LittleTraverseBaybandsofOdawaIndians1260AjijaakAve.Petoskey,MI49770

2017MinaMskikiGumikAnnualReport

LITTLETRAVERSEBAYBANDSOFODAWAINDIANSHealthDepartment

MISSIONSTATEMENT

ItistheresponsibilityofHealthAdministrationforoverallplanning,development,implementationandmanagementoftheservicesprovidedbytheLTBBHealthDepartment.Todevelopexpandservicesfordirectmedicalcare,preventativemedicine,communityhealth,includedinIndianHealthServices(I.H.S.)638Contractandallotherhealthgrantsandcontracts.Toplanandorganizeactivitiesrelatedtoclinicalservicestoensurepatientneedsaremetinaccordancewithmedicalstandardsandhealthcareadministrativestandards.Todeveloppartnershipsandcoordinateactivitieswithotherhealthserviceagenciestoincreaseservicesandextendprogramdollars.TodevelopprogramsandaccessresourcestoincorporatewellnessanddiseasepreventionactivitiesforLTBBTribalMembers.Tomaintainbudgetbasedonappropriateworkloadandanticipatedrevenues.AscloselyaspossiblewithoutjeopardizingtheHealthServicesthataredelivered.Tomonitorandcontrolhealthdepartmentcoststomaintainexpenditureswithinallocationsandbudget.Todevelop,implement,andevaluatemethodstoensureeffectiveandefficientuseofstaff,facilities,equipment,andotherresourceswhilemaintainingprogramstandards.

InDecemberwefilledprescriptionsfor583patientsandatotalof2012prescriptionsdispensed.Thisnumberisslightlyaheadofourinitialestimates.Nowprescriptionsthatarecalledinaheadoftimeorsenttouselectronicallyfromyourdoctor’sofficeareusuallyfilledandwaitingforyouwhenyouarrive.Waittimesforwalk‐insarenormallylessthanfiveminutes.InadditiontofillingyourprescriptionsweareplanningtoprovideMTMservices(medicationtherapymanagement).Oneofourpharmacistswillreviewyourmedications,medicaldiagnosis,andotherhealthfactorstoensureyourmedicationtherapyisoptimizedandyouwon’thavebadinteractionsamongyourmedications.Withtwopharmacistsonstaffwearenevertoobusytoansweranyquestionsyouhaveaboutyourmedications.Pleasedonothesitatetocallus.LTBBOdawapharmacyphonenumberis231‐242‐1750andisopenedfrom8a.m.to6p.m.MondaythroughFriday.

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OnNovember27thwehiredpharmacistMarkDawsonandpharmacytechnicianMariaSargent.Markcomestouswithover25yearsasthepharmacymanageratthePetoskeyWalgreens.MarkwasbornandraisedinPetoskey.HebringshisdecadesofexperienceinservingthePetoskeycommunitytoourpharmacy.MariaworkedinPurchasedandReferredCareandknowsmostofthepatientsfromherexperiencethere.Sheisenjoyinghernewpositionandweareveryhappyshehasjoinedthepharmacystaff.

TheLTBBPharmacyofficiallyopenedonDecember4,2017!Thingswerehecticthosefirstfewweeks.Everyprescriptionthathadbeenfilledatotherpharmacieshadtobetransferredtoourpharmacy.Thiswasatime‐consumingprocessbuteveryonewasveryunderstanding.Itwasalsoaveryexcitingtimeforbothtribalcitizensandthepharmacystaff.Afterseveralyearsofdiscussionandplanningthepharmacywasnowareality.

Departments

HealthAdministrationHealthDirector–JodyWerner

BusinessOfficeBusinessOfficeManager–ChristinaDuBois

HealthClinicMedicalDirector–Dr.Samuels

DentalClinicDentist‐Manager–Dr.Selden,DMD

BehavioralHealthBehavioralHealthManager–MalcolmWilson,MSW

CommunityHealthCommunityHealthManager–MicheleKeshick,RN

PharmacyChiefPharmacist–TomSandison,RPH

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PHARMACYTheLTBBHealthDepartmenthiredChiefPharmacistTomSandisoninMay2017.Tomcametouswithover10yearsofexperienceoperatinganFQHC(federallyfundedhealthcenter)pharmacy,whichissimilartotheLTBBPharmacy.HewaslookingforanewcareerchallengeandthiswasagreatopportunityforhimandgoodfitforLTBB.Thesummerandfallof2017wasspentfinalizingthelayoutandremodelingofthespaceforthepharmacy,obtainingtherequiredpermits,andallthethingsthatareneededtooperateapharmacy.Thiswasalsowhenthedatawasanalyzedtodetermineapproximatelyhowmanyprescriptionsweshouldexpecttobefillingperday.Itsoonbecameapparentthatthepharmacywouldneedtohireanadditionalpharmacistandpharmacytechnician.

