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AATCHB Executive Director’s Report Consumer Conference

AATCHB Executive Director’s Report Consumer Conference “Mind and Body: Putting a Price Tag on Good Health” Rushmore Holiday Inn Rapid City, South Dakota October 25, 26, 27, 2005. Presented by: Carole Anne Heart, Executive Director Aberdeen Area Tribal Chairmen’s Health Board

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AATCHB Executive Director’s Report Consumer Conference

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  1. AATCHB Executive Director’s Report Consumer Conference “Mind and Body: Putting a Price Tag on Good Health” Rushmore Holiday Inn Rapid City, South Dakota October 25, 26, 27, 2005 Presented by: Carole Anne Heart, Executive Director Aberdeen Area Tribal Chairmen’s Health Board 1770 Rand Road Rapid City, South Dakota www.aatchb.org

  2. The High Cost of Being Healthy • “Medical costs are a growing burden for middle income families with children, as well as for the working class, people with chronic illnesses, and the uninsured. Many who cannot pay, skimp on health care, go without prescription drugs or simply ignore their bills. According to the Kaiser Foundation Study: • More than one in five American currently have an • overdue medical bill. • Nearly two our of 10 say health care costs are their • biggest monthly expense after rent or mortgage • payments. • Almost three out of 10 estimate they paid $1000 or • more for health care in the past year on top of premiums. • Kaiser/Harvard/USA Today

  3. Change This . . . Mission Accomplished! • In 1994-1996 the causes of death for Indians were • considerably higher than those for the U.S. all races • as shown in the following: • Alcoholism – 627 percent higher • Tuberculosis – 533 percent greater • Diabetes Mellitus – 249 percent greater • Accidents – 204 percent higher • Suicide – 47 percent higher • Pneumonia/flu – 71 percent higher • Homicide – 63 percent higher • Infant mortality – 3x higher

  4. Programs of the AATCHB: 1. Northern Plains Healthy Start (NPHS) 2. Northern Plains Tribal Epidemiology Center (NPTEC) a. STD/HIV Prevention Program b. MCH Program c. Academic Liaison d. Injury Prevention Initiative 3. Tribal Tobacco Program 4. SIDS/FAS Prevention Program 5. Information Technology

  5. Funded NARCH: 1. Streptococcus mutans Dental Caries among AI Children, David Drake, U of Iowa 2. Predicting Insulin Resistance in AI Youth Dr. Jennifer Larsen, UNMC, (2 Sections not funded) Tobacco: Smoke free homes Project Export Suicide Conference Awaiting Word SIDS /FAS to Bush Found NPHS grant to HRSA Grants :

  6. AATCHB Executive Committee: • Duly elected at Quarterly Board Meeting, March 29, 2005, held at Marina Inn, South Sioux City, Nebraska • Chairman of Board:John BlackHawk, Chairman • of Winnebago Tribe of Nebraska • Vice-Chairman:Roger Trudell, Chairman, • Santee Sioux Tribe of Nebraska • Secretary:Cynthia LaCounte, Chairwoman, • Trenton Service Unit (Vacant) • Treasurer:Cecelia FireThunder, President, • Oglala Sioux Tribe • At Large Member: Charlie Colombe, Chairman, • Rosebud Sioux Tribe,

  7. Reorganization of AATCHB:

  8. New Staff: • Marie Lange: Receptionist (Oglala) • Ahmed Ahmed: Cancer Director • Leah Frerichs: Research Associate for Cancer • Kin Chit: Cancer Epidemiologist • Paulette High Elk: MDM Community Liaison (CRST) • Announcements – Staff Changes • Jacqueline LeftHandBull – Administrative Officer New • Teresa Chief Eagle Bernie – NPHS Acting Director • Collette Keith – Public Relations Director pending • Austin Keith – Mental Health Consultant temporary • Matthew Town – STD Coordinator

  9. Financial stability of AATCHB, thus far, Is supported by “soft money” federal funding and private grants. Our first and foremost task to keep AATCHB functioning is to constantly seek new, innovative, permanent funding for AATCHB and to maintain stability and continuity (which we have been able to do for the past 5 years) In order for AATCHB to survive as a viable, credible, reliable Indian organization responding to the critical health needs of Aberdeen Area Tribes we must have strong partnerships with entities that can work with us.

