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About Siletz news / (Siletz, OR) 199?-current | View Entire Issue (Sept. 1, 2012)
General Council Meeting . Nov. 3,2012 • 1 p.m. Siletz Tribal Community Center Siletz, Oregon Call to Order Invocation Flag Salute Roll Call Approval of Agenda Approval of Minutes Programs: Update on Clamming Issues Violence Against Women Program - * Kelley Ellis f Tribal Council Candidacy Declaration t Tribal Members’ Concerns ’ Photo by Diane Rodriquez Morgan Crawford Chairman’s Report Public Information Announcements Adjourn Windy Hill Katerie Whitehead Records Management Programs 1 Hill and Whitehead pose for a picture at the Siletz Rec Center, where they spent the day helping out with a Hands on Food activity. “Being a TYEE worker taught me the importance of being at work on time,” said Hill. STBC sets RV park pricing, Tribal member discounts now available Logan Road RV Park Washburn, con’t from page 1 Previously, he served as general counsel for the National Indian Gaming Commission from 2000 to 2002 and as an assistant U.S. attorney in Albuquerque, N.M., from 1997 to 2000. Washbum was a trial attorney in the Indian Resources Section of the U.S. Department of Justice from 1994 to 1997. He earned a B. A. from the University of Oklahoma and a J.D. from Yale Law School. Daily: Back-in $32 + tax Pull-thru $38 + tax Weekly: Back-in $199 + tax Pull-thru $229 + tax Monthly: Back-in $600 + tax (summer rate) Pull-thru $600 + tax (summer rate) Hee Hee lllahee RV Resort Daily: Back-in $32 + tax Pull-thru $34 + tax Weekly: Back-in $ 170 + tax Pull-thru $180 + tax Monthly: Back-in $430 + tax Pull-thru $440 + tax Members of the Siletz Tribe receive a 15 percent discount on their stays, includ ing monthly stays. Utilities, cable TV and Wi-Fi included. Rates subject to change. Tooth Talk: What does insurance have to do with it? A lot, as it turns out By Mary Ellen Volansky, EPDH, MS That doesn’t quite have the same ring to it as Tina Turner’s song, What's Love Got To Do With It, does it? In this case, insurance does have something to do with it, “it” being the services provided by the Siletz Community Health Clinic/Dental Clinic program. Are not the services at the Siletz Den tal Clinic free? It’s a Tribal dental clinic, right? Doesn’t the federal government through the Indian Health Service (IHS) support this clinic? What benefit could my having insurance bring to this clinic? All good questions, so read on. Insurance companies vary as to what they will cover. Orthodontics may not be covered or only partly covered. Sealants are covered, but usually only for children. Possible services covered by insur ance include fillings (silver or tooth colored), cleanings, X-rays, examina tions, root canals, crowns and bridges, dentures, fluoride, sealant, scaling and root planing, and home care instructions. For Siletz Tribal members, all ser vices in the Siletz Dental Clinic are free, including prescriptions. There is one exception - with items such as crowns, bridges, dentures and some night guards, if an item needs to be replaced within five years, you are required to pay the labora tory fee for it to be remade. Being referred to a dental specialist is sometimes covered by Gatekeepers and sometimes not. Dental specialists include but are not limited to periodontists, ortho dontists, oral surgeons, pediatric dentists and endodontists. People who are members of a Tribe other than Siletz receive free service if the dental work can be done in this clinic. You are not covered at this clinic for work provided by an outside dental specialist or for prescriptions. Work sent to a lab will have a fee. For example, a tooth that needs a crown is prepared in this clinic (i.e., examination, X-rays, diagnosis, local anesthesia, drilling to remove decay, impressions and measurements). The information obtained by the dentist is sent to the lab technician, who uses this information to make the crown. Back to funding - Doesn’t IHS pay for all these services to Tribal members? Simply put, no. IHS did not pay for the beautiful and up-to-date clinic on Gwee-Shut Road. Judy Muschamp, health director, did obtain a good portion of the money for the building by applying for a grant. Where does the rest of the money come from? First, there is a difference between an IHS clinic and a Tribal clinic. Some of you know the difference based on your expe riences with health care over the years. Locally, Chemawa and Warm Springs are IHS clinics, and Siletz and Grand Ronde are Tribal health clinics. It’s complicated and for the purpose of this article, IHS clinics are funded by IHS and staff generally practices within federal government guidelines. Tribal health clinics obtain much of their money from IHS but are run by the Tribal Council and the director of the clinic. The Tribe gets to make its decisions about how to run the clinic. And - this is a big “and” - Tribal clinics can bill insurance for the services they provide if they become an AAAHC (Accreditation Association for Ambulatory Health Care) member public health clinic. The Siletz Community Health Clinic/ Dental Clinic is an AAAHC member. Membership is earned by running a clinic at the high standards of AAAHC rules and having inspectors from AAAHC inspect the clinic. The inspectors walk through the clinic to see if you are actually following those rules. This past June, the Siletz Community Health Clinic/Dental Clinic had such an inspection. We have been a member for nine years and are awaiting the outcome of our fourth inspection for full mem bership in the AAAHC community of public health clinics. We are proud to have earned this accreditation and we are confidently awaiting confirmation that we have maintained our standards. The Siletz Dental Clinic can and wants to bill insurance companies: ODS, Blue Cross and Blue Shield, Samaritan, Oregon Health Plan, etc. We can bill for all dental services covered by your spe cific plan. To bill your insurance company, we need a copy of your insurance card, which has information about your specific insurance plan. If you or your children are eligible for the Oregon Health Plan, request an “open card.” An open card allows you to obtain services from any qualified provider of your choice who accepts Oregon Health Plan. The Siletz Community Health Clinic/Dental Clinic accepts the Oregon Health Plan and we want to be your choice for oral health care. The money collected from insurance companies for the services we provide to you will go to the clinic. This income will allow us to continue and expand services to you. Please help us to help you. Help us provide the best services with the best equipment and the best staff to provide quality care. That’s what insurance has to do with it. September 2012 • Siletz News • 9
