FOR PROVIDERS

Become an Anishnaabek Healing Circle Network Provider The Inter-Tribal Council of Michigan (ITC) is currently recruiting both clinical treatment and recovery support providers into the Anishnaabek Healing Circle, Access to Recovery Network. Depending on the services you provide, you can become either a clinical or recovery support provider, or both. Fill out the appropriate application(s). To join the Network and become a provider: Complete the Clinical Treatment Provider Application and Provider Agreement Complete the Recovery Support Provider Application and Provider Agreement Submit the application to the Inter-Tribal Council of Michigan The Provider Agreement specifies the services to be provided, as well as standards and reporting requirements to be followed. Service definitions, reimbursement rates and processes are outlined in this section and can be downloaded and printed from this website. Upon approval of the application and agreement, the ITC will issue the applicant a provider certificate and a vendor number. The vendor number is a unique identifier that will allow the provider to bill for client services using the ITC electronic voucher system. back to the top

Basic Requirements for Clinical Treatment Providers Organizations will be licensed by the State of Michigan or under Tribal Codes for the services they are providing. Individual counselors will be certified, licensed and/or registered in their specialty. Substance abuse counselors must meet Tribal, Indian Health Services, Michigan or the IC&RC certifications standards. Appropriate certifications include CADC-I, CADC-II, 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. If an individual counselor has less than one year of experience working with Native American 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. back to the top

Basic Requirements for Recovery Support Providers 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 Native American 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. Special Note to potential Recovery Support Providers: We strongly encourage culturally-based and faith-based recovery support providers to apply to the Anishnaabek Healing Circle Network. The assistance provided must be as diverse as the people seeking assistance. Many paths lead to the road of recovery; we honor anyone who chooses to step onto the path. We will seek ways to support adults, adolescents, elders, in Native and non-Native ways, by whatever means is available, in whatever manner is needed, to maintain recovery from substance abuse. If you, as an organization or as an individual have skills to support mental, physical, spiritual or emotional recovery, please consider becoming a provider in the Anishnaabek Healing Circle Network. You do not need to be a “business” or affiliated with a substance abuse program: we are looking for peer recovery support providers, for cultural resource people, for pastoral counselors, for mentors, for local groups that already provide drug and alcohol-free activities in the community. Contact the ATR Administration Team (Section V) for details. back to the top

Critical Components for Providers All providers must agree to implement the GPRA (Government Performance and Results Act) reporting requirements. Providers will use the ITC electronic voucher system for requesting payments. Providers must have internal record-keeping to allow for successful random audits of services. back to the top

GPRA Requirements GPRA (Government Performance and Results Act) reporting requirements are mandated by the grant. Funding will be pulled from the ATR program by the federal funding agency if GPRA requirements are not met. Each client enrolled in the program must have a GPRA form completed at the time of assessment into the program (Intake), at discharge from ATR-funded services (Discharge) and at 6 months post Intake date (6 Month Follow-up). The grant mandates a minimum 80% completion rate for 6 month follow-up GPRA interviews. Collecting the GPRA will be an assigned responsibility (and a reimbursable voucher expense). Primary counselors/providers are expected to cooperate fully to pre-actively track clients and complete the GPRA interviews within the established timelines. Training on GPRA will be available through ITC, as will technical assistance on tracking, collecting and reporting. back to the top