  10. Mission of AATCHB: • Improve the effectiveness of the Board through • responsible participation of Indian people in • making decisions about their health services in • order to improve their health status. • To assist the Indian Health Service in • establishing program priorities and distributing • existing resources. • To advise and assist the Director, AAIHS • in developing long-range program plans.

  11. Mission Continued: • To represent the Indian interests and desires at • all levels for health related programs. • To assist in development of Indian responsibility • for community activities affecting health. • To assist member tribes in the development of • health programs that will be beneficial to Tribes.

  12. Mission continued: • To represent the organization and member • Tribes in the Congress of US, at any hearings • and at national organization meetings on • health issues and care. • To establish participation in any meetings that • will provide clear and concise information to • Tribes.

  13. Activities Performed by AATCHB: • Advocacy • Policy Analysis • Legislative Updates • Information dissemination • Networking for Tribes, with Tribes • Monitoring Legislative process • Creating congressional support • Increasing Funding Base for Operations

  14. New Initiatives: • Administrative Officer (completed) • Media/Public Relations (partially completed) • Grant Writer (still advertised) • Others: • Grant Writing Institute • Tele-Health • Behavioral Health Initiative • Capital Investment in Building • Advocacy Initiative

  15. Meetings, Conferences, Initiatives, Jan 2005 1. DST Planning Committee, Rockville 2. Review of Personnel Polices and Procedures 3. OST Tribal Health Planning Meeting Statewide Planning Mtg for Alcohol Services 4. National Epi Mtg – Albq 5. TeleHealth Conference Call 6. Tribal Consultation Mtg Rapid 7. Combined Executive Committee, RC 8. ATSDR Conference Call on Black Mold DST Conference Call 1-22 9. Unintentional Injuries Grant due, 1-24 Mtg at Senator Johnson’s Ofc on SIDS Earmark

  16. February 2005 1. Mtg OST Health Programs Planning (2-1) 2. Environmental Issues Conf Call (2-18), BHSC Mtg 3. DST Planning Meeting Albq (2-7 to 2-9) 4. DST Conf Call (2-11), Meeting with USD Medicine 5. Bush Grant due (2-14) 6 “Barriers” Conf Call (2-17) 7. Global Health Conf Seattle (2-18 to 20) 8. DST Conf Call (2-18) 9. SLRP Exec Com Mtg, Deadwood (2-23 to 2-24) 10. Women’s Health Conf Call (2-25) 11. NCAI, Wash DC, (2-27 to 2-28) March 2005 1. Meet with USD on partnership ideas 2. DSt Conf Call (3-11) 3. DST Planning Mtg, Albq (2-16 to 2-19) 4. Quarterly Board Meeting, Sioux City, (3-22 to 3-24) 5. AALC, Sioux Falls (3-28 to 31)

  17. March 2005 1.NCAI, DC, (2-27 to 3-2) OEHE Mtg, Rushmore Plaza, HI, (3-1 to 2) 2.CDC Environmental Health Conf Call (3-8) 3. Meet with USD on partnership ideas, RC, (3-9 to 10) 638 Grant Review, SF (3-8 to 9) 4. DST Conf Call (3-11) 5. DST Planning Mtg, Albq (2-16 to 2-19) Rapid City Regional Luncheon, Ofc, (3-17) 6. Quarterly Board Meeting, Sioux City, (3-22 to 3-24) (Elections of Officers) 7. AALC, Sioux Falls (3-28 to 31)

  18. April 2005 1. NA Calling Radio Program, DST Conf 2. Speak at Wakpala School 3. UND Center for Rural Health Conf, (3-7) Gov Rounds Health Summit, Tinka Duran 4. IHS Budget Formulation Meeting, DC (3-13 to 14) MT/WY Tribal leaders Conf, Billings, Neva (4-12 to 14) 5. NE Dpt Health, NPTEC Staff (3-15) 6 Kota Noon Show: Breastfeeding (4-18) 7. AATADA Conf, Spearfish, (3-20) Speak to PA at USD “Cultural Competency” (4-19) 8. DST 2nd Annual Conf, Albq, (3-25 to 3-28) LIFP, RWJ Site Visit (4-22) AAIHS Wellness Conf, RC Bush Foundation site Visit, (4-28) 9. IHS Research Conference, Seattle, NPTEC (4-29-30)

