Image provided by: University of Oregon Libraries; Eugene, OR
About Smoke signals. (Grand Ronde, Or.) 19??-current | View Entire Issue (Jan. 15, 2009)
4 JANUARY 15, 2009 Smoke Signals fiVAeenirDg) dlosconsses IhieaOftGuy liiffestiyOes By Dean Rhodes Smoke Signals editor A second briefing by Tribal Health Executive Director Mark Johnston on the Tribe's hiring of a new third party administrator to process health claims evolved into a broad ranging discussion about lifestyles and their monetary effects on the Tribal member health plan at the Jan. 4 General Council meeting held at the Monarch Hotel & Con ference Center in Clackamas. Johnston made his first presenta tion about the third-party admin istrator changeover at the Dec. 7 General Council meeting (see Dec. 15 Smoke Signals). Johnston and Health & Well ness Administrative Officer Allyson Lecatsas repeated the presentation, as well as expanded on details in re sponse to Tribal member questions. Tribal Elder Les McKnight asked, after hearing that the new provider network, First Choice Network, only enrolls doctors in Washington, Ida ho, Oregon and Alaska, about Tribal members living in other states. Lecatsas said that there are corre sponding provider networks in other states that Tribal members use. 'Tribal members who live outside of that area have received different information," Johnston added. Tribal member Joseph Brisbois asked what Tribal members should do if they require medical care while traveling outside of the network's four-state Northwestern region. Lecatsas said that Tribal mem bers, in an emergency situation, should go to the nearest provider regardless of the doctor's network affiliation. "Since it is an emergency, it will be paid as in-network," she said. Lecatsas added that health care while traveling abroad is more complicated. Tribal members would probably need to pay for their health treatment upfront perhaps with a credit card and then submit their bills to Shasta Administrators of Bend for reimbursement. Johnston repeated the reminder . - I V o J f - Photo by Michelle Alaimo Tribal member Bryan Mercier questions whether the Tribal Health Department is planning on educating Tribal members on healthy lifestyle choices during the General Council meeting held at the Monarch Hotel & Conference Center in Clackamas on Sunday, Jan. 4. that the Tribal member health plan is self-funded, meaning that when Tribal members go to a doc tor or hospital, they are spending Tribal funds. "Shasta is just a claims proces sor, not an insurance company," he said. Johnston said the Tribe also will continue to work on making the Tribal member health plan a sec ondary payer for Tribal members who have other health insurance, thereby reducing Tribal costs. In response to another question, Lecatsas said that Tribal members who are also Tribal employees only received one health card - the Trib al employee health card and that Shasta will automatically make the employee health plan primary and the Tribal member health plan secondary for that group of Tribal members. Tribal Council member Valorie Sheker said that one of the reasons the Tribe selected Shasta Adminis trators as the Tribe's new third party administrator is that the company agreed to possibly hire a Tribal mem ber as its onsite representative and teach that employee how to manage Tribal health care claims. "It's a very complicated process," Sheker said. But the discussion turned on a dime when Tribal member Bryan Mercier asked if the Tribal Health Department has expanded plans on educating Tribal members about making healthy lifestyle decisions, such as not smoking, drinking or using drugs, as well as getting ad equate amounts of exercise. , "They are the ones that draw down Tribal funds," Mercier said, point ing out that health care expenses account for about 25 percent of the Tribe's overall governance budget. Tribal Chairwoman Cheryle A. Kennedy said that, based on her experience in the medical field, it is a well-known fact that some demo graphic groups, such as teenagers, have very little effect on health care plans while others, such as women of child-bearing age, have more. In addition, Kennedy said, Grand Ronde Tribal members have the same rate of diabetes and heart disease as other Native American populations. "And our population tends to live longer," Kennedy said, referring to a healthy stock gene. "During the elimination of Native Americans, only the healthiest survived." Tribal Council member Kathleen Tom agreed with Mercier, saying that many illnesses, from lung cancer to heart disease to diabe tes, are preventable by changing lifestyles. But Sheker asked if the discus sion meant that eventually the Tribe would segregate Tribal mem bers who smoke andor drink. "Would it mean we would not cover them? Or they would have a co-pay? What is the point of this discussion?" Sheker asked. Kennedy said segregation was not the intention. "We need to build a plan that is responsive to Tribal members' needs, not segregate them," she said. Mercier agreed, saying that the Tribe needs to work at making Tribal members aware enough of their health status to make good lifestyle choices that would contrib ute to reduced health care costs. And Tribal Council member Wink Soderberg said the Tribe needs to investigate use of alternative, na turopathic medicines in its health care arsenal. Johnston wrapped up the discus sion, saying many of those items would be good questions for the Tribal Health Care Task Force to address. In other action, it was announced that the next Tribal Council meet ing will be held at 10 a.m. Sunday, Feb. 8, at the Tribal Gymnasium in Grand Ronde. Tribal members Bryan Mercier, Robert Nagel and Dan Stroebel won the $50 door prizes and Tribal Elder Marilyn Portwood won the $100 door prize. Stroebel donated his door prize to the Veterans' Special Event Board and Portwood donated her winnings to the Tribal Library. B (P IT 1-3 nzn ftfwmafwl hy to Owvi JUwtit llwiih and Wftfatm CrJ ftmtel Clink WJ-1 79-2020 i Home Energy Efficiency Program The Grand Ronde Tribal Housing Authority's naw TEEPQ program provides anargy adu cailon services, and funding for home neryy saving projects, and home energy generation projects Enroeed TMbet members Rvtno In PoSi, YamhM, Marion, MUnnofTMn, iiHiiiuuH ano neeneiceoncawPee may apply tor the eneryy prefect fUndng. A All Trll Matin MflfcU Ut ftaa Baff ! Kill avalUala ml If III in litiristii li: Mafclag ft mmtm rgf ffUiaet Loweriag fmi aiaatklf etllitf Raalaalag liaaaaa wllk aaargr tn- kaal mm 4 ! fmt Than wa want to baar fron reel al I00) 423-C2X3, a ZiiZ. t:ir3 r Ad created by George Vakfet Ad created by George Valdet
