“Cha-may weeya ”
Medicine Talk
Siletz
Community
CHS Funding Includes Priority I
and II Care, With Limits
Cracked Teeth: Is It Worth It?
by Teri (the tooth fairy) Coddington, RDH
by Judy Muschamp
Oral Piercing - The Jewelry, The Risks
Piercing, like tattooing, is just one
of today’s popular forms of “body art”
and self-expression. Piercing may seem
daring, cool and safe; however, piercing
the tongue, lips, or cheeks is not as safe
as some would have you believe.
That’s because the
mouth’s moist environ
ment, home to huge
amounts of breeding
bacteria, is an ideal
place for infection. If
you’re thinking about
getting a piercing, or if you
already have one or more, there
are some health risks you should
know about.
The harmful effects can happen
during the piercing, soon after, or even
long after the procedure. An infection
can quickly become life threatening if
it’s not treated promptly. Bacteria can
enter the bloodstream through the pierc
ing site in the mouth and travel to the
heart, which can cause endocarditis or
even death.
After a piercing, the tongue may
swell and block the airway. Nerve dam
age can result in a numb tongue and
feeling might not ever return. In
addition to serious heath
problems, a large protrud
ing scar can form around
the piercing site. Swallow
ing the jewelry can punc
ture the bowels or intestines.
One of the biggest
problems with having a
tongue piercing is cracked
teeth, which usually leads to the
need for dental restorations, such
as crowns or fillings. In addition to
getting cracked teeth, you may get gum
damage, recession, and sensitive teeth.
Don’t pierce on a whim. The pierc
ing will be an added responsibility to
your life. It will need constant attention
and upkeep.
Health
Clinic
Eligible Contract Health households
recently were mailed a postcard alert
ing you to our funding crisis and moving
priorities to emergent/acutely urgent
care only. This action was necessary in
order to preserve enough funds to cover
the most dire health conditions through
the end of December 2004.
As you all may know. Priority I care
is very restrictive and the CHS techni
cians who must implement the policy
receive the unfortunate brunt of un
happy callers.
In recognition of the important
health care needs of tribal members,
Tribal Council has allocated additional
tribal resources to CHS in order to
expand care to Priority I and II. So in
addition to emergent/acutely urgent
care, some preventive care services will
be available with prior approval.
Preventive care is primary health
care aimed at preventing disease or dis
ability. This includes services proven
effective in avoiding the occurrence of
Use the Siletz Mail Order Pharmacy
The Siletz Clinic Pharmacy pro
vides mail order service to Siletz Tribal
members and their minor dependents
in the 11-county service area. You may
receive up to a 90-day supply of main
tenance medication.
Mailing will be provided to those
members who live 40 miles outside the
Siletz clinic area. If another insurance
is billed, a 30-day supply may be the
maximum per fill.
Prescriptions will be mailed via U.S.
Postal Service. Prescriptions requiring
special handling will be sent via certi
fied mail. Our pharmacy has limited
storage space, so we order your pre
scriptions when we receive your order.
Please allow 7-10 working days for
your order to be processed.
The Siletz Tribal Health Program
is only responsible for providing drug
medication that will assist in maintaining
the quality of patient care. Cost contain
ment is important, therefore the follow
ing classes of drugs will not be provided:
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Siletz News
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Drugs used for cosmetic purposes
Weight reduction products
Fertility drugs
Sexual performance enhancement
drugs
Investigative drugs
Food supplements
Vitamins and over-the-counter
products that are not on the formu
lary list
Compounded prescriptions are
covered with limitations
Controlled substances for intrac
table pain may be dispensed only
in accordance with clinic policy.
Your doctor will be requested to
provide a copy of the pain contract
A registered pharmacist is available
for consultation anytime during standard
business hours (8:30 a.m. to 12:30 p.m.
and 2 p.m. to 5 p.m. Monday through
Friday, except Tuesday afternoons).
October 2004
Using Mail-Order Service
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Call I-81X1-648-0449or541-444-9624
for a refill on your prescription.
Send an order form and your new
prescription to the address listed on
the mail-order service form. You
can obtain forms from either the
Siletz Clinic Pharmacy, Contract
Health Service, or your local com
munity health advocate.
If the prescription is too soon to fill
or not fillable, you will be notified
by phone.
You are advised to transfer your pre
scriptions from Pequot before the end
of December 2004. Effective Jan. 1,
2005, orders through Pequot will not
be filled. Your existing Pequot Rx card
will remain valid for up to $500 annu
ally at a local retail pharmacy.
For assistance, please contact your
local community health advocate or the
Siletz Clinic Pharmacy.
an illness or condition. Examples of
care include non-urgent preventive
clinical care, routine prenatal care, screen
ings for known diseases, mammograms,
immunizations, well-child exams,
sports physicals, and many others.
Because all Indian Health Service
funds have been obligated, Tribal Coun
cil has the authority to regulate how tribal
resources will be administered. All
council members impressed upon staff
the importance of using this additional
funding in a fair and equitable manner.
In other words, one individual’s health
needs cannot exhaust all resources.
To comply with council’s directive
of fairness and equitable administration
of tribal resources, caps and limits
have been established.
During the risk period when IHS
catastrophic funds are not available, Pri
ority I services are capped at $25,000
per episode. Priority II services are
capped at $150 per person, per week.
Unspent balances will not be carried
forward from week to week. Individu
als will be personally responsible for
payment of care that exceeds these caps
and limits.
Emergency care must be reported
to CHS within 72 hours. Preventive or
specialty care must be approved prior
to service.
Please call CHS at 541-444-1236
or 1-800-628-5720 for more informa
tion or to obtain prior approval.
After hours clinic providers (Gate
keepers) are available to assist you in
determining whether you require imme
diate medical attention. After 5 p.m.
weekdays and all day weekends, call
541-444-1236 if you need medical
consultation.
All emergency room reports are
reviewed before CHS will make pay
ment. The purpose of review is to assess
validity of the emergency. Payment will
be denied if routine care is obtained in
an emergency room.
Please note: Gatekeepers cannot
obligate CHS funds; you will still
need to call CHS within 72 hours of
emergency room services.