  19. May 2005 1. Speak for DST At TSGConf in San Diego, (5-2 to 5-3) IRB Training I, NPTEC, Rapid City 2. Speak at Minneapolis Health Start, (5-5) 3. Health Marketing Grant Meeting (5-10) 4. Wokunze Mtg, Pierre, (5-13) 5. KOTA Noon Show: Infant Mortality (5-16) 6. DHHS Budget Consultation, DC (5-17 to 5-18) 1st Annual NP Tribal Tobacco Conference, RC, 5-18 to 19) 7.Executive Committee Conf Call (5-23) 8. OST-HHS Health Assessment, Spearfish, (5-24) IHS Epi Site Visit, (5-24) 10. NPTEC Hosts Epi Meeting, (5-25-26) “Barriers” Conference Call 11. DST Conf Call (5-27), OST Conf Call

  20. June 2005 1. 1st Annual “Embracing Wellness Conf”, RC, 6-1 to 2) LIFP Conference Call IHS TTAG Workshop 2. Speak Tribal Juvenile Justice Wkshop, Eve, (6-7) Tribal Marketing Grant Meeting 3. Phoenix Area IHS Conf, Las Vegas, DST (6-10) 4. Health Marketing Grant, Chamberlain (6-14) 5. Meeting with Attorney Contracting Initiative (6-15) 6. IRB II Training, Ft. Yates, 6-16 to 17) 7. Speak at Public Health Video Conf, Chapel Hill, NC, 6-20-21) 8. Navajo Nation Planning Session (6-22) 9. Speak at SD Public Health Conf, Pierre (6-22) 10. Meet with ASU School Public Health (6-24) 11. IHSBehavioral Health Conf, San Diego (6-27-20) 12. AAIHS Meth Conf, Sioux Falls, (

  21. July 2005 1. Attended NIHB Conference, Rapid City (July 6-8) 2. IRB Training III, Rapid City (July 12) 3. Marketing the Healthcast, Vermillion (July 14) 4. Took Two Day Vacation* (July 15-18) 5. Job Interviews for Adm Officer 6. Meeting with Dr. Garry on Suicides, Ofc (July 20) 7. Tribal Consultation Policy, Prairie Knights (July 21) 8. Meet @ KAT Productions on grant (July 22) 9. AALC Meeting, Fargo ND (July 26-28) August 2005 1. Partner Services Training, Prairie Knights (Aug 2-3) 2. Combined Executive Committee Mtg, RamKota (Aug 2-3) 3. Alternative Medicine Mtg (cancelled) (Aug 4-5)

  22. August 2005 (continued) 4.OHP Staff Meeting-Conf Call, (Aug 8) 5. Upper Plains Summer Institute, SFalls, (Aug 9) 6. Youth Tobacco Conference, Pierre (Aug 12-13) 7. Native American Advisory Council, Ft. Thompson (Aug 12) 8. Suicide Mtg Front Porch Coalition, Rapid City (Aug 17) 9. Senator Johnson Visits AATCHB Offices (Aug 18) 10. Mt-Wy Tribal Leaders Meeting (cancelled due to above) 11. Meth Summit, Rep. Stephanie Herseth, Rapid (Aug 22) 12. OST Inservice, Spearfish (Aug 24) 13. Interviews for AO, (Aug 24) 14. Reschedule “Environmental Contaminant Conference) originally set for Aug 25-26 15. CDC Conference Call (Aug 30) 16. Meeting with Ketel Thorstenson (Aug 31)

  23. September 2005 1. Strategic Long Range Planning Session, Revenue Generation Workgroup, Pierre, SD (Sept 1-2) 2. Suicide Conference Conf Call (Sept 6) 3. AO Job Interviews, (Sept 7) 4. LifeSavers Conference, Bismarck, ND (Sept 8) 5. LIFP Conference Call (Sept 12) 6. NARCH IV application due, (Sept 14) 7. Tribal Advisory Group Data Mtg, Ft. Thompson (Sept 20) 8. AO Job Interviews (Sept 21) 9. Grant Writer Interviews (Sept 22) 10. Women’s Health Summit, SFalls, (Aug 23) 11. 2007 Budget Evaluation Workgroup, DC (Sept 27-28) 12. Grant Writer Interviews (Sept 30)

