Wednesday, February 21, 2018

Federal diabetes program for Indians is saving lives in Cherokee Nation


The recent federal budget extension includes funding for the reauthorization of the Special Diabetes Program for Indians. This is significant for the Cherokee Nation and all of Indian Country. The budget for SDPI has been renewed at the current funding level of $150 million until the end of FY 2019.

Sadly, one in four Cherokees over age 50, and one in three over age 60, has diabetes. But through the federal investment in SDPI, Cherokee Nation has received the resources needed to address our disproportionate burden of diabetes. SDPI is a lifesaving program and continues to play a significant role in improving health care quality and access for Cherokee families.

Established in 1997, SDPI currently supports more than 300 diabetes programs in 35 states that have led to significant advances in diabetes education, prevention and treatment. Last year, more than 10,000 diabetes patients in the Cherokee Nation Tribal Jurisdictional Service Area benefited from SDPI.

SDPI funds have been utilized to support nearly 30 schools and Cherokee community organizations in increasing physical activity levels and healthy nutrition for schoolchildren and community members.  It’s critical we begin the education process with our youngest citizens to ensure they grow up eating healthy and getting plenty of physical activity.

Cherokee Nation’s program, one of our most successful public health programs, targets Type 2 diabetes through collaborations with coalitions that include the state, municipalities and communities to implement programs such as Farm-to-School efforts to reduce diabetes risk factors. We have served 527 participants with prediabetes education and activities, which resulted in a loss of 4,478 pounds and an average weight loss of 8.5 pounds per Cherokee Nation participant.

Recently, the Centers for Disease Control and Prevention published data that shows some diabetes rates are improving for tribal citizens. Native people have experienced a 54 percent decline in rates of end-stage renal disease due to diabetes, which represents the steepest decline of any ethnic group. These kinds of improvements have resulted in significantly more patients with controlled blood sugar, blood pressure and cholesterol. These health indicators are associated with the reduction of diabetic complications, including heart attack, strokes, blindness, amputations and kidney failure.

Simply put, SDPI is saving lives in Cherokee Nation, transforming communities and saving our federal health care system dollars. We are pleased congressional leaders did the right thing and continued its funding.

Friday, February 9, 2018

Efforts in health care financial management equate to more services, more assistance for Cherokees


Cherokee Nation Health Services offers our citizens some of the best care available in Indian Country. Folks in northeast Oklahoma know this, but recently we changed a few things that are creating more and better health services for Cherokee families. I am proud to say we are reaping the benefits of those efforts.

When someone comes to a Cherokee Nation health center and needs something that our own clinics do not provide, like a knee replacement for example, we send them to a specialist who is outside our network of Cherokee Nation doctors and health care providers. Under that system, we negotiate with insurance companies, hospitals, doctors and other vendors and pay for those services.  When patients have a primary insurance, Medicare Part A and Part B, or Medicaid we are able to spend significantly less on the required service and then spend those dollars on other patients.

In our recent history, the growth of referrals for care like this have been dramatic. In 2004, our system averaged 87 of these referrals per day. In 2017, those referrals had grown to an average of 410 per day. Because of this growth in needed referrals, our programs have had to manage their available resources. Some of the services that were being declined over the past year include elective orthopedics and some of the related diagnostic tests to those procedures.

To help address some of the recent limitations we had on issuing referrals for outside costly, nonlife-threatening treatments, we changed our records system, moving all patient health and medical records to a digital format. When a patient comes in, our newly installed software communicates with all payment systems, including IHS, private insurance companies, Medicare and Medicaid.

The new efficiency has helped enable the tribe to collect almost $9.5 million in the first three months of FY2018 in third-party billing. Those additional funds will translate to more contract health dollars to approve referrals for surgeries, MRIs and other related tests and help cover a portion of more elective orthopedic referrals for our patients, who visited Cherokee Nation Health Services more than 1.2 million times last year.

It also allowed us to measure quality outcomes and efficiency, so doctors can earn more incentives when patients are treated and get what they need. The strategic changes in the physician salary structure reward our doctors for the quality and quantity of patients they see. Quality is up across the board at Cherokee Nation Health Services, and we have more funds dedicated to contract health needs.

