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Tribal Health proposes new policies for travel, controlled substances

ST. IGNATIUS — During Aug. 27 - 30, 2018, Tribal Health will host a series of public hearings and comment opportunities regarding the 1) Medically Related Recipient Travel Program Policy and  2) Controlled Substance Utilization and Dispensing Limitation Policy.  

“Currently there is a practice, but not a policy, in place regarding medically related travel assistance, in addition to a focus on controlled substance use and dispensing,” said Teresa Wall-McDonald, Tribal Health Department Head. “Tribal Health is using the Tribal Administrative Process Ordinance to allow the Tribal Membership to have a voice and participate in shaping these policies for the future. It is why Tribal Health is holding hearings across the entire reservation. We hope that people who are interested will engage and participate in a meaningful way.”

Overview:  Proposed Medically Related Recipient Travel Program Policy

Tribal Health of the CSKT manages health care delivery to eligible TH recipients. Health care delivery includes providing health care in established health care centers and paying for purchased care from private providers, through Tribal Health Paid Care, if the recipient is deemed eligible. 

Federal Indian Health Service budget levels are limited to a fraction of the actual medical need. Therefore, travel dollars taken from the health care budget impact the provision of health care and are not intended to cover all of the costs associated with medically related travel. A policy is proposed for public comment to include criteria (such as one room per family per intensive care unit (ICU) incident; one meal ticket per family with meal rates at the Medicaid rate) and processes for authorization of medically related escort travel costs. 

With the proposed policy, assistance will be limited to THPC eligible recipients and family members. Families will be asked to identify one family member as the representative of the family to receive assistance. One room will be made available in the case of Kalispell and Missoula ICU related assistance. The CSKT have direct bill rooms that will be utilized. 

Meal assistance and privately owned vehicle assistance will be limited to the Medicaid rate/s. No airline travel will be considered as part of this policy. 

In the event of scheduled medical procedures, if an escort is medically necessary for the safe transport of an elder or a child, medical travel assistance can be requested. The opinion of the medical provider will be sought as to the medical necessity for an escort.  

Recipients needing an escort may be asked to use a “near-by” medical provider if the procedure that is being done is one that is universally available.    

Tribal Health medical ICU and medical travel assistance is not intended to cover 100 percent of the costs that a family may incur. Rather, it is intended to provide limited support to families who have a primary support person in times of medical need.    

Tribal Health is proposing to purchase DHRD bus tickets for eligible THPC recipients for reoccurring local medical travel to non-TH medical providers, provided the recipient is ambulatory.  

Medically fragile recipients will still be transported by THas much as possible. DHRD and TH are working on a plan to improve dialysis transports with a new vehicle.

Overview:  Proposed Controlled Substance Utilization and Dispensing Limitation Policy

Tribal Health Pharmacies of the CSKT have noted increased utilization and a significant disparity in the quantities of specific medications dispensed over the past several years. One of the offending drug classes are opiate medications, specifically those containing hydrocodone in which the prescriptions often meet or exceed quantity limits set by suppliers. 

Pharmacists and medical clinicians also have access to the Montana Prescription Drug Registry online, which provides information regarding prescriptions filled at any pharmacy in Montana and includes the name of the medication, date filled, quantity dispensed and the prescriber’s name. This information allows clinicians to identify individuals obtaining prescriptions from multiple clinicians and pharmacies. 

Tribal Health has significant concerns in regard to increasing prescription drug abuse, rates of death secondary to opiate overdose and prevalence of infants born with neonatal abstinence syndrome within our communities. In regard to these public health concerns about opiates and in accordance with fiscal responsibility, our TH pharmacies will benefit from a policy that guides pharmacists, pharmacy technicians, and other medical staff on the best course of action for addressing prescribing practices and dispensing high utilization medications.

Copies of the proposed policies, comment forms, and information about the public hearings, can be found online at: www.cskthealth.org under the “Events” tab.  Hard copies can also be picked up at each of the Tribal Health Centers, in addition to CSKT Administration. Interested members of the public are encouraged to participate and comment on the proposed policies during the hearing. 

How to Comment

Comment forms can be downloaded online at: www.cskthealth.org under the “Events” tab, or picked up hardcopy, at each of the Tribal Health Centers, or at CSKT Administration. Members of the public who would like to comment at a hearing are asked to call Yvonne Conko at Tribal Health, 406-745-3525, no later than three days prior to each hearing, to be placed on a scheduled list of commenters during each hearing. 

All public comments will be provided to the CSKT Tribal Council for review and consideration prior to policy adoption. Additionally, Tribal Health staff, including Medicaid and Veterans Affairs specialists will be on hand to answer questions at each hearing. Public hearing oral comment time is limited to 5 minutes. The deadline for written comment is Sept. 14. Written comment submissions may be emailed to: info@cskthealth.org or delivered to: St. Ignatius Health Center - 35401 Mission Drive (physical)/PO Box 880 (mailing), Attn. Yvonne Conko; or Confederated Salish & Kootenai Tribes - 42487 Complex Blvd. (physical)/ PO Box 278 (mailing), Attn. Donna Durglo.

The proposed effective date for the policies is fall of 2018.

Tribal Health Policy Hearings 

Hot Springs

Monday, Aug. 27, 

Hot Springs Senior Center - 101 Main St. #1  

1-2 p.m. — Medical Travel Policy

2-3 p.m. — Controlled Substance Policy

Light refreshments served.

Arlee

Monday, Aug. 27

Arlee Community Center, Pow Wow Road

6-7 p.m. — Medical Travel Policy

7-8 p.m. — Controlled Substance Policy

Light refreshments served.

St. Ignatius

Tuesday, Aug. 28

St. Ignatius Community Center, 332 Mountain View Dr.

1-2 p.m. — Medical Travel Policy

2-3 p.m. — Controlled Substance Policy

Light refreshments served.

Dixon/Charlo

Tuesday, Aug. 28

Dixon School Community Building, 411 B. St.

6-7 p.m. — Medical Travel Policy

7-8 p.m. — Controlled Substance Policy

Light refreshments served.

Pablo

Wednesday, Aug. 29

CSKT Council Chambers, 42487 Complex Blvd.

1-2 p.m. — Medical Travel Policy

2-3 p.m. — Controlled Substance Policy

Light refreshments served.

Ronan

Wednesday, Aug. 29

Marvin Camel Building/Ronan Senior Center, 35806 Terrace Lake Rd.

6-7 p.m. — Medical Travel Policy

7-8 p.m. — Controlled Substance Policy

Light refreshments served.

Polson

Thursday, Aug.30 

Polson Tribal Health Center, 3rd Floor, #5 Fourth Ave. E

1-2 p.m. — Medical Travel Policy

2-3 p.m. — Controlled Substance Policy

Light refreshments served.

Elmo

Thursday, Aug. 30

Elmo Health Center, 33116 Hwy. 93 N

6-7 p.m. — Medical Travel Policy

7-8 p.m. — Controlled Substance Policy

Light refreshments served.

 

 

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