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About Siletz news / (Siletz, OR) 199?-current | View Entire Issue (June 1, 2000)
TRIBAL PROGRAM NEWS____________ Prevention Program Needs Participants Are you between the ages of 12 and 17? Are there things you would like to see happening in your community, for fun, that are not happening? Do you have ideas for activities that would help you not be bored? Would you or some of your friends be willing to help raise money to fund a dance or a trip to somewhere? Please contact Lisa Brown, prevention coordinator, if you are interested in being involved in a process to make changes or develop community activities. Meeting dates will be set in the future. We will come together to play games, share ideas about our community, and decide on things we would like to do. Call 1-800-922-1399, ext. 333, or 541-444-8333. Editor’s note: This letter originally was sent to Lisa Brown, prevention coordinator for the Siletz Tribe. She then sent it to Siletz News. Dear Lisa: Just got your envelope in the mail about the big raffle prize - thanks so much for sending it on. I am really looking forward to making the trip up the river, since I’ve never been further than Agness before. I want to thank you and the Confederated Tribes of Siletz for this gift - winning is a big surprise for me, as I don’t usually enter raffles. I just wanted to support the tribe. So, thanks again. Also, thanks for the articles by Robert Kentta; they are really informative. Yours sincerely, Linda Nading Vancouver, B.C. To the editor: I would like to express my deepest sympathy to the Marzan, Rilatos, and Lester Simmons families due to their recent loss. Mary and I were school chums at Siletz School. She was a very good student and was well liked by all. I did not see her very often in later years, only occasionally at a pow-wow now and then. She will be missed. I would also like to personally thank Tribal Council for cleaning up the cemetery. It looks beautiful and is something to be proud of. Martha Lockhart Important Details about Contract Health Services (CHS) The Siletz Contract Health Services is a program operated under a compact agreement between the Siletz Tribe and Indian Health Service (IHS), an agency of the Public Health Service under the U.S. Department of Health and Human Services. The program serves more than 2,544 Siletz Indians and their eligible dependents. The CHS program is not an entitlement program, insurance program, or established enefit package. Program payments are based on clearly defined guidelines that fluctuate from one cntena level to another, based on the availability of funds. If the program experiences catastrophic cases, this uses the funding quickly and lowers the level of services available especially toward the end of the year. The program is intended to pay for health care when no other source is available and provide better health for tribal members. The CHS program does not approve services based on the level of need but looks for the medical condition to fit the level of service that the funding level is at, at the time of request. Level of Services Level I - Emergent and Acutely Urgent Diagnostic or therapeutic services that are necessary to prevent the immediate death or serious impairment of the health of the individual Examples: acute trauma, acute injury, psychiatric care involving suicide obstetrical deliveries, and neonatal care. Remember that all emergency room visits are reviewed for appropriate use. Level II - Preventive Care Services. Examples: routine prenatal care, non-urgent preventive ambulatory care, reactive airway disease, asthma, mammograms, public health intervention, laboratory, and radiology services. Level III - Primary and Secondary Care Services. Examples: scheduled ambulatory service; ear, nose and throat (ENT); gynecology; pediatrics; ophthalmology; dermatology podiatry; physical therapy; optometry; prosthetic devices, including specialty visits and consultation; and allergy testing for people with reactive airway disease Level IV - Chronic Tertiary and Extended Care Services. Examples, elective surgeries, skilled nursing facility, rehabilitation care, organ transplantation, and highly specialized medical services and procedures. Level V - Excluded Services. Examples: cosmetic procedures, extended care in a nursing home, acupuncture, naturopathy, plastic surgery without reconstructive care and experimental services. These are limited examples; the standard operations manual gives the CHS Department guidelines with rules and procedures to follow. CHS gatekeepers determine medical necessity and indicators for the program. The team meets every Wednesday at 8:30 a.m. This team includes the clinical director, clinic nurse practitioner, clinic social worker, clinic dental officer, health director, and the CHS administrator. The 2000 allocation for CHS has been amended to restore the budget. We have experienced three catastrophic health cases, however, that have helped deplete the budget rapidly. r We are taking several steps to Improve the situation. The CHS Department is preparing a preferred provider list for a reduction in cost. Some contracts became effective May 1,2000. Preferred providers may not be as convenient, but will be the most cost-effective way to continue services. E^ect,ve Ju,y anY CHS eligible individual who lives within 40 miles of the Siletz Community Health Clinic, the Grand Ronde Health Center, or the Chemawa Health Center will be required to seek primary care at those facilities. This emergency measure will help reduce costs to the CHS program. We also are screening and encouraging anyone who may be eligible for alternate resources to access those resources. If you are an elder and/or on early disability, you are eligible for Medicare Part B, which covers physician visits. The cost is only $49 per month. The Oregon Health Plan is free if you are income eligible Ronda Austin recently was hired as the patient benefits coordinator. She would be happy to assist anyone in applying for Medicare, Oregon Health Plan, veteran’s benefits disabled children’s services, worker’s compensation, or any other resource. She can be contacted through the Siletz Community Health Clinic at 541- 444-1030 or 5