I am proud of the strategic efforts we made to modernize our health system and collect more from private insurance, Medicaid and other third-party billing streams. The increase in collections also comes from our successful outreach to sign up more patients for Affordable Care Act marketplace insurance, SoonerCare and Medicare. These aggressive efforts to enroll more Cherokee Nation Health Services patients have been successful and are helping provide better health care services for our people.

Our patients have more health needs than we could ever possibly meet, so we are evolving with the times. There is constant growth in health care, especially as the “baby boomer” generation matures and needs more and more care. We want all our patients—Cherokees as well as other Natives in northeast Oklahoma—to live healthier lives. To address these growing challenges, we have been resolute in committing more gaming revenue dollars specifically for contract health services, which now is an annual commitment of about $7 million.

We feel that these changes will set Cherokee health on a path for unprecedented financial security and open up more dollars for specialty care, including visits to cancer doctors and heart doctors and a return to covering a range of bone and joint surgeries.

Soon we will open the largest tribal health care facility ever built in America. A topping out ceremony is planned on March 9, and in 2019, when the facility (located at the W.W. Hastings campus in Tahlequah) is opened, it will house more health care specialists of our own and have two MRI machines. Currently, Cherokee Nation does not have either of those specialty services in-house, and we use contract health dollars to help pay for citizens needing those medical services.

Patients can get more information about additional coverage options by contacting their patient benefits coordinator at any Cherokee Nation Health facility or visiting www.CherokeeCare.com.

Monday, February 5, 2018

Cherokee Nation seed bank preserves Cherokee food history


Preservation of Cherokee heritage comes in a wide array of forms. We have Cherokee Nation preservationists in areas like language, which is spoken and written. We have song and dance traditionalists, and we have master artisans devoted to traditional Cherokee arts like carving, pottery and basket weaving. However, during my tenure as Principal Chief, one of the most popular and highly participatory efforts has been food preservation through the Cherokee Nation seed bank program.

Our effort, led by Senior Director of Environmental Resources Pat Gwin, is something that just about any Cherokee nationwide can do and enjoy with their family. For Cherokee Nation citizens, it is a way to perpetuate crops that Cherokee people have relied on for generations.


Despite a difficult growing season in 2017, Cherokee Nation’s seed bank will offer an assortment of seeds this year. In 2017, we issued about 3,785 seed packages to tribal citizens and estimate to do about 5,000 this year. Requests for heirloom seeds will run through the end of April.


The heirloom seeds possess traits that any grower desires, including being drought and pest resistant and having low fertilization needs. The seed bank, which originally started in 2006, has a supply stock that is healthy, strong and unique to the Cherokee people.


Historically, our people have always been exceptional agriculturalists, and our ancestors farmed these same crops for hundreds of years. It connects who we are today as Cherokee people to our rich history, is something we can share with our kids and grandkids, and promotes healthy food consumption and physical activity. Anything we can do to encourage a new generation of Cherokees to connect with their tribal heritage is worth pursuing.


Applicants are limited to two varieties of seeds, and each request must include a copy the Cherokee Nation tribal citizenship card, as well as proof of age and address.


To submit an order, visit https://secure.cherokee.org/seedbank and create an account. Follow the instructions to see a complete list of available seeds and to place and track orders. For more information, email seedbank@cherokee.org or call 918-453-5336.


The seeds that are available this year include:

Corn

Cherokee Flour (a large flour corn)

Colored (multicolored)

White

Yellow

Cherokee White Eagle (a dent corn)

Beans

Cherokee Long Greasy

Trail of Tears (a small jet black bean)

Turkey Gizzard Black

Turkey Gizzard Brown

Squash

Georgia Candy Roaster (a long storing squash that can be prepared as squash, sweet potatoes or pumpkin)

Gourds

Basket

Dipper

Jewel

Buffalo Gourds

Trail of Tears Beads

Indian Corn Beads

 Tobacco

           Native Tobacco (ceremonial tobacco, not smoking tobacco; restricted to those at least 18 years of age)

 Native Plants

           Buttonbush

Cutleaf Coneflower

Hearts-a-bustin

Jewelweed

New Jersey Tea

Possum Grape

Purple Coneflower

Rattlesnake Master

Rivercane

Sunchoke

Wild Senna