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CHANGES IN HEALTH SERVICES poison-proof your
HOME
Smoke Signals June 1989
SPECIAL LETTER TO PATIENTS ELIGIBLE FOR
THE CONTRACT HEALTH SERVICES PROGRAM
OF THE PORTLAND AREA INDIAN HEALTH
. SERVICE WESTERN OREGON SERVICE UNIT.
The CHS Program of the Portland Area Indian Health
Service has experienced severe spending increases this
year. It has been projected that if spending continues at
the present rate, the program will overspend by more
than one million dollars. This is not allowed by law, so
we must wither make major cuts in the program now or
plan to close the program down for a period of time
when the programs runs out of money prior to the end
of the year. We feel it would be much better to make
cuts now so that we can continue to provide the most
critical emergency services to eligible patients through
out the entire year.
At a special meeting of the Executive Council of the
Portland Area Indian Health Service April 27, the
following changes were made in allowable costs under
the CHS program, effective as of that date:
1. All eyeglasses, hearing aids, and refractions must be
deferred.
2. All hospital admissions must be limited to a very
strict interpretation of Priority I (necessary for the pres
ervation of life, limb, or function) and deferrals made
whenever possible.
3. A strict interpretation of Priority I must be applied to
skilled nursing care, medical equipment purchases,
physical therapy, prosthetics, and all mental health
therapy.
4. Use of alternate resources must be increased. IHS
staff will be reviewing every case for possible Medicaid
or insurance eligibility, and will require application by
the patient if there js a possibility of eligibility.
5. Every emergency room visit will be reviewed by our
physician, and denials will be made for non-emergency
visits.
6. Dental care purchased through Contract Health
Services will be limited to emergencies only (serious
infections and trauma involving serious injury.)
7. Any cardiac surgery will be performed at St.
Vincent's Hospital in Portland, where we have a
contract and reduced rates, unless we can get DRG
rates in a local hospital.
8. Payments to pharmacies for prescription costs will be
reduced by switching to the Medicaid formulary and
fees.
, 9. Ambulatory care (outpatient care) will be restricted
to a strict interpretation of Priority I only.
CLARIFCATION FROM GRAND
RONDE CONTRACT HEALTH
In clarification of this recent notice that many of you
received from the Western Oregon Service Unit,
regarding Contract Health Services. This letter will not
be effecting Grand Ronde CHS eligible tribal members.
However, due to our own spending increases this year
Grand Ronde Contract Health Services will be experi
encing some spending changes.
1. Ail Hospital admissions for members without a
primary insurance or Medicare will be required to apply
to Adult and Family Services for a medical card.
2. All OB patients without a primary insurance prior to
delivery will be required to apply to AFS for a medical
card.
3. All emergency room visits will be limited to preserva
tion of life, limb or function. These visits will be
reviewed by the community Health Nurse, if these do
not fall within Priority I they may result in a denial
4. All immunizations, school physicals, routine physicals
will be referred to WOSU-Chemawa Clinic, the County
Health Department. For the Grand Ronde area
members, there is the Wednesday clinics at the Tribal
Office that are available.
5. All ROUTINE mammograms and ROUTINE OB
ultrasounds will not longer by a Priority I Level. Excep
tions will be:
a. Any suspect mammograms
b. Follow-Up mammograms after an abnormal one
c. OB ultrasounds ordered to rule out any anomalies
6. All cardiac surgeries will be performed at St.
Vincent's Hospitals in Portland, unless we can get DRG
rates in a local hospital.
7. All extensive pediatric services will be referred to
Dorbechors Children's Hospital at OHSU.
8. Pharmacies will be asked to dispense generic brand
products unless specified by a physician. Absolutely no
over the counter drugs.
For non-life-threatening emergencies that occur on
WEEKENDS OR AFTER BUSINESS HOURS, there
is the Immediate Care Clinic, located at 3777 Commer
cial St. SE Salem - phone 588-9026, or the After Hours
Clinic at 1233 Edgewater St. NW Salem - phone 371
8212. For acute problems, (i.e. colds, flu, allergies, shots,
rashes-skin problems( appointment should be made a
few days ahead of time for the Wednesday Clinics.
It is extremely important for PRE-Authorization
BEFORE your doctor or dental appointments.
We deeply regret the hardship and the inconvenience
this program change will mean for some of our patients,
but please understand that it was absolutely necessary
because of a spending crisis which has been brought on
by increased cost, increased medical inflation, increased
need for medical and dental services in our population,
and a rapid growth in the population we serve, please
understand that CHS is not telling you that cannot
receive medical services, it is just that we can only pay
for the most urgent and emergent services.
Thank-You for your understanding and cooperation-in
this matter. Hopefully these measures will be temporary
in nature, and we will keep you informed if they can be
relaxed at some point in the future. If you have any
questions, please feel free to contact us at 879-5211 or
toll free at 1-800-422-0232.
Contract Health Services
Teri Holsclaw
Mary Brickell
'
The Health Sciences Minority Program at the Univer
sity of Minnesota is offering a variety of summer
enrichment and exploration programs for students who
might be interested in pursing health sciences careers.
All programs are offered at no cost to the accepted
student. To be considered for any of the programs, an
application must be submitted that describes the student
candidate as a members of an under represented group
in the health sciences including American Indians. For
more information and an application, contact Cynthia
Simmons-Cooper, Health Sciences Minority Program
W61 Centennial Hall, 614 Delaware Street SE, Minnea
polis, MN 55455 (612-624-7901).
Grandparents and older adults who do not have
children living in the home need to be alert to the
dangers of accidental poisonings when youngsters come
to visit. Because they don't have to worry about child
safety on a daily basis, older persons often forget to put
away medicines, cleaners, and other potentially harmful
substances when children are around.
That oversight can sometimes be fatal. In a recent
Consumer Product Safety Commission Study, 17 percent
of the child poisoning cases investigated involved
grandparents' medications. The most common reason
for the accidents was the easy availability of the medi
cines, either because they were placed on a shelf or
counter within the child's reach or because the caps
were not child-resistant.
"Older persons who do not request child-proof con
tainers because they have difficulty opening them should
take extra precautions to keep medicines up high, out of
the reach and sight of children," advises Brian Howell,
director of the Oklahoma Poison Control Center at
Children's Hospital of Oklahoma, Oklahoma City.
"They should also beware of medicines kept in purses
and suitcases when visiting homes with young children,"
Howell says, noting that young ones are often attracted
to bottles of brightly colored pills.
Other guidelines Howell recommends for poison
proofing your home are:
- Avoid using hazardous household products while
children are in the home. If you do use them, do not
leave them open and or unattended.
Use child-resistant closures on medicines if at all
possible.
Discard old medicines and household products when
they are no longer needed.
- Do not make a game out of taking medicine, since
children love to imitate adult behaviors.
Keep a bottle of syrup or ipecac on hand in case
vomiting needs to be induced. But don't use the ipecac
unless instructed to do so by a health professional or
poison control center. Sometimes it will make the
effects of the poison worse.
Keep the number for your nearest poison control
center close to the phone. You'll find the number in
the front of your telephone directory, or call the local
hospital and request the number.
You can help save the life of a child by practicing these
safety tips and by encouraging others to do the same.
For other tips on poison prevention, call your local
poison prevention center.
- From "Highlights", published by the American
Association of Retired Persons.
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Contract Health Bookkeeper, Ellen Calder