How a Client Enters and Moves Through the System There is no “wrong door” for entry into the Anishnaabek Healing Circle Program. Clients may be self-referred or referred through any other avenue – tribal programs, other network providers, courts, social services and other sources. Twelve tribal sites will serve as ATR Access and Care Coordination Centers. These Centers are responsible for determining client eligibility by performing an initial screening. If the screening shows an alcohol or other drug problem, the client is registered for the program, given a unique client ID# (that will follow them throughout multiple episodes of care) and given a full assessment. After the assessment, the assessor recommends an appropriate level of care, using ASAM criteria and requests a service voucher. ITC authorizes the service voucher and the client is given a list of service providers for the appropriate level of care. The location and contact information for all providers in the network is available for download from this website. The list is updated weekly. The client chooses a treatment provider, makes an appointment and begins treatment within 30 days of the assessment. The ATR Tribal Access and Care Coordination Center assigns a Care Coordinator who advocates for the client, helps the client navigate the system, provides case management and is responsible for seeing that the GPRA data is collected and reported appropriately. The client chooses the clinical treatment and/or recovery support provider(s) they will work with. The client may elect to receive services from the same tribal program where they were assessed, and are encouraged to do so. Client choice may be between agencies, or it may be between counselors within the same agency or organization. Based on the treatment and recovery support plan, the client receives services and is discharged after successful completion of the ATR program. Client outcomes are measured with the GPRA tool at Intake, Discharge from ATR and at 6 month post intake. back to the top

ATR Voucher System and How it Works The electronic voucher reimburses the provider for services the client uses, based on their individual treatment and recovery support plan. Vouchers have an active life of ninety days from the date of issue. Reauthorization is based on needs of the client as determined by the 90 day review. Voucher training is provided by ITC on entry into the network. back to the top

Working with Tribal Access and Care Coordination Centers The twelve federally recognized tribes in Michigan act as ATR Access and Care Coordination Centers and as clinical treatment and recovery support providers (see map, Section V). The Tribal Access Center will provide care coordination services (see service list, Section II). The network providers will offer clinical treatment and recovery support services. The Tribal Access Center and the provider(s) that the client chooses will complete Qualified Service Agreements in order to share information and to provide integration of care. The Care Coordinator assigned by the Tribal Access Center will work with the provider to ensure that GPRA data collection is complete and will act as a resource and advocate to locate and access ancillary services for the client. The more closely the Care Coordinator and the provider(s) work together, the more likely the client will be able to successfully navigate the system and take full advantage of the opportunities presented by the Anishnaabek Healing Circle Program. back to the top

Reimbursement Rates/Service Definitions Established reimbursement rates and service definitions are used to determine the amount of voucher reimbursement for services. The amount and type of service must be pre-authorized by the ITC Voucher Coordinator and an electronic voucher issued prior to services being initiated. The voucher amount is based on assessment; level of care is determined using ASAM criteria. The Voucher has a life of 90 days and can be modified to add or delete services depending on review of the treatment plan. The Reimbursement Rate Schedule and Service Definitions can be downloaded from this website by clicking on the appropriate link. Maximum Annual Amount Per Client By Level of Care: Client Access & Care Coordination, $570 to $1,930 per client Brief Intervention, $600 per client Outpatient Treatment, $2,200 per client Intensive Outpatient Treatment, $2,500 per client Residential Treatment, $3,100 per client Recovery Support, $ 1,600 per client Federal regulations require that ATR funds must be used to supplement and not supplant (replace) existing resources. back to the top

Download Section (pdf and word format)

ATR Provider Application Forms

Clinical Treatment Enrollment Application (pdf)	Clinical Treatment Enrollment Application (word)
Recovery Support Enrollment Application (pdf)	Recovery Support Enrollment Application (word)
Clinical Treatment Staff Information Enrollment Form (pdf)	Clinical Treatment Staff Information Enrollment Form (word)
Recovery Support Person Information Enrollment Form (pdf)	Recovery Support Person Information Enrollment Form (word)
W9 Form (only available in pdf)

ATR Provider Manuals

Clinical Treatment Provider Manual (pdf)	Clinical Treatment Provider Manual (word)
Recovery Support Provider Manual (pdf)	Recovery Support Provider Manual (word)

ATR Service Rates and Definitions: Allowable Services and Payment Limits

Reimbursement Rate Schedule (pdf)	Reimbursement Rate Schedule (word)
Service Definitions (pdf)	Service Definitions (word)

