PAGE 8 SEPTEMBER 8, 1878
B u d g et ’7 9
Note: The Tribal Council is currently in the process of reviewing
In the meantime Spilyay will be presenting the highlights of each
the proposed tribal budget for 1979. By October 2 it should be posted for branch’s proposed budget and objectives with emphasis on changes,
tribal members to inspect with general council meetings held increases, and new programs.
thereafter on a district basis.
Health Br anch's Cure For Itself And Community
by Cynthia Stowell
One of Tribal Council’s cur
rent priorities is health and
social services but it remains to
be seen whether the Health
Branch’s proposed 65 percent
increase will survive their scruti
ny.
Objectives for 1979 as well as
requested dollars point out three
major directions planned for the
branch: improved and expanded
services to the community, bet
ter coordination among the de
partm ent and programs, and the
development of staff.
Health Branch Manager Bob
Jackson, who arrived last winter,
has taken a firm hold on the reins
of what many felt to be a
runaway collection of human
services, and is attempting to
whip it into shape.
Jackson was initially quite
impressed with the scope of
services available in a com
munity the size of Warm Springs.
“I see it as a major commitment
on the part of the Tribes to deal
with as many of its own problems
as it can,” he remarked.
But* such a comprehensive
self-help approach has certain
challenges built in, Jackson dis
covered. One is the effective
utilization and training of tribal
members as providers and an
other is maintaining continuity
in services.
Many internal changes, in
cluding adm inistrative reorgan
ization, branch-level coordina
tion of training, and the formal
ization of procedures, have been
proposed as solutions to these
problem areas.
But at the same time the
branch will continue to expand
its service potential with the
addition of five new programs
and 12.5 new positions.
&
What’s new
Two entirely new depart
ments were created in the Health
Branch, once of which is already
functioning. A 1978 objective
calling for a Comprehensive
Health and Social Services Plan
for the Tribes is being realized in
the hiring of a Health Planner,
Sal Sahme. He will spend 18
months determining the needs of
the Warm Springs community
and designing a plan of action to
address those needs, a process
he hopes will be just a beginning
to continuous health planning
(see separate story)’.
The Health Branch plans to
put more energy into prevention
in 1979 to supplement its already
extensive in tervention
pro
grams, said Jackson. The addi
tion of a Community Mental
Health Educator is a step in this
direction. His-her tasks would be
threefold: to act as a liaison
between the community and
health branch programs, to as
sist existing programs in edu
cational-preventative
efforts,
and to prioritize community
mental health concerns and co
ordinate branch efforts to deal
with those problems.
The mental health educator
would augment the Indian Health
Service educator’s contributions
to the improvement of physical
health in the community, said
Jackson.
In a similar public relations
and education vein, the branch is
currently working on a brochure
explaining available services
and how they can be used. Due to
be completed by December, the
brochures will be printed when
funds become available in 1979
and then distributed to tribal
members, and the general public.
A pilot project has been
conceived to extend service to a
segment of the population that
had not received effective treat
ment. The Wilderness Program,
if approved, would provide youth
who are chronic alcohol and drug
abusers with a survival exper
ience in the out-of-doors. Young
people who are without motiva
tion or direction would learn self-
reliance and pride by living and
working in an isolated area and
engaging in traditional activities
with the guidance of well-trained
staff. According to Jackson, the
Wilderness Program is the Num
ber One grant in the state, and
the National Indian Activities
Association is very interested in
funding it.
A new item in the Health
Branch’s budget is the Senior
Citizen’s Program which incor
porates some existing services
but adds the operational expen
ses of the new senior citizens
HUD complex. Monthly meals,
excursions, rent and wood will be
continued. In addition, recrea
tional facilities will be provided
at the complex, including saunas
and whirlpools, and a .custodian
will be hired to live at the
complex and.oversee the physi
cal plant.
What’s different
Staff training has always
b’een available at the depart
mental level, but such oppor
tunities will be offered on a
branchwide basis in 1979, to be
coordinated by the Mental Health
Professional. This system should
prevent duplication of efforts but
also allow common needs to be
addressed and provide exposure
to a variety of treatm ent theories
and methods, predictedJackson.
The main objective is not to find
one treatm ent modality for all
programs but to give depart
ments the opportunity to select
the best modality for their pur
poses.
Each position in the Health
Branch will have its own stan
dards by which the staff member
will be measured, thus providing
“planned, systematic opportuni
ties for growth,” said Jackson.
This two-way commitment —
from management to supply
training and advancement, and
from the employee to willingly
engage in self-improvement —
should result in the increased
self-confidence of staff and ulti
mately the confidence of clients
in the programs, remarked Jack-
son.
While employees are on the
road to self-betterment, Jackson
is asking them to also focus their
attention on the tightening and
formalizing of program proced
ures. It is a “survival process,”
the manager explained, by which
policy must be documented so a
client can be more assured of
moving smoothly through the
system. These in-house proced
ural efforts muct be coordinated
Designing A Health Plan
Far The Reservation
among the departments to pro
vide continuity in servicing,
Jackson noted.
