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.
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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.
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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?