Terri Tavenner, Associate Director, Anishnaabek Healing Circle Inter-Tribal Council of Michigan ATR and Service Integration What Does It Mean? 1

ATR III Goals Goals of the Anishnaabek Healing Circle:  Expand capacity, by bringing providers into the ATR Network  Support client choice, by offering recovery support options  Increase the array of clinical and recovery support services Target Population Eligible clients are enrolled members of the 12 collaborating tribes in Michigan and members of other federally recognized, state recognized, and Canadian tribes residing in the project service area. Non-native family members and descendants are eligible as well. All clients must have a current or past problem with alcohol or drug abuse. The project serves clients age 12 and older: 8752 clients in 4 years.

3

ATR II Gender 4

The Anishnaabek Healing Circle is effective! 5 ATR II client outcomes (N=2984). Improvements in abstinence, no arrests, no HBSC and socially connectedness were statistically significant (p<.001).

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 Anishnaabek Healing Circle Phases

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.

Enhance and Expand The ITC philosophy is to build the capacity of collaborating tribes. 12 tribes and one urban Indian center are the ATR Access & Care Coordination Centers – the gateway into ATR services. Empowerment implies responsibility: every tribe builds on what resources already exist in their community to meet their own needs.

Care Coordination Care Coordination is the key to sustained recovery. A Care Coordinator who is connected to the community can help the consumer connect. The consumer and the Care Coordinator are partners who discover local recovery resources.

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.

Seeing the Big Picture Key elements to integrating services Building relationships Taking Time Sharing stories and dreaming dreams Including everybody Forming a Learning Community Building on community strengths and resiliency

Recovery Coaching is a step towards integrating the community into the recovery circle Helping Healer-Concept developed through a previous grant to help bridge clinical therapy and cultural resources. Works closely with consumers. Can connect consumer to cultural & spiritual teachings through storytelling, talking circles, and hands on lessons with individuals.

New Developments for ATR III Strategies for building our capacity to provide a full array of recovery support services include:  A Recovery Coach Curriculum and Certification process  A Recovery Oriented System of Care within our tribal communities  Outreach to previously under-served populations: veterans and military, chronic substance abusers, prisoner re-entry, elders and adolescents. 22

Developing a Recovery-Oriented System of Care (ROSC)  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 23

Outcomes:  Certified 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. 24

Winter Teaching Lodge Behavioral Health Cultural Service Expansion with ATR

The solutions already exist. Choose Recovery

 Access to Recovery  Anishnaabek Healing Circle  2956 Ashmun, Suite A  Sault Ste. Marie MI  (906)  Staff  Eva Petoskey, Director ( )  Terri Tavenner, Associate Director  Donelda Harper, Training & Audit Specialist  Lori McDonald, GPRA & Media Specialist  Aagii Clement, Provider Liaison Specialist  Connie DePlonty, Voucher Coordinator  Cora Gravelle, Call In Center Client Access & Outreach  Sheila Hammock, Call In Center Client Access & Follow-up 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. 28