Image provided by: University of Oregon Libraries; Eugene, OR
About Smoke signals. (Grand Ronde, Or.) 19??-current | View Entire Issue (Sept. 1, 1994)
September 1994 -tr Page 8 Health and Human Services Smoke Signals Contract What is Contract Health Care? The Contract Health Service program is federally funded under P.L. 93-638 by Congress for the Grand Ronde Tribe to assist eligible Indian people with payment of eligible medical anddental services. Who is eligible? Contract Health Services is restricted to those individuals and their minor dependents who (1) live on an Indian reservation or other trust land, (2) live off of the reservation, but reside within the service area and be a member of the Tribe for which the service area was established. Enrolled Grand Ronde tribal members must reside within the counties of Washington, Multnomah, Marion, Polk, Yamhill, and Tillamook. All services must be preauthorized by the Contract Health programbased on medical priority. Priorities for Contract Health Services Priority I: Emergent or Acutely urgent careUrgent and emergent care must be done within 30 days to Dental clinic Kids: Remember to brush and floss By Dr. Scott van Dyken Everyone has probably seen that commercial on television with the slimy green guy "Mr. Yuck Mouth" and how he talks about the effects of not brushing and flossing your teeth and gums. Well, believe it or not, he is not too far off. When we don't brush, plaque, (a combination of food product, saliva, and BACTERIA) sticks to the teeth. This plaque is a substance that must be taken off with a toothbrush and floss before the acid content in the plaque reaches levels that are harmful to our teeth. This acid content reaches harmful levels about 28 hours after contact. If you were to brush and floss your teeth perfectly once a day, you would be protected; however, most people usually miss those "hard to reach" places on their teeth so it is better to brush and floss twice per day. Brushing and flossing twice per day will keep away bacteria in plaque, and you will be rewarded with a brighter and happier smile. Let's talk teeth... By Linda Mann, RDH Diabetic smokers, ages 45 and Health preserve life, limb, function, or the senses. Priority II: Preventive care Primary health care that is aimed at the prevention of long term disability. This includes services proven effective in avoiding the occurrence of a disease (primary prevention) and services proven effective in mitigating the consequences of an illness or condition (secondary prevention). Priority II services are available at most Indian Health Service facilities. Priority III: Primary and Secondary care Inpatient and outpatient services that involve the treatment of prevalent illnesses or conditions that have a significant impact on morbidity and morality. This involves treatment for conditions that may be delayed without progressive loss of function or risk of life, limb, or senses. It includes services that may not be available at many IHS facilities and may require specialty consultation. Priority IV: chronic Tertiary and Extended care Inpatient and outpatient care services that require (1) a specialist or sophisticated news older have a greater chance of developing severe periodontal disease with loss of tooth supporting bone than people without those risk factors. That was the conclusion of a study conducted at the State University of New York at Buffalo. In light of this finding, regular dental care for the diabetic patient is crucial. Good oral hygiene must be routinely practiced at home. It is important to brush after meals and snacks. In choosing a toothbrush, make certain it is soft-bristled. This is important in preventing damage to your gums. Flossing is one of the most effective ways to clean in between your teeth where the toothbrush cannot reach. Remember home care procedures are very important, but it is also important to visit your dentist regularly. Dontbeanother statistic; take care of your teeth, and they will help take care of you. Dental clinic services The Grand Ronde Dental clinic staff believes that dental health is very important to overall general health. It is our goal to provide quality dental care in a professional and caring manner. The dental team consists of one questions equipment and tertiary care facilities, (2) that are not essential for initialemergent diagnosis or therapy, or (3) that are high cost, elective, and have less impact of mortality that morbidity. These services are not readily available from direct care IHS facilities. Who determines priorities? The priorities are determined by Indian Health's operational procedures. The interpretation of the priorities for our tribal health program is determined by consultation with professional health care providers at the Grand Ronde clinic and Chemawa Service unit. How do I use Contract Health Services? Patients need to establish their eligibility with Contract Health Services prior to receiving medical or dental care. You can receive a health application by dialing 