In this issue: Helena Indian Alliance, foot health, new CMS podcast, funding opportunities, and more
Spotlight: Helena Indian Alliance
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Helena Indian Alliance's Leo Pocha Memorial Clinic is an urban Indian clinic funded under Title V of the Indian Health Care Improvement Act.
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The clinic has significantly expanded staff and services thanks to third-party revenue—especially from Medicaid.
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Just a few years ago, only 20% of patients who used the clinic had insurance. Today, up to 85% of patients have insurance.
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Helena Indian Alliance was able to remodel its reception area, purchase new equipment, and hire new staff because of increased third-party revenue.
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Helena Indian Alliance Executive Director Todd Wilson says this increase is due in large part to Medicaid expansion, which covers 91% of the Alliance's Medicaid population. More Medicaid-covered patients translated into an increase in third-party revenue from $150,000 in 2015 to $850,000 in 2018.
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"With third-party revenue, we were really able to expand our personnel and the services we provide." — Todd Wilson, Executive Director, Helena Indian Alliance
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This increase in revenue allowed the Alliance to hire nine new employees, including administrative staff, medical assistants, nurse practitioners, substance use disorder staff, caseworkers, and others.
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New patients without insurance are connected to an enrollment coordinator who explains the benefits of having insurance—for patients and the Helena Indian Alliance. The coordinators help them determine eligibility and enroll. Some patients initially resisted because they were used to relying solely on Indian Health Service (IHS) for health care, but Wilson says a little education convinces patients that insurance is also important.
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The Alliance's high insurance enrollment rate resulted in unexpected assistance earlier this year, Wilson says. "With the government shutdown, which temporarily cut off funding from IHS, we were able to sustain operations without any cutbacks because of third-party billing."
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Flyers and fact sheets
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National Infant Immunization Week
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Routine immunizations are covered by insurance as an essential health benefit. Help prevent outbreaks of measles and other contagious diseases by encouraging new and expectant parents to get their infants vaccinated on time and by promoting vaccinations during National Infant Immunization Week—April 27–May 4.
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For details, refer to the Centers for Disease Control and Prevention's parent-friendly 2019 vaccination schedule for infants and children through 6 years of age.
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Maintaining foot health prevents amputations
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Foot Health Awareness Month in April is an opportunity to highlight the work podiatrists do to save the feet of people with diabetes and the importance of those patients receiving foot care.
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Podiatrists specialize in conditions of the foot, ankle, and lower leg. They are experts at treating foot ulcers or wounds that put patients with diabetes at risk for lower-limb amputations.
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To decrease that risk, patients with diabetes should see a podiatrist at least once a year. They should also avoid walking barefoot and check their feet daily for cuts, blisters, and sores—all of which could become infected and require surgery.
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"Sometimes patients are unaware of the significant risk a diabetic foot ulcer poses and believe a foot ulcer will heal on its own," says Parminder Jagur, a podiatrist at Sacramento Native American Health Center (SNAHC) in Sacramento, CA. "But foot ulcers tend to heal faster with wound care if they are found and treated early enough."
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Dr. Parminder Jagur, Sacramento Native American Health Center
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At SNAHC, Jagur works closely with primary care providers and a certified diabetes educator. He also walks patients through a set of diabetic foot care guidelines from the American College of Foot and Ankle Surgeons.
"Diabetes education is crucial," Jagur explains. "We offer classes on a regular basis so that patients understand how routine podiatric care can help them live their lives and keep their feet."
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Increasing access to healthy foods where people shop
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Eating nutritious foods can help prevent diabetes and lower the risk for diabetes-related complications.
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Programs to increase access to healthy foods wherever people buy groceries may help promote nutrition in Native communities. Locations include grocery stores, supermarkets, and convenience stores.
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For example, 65% of Chickasaw and Choctaw Nations of Oklahoma tribal members shop for food at a convenience store at least once weekly, and 56% travel more than 20 miles round-trip to buy groceries.
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Over a 14-month period, the Tribal Health and Resilience in Vulnerable Environments (THRIVE) program implemented promotion, placement, and pricing strategies in eight rural, tribally owned convenience stores in the Chickasaw and Choctaw Nations. As a result, the availability and sale of healthy food options increased in both Nations.
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New podcast series, CMS: Beyond the Policy
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The new Centers for Medicare & Medicaid Services (CMS) podcast, "CMS: Beyond the Policy," seeks to demystify policy and program updates by presenting them in an easily accessible format.
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The first episode on Evaluation and Management Coding goes over the 2019 Physician Fee Schedule. CMS will release new episodes periodically and feature a range of subject-matter experts.
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Project LAUNCH
Deadline: April 19, 2019
The Substance Abuse and Mental Health Services Administration's Linking Actions for Unmet Needs in Children's Health Grant Program (also known as Project LAUNCH) will provide grants to promote healthy social and emotional development in children up to 8 years of age. At least three tribes and tribal organizations will receive awards. Learn more about Project LAUNCH.
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Networks for Oral Health Integration
Deadline: April 29, 2019
The Health Resources and Services Administration's Networks for Oral Health Integration (NOHI) will fund efforts to improve dental care access for children ages 17 and younger. Tribes and tribal organizations are encouraged to apply. Learn more about NOHI.
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Rural Communities Opioid Response Program–Implementation
Deadline: May 6, 2019
The Health Resources and Services Administration's Rural Communities Opioid Response Program (RCORP)–Implementation grants will support activities that expand access to and strengthen the quality of substance use disorder prevention, treatment, and recovery services in high-risk rural communities. Tribes and tribal organizations are encouraged to apply. Learn more about RCORP–Implementation.
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Tribal Public Health Conference 2019
April 9–11, 2019
Tulsa, OK
Register for the Public Health Conference
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The Southern Plains Tribal Health Board and the 7th Generation Conference are hosting the Tribal Public Health Conference with the theme, "Strength In Community, Power In Connection." Tribal elders, tribal partners, health care providers and administrators, and public health professionals from Oklahoma, Kansas, and Texas are encouraged to attend.
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CMS ITU Outreach and Education Training
April 23, 2019
Albuquerque, NM
Register for the ITU Training
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The target audience for this CMS ITU training is business office staff, benefits coordinators, patient registration staff, medical records staff, and purchased/referred care services staff. Topics include CMS Tribal Affairs updates, Medicare, Medicaid, the Children's Health Insurance Program, state-administered programs, Social Security, and Veterans Affairs.
Upcoming ITU Outreach and Education Trainings:
May 14 in Tulsa, OK
May 14 in Kansas City, MO
May 30 in Bemidji, MN
June 4 in Sacramento, CA
June 18 in Billings, MT
June 25 in Richmond, VA
August 14 in Norwich, CT
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Contact Us
Do you have news to share? Send it to coveringic@kauffmaninc.com for possible inclusion in an upcoming newsletter. Contact us with other comments or feedback, too.
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About the Newsletter
Covering Indian Country is published by the Centers for Medicare & Medicaid Services (CMS) Division of Tribal Affairs to share resources, success stories, and best practices with the people who connect tribal communities to health coverage.
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