GPRA

GPRA Form Section A-H (full GPRA, use with every client) (pdf)	GPRA Form Section A-H (full GPRA, use with every client)(word)
GPRA Short Form Section A-B (use only for a client screened with Audit/Dast and for whom NO OTHER ATR services are planned (pdf)	GPRA Short Form Section A-B (use only for a client screened with Audit/Dast and for whom NO OTHER ATR services are planned (word)
GPRA Manual: How to Submit GPRA Data GPRA Question-by-Question Instruction Guide (pdf)	GPRA Manual: How to Submit GPRA Data GPRA Question-by-Question Instruction Guide (word)

ATR Consent Forms / ATR Specific Client Consents:

Informed Consent for Use & Disclosure of Protected Health Information (pdf)

Informed Consent for Use & Disclosure of Protected Health Information (word)

PHI

Informed Consent for Evaluation/GPRA9 (pdf)	Informed Consent for Evaluation/GPRA9 (word)
Informed Consent for Peer Recovery Support Services (pdf)	Informed Consent for Peer Recovery Support Services (word)
Qualified Service Organization Agreement (QSOA) (pdf)	Qualified Service Organization Agreement (QSOA) (word)

Voucher System

Voucher System Operations Manual (pdf)	Voucher System Operations Manual (word not available at this time)
Client Coding Record (pdf)	Client Coding Record (word)

Voucher Forms

Client Registration Form (pdf)	Client Registration Form (word)
Client Screening/Assessment Summary (pdf)	Client Screening/Assessment Summary (word)
Voucher Request Form (pdf)	Voucher Request Form (word)
Voucher Transaction Form (pdf)	Voucher Transaction Form (word)
Recovery Support Provider Notes (pdf)	Recovery Support Provider Notes (word)
Recover Support Voucher Service Authorization Form (pdf)	Recover Support Voucher Service Authorization Form (word)

ATR Screening Tools

AUDIT & DAST-10 (pdf)

AUDIT & DAST-10 (word)

ATR Assessment Tools

Recovery Support Assessment (pdf)

Recovery Support Assessment (not available in word)

Recovery Management Tools

Anishnaabek Healing Circle Recovery Management Workbook (pdf)	Anishnaabek Healing Circle Recovery Management Workbook (word)
"Honoring the Power of the Four Directions:" The Medicine Wheel approach to Recovery Support Planning (pdf)	"Honoring the Power of the Four Directions:" The Medicine Wheel approach to Recovery Support Planning (word)
Anishnaabek Cultural Assessment Instrument: Culturally-based Treatment and Recovery Support Planning. A, free, online tool: go to www.itcmi.org and click on Anishnaabek Cultural Assessment listed under Behavioral Health Services on the Home Page. (pdf)	Anishnaabek Cultural Assessment Instrument: Culturally-based Treatment and Recovery Support Planning. A, free, online tool: go to www.itcmi.org and click on Anishnaabek Cultural Assessment listed under Behavioral Health Services on the Home Page. (word)

Survey Instruments

Client Satisfaction Survey (pdf)

Client Satisfaction Survey (word)

About ATR

ATR Program Flyer (pdf)	ATR Program Flyer (not available in word)
Become an ATR Clinical Treatment Provider Brochure (pdf)	Become an ATR Clinical Treatment Provider Brochure (word)
Become an ATR Recovery Support Provider Brochure (pdf)	Become an ATR Recovery Support Provider Brochure(word)
ATR Participant Brochure (pdf)	ATR Participant Brochure (word)

News and Resource Material for Providers

News Updates (pdf)	News Updates (word)
Recovery Support Services (pdf)	Recovery Support Services (word)
Calendar of Events and Activities (pdf)	Calendar of Events and Activities (word)
Training (pdf)	Training (word)
Technical Assistance (pdf)	Technical Assistance (word)
FAQ: Frequently Asked Questions (pdf)	FAQ: Frequently Asked Questions (word)
Articles and Documents (pdf)	Articles and Documents (word)

Training

GPRA Goof-Ups (pdf)	GPRA Goof-Ups (word)
GPRA Samples (pdf)	GPRA Samples (word)

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