1-800-775-0095 and requesting one applicationfor eachfamiry member. After eligibility is established, you will need to phone in appointments 3-7 days in advance for dentist, one hygienist, two dental assistants, and a dental receptionist We also have an orthodontist who provides servicesonalimited basis. The Dental clinic provides basic services to all Native American descendents. They include: exams, cleanings, fillings, crown and bridge work, full and partial dentures, extractions, and root canals. For procedures requiring laboratory services, the "direct" or "self-pay" patient is responsible for the fee incurred. Patients are seen at the Dental clinic Monday throughFriday, with the exception of legal holidays. Clinic hours are 7:45 a.m. to 4:45 p.m. Emergency walk-in time is 8 9 a.m. Patients requesting emergency treatment should register with the receptionist no ater than 8 a.m. "No Cavity Club' Congrats to our new members: Matthew Castelon KaylaLeno Nicole Porter Anthony Stone Samantha Stone answered preauthorization, even if you have insurance, medicare, or medical assistance through the state. Emergency visits have to be reported within 72 hours after the services. (Emergency room services will be reviewed by the Family Nurse Practitioner at the Tribal Clinic, for priority level of the emergency service.) Inform doctors of private insurance, medicare or other health coverage you may have. Mail CHS allpreauthorizedbillsand insurance explanation ofbenefits to: Contract Health Services, 15 GrandRonde Road,GrandRonde,Oregon97347. Inpatient hospital stays All patients that do not have an alternate resource and are going to be hospitalized must apply for medical assistance through the Oregon Health Plan. Refusal to apply for alternate resources will result in denial of payment Should I keep my insurance? Yes, by all means. If you have health insurance we can pay for your deductible and any balances after the insurance company pays, assuming you meet all the Nanitch Sahallie's Nanitch Sahallie is a youth residential treatment facility located in Keizert Oregon, It is owned and operated by the Grand Ronde Tribe, To protect client confidentiality, all printed essays: wilt be kept anonymous. For me, treatment kind of woke me up from my life of ignorance: : toward my problems and behaviors. It showed me that I could make my life into something great, and it didn't have to be so miserable. It let me understand myself and gave me some confidence, self-esteem, and pride in my native culture, i learned why I always gave up and failed, Most of all I learned how to be myself and exactly what it is I want out of life. I have had a chance to mature greatly, learn open-mindedness and willingness. When I first entered treatment 1 was unhappy; the treatment center was a place that told me when to go to bed and when to get up. After I had been here a while, treatment has kind of been like a school that was my family and home. I have felt trapped and requirements of theContractHealth Services program. If after a determination that there are no alternate resources (insurance or other government programs), we are responsible for the total charges. The disadvantage to not having an alternate resource, is that with limited funds, we may run short of funds and may not be able to pay for services. For those who have health insurance, medicare, etc., Contract Health can pay only after the insurance company has paid. Contract Health has recently started mailing and "Explanation of Benefits" of its own to tribal members. This will be sent out of the ContractHealthofrice twice per year. This document will show all preauthorized calls and ancillary charges incurred (lab, x-ray, interpretation bills). It will state the care provider's name, purchase order number, date of service, and whether the document is "open" or "paid". If a document is open, this indicates there has been no payment of services. Please take a look at this document, and call us if you have any questions at 1-800-775-0095 or 879-2000. Client Corner homesick at times, but there was always someone to help me understand my feelings and that everything they did was for a reason. During the bulk of the stay, 1 felt hopeless in getting out, but when I talked my feelings out, I felt better and motivated to healing myself, I felt focused on making my life better for me and those who are a part of it It has been one hell of a roller coaster ride in an emotional sense. There has been pain, joy, happiness, anger, hurt, confusion, anxiety, and a lot of other feelings felt I have applied a lot of open mindedness and willingness to make treatment work for me. I have seen many others go through hell and then some because they didn't use open-mindedness and willingness in their treatment and recovery, I have learned to live without everyday things, and learned about taking those everyday things for granted, Above all, treatment' was something I am grateful for, and I encourage anyone who has a chance to go, to go.Jt will change your life... i i