S everal
ad m in istrativ e
changes have been made within
the Branch to produce a more
smoothly-working and account
able organization, pointed out
Jackson. Two offices were given
their own budget — Alcohol and
Drugs and Health, Welfare, Pro
bation-Parole. Previously they
operated out of program budgets
and their objectives were not
isolated.
Three programs that receiv
ed no direct superivision —
Maternal and Child Health, Com
munity Health Representatives
and Nutrition — have been
combined into one program,
Allied Health Services, under the
supervision of Adeline Miller.
Also combined under the Welfare
Supervisor, Gayle Rogers, were
WIC and the Se 3F Citizen Pro
gram. (see department and pro
gram breakdown below).
And what’s more
The PATH foster care pro
gram received a large boost
because of the increased cost of
-groceries and child care, but also
because of the addition of a new
component. A live-in facility has
been proposed for young children
who cannot adapt to a foster
home and are too young for the
group home. To be located in the
residence of the late Vernon
Jackson and his family, the pro
ject is being referred to as the
Jackson Home.
As presented in the budget
package, tribal expenditures in
the Health Branch for 1979
appear to increase dramatically,
but as Jackson pointed out,
grants and contracts may pro
vide many of the actual dollars.
In 1978 one-third of the Health
Branch’s funds were supplied by
outside sources and Jackson
anticipates that proportion to
remain about the same or rise a
bit in 1979.
Although branch
depart
ments actively seek outside fund
ing, they try not -to let the
availability of funds dictate
structure and content of pro
grams. A grant won’t be ac
cepted if it is too compromising,
HEALTH PLANNER SAL SAHME AND BRANCH MANAGER BOB JACKSON.
Jackson said.
In the past, federal monies
anyone involved or interested in
While working toward a around the availability of funds,
have comprised the bulk of
health
planning,
including
the
he
noted.
The
“phenomenal
graduate degree in mental health
Tribal Council, Health and Wel outside funding but the Health
administration, tribal member growth” of the Health Branch
Breanch will be tapping state
fare
Committee, and employees
Sal Sahme conceived the idea of has proceeded with no particular
funds in the coming year — if
a comprehensive health plan for direction. As a result, treatment in the Health Branch, Bureau
Ballot Measure No. 6 (property
and
Indian
Health
Service.
is
inconsistent
and
communica
the Warm Springs community.
tax limitation) does not alter the
Three
laws
in
particular
will
Now, four years and two health tion among departments and
picture significantly, remarked
be presented, said Sahme: P.L.
branch m anagers later, that with potential clients is lacking,
Jackson.
93-638, the Indian Self-Determi
dream is being realized — and Sahme observed.
nation
Act;
P.L.
94-437,
Indian
COMPONENTS OF THE
Sahme is back in town to make
Health Care Improvement; and
“The most critical thing in
sure it happens.
HEALTH AND SOCIAL
P.L. 93-641, National Health
Sahme is the new Health the whole planning process is the
SERVICES BRANCH
Planning and Resource Develop
Planner, a position that is not need for not only the providers
ment. He will explain not dnly HEALTH BRANCH OFFICE
budgeted until 1979 but is well owning the plan but also for
the “what, why, where and how” Health Planner
underway in 1978. As proposed, people in the community to have
of the acts, but also the limita Community Mental Health Edu
the comprehensive Health and ownership,” said Sahme about
tions and constraints posed by cator
Support Services Plan is an the process he is launching. “The
the laws and their implications Mental Health Professional
18-month project, but Sahme planning process has to be very
for the Confederated Tribes.
predicts that the result of his visible to the community and its
Alochol an Drug Department
A follow-up workshop will be
work will be a “foundation” from purpose very obvious.”
Alochol Program
To ensure community in held with the same participants
which an ongoing tribal health
Drug Program
to establish planning priorities
been
planning process should develop. volvement Sahme has
Wilderness Program
and suggest program âlterna-
Already Sahme has his next working closely with the -Health
Crisis and Family Unit
tives. This whole exèrcise should Family and Childrens Services
year and a half mapped out, and Welfare Committee and will
serve to identify the “leader
starting with a community pro be holding a general council
Residential Group Home
ship” who will keep the planning
file, moving on to an assessment meeting in the next month.
Outreach Program
process ongoing, said Sahme.
of the community’s needs based Sahme also hopes that people
PATH Foster Care
Sahme noted that the Tribes Health, Welfare, Probation -
on gaps in existing services, and will feel free to volunteer their
face a critical period in planning, Parole
the design and implementation input at any time.
since they have the opportunity
One of Sahme’s first projects
of a health plan for the reser
Parole-Probation
to shed the “paternalism ” of the
vation. The first rough draft is will be to offer a workshop on
Allied Health Services (CHR,
federal government’s delivery of MCH, Nutrition)
due to be completed by April 1. current health legislation that
services and design a system
Sahme feels comprehensive affects planning on this reser
Welfare (WIC, Senior Citi
planning is long overdue. In the vation. Scheduled for mid-Octo
zens)
(Continued on Page 12)
past, planning has
revolved ber, the workshop is intended for