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Laugh,LearnandLiveclassesarehostedonceamonthandaresponsoredbySDPIpreventionandcontrolandhealthyheart.Theseclasseshavebeenverywellattended,averagingabout15people.Thefeedbackhasbeenpositive.Wearealsoincorporatingtheeducationalandactivitythatparticipantshavesuggested.Theseclassesfocusonstressreductionandbuildingasenseofcommunity.Wealsodemonstratehealthyfoodchoicesandprovideanutritionaleducationalcomponenteachclass.ThenutritionalcomponentisledbyourregistereddieticianCarlaGordon.Thisclasshasdecreasedfeelingsofdepressionandsocialisolationinseveralofourpatients.TheaquaticexerciseprogramisofferedSeptember‐June.Thiscontinuestobeasuccessfulprogram.ItistaughtbySheranPaton.ClassesareheldTu/Th@530pmatOdawahotel.ClassesrunSeptemberthroughMay/June(whenschoolisout).Theyarebetween5‐7peopleateachclass.

HEALTHDEPARTMENTFUNDINGTheLittleTraverseBayBandsofOdawaIndians(LTBB)HealthDepartmentismajorlyfundedundera638contractwiththeUSIndianHealthService.Thiscontract(AnnualFundingAgreement)outlinesthecoreservicesthatweprovide,suchasHealthAdministration,HealthClinic,Purchased/ReferredCare,CommunityHealth,DentalandBehavioralHealth.Inaddition,specialprogramsareprovidedthroughgrantsobtainedfromvariousfundingentities,whichallowustoexpandandaugmenttheservicesprovidedbytheLTBBHealthDepartment.ThepharmacystartedinDecember2017.Thedevelopmentphasewasfundedbythirdpartyrevenue,andthepharmacywillbeself‐sustainingongoing.

2017HealthDepartmentBudgetI.H.S.Funding $5,368,00003rdPartyFunding $888,484.00

ATRBudgeted $12,517Total $6,269,001TotalExpenditures $5,515,581.91

Revenue3rdParty $890,100Dental $105,455ATR $96,160TotalRevenue $1,091,715

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Homegrownproject‐Itisamultigenerationalprojectthatissponsoredbycommunityhealth,diabetes,andhealthyheartandhealthadministration.Itisapartofourvisiontohavefoodsovereignty.Thisprogramhasbeenverysuccessful.Wecontinuetoencouragefamiliestoharvestandpreservefoods,aswellas,plantinggardensattheirhomes.CarolKiogimaismonitoringtheharvests.WehavecontractedBergFarmsagain2018.HarvestingwillstillbeonMondayevenings.CarolKiogimawillbemonitoringtheharvestwhichareslatedtobeginattheendofJuly2018.Wewillbehostingfoodpreservationclassesaswell.WatchtheOdawanewsletterforupcomingevents.NativeWayOneandTwoiscurrentlysupportedbythirdpartyfunds.Itisstillourlong‐termgoaltorelocatethegymtoasitethatisnotsoisolated.tribalmember’svolunteersleadmostoftheclasses.Thishelpsusbuildsustainabilityoftheprogramscurrentlyoffered.ReginaBrubacker‐CarveristheYogainstructor.Approximately4‐8regularattendees.YogaisheldatNativeWaythereare4‐8regularattendees.Taekwondoclassescontinuestobesuccessfulwithapproximately15regularparticipants.Youthboxinghasresumedandiscurrentlyrecruiting.WecanlookforwardtoTaichiclassesintheverynearfuture.Thereare145cardholderstoNativeWay.

