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