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About Smoke signals. (Grand Ronde, Or.) 19??-current | View Entire Issue (Dec. 15, 2008)
Smoke Signals 3 DECEMBER 15, 2008 Aew medical cards should be arriving in mail in mid-December, go into effect Jan. 1 f . f mms ." I .i 'if " :. y V J" 1 ' J Photo by Michelle Alaimo Tribal Health Executive Director Mark Johnston updates Tribal members on the Tribal health plan during the General Council meeting held at the Tribal Community Center on Sunday, Dec. 7. By Dean Rhodes Smoke Signals editor A new third party administrator for the Tribal health plan will save the Confederated Tribes of Grand Ronde millions of dollars in 2009, said Mark Johnston, the Tribe's Health executive director, at the Dec. 7 General Council meeting held in Grand Ronde. "In the current (budgetary) cli mate, that is very important," he said. Johnston briefed about 130 Tribal members on the changeover, which will go into effect Jan. 1. Currently, United Medical Re sources in Cincinnati, Ohio, pro cesses health-care claims for the Tribe's self-funded health plan. UMR will continue processing claims for services provided through Dec. 31. Starting with health services provided on Jan. 1 and thereafter, Bend-based Shasta Administrators will process claims. Johnston said Tribal members will receive new medical cards in the mail in mid-December. Ac companying the new medical cards will be a benefit confirmation let ter, which Tribal members should review to ensure all of the informa tion is correct. Tribal members should start us ing the new medical cards on Jan. 1 and thereafter. Johnston stressed that the change in third party administrator will not affect any current benefits, such as prescription drugs, dental or vision. He said the Tribe was looking for a third party administrator with a Northwest presence, previous Tribal experience and the ability to process claims at the less expensive Medicare rate. "I hope Shasta will help allevi ate problems in getting the claims processed in a timely manner," Johnston said. "I think this is an excellent fit for the Tribe." Tyler Moore, a Shasta represen tative, said his company answers phones with a human being instead of computer program. In addition, since Shasta is in Bend, it will be in the same time zone as most Grand Ronde Tribal members. Moore also said the new provider network. First Choice Health, has higher penetration with more doc tors in the network. If a preferred doctor is not in the network, Moore said Tribal mem bers should contact Shasta and First Choice will "work aggressively to enroll them." Johnston reminded Tribal mem bers that they will have a six-month grace period to either get their doc tor enrolled in First Choice or find a new provider before they would have to pay an out-of-network rate. Tribal member Bryan Mercier asked if the Tribe should inves tigate abandoning a self-funded health plan and return to a contract health plan, such as ODS. Johnston said the Tribal health plan has about four times more people enrolled than in 2000, when the Tribe contracted with ODS, and the Tribe can save a lot of money as a self-funded program using the Medicare discount. In 2007, the Tribe spent $20.7 million on the health plan. Johnston also emphasized that since the Tribal health plan is self funded, Tribal members should remember it is their money being spent when they go to the hospital or visit a doctor. Johnston also announced the health plan's Native name Skoo kum, which means strength, strong and wise. "It also sometimes means scary," said Tribal Elder Betty BIy. "We'll try to make sure it is not a scary plan," Johnston said. Tribal members with questions about the new third party admin istrator can call Barbara Steere at 503-879-2487 or Jim Holmes at 603-879-2221. In another presentation. Tribal member and Spirit Mountain Com munity Fund Director Shelley I lanson gave an update on the fund, which donates 6 percent about $ 1.4 million a year of Spirit Mountain Casino's net profits to charitable organizations in 1 1 west ern counties. "As a Tribal member, it makes me proud that we were the first Tribe to create such a fund," Han son said. Hanson said the fund has given away more than $45 million since it was founded in the mid-1990s and has grown to be the 10th largest charitable foundation in Oregon. In 2008, the Community Fund received 433 requests for $14.2 mil lion in funding, and awarded 148 requests for $4 million, which is a 34 percent approval percentage. Also in 2008, the Community Fund gave $301,000 to six of Or egon's nine federally-recognized Tribes. In 2009, Hanson said the Com munity Fund will attempt to mirror the success of the Hatfield Fellow ship Program by bringing 20 Native Americans to Salem to learn about state government. In other news: The next General Council meeting will be at 10 a.m. Sunday, Jan. 4, at the Monarch Hotel & Confer ence Center in Clackamas. Tribal members sang "Happy Birthday" to Tribal Elder Nora Kimsey, who turned 100 on Dec. 2, and members of her family gathered for a portrait. Tribal Elder Kathryn Harrison gave the invocation and Tribal Council Secretary Jack Giffen Jr. asked for a moment of silence for those who died during Pearl Harbor in December 1941 and "veterans who gave their lives since that day." Elders' Committee nominees are Violet Folden, Duane Wheeler, Dakota Whitecloud and Tom LaChance. The election to Till three seats will be conducted at February's General Council meet ing in Grand Ronde. Tribal members Tim Mooney and Dorothy Leno and Tribal El der Chip Tom won the $50 door prizes and Tribal Elder Ellen Fischer took home the $100 door prize. D Attention Tribal members Effective Oct. 1, copies of Legislative Action Committee recommen dations became available on the Tribal member side of the Tribal Web site. They are located with the Legislative Action Committee minutes. These forms are only a recommendation used by the Legislative Action Committee to move discussion items to a regular Tribal Council meeting for a vote of the Tribal Council. If you have any questions, please contact Dakota Whitecloud, Tribal Council Relations Coordinator, for more information. You may reach her at 503-879 1309 or 1-800-422-0232, ext. 1309. D