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HEALTHADMINISTRATIONThebiggestnewsin2017wastheopeningoftheLTBBPharmacy.WithsupportfromtheExecutiveandTribalCouncil,weopenedapharmacyintheHealthDepartmentinDecember2017.ThisisawonderfulserviceforpatientsoftheLTBBClinic.

Therewereseveralconstructionprojectscompletedduring2017.TheBehavioralHealthareawasremodeledtoincreaseofficespaceandaddaconferenceroom;thepharmacyspacewasdesignedandcreated;andanewsewerlinewasdrilledtoresolvethesewageflowissuestothebehavioralhealtharea.Anotherconstructionprojectwastheclosingoftheformerhealthdepartmententranceandopeningthenewentrance,whichbringscarsintothehealthdepartmentthroughanewroadaspartoftheVictoriesSquareretaildevelopmentproject.Staffandpatientsweredisplacedastheseprojectswerecompleted;weappreciatedeveryone’spatienceasweworkedthroughconstruction!

Duetotheconstruction,theLTBBHealthDepartmenthasanewaddress,althoughourlocationhasnotchanged.Ournewmailingaddressis1260AjijaakAvenue,Petoskey,MI49770.

TheHealthDepartmenthasbeenrestructuredtoincludeaBusinessOffice,ledbyBusinessOfficeManagerChristinaDuBois.TheBusinessOfficeoverseestheentirethirdpartyrevenuecycle,aswellasthePurchasedandReferredCareprogram.

TherearefourProjectPeriodObjectives(PPO)‐1)increasingthenumberofpeoplewithimprovedaccesstosmoke‐freeand/ortobacco‐freeenvironments,2)increasethenumberofpeoplewithimprovedaccesstoenvironmentswithhealthyfoodandbeverageoptions,3)increasethenumberofpeoplewithimprovedaccesstophysicalactivityopportunitiesand4)increasethenumberofpeoplewithimprovedopportunitiesforchronicdiseaseprevention,riskreductionormanagementthroughclinicalandcommunitylinkages.ThisisthefourthseasonforOdawegamigohns(tribalfarmersmarket)andwillbegininJune2018.TheresaKeshickhasagreedtobethemarketmanager.OdawegamigohnswillbelocatednearLTBBPowWowgroundsjustoffPleasantView.ColonCancerProject‐BillijoHeadandReginaBrubacker‐Carverareco‐coordinators.Theprimaryfocusofthisgrantistoincreasecoloncancerscreeningsforourpatients.

MTFAC‐MichiganTribalFoodAllianceCollaborativeProjectBilliJoisthecoordinatorofthisgrantaswell.Theprimarygoalofthisprojectistoincreasethenumberofchildrenages3‐11thatarescreenedforBMIandthatarereferredtonutritionalresources(RD).Weworkwithcommunityhealthandtheclinictoaccomplishthisgoal.

BUSINESSOFFICEIn the irst quarter of 2017, theHealth BusinessOf icewas createdwithintheLTBBHealthDepartment.TheIndianHealthServicehashadtheBusinessOf icedivisioninplaceformanyyearsandtribesacrosstheUnited States have created a Business Of ice within their HealthDepartment.TheBusinessOf icecontainsPurchased/ReferredCareandtheHealthDepartmentRevenueCycleTeam,whichconsistsofamedicalcoderandmedicalbillerwhoprocessourprovidervisitsandbillthemtoinsurancewheneverpossible.Unitingthese teamstogetherhasprovenvery bene icial to the LTBB Health Department. The Patient Bene itsSpecialist,CentralRegistrationClerk,andMedicalBillingSpecialistworkclosely together to assure that patient’s health insurance is billedwheneverpossible.Thiscoordinationhasincreasedef iciency,accuracy,andultimatelyrevenuefortheLTBBHealthDepartment.

BusinessOf iceStaff(fromleft):ChrisWemigwase,MarciaSutton,ValorieGlazier,JadeKiogima,SandraDuBois,DawnMcNamara,

ChristinaDuBois,JenniferYuhn.

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DataforPurchasedReferredCare

End of Year Data 2017

Patient Benefits Specialist-

Members Assisted 339

Reference Numbers Issued 12,201

Number of bills paid 6,534

Amount paid to Providers $816,945

Prescription Costs:

340-B Drug Program Amerisource Bergen

$ 154,499

Prescription Services $ 138,507

Rite Aid $ 133,630

TOTAL Prescription Costs: $426,636

Revenue Received from Capture Rx $654,960

Theyprovideeducation,parentingclasses,breastfeedingsupport,transportationtoappointmentsifneeded,aswellas,emotionalsupportandreferralsasneeded.Inaddition,inreturnfortheirattendance,theclientscanreceiveassistancewithdiapers,clothing,breastfeedingsuppliesalongwithotheritemsifaneedisshownandsupportedbythegrant.Cribs,PacNPlays,strollers,highchairsandotheritemsareavailableonasneededbasis.CarolandAshleyarebothcertifiedfromtheNationalChildPassengerSafetyTrainingProgramandareabletodistributecarseatstohelpkeepourchildrensafe.ThecarseatsareobtainedfromaStateGovernmentprogram.BothofthemarealsotrainedintheSCRIPTProgramwhichisaprogramtohelpmother’sdecreaseorquitsmoking.Carolisalsoacertifiedlactationcounselorandcertifiedinperinatalbereavement.HealthyStartandTribalHomeVisitinggrantsworktogethertoimplementtheFamilySpiritCurriculumfromJohnHopkinsUniversity.Thisyeartheywillbehostingseveralfamilyeventswhichwillincludetwofather’sevents.TheREACHJourneytoWellnessGrant–BilliJoHeadcoordinator.ThisgrantisfunneledthroughTribalCouncilofMichigantousandisfundedbytheCentersforDiseaseControlandPreventionandtheDepartmentofHealthandHumanServices.ItwasslatedtoendinSeptember,2017,however,weweregrantedanotheryear.JourneytowellnessisaninitiativetoimprovethehealthandqualityoflifeofNativeAmericansinMichigan.

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TribalHomeVisitingGrantReportProjectYear3of5‐AshleyDominic,familyspiriteducator.ThisprojectisfundedbytheFederalAgencyforChildrenandFamiliesandLTBBisasub‐granteepartneringwiththeInter‐tribalCouncilofMichigan.ThisgrantisanextensionoftheHealthyStartgrant.AshleyandCarolSodmon‐MorrisRNMSNMaternalChildHealthNurseworkcloselytogethertoimplementtheFamilySpiritCurriculum.ProjectDirectorisMicheleKeshick,RNBS.TribalHomeVisitingandHealthyStartareavailabletoanyAmericanIndianchildages0‐5,aswellas,prenatalandpostnatalmoms(dadstoo).Therearenoincomeguidelines.BothprogramsprovideparentingeducationthroughevidencebasedcurriculumcalledFamilySpiritprimarilyonanindividualbasiseitherinthehomeorofficesetting.Breastfeedingispromotedandsupported‐Carolisalactationcouncilor.Incentivessuchasinfantandtoddlerclothing,diapers,transportationandothermaterialsformoms,dad,andbabiesareavailableforparticipationinhomevisits,assessmentsandevents.MaternalChildHealth/HealthyStart‐(year18)Carol‐Sodmon‐MorrisRN.BSN.Fortheyear2017,theyhad115activeclientsinthisprogram,47newoneswereadmittedandatotalof224visitswereconducted.Theprimarygoalofthisprogramistoreduceinfantmortality.

PurchasedandReferredCare(PRC)LTBBPurchasedandReferredCareisafederallyfunded(IHS)programthat helps eligible Tribal Citizens pay for health care services that arereferred from our LTBB Clinic. PRC pays insurance co‐pays anddeductibles,ortheagreeduponreimbursementratesforouruninsuredpatients.InFiscalYear2017,Purchased/ReferredCareexperiencedincreasesinvolumeofreferencenumberrequestsandthenumberofbillspaid.However,wehavebeenabletorealizesignificantsavingsinprescriptioncoststhroughtheCaptureRxprogramthatdirectsinsurancemoniesfrom340Bsalesbacktothetribe.Asthetableshowsabove,CaptureRxrevenueshavemorethancoveredourotherprescriptioncosts.WiththeopeningoftheLTBBPharmacyinthefourthquarter,ourCaptureRxrevenuehasgonedown,howeverourprescriptioncostshavedroppedsignificantly,aspatientsareabletogettheirmedicationsthroughtheLTBBPharmacywithnooutofpocketcosts.

RevenueCycleTeamTheRevenueCycleTeamconsistsofaMedicalCodingSpecialistandaMedicalBillingSpecialist.ItistheirtasktotranslatepatientvisitsinourMedical,Dental,andBehavioralHealthdepartmentsintobillableencountersthataresenttoapatient’sinsurance.Thepatient’sinsurancereviewsourrequestforpaymentandissuespaymentiftheclaimisaccurate,complete,andacoveredbenefit.ThisprocesscreatesrevenuefromtheservicesweofferhereattheLTBBHealthDepartment.ThisisanintegralpartoftheHealthDepartment’soperationsandallowsustogrowandoffermoreprogramsforourclients.InFY2017,theLTBBHealthDepartmentgenerated$357,352.Inaddition,ourMedicalBillingSpecialistworkedwiththeStateofMichigantoreceive$250,763insettlementmoniesfromclaimsthatwerenotpaidatthecorrectratefromFY09‐FY14.

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HEALTHCLINICTheMinaMskikiGumik(HealthClinic)isafullserviceprimarycareclinic.Healthservicesareprovidedfivedaysperweek.Officehoursare8a.m.to5p.m.withpatientcarehoursfrom9a.m.to5p.m.Dr.TerrySamuels,MD,MedicalDirector,isafamilymedicinephysicianwhoseespatientsWednesdaythroughFriday.AsanLTBBtribalmember,Dr.Samuelshasbeenwiththeclinicsince2002.Dr.MeyersonourpediatricianwillfinishhislastdaysofclinicalcareinJanuary2018ashispositionasMedicalDirectorofEmmetandCharlevoixCountyHealthDepartmentshasrequiredmuchmoreofhistimeasoflate.Dr.AmyMitchell,MD,isafamilymedicinephysicianwhoseespatientsfourdaysperweekattheclinic.Dr.MitchellattendedresidencyattheUniversityofMichiganandhasbeenonstaffsince2/17.WeareactivelyseekingareplacementforDr.Meyerson.CariAnneJeffers‐Wcisel,MS,PA‐C,isaphysicianassistanthasbeenwiththeclinicsince2002.MinaMskikiGumikHealthClinicalsoemploysoneRegisteredNurse,twoMedicalAssistants,andthreefrontofficestaff.

Thehealthclinicsaw1448patientsin2017withover4739visits.

OurHealthPromotionandDiseasePreventioneffortscontinuethrougheducationandscreening.Wecontinuetoimprovedocumentationofhealthindicatorssuchassmokingstatus,alcoholscreening,domesticviolenceandobesityamongothers.Improvedreportingisanecessarycomponentoftreatmentand

prevention.Wepromote healthybehaviorsthatincludeexercise,nutritionandsafersex.

ThisprogramisalsoaHomegrownpartner.WecontractDanielBergatBergFarmtogrowandtendproduceforourcommunitymemberstoharvestthroughoutthegrowingseason.WeofferfoodpreservationworkshopsinconjunctionwithSDPI‐preventionandcontroleducation.Theseclassesputfreshlocalproduceinthehandsofourpeople.Theylearnhowtoeatbetterandhowtopreservefoodstheseasonsbountytohelpsustaintheirfamiliesthroughoutthewinter.Inaddition,MarleneandReginabecametrainedTaiJIinstructorsaspartofourcollaborationwiththeElder’sdepartmentonafallpreventionproject.Wearemirroringthisgrantsothat55andyoungercanparticipateaswell.MarlenehasclassesfortheElder’stwiceaweek.

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Fitnessisnotaboutbeingbetterthansomeoneelse…it’saboutbeingbetterthanyouusedtobe.

SDPI‐Diabetespreventionandcontrol‐ReginaBrubacker‐Carver,HealthEducator.Since2005ReginaBrubacker‐CarverhasbeentheroleofHealthEducatorfocusingon5mainareas:educationandriskreductionintheareasofobesity,diabetesandtobaccoabuse,increasingknowledgeofandaccesstothebenefitsofphysicalactivity,andexpandingourprogrammingtoimpactthehealthofourchildren.ReginaisresponsibleforstafftrainingsinHIPAA(HealthInformationPortabilityandAccountabilityAct),StandardPrecautions,CPRtrainings,andNativeWayorientations.Individualappointmentsareavailableforgeneralhealtheducation,healthassessments,aswellas,thedevelopmentofpersonalwellnessplans.Reginaleadsyogaclasstwiceaweek.ShealsoisamemberoftheMSUEfederallyRecognizedTribesEducationProgram(FRTEP)’sAdvisoryBoard,aswellas,beingactivelyinvolvedinhorticultureandSmall‐ScaleAgricultureworkgroup.Thisinvolvementisasteppingstoneintheprocessthatwillleadourcommunitytoobtainingfoodsovereigntyinthefuturewhileincreasingtheavailabilityofhealthy,locallygrownfoodsforourcommunity.Wearelookingforwardtothe2018growingseason.Wearepromotinghealthyfoodchoices,increasingfamilyparticipationinphysicalactivityandstressreductionthatispresentedinaculturallyappropriatemanner.WealsooffertraditionalservicesofJakeandMaryPineandRegisteredDieticianservicesofCharlaGordon,bothofwhomarecontractedinpartbySDPI.Alloftheaforementionedprogrammingisinfusedintoallareasofcommunityhealth.Addressingtheseareaswillalsodecreasecardiovascularriskfactorsforourclientsandtheirfamilies.Wewillcontinuetoworktoreducethecardiovascularriskfactorsforallofourpeopleregardlessofage,diagnosis.Wewillcontinuetofocusprogrammingthatencouragesclientsandfamiliestoincreasethetimespentbeingphysicallyactiveandmakinghealthierfoodchoices.Ourmantrais‘movemoreeatbetter’.

DENTALCLINIC      TheDentalprogramoffersthefullrangeofDentalservicesincludingdentalhygiene(cleaning)andrestorativeservicessuchasfilling,simplerootcanals,crowns,bridges,anddentures.TheDentalClinicisstaffedwithafulltimeDentist,DentalAssistant,DentalHygienist,andDentalFrontDeskAssistant.TheDentalClinicschedulesappointmentsfivedaysperweek.

InMay,2017,Dr.JohnN.SeldenjoinedtheLTBBDentalClinic.Dr.SeldengraduatedfromtheUniversityofMichiganDentalSchoolin1993.Dr.SeldenbringsabroadbaseofdentalexperiencetoLTBBDental,havingpreviouslyworkedinprivatepracticeandwiththeIndianHealthService.

TheHealthSystemsDirectorhascompletedqualityimprovementsfor2017suchas:newdentalequipmentwhichallowsforimprovedservicealongwithmonitoringandqualitycontrolofsterilizationtechniques.

Approximately1,300dentalappointmentswereprovidedin2017.Inordertocontinuewithbothqualityandquantityofserviceprovided,LTBBDentalClinicwillbeupgradedwithmodernfunctionaldentalequipmentintwoworkrooms.AdditionalupgradestothesterilizationworkspacewillallowfortheclinictohireasecondDentist.

WelookforwardtocontinualimprovementsasweworktomeettheneedsofLTBBTribalMembers.

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BEHAVIORALHEALTHItwasaverybusyyearin2017inBehavioralHealth/SubstanceAbuseProgram.Wehavenotonlyupgradedourlookswiththenewconstruction,whichhascreatedadditionalofficesandmeetingrooms.OurmajoraccomplishmentandareproudthatwehavepassedanotherCommissiononAccreditationofRehabilitationFacilities(CARF)withhighhonors.ThisplacesusintheupperthreepercentofallCARFaccreditedentitiesinternationally.ThisaccreditationisvalidthroughAugust31,2020.Intheyear2018weareimplementingtheWellbrietymovementandmaterialsintoourmatrixgroups.WewillcontinuetostrengthenourteamwithtrainingssuchasRationalEmotiveBehaviorTherapy(REBT),EyeMovementDesensitization&Reprocessing(EMDR),WhiteBisonhealingresourcesandwillcontinuetointegratetheculture,knowledge,valuestoindividuals,families,andthewholecommunity.In2017theBehavioralHealth/SubstanceAbusereceived240patientswhichtotaledover2097visits.

MISSIONSTATEMENT

“Weherebycommittoprovidethemosthighlyqualifiedhealthpersonneland

servicestoinsureaholisticