Smoke Signals 3
DECEMBER 15, 2012
General Council briefed on SEtooEturoi expenses
II I MM
Photo by Michelle Alaimo
Allyson Lecatsas, Tribal assistant executive director of Health Services, tells
the membership how the Tribe has kept health care costs in line and how the
Tribe plans to continue to limit increases during the General Council meeting
held in the Tribal Community Center on Sunday, Dec. 2.
- Millions of dollars
Tribal members
encouraged to enroll
in Medicaid 'to take
burden off the Tribe'
By Dean Rhodes
Smoke Signals editor
Like other governmental enti
ties, the Confederated Tribes of
Grand Ronde is analyzing ways to
keep often double-digit increases
in health care expenses from con
suming more and more of a limited
budget.
During the Dec. 2 General Coun
cil meeting held in the Tribal Com
munity Center in Grand Ronde,
Tribal Assistant Executive Director
of Health Services Allyson Lecatsas
briefed the membership on ways
the Tribe has kept health care costs
in check and plans to continue com
bating those increases, including
asking Tribal members to apply for
Medicaid and look at other insur
ance coverage accessible to them.
Lecatsas said during her more
than 30-minute presentation that
the ultimate goal of Skookum ad
ministrative changes planned for
2013 will be to take more of the
burden of funding health care for
Tribal members off the Tribe and
moving it to Medicaid, a federal
program that is administered by
the states that is available for peo
ple with low incomes or are medi
cally needy, or to other insurance,
such as employer-sponsored plans.
Native Americans are exempt from
any cost sharing co-pays in
Medicaid.
But first, Lecatsas presented a
history of Tribal health care.
Since federal funding through
Indian Health Service and Contract
Health Services is woefully insuf
ficient to provide adequate health
care for all Grand Ronde members,
the Tribe started paying premiums
of Tribal members to have com
mercial health insurance through
Oregon Dental Service in 1997.
In September 2004, the Tribe
moved to a self-insured plan, which
pays medical bills for Tribal mem
bers using gaming dollars. In 2009,
the Tribe started using Shasta
Administrative Services of Bend
as its third party administrator for
health care claims.
In 2010, a Tribal workgroup was
formed with the goal of finding pos
sible cost savings in Skookum.
Lecatsas said that Skookum was
Graphic created by George Valdez
originally conceived to be the payor
of last resort. In 1997, 58 percent
of Tribal members were enrolled
in Oregon Dental Service insur
ance, but now almost 100 percent
of Tribal members are enrolled in
Skookum, with 85 percent to 90
percent of them not having any
other insurance coverage.
Because of this, the Tribe has
seen health care costs consume an
increasing portion of gaming dol
lars, from $3.4 million in 1997 to
$22 million in 2007. An analysis
commissioned by the Tribe in 2007
projected that Tribal health care
costs were on a trajectory to exceed
$29 million by 2010.
However, Lecatsas said, admin
istrative changes made during the
last four years have saved the Tribe
$20 million and reduced annual
health care expenses to $18.5 mil
lion in 2011.
But, she added, Skookum will
not be sustainable at the current 8
percent to 10 percent rate of infla
tion seen annually in the health
care industry.
Lecatsas said the Tribe will start
in 2013 asking Tribal members
to apply for Medicaid in their re
spective states. In Oregon, that
would mean applying to the Oregon
Health Plan unless a Tribal mem
ber can show proof that they are not
eligible for Medicaid.
Lecatsas said a 2011 survey of
Tribal members, which drew 2,760
responses, found that 60 percent of
Tribal members did not have other
health care coverage options besides
Skookum. It also found that of those
1,648 Tribal members who do not
have other health insurance options,
701 reported being unemployed.
In addition, Lecatsas said, of
those who responded to the survey
who reported income levels, only 32
percent earned enough money to be
disqualified for Medicaid coverage
and 55 percent reported income
levels at or below 133 percent of the
federal poverty, which means they
might qualify for Medicaid.
If Tribal members applied to
Medicaid and were accepted, it
would take a significant burden off
Tribal dollars.
