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About Siletz news / (Siletz, OR) 199?-current | View Entire Issue (March 1, 2003)
TRIBAL PROGRAM NEWS Oregon Health Plan Changes Affect CHS In January, CHS staff attended an Oregon Health Plan (OHP) meeting that introduced upcoming plan changes. The news was so devastating that CHS met to prepare a screening process for all CHS patients who don’t have any insurance. Effective March 1,2003, the OHP will no longer cover vision, dental, audiological (hearing aid related), non- emergent transportation, durable medical equipment, A&D, mental health, and pharmacy (durable medical and dental are covered for January and February, but dental has a $500 maximum). Premiums and co-pays are man datory for people in the standard benefit package, $2 per visit and $250 per inpatient stay. Native Americans are exempt from both. Coverage will no longer be effective retroactively, paying back to the date stamped on the application. In previous years, CHS saved thousands of dollars using this program by date stamping applications at the time of a medical crisis. This is no longer effective. Because of this change, CHS will seek approval and implement the following policy. 5.1 Mandatory use of alternate resources: A. An individual is required to apply for an alternate resource if there is a reasonable indication that the individual may be eligible for the alternate resource by OHP screening or admitted to the hospital for more than 24 hours without a primary resource and OHP is available. 1. Waiving the alternate resource requirement is allowable if the health director has income documentation that clearly indicates a patient is over income for OHP. B. Refusal to apply for alternate resources when there is a reasonable possibility that one exists or refusal to utilize an alternate resource requires the denial of eligibility and payment for CHS and will apply as follows. 1. The CHS technician will do OHP screening. 8 □ Siletz News 2. 3. 4. 5. If you are under the income guidelines, an OHP application will be mailed to you and stamped for that date. Documentation will be placed in a binder by date of stamp and documented on page 11. After 45 days of the documen tation entering the binder, a second notice will be sent to the patient and entered on page 11. After the 46th day from the date of the OHP application, services will be put on hold and the patient will not receive a pre-authorization number. 6. 90 days after the documented OHP screen, if there is still no indication of compliance, the visit will be canceled and a letter of denial will be sent for failure to apply for OHP. If you do not understand this policy or the changes, please contact the CHS office. Remember, the community health advocate in your area is available to help with the application process. The three most important things to remember when applying for OHP are - enclose a copy of your Social Security card, a copy of your tribal ID, and a copy of your income verification. These are mandatory documents. We ask that all programs take a pro active approach to this change and help clients/patients with the OHP appli cation process. This is so very important to save your CHS program. ».................................... ———~~—-———■— Walt’s Words of Wit and Wisdom By golly, the other day I was watching and listening to the girls in my home. They were busy on the computer, something about it’s my 15 minutes or something like that. I think the TV is obsolete now. Anyway, it did bring back some of the “old” memories. Like coming home from school. Of course, the first thing was the dad- blamed cows - had to go round them up. They liked to hide (someday I’ll tell X* the needle got close to the center of the record, it would sound normal, I guess, then toward the end the music would speed up. We thought this was great. In an old hay bam up the road about three miles was an old dance hall. It had a player-piano in it. To this day, I don’t know how a player-piano works. I don’t remember if it had to be peddled or if it had a wind up spring, but we would play that old thing and thought it was great about their hiding process). music. Then milk them and run the As I said earlier, milk through the cream we had no electricity. separator, done on a hand- My uncle had his cranked machine, then to house wired, though. get into the house and He had a very large listen to the radio. six-volt battery. The I- ' 1 The radios were not lights were not much use, nice and quiet like those but could light enough to today. They had many knobs find the lamp and light it. to turn and a lot of scratchy noises He had a big wheel in the creek that came from some of them. The old he used to charge the batteries. I could Atwater Kent was the best, I think. never understand why he didn’t hook About the time the chores were the wires up to the house. He would tell done, the programs would come on, me that the distance would take away like Red Ryder, Lone Ranger, Capt. too much voltage, but that didn’t make Marvel, and Superman. These were too much sense to me at the time. very important, oh yeah. Robison Now, he worked in Kernville Crusoe - that would really set off the rafting logs. When he was gone, being imagination of being somewhere the enterprising person that I was and isolated. Big dreams, really grandiose. knew quite a bit, I ran two wires from Then when we wanted music, the water wheel to the house and well, we had a phonograph but we had hooked it all up. Being very proud of no electricity. The phono was a my accomplishment, I went and started windup. It had a crank on one side that the darn thing up. You know, my uncle seemed endless to wind up and on top was right. There wasn’t enough power had a big bellows-like thing that the sound came from. When the record come through to light a bulb and made it glow a little. started, the music would be slow. As □ . March 2Q03 When we went to Logsden to get gas for whatever we were to run, the pump was a hand pump. The station was a tall bottle, so to speak, with gallons on it. The owner of the store had a cardboard pricelist of how much it was per gallon up to 10, After 10, it had to be pumped full again. Gas was 10 cents a gallon. When I got my car it went up to 18 cents a gallon. That’s the story of my life, a day late and a dollar short. In 1941, after a lot of work by volunteers cutting the right of way and placing light poles, we received power. Boy, that was something. One light bulb in the middle of the room, probably equivalent to a 40-watt bulb, but that didn’t daunt us none. Now life had changed a little on the farm. We got to eat supper and listen to the radio before the cows were milked. Had an electric-operated cream separator with lights outside. They were much brighter than the ones in the house, which shows where my uncle’s priorities were. Our way of life changed considerably that day. World War II had just begun and one couldn’t buy a tractor with rubber tires or a self starting motor. It to be hand cranked. A 1941 Ford tractor sure beat the dam horses. It was temperamental all right, but not near as bad as the horse. For some reason, I can remember things almost word for word of that era, but I can’t remember what happened yesterday. Maybe in 50 years, I’ll remember what happened today. You think, maybe?
