service configuration and client phases eva petoskey, ms anishnaabek healing circle atr director 1
TRANSCRIPT
1
SERVICE CONFIGURATION AND CLIENT PHASES
Eva Petoskey, MSAnishnaabek Healing Circle ATR Director
2
3
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. 8752 clients over four years. 2188 clients/year.
4
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
5
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+
0 200 400 600 800 1000 1200 1400
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
6
ATR II OUTCOMES
Abstinent
No Arrests
Employed/In School
HBS Consequences
Social Connect
Stable housing
0.00
%
10.0
0%
20.0
0%
30.0
0%
40.0
0%
50.0
0%
60.0
0%
70.0
0%
80.0
0%
90.0
0%
100.
00%
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
7
ATR CLIENT PROCESS
Client is registered in the voucher system and assigned an ATR number.
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.
8
ATR CLIENT 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.
9
ATR CLIENT PROCESS
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.
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.
10
RECOVERY ORIENTED SYSTEMS OF CARE
In a recent article on recovery in historically disempowered communities, White & Sanders (2004) discuss the importance of utilizing approaches in tribal communities that shift the model of intervention from acute care of individuals to a sustained recovery management approach that relies on partnerships with individuals, families and communities.
11
INDIVIDUAL AND COMMUNITY CHANGE The stages of change are (DiClemenet &
Prochaska 1982) Pre-contemplation Contemplation, Preparation, Action, Maintenance &Relapse
The nine stages of community readiness defined by the model include no awareness of the problem, denial, vague awareness, preplanning, preparation, initiation, stabilization, confirmation/expansion, and professionalization. (Edwards 2000)
Readiness to Change and
Recovery Tasks
ANISHNAABEK HEALING CIRCLE PHASES
13
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
14
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
15
References
DiClemenet, C.C., & Prochaska, J.O. (1982). Self change and therapy change of smoking behavior: A comparison of processes of change in cessation and maintenance. Addictive Behavior. &: 133-142.
White, W.L., & Sanders, M. (2004) Recovery management and people of color: Redesigning addiction treatment for historically disempowered communities. Unpublished article posted at www.bhrm.org
Edwards, R.W., Jumper-Thurman, P., Plested, B.A., Oetting, E.R., & Swanson, L. (2000) Community readiness: Research to practice, Journal of Community Psychology, 28(3), 291-307
Yellow Horse Brave Heart, M., & DeBruyn, L.M. (1998) The American Indian holocaust: healing historical unresolved grief. American Indian and Alaska Native Mental Health Research, 8, 60-82.
16
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] Donelda Harper, Training & Audit Specialist [email protected] Lori McDonald, GPRA & Media Specialist [email protected] Aagii Clement, Provider Liaison Specialist [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 TI023118-01) 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.