By Dean Rhodes
Smoke Signals editor

As health costs continue to increase, the staff of the Tribal Health & Wellness Clinic is continuing to find ways to save Tribal dollars that fund the Tribal member health plan.
Those cost-saving tactics were the main topic of discussion at the Grand Ronde General Council meeting held Sunday, Feb. 7, at the Monarch Hotel and Conference Center in Clackamas.
Tribal Health Services Executive Director Mark Johnston, Assistant Executive Director Allyson Lecatsas and Pharmacy Director Julie Davis reviewed the cost-saving moves for about 30 Tribal members in attendance.
Johnston briefed Tribal members on the total cost of the Skookum Tribal member health plan, pointing out that the estimated 2010 budget is about $1.5 million less than 2009’s budget.
Johnston said the Tribe has saved almost $8 million to date by accessing Medicare Like Rates and the other programs.
The most recent cost-savings move, Davis said, is the prescription medication change that requires Tribal members buy their maintenance drugs via mail order or in person from either Express Scripts or the Tribe’s Grand Ronde Pharmacy.
Johnston said the move will save the Tribe member health plan more than $800,000 annually because the Tribe can purchase drugs at a “deeply” discounted government rate.
Davis said it costs the Tribe an average of $38.77 per Tribal member prescription when filled at an outside pharmacy and only $13.85 per Tribal member prescription when filled at the Tribal Pharmacy -- about 35 percent of the outside pharmacy expense.
The new prescription rules, which went into effect on Feb. 1, only apply to maintenance drugs, such as those taken for blood pressure, diabetes and depression. Medications for short-term medical problems still can be purchased at outside pharmacies.
Davis said that Tribal members who get their prescription drugs through the Grand Ronde Pharmacy will not have to pay the co-pay while the prescription drugs obtained through Express Scripts will still require Tribal members pay the co-pay.
In addition to reviewing the Health Plan changes, Johnston also presented an overview of three construction projects currently occurring at the Tribal Health & Wellness Center.
The dental wing expansion, which is doubling in size, will be completed in April and cost $799,568. The Wellness Department addition, which will allow the Community Health program to work in conjunction with the clinical side, is costing $625,000. The remodel of the Health & Wellness Center’s interior, which will double the size of the pharmacy and install new Native-themed carpeting, will cost $821,875.
“I think you will all be happy with the changes in your clinic,” he said.
Johnston said more than $2 million of the construction costs comes from various federal grants and only $242,254 is Tribally funded.
“That’s nearly $10 in federal funds to every $1 in Tribal funds,” he said. “We’re getting a lot of bang for the buck here.”
Johnston said he expects the Health & Wellness Center to be self-sufficient by 2011 and not require any Tribal funding beyond funds that go into the Tribal member health plan.
Tribal Elder Bernadine Shriver asked why the Tribe recently sent out letters inquiring if Tribal members were covered by other health insurance.
Johnston said it is an effort by the Tribe to ensure that the Tribal member health plan is the secondary payer, which will save Tribal dollars.
“The goal is to be efficient and use those resources of the first plan, as they are designed to be,” Johnston said. “We’re gently trying to get back to being the secondary payer and save Tribal dollars.”
Tribal Elder Robert Nagel asked if sleep disorder services will ever be offered at the Tribal clinic.
Lecatsas said that the Tribe has executed a contract with Dr. Craig Winkler of McMinnville and that after construction is finished at the center, sleep disorder services will be offered in Grand Ronde.
In other action:
• The next General Council meeting will be held 10 a.m. Sunday, March 7, at the Tribal gymnasium in Grand Ronde, and be followed by the second community meeting.
• Tribal Elders Terry Boerckel and Gladys Hobbs and Tribal member Stephanie Wood won $50 Safeway gift certificates and Tribal Elder Ruby Bigoni won a $100 Safeway gift certificate.
• Grand Ronde Tribal Housing Authority Executive Director Carina Kistler distributed energy savings packets to Tribal members as part of the Tribal Energy Efficiency Program Through Education and Innovation.

Photo by Dean Rhodes

SIDEBAR TO COUNCIL

Community meetings begin in Clackamas

By Dean Rhodes
Smoke Signals editor

The Tribe’s annual process of soliciting membership input through community meetings began Sunday, Feb. 7, at the Monarch Hotel in Clackamas following the regularly scheduled 10 a.m. General Council meeting.
Tribal Planning and Grants Development Manager Kim Rogers said the community meetings are designed to aid Tribal strategic planning, as well as meet grant program requirements.
This year’s community meetings concentrate on community and economic development, Spirit Mountain Casino and the Tribal health plan.
After Rogers and Spirit Mountain Casino Executive Director Rodney Ferguson made presentations on community and economic development and the casino, respectively, the approximately 12 Tribal members who remained on a Super Bowl Sunday afternoon split into groups to discuss each topic individually.
Tribal member comments regarding community and economic development included suggestions to list properties owned by the Tribe so members know about them, use the Portland area office for vocational rehabilitation training and rent out Tribal properties to other Indian organizations.
Health plan suggestions included more attention be placed on prevention than “Band-Aid” approaches after someone gets sick.
Comments regarding the casino included more training and education for Tribal member employees, such as a leadership program, as well as a concern that Tribal member employees do not follow the chain of command in resolving issues, instead opting to go directly to Tribal Council with their work-related complaints.

Upcoming community meetings will be held:

• Following the General Council meeting on Sunday, March 7, in the Tribal gymnasium in Grand Ronde.
• 12:30 p.m. Sunday, March 28, at the La Quinta Inn & Suites in Tacoma, Wash.
• Following the General Council meeting on Sunday, April 11, at the Holiday Inn in Eugene, Ore.
• At noon Sunday, April 25, at the Red Lion Inn in Yakima, Wash.
• And at noon Sunday, May 23, at the Riverhouse Inn in Bend, Ore.
  For more information on the community meetings, contact Rogers at kim.rogers@grandronde.org or 503-503-879-2250.