coaches and recovery coach supervisors completed a 5 day
training in June, 2012. They have returned to their tribal communities to integrate peer
recovery coaching into their respective recovery-oriented systems of care.
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
Tribal Feedback
Enhancement of Recovery Services
● Transportation
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Special Need Fund
Alcohol Drug testing
Acupuncture
Physical Fitness & Well-being
Traditional Healing Services
Housing support
Medical Care
Alcohol/Drug Free Social Activities
Monitoring of Service Array
ATR is
Effective
ATR II client
outcomes
(N=2984).
Improvements in
abstinence, no
arrests, no HBSC
and socially
connectedness
were statistically
significant
(p<.001).
ATR II Intake, Follow-up, and Change
on Key Indicators
Stable housing
3%
79%
77%
17%
Social Connect
HBS Consequences
Employed/In School
No Arrests
77%
8%
91%
84%
4%
57%
55%
5%
97%
92%
30%
Abstinent
0.00%
90%
52%
20.00%
Change
40.00%
At 6 Months
67%
60.00%
At Intake
80.00%
100.00%
Access to Recovery
Anishnaabek Healing Circle
2956 Ashmun, Suite A
Sault Ste. Marie MI 49783
(906) 632-6896
www.atrhealingcircle.com
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Staff
Eva Petoskey, Director Direct line (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 (1 H79 TI023118) 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.