  24. Executive Director Serving on Committees: • DST Co-Chair • IHS Budget Formulation 2007 Co-Chair • Center Rural Health Advisory Board • 4 State FAS Advisory Board • SDSU Wokunze Project Advisory Board • NIHB Alternate • National Womens Health Cultural Competency • Advisory Committee • TTAG Alternate • AI/AN Barriers to Accessing DHHS Programs Team • Revenue Generation Co-Chair

  25. Chairmen Assignments to National Committees Committee Rep Alternate Restructuring Greg Bourland Skip Longie DONE Diabetes John Blackhawk Lorelei DeCora NIHB J Blackhawk CAHeart Budget Form Roger Trudell CAHeart Facilities JC Crawford Ron Valandra Level NF Skip Longie CAHeart DONE Consultation John BlackHawk CAHeart Human Services Cynthia LaCounte TTAG/MM John Blackhawk CAHeart DST John Blackhawk CAHeart

  26. Barriers to Health Care in Aberdeen Area • Trust responsibility functions have not kept pace with the demands of a growing population, inflation or disease burden. • Treaty obligations have been diluted • Rural isolation, poverty and cultural differences • AA tribes are predominantly non-self governance • Facilities, healthcare professionals and specialized care is not on same level as facilities off reservation. • States and Federal agencies are not well informed about the role of tribal sovereignty and fail to network or partner adequately.

  27. Barriers to Health Care in Aberdeen Area • Lack of communication • Development of a Strategic Plan • Weak tribal/intertribal infrastructure • Weak economic base • Lack of adequate health care providers • Lack of means to access existing care • Large % of people living in poverty • Failure to honor culture which provides • resiliency • Little prevention education

  28. The Contributing Factors to Health Disparities: • health status of patients/personal responsibility • patient beliefs • language problems and lack of understanding culture • health care access • lack of adequate human and financial resources • lack of treatment options • stereotyping • provider biases • patient-physician relationship • healthcare delivery system

  29. “For AI/AN people, the federal responsibility to provide health services represents a “pre- paid”entitlement, paid for by the cession of over 400 million acres of land to the U.S. In many of the treaties negotiated between Tribes and US, specific provisions for basic healthcare, such as the services of a physician and the construction and maintenance of hospitals and schools were included.” Sally Smith, before the Senate Select Committee on Indian Affairs

  30. Recommendations • Raise the standard in upholding treaty obligations for health care of American Indians • Assist in strengthening infrastructure of Tribes • Re-evaluate effectiveness of programs, critical care, ambulance services, swing beds, long term care and traditional health • Work to build tribal infrastructures • Educate each SU, all staff, patients and Tribes through extensive education and outreach to to enroll in Medicare/Medicaid. • Require states to work as partners with Tribes

  31. How is AATCHB responding? • Creating a stable, credible organization • Establishing a Strategic Long Range Plan • Creation of the Northern Plains Tribal Epi • ~ NARCH, MCH, Academic Liaison, Injury Prevention, others • Supporting Tribes through NPHS • ~SIDS/FAS Prevention Video • ~ Rites of Passage Program • ~ Breastfeeding Conference • Finding Partners • Sponsoring Conference/Seminars • ~ First Cancer Conference • ~ IRB Trainings (3) • ~ Grant Writing Workshops • ~ First Ever Tobacco Training • ~ First Asthma Conference (July)

  32. CIRCLE OF HEALTH HEALTH DIRECTORS PHS NURSES NPHS SOCIAL SERVICES ALCOHOL AATCHB EMS CHR MENTAL HEALTH

  33. COMMUNITY ORIENTED HEALTH POLICY PREVENTION RESEARCH HEALTH PROGRAMS CLINICAL SERVICES ORGANIZATIONAL CAPACITY WORKFORCE CAPACITY & COMPETENCY INFORMATION & DATA SYSTEMS

  34. “Sadly, our national honor has been repeatedly blemished by our failure to Live up to our word and to extend a fragment of the human respect that first greeted visitors to these shores. The Tribal structures have, however, survived, and sovereignty, in a real, although diminished form, has continually been acknowledged by the courts. Such sovereignty must be encouraged; for it is by the strengthening of tribal bonds and culture that not only Indian people will be served, but our national honor as well.” Larry B. Levanthal, Quare, University of Minnesota Law School, 1977

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