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About Smoke signals. (Grand Ronde, Or.) 19??-current | View Entire Issue (Dec. 1, 2002)
6 DECEMBER 1, 2002 Smoke Signals Committee Summit Puts More Work on Committee Shoulders Effort to improve communication with Tribal Council covers a lot of details. By Ron Karten Committees do so much of the work of the Tribe, but Tribal Council in recent years has felt that it "needed closer communication," Tribal Council Chairwoman Cheryle Kennedy told a packed meeting at the Spirit Mountain Casino on Hal loween day. "As far as the Tribal Council is concerned, we're very grateful for that," said Kennedy. "You've been meeting regularly, tending to business and coming annually to us, but we knew that there were a lot more things going on," she said. As a result, Tribal Council Liaison Charles Haller II coordinated a Summit Meeting to bring together the Council and the Committees to de scribe a way to make communications more timely and more complete. The process in cluded a description of the new General Committee Ordi nance, now cover ing all committees, with exceptions for the Enrollment and Fish & Wildlife committees, which have federal requirements to meet. For other committees, however, the overall com mittee ordinance will provide the framework and committee by-laws will fill in the details. "We're trying to formalize the process," said Haller. "My job is to facilitate the communica tion." The summit included a session describing how to create committee by-laws. New are require ments for sending out regular meeting notices, naming regular meeting days, submitting meet ing minutes to Tribal Council within five days of meetings and expediting the appointment pro cess for naming new members. The overall committee ordinance also elimi nated committee liaisons because they over lapped with the duties of commit tee chairs and C: m "confused the process," said Kennedy. The by-laws process will allow committees to spell out how they wish to deal with Tribal de partments. The importance of the Committee structure is underscored by the Tribe's investment in it. The Summit Members of the Grand Ronde Tribal Council and members of the various Tribal Commit tees met at the Tribe's Spirit Mountain Casino on Thursday, October 31 to discuss new bylaws and com mittee ordinances. Tribal Council Chairwoman Cheryle Kennedy told the gathered crowd that the council and committee members need to communicate more regularly and that she was proud of the work being accomplished by committee members. Tribe spends $315,000 a year on the system of committees, reported Tribal Financial Officer, Larry Kovach. The target date for approved by-laws is the first of next year. Behavioral Health Unit Gets 2nd State Certification New designation means reimbursements for Health & Wellness Center and a move to get away from the "Cult of Personality' By Ron Karten The Behavioral Health unit has been seeking two certifications. The Drug and Alcohol Certification was awarded last year at the end of May, and this year, on June 14, Behavioral Health received a Men tal Health Certification. The certification process aims to improve service levels through a range of policies and procedures and could result in new reimburse ment payments to the Health and Wellness Center from state agen cies as well as third party payers, like insurance companies. The process "involved creation of policies and procedures that were substantially in compliance with three credentialing agencies," said Dr. Joseph Stone, Director of the Tribe's Behavioral Health unit. Those agencies are the Indian Health Service, the State of Oregon and the Accreditation Association for Ambulatory Health Care. The policies and procedures were "built around good supervision and collaborative care," said Stone. Rather than maintain what Stone called, "a cult of personality" in which patients select therapists or doctors based on their credentials or personalities, Stone endeavored to build a program based on "good supervision and collaborative care." When patients select individual therapists, Stone said, "you set up expectations that that person can be. everything to everybody, and ultimately, that person fails." "I want a highly trained and ef fective staff," Stone said. "I see most patients indirectly, but make sure that the work proceeds appropri ately." "When we try to heal on the cha risma of a personality, we don't do as well," said Dr. John Bellville (pro filed in SS, 8102), psychiatrist on staff. "It fosters a dependent patient population," he said. "We want to foster independent patients who improve by what they do. It's a question of healing by association (with a specific therapist), which is short lived, versus healing by (a patient's) own choices." With a collaborative effort, said Stone, "the program itself becomes the therapeutic entity." What all this means is that all therapists bring cases back to the group with "in-depth case notes" not just for discussion but to "a structured and formalized process." The group then looks at the diag nosis in two ways. First, what does the science of behavioral psychol ogy say? The second part is the "art" part. Questions come up: how is information that the patient needs to know delivered? "It may not be direct," Stone said. "It may be listening and collaborat ing and paying careful attention. There may be suggestions about how things might improve." The message is delivered "We'll help you if you want to make it bet ter," said Bellville. When Stone arrived at the pro gram, it was not state certified. "I had to look at what was needed to provide ethical, sci entific and culturally relevant treatment," said Stone. "And then how to combine that into a formal delivery system that meets the demands of the law, which are fairly rigorous and spelled out. That's how we forged our team." In 10 tol2 hour "very inten sive" sessions, the team started with a sense of how it should be, then listened to one another on virtually every point. "We experimented and fine tuned." They consulted with experts. At one point, they realized that their procedures were set up "to make the chart look good." A lot of places "make the chart look good" by rejecting, for example, drug or alcohol patients who re lapse. That makes a clinic's statis tics look good, but is not particularly helpful to a lot of patients. With Indian alcoholism 625 percent higher than alcoholism in the domi nant culture, this clinic decided against that approach. "The program is systematic," said Stone. "It takes time as any heal ing process does. "We've got a good strong staff pro viding services to individuals who are unique by history. We conduct a rigorous inquiry. If there are dif ferences (with what we expect), we ask ourselves, 'How do we improve our system by recognizing and in- : . "w'' ' Dr. Joseph Stone corporating those differences into treatment?' "When you have people who have been impacted and oppressed for generations, treatment needs to be robust and comprehensive," Stone said. Although the Oregon economy needs to improve and the Health & Wellness Center needs to make a good case for gaining reimburse ments from new payers to make this new certification pay for the com munity, down the line, it could be worth something. Still, according to the Tribe's Behavioral Health staff, the process and the credibil ity in the community that the pro cess gives could be extremly valu able. D