"We want to move Skookum back
to being the payor of last resort,"
Lecatsas said. "The Tribe could
be saving a tremendous amount
of money to the health plan that
we are paying unnecessarily just
by making a few administrative
changes. And, of course, this would
be by making it mandatory that
Tribal members who do not have
other coverage either provide proof
that their income is over the Medic
aid eligibility or that they actually
apply for Medicaid and get enrolled
or be denied. ... This will not affect
the benefits you receive, but how
we administer the plan."
Tribal members covered by the
Oregon Health Plan would see
Medicaid be the primary payor of
their health care expenses with
Skookum being secondary, pay
ing only what Medicaid does not
cover.
Lecatsas said Tribal members
in 2013 will see Health Services
implement Medicaid verification.
Currently, she said, the Tribe is
only encouraging Tribal members
to apply for Medicaid, but it is not
mandatory.
Tribal members with questions
about the Skookum health plan
are encouraged to contact Lecatsas
at 503-879-1359, Barbara Steere
at 503-879-2487, Melody Baker
at 503-879-2011, Tresa Mercier
at 503-879-2008 or Jim Holmes at
503-879-2221.
In other action, Evelyn Seidel,
Duane Wheeler, Gladys Hobbs,
Louise Medeiros and Julie Duncan
were nominated for three open
seats on the Elders Committee.
Votes will be accepted during the
Elders Committee meeting from
10:30 a.m. to 12:30 p.m. Wednes
day, Dec. 26, at the Elders' Activity
Center and again during the Jan. 6
General Council meeting between
10 a.m. and noon in the Tribal Com
munity Center.
Steven Soderberg, Linda La
Chance and Cordelia Kneeland
won the $50 door prizes and Felicia
Torres won the $100 door prize.
Kathryn Harrison, Margaret Pro
vost, Seidel and Raymond Petite
won earrings made and donated
by Tribal Council member Jon A.
George.
The next General Council meet
ing will be held at 11 a.m. Sunday,
Jan. 6, in the Tribal Community
Center.
Committee & Special Event
Board meeting days and times
Below is the most current information on the meeting days and times for
Tribal Committees and Special Event Boards:
Ceremonial Hunt Board meets as needed. Chair: Shonn Leno.
Cultural Trust Board meets at4 p.m. on the first Tuesday of each month
in Modular No. 2. Chair: Perri McDaniel.
Culture Committee meets at 1 p.m. the first Wednesday of the month
in Modular No. 3. Chair: CeCe Kneeland.
Education Committee meets at 5:15 p.m. on the first Monday of the
month in the Adult Education Building. Chair: Tammy Cook.
Elders' Committee meets at 10 a.m. the third Wednesday of the month
in the Elders' Activity Center. Chair: Gladys Hobbs.
Enrollment Committee meets quarterly in Room 204 of the Governance
Building. Acting Chair: Robert Schmid.
Fish & Wildlife Committee meets at 5:30 p.m. the second Tuesday of
the month at the Natural Resources Building. Chair: Harold Lyon.
Health Committee meets at 10 a.m. the second Wednesday of the
month in the Tribal Wellness Center. Acting Chair: Patti Tom-Martin.
Powwow Special Event Board meets at 5 p.m. the first Thursday of
the month at the Tribal Community Center. Chair: Dana Ainam.
Rodeo Special Event Board meets at 6 p.m. the first Thursday of the
month at the Tribal Rodeo Office. Chair: Harold Lyon.
Social Services Committee meets at 4 p.m. the second Monday of
the month in the Social Services Conference Room. Chair: Jenny San
chez. Timber Committee meets at 5 p.m. the second Thursday of the month
at the Natural Resources Building. Chair: Bob Mercier.
Veterans Special Event Board meets at 4 p.m. the first and third Tues
day of the month in the Elders' Activity Center. Chair: Gene LaBonte.
Committee seeks Elders' phone numbers
The Tribal Elders Committee is working on a volunteer phone list of
Elders. If you would like to submit your phone number and address to be
available to other Elders, send it to elders.committeegrandronde.org or
leave a message at 503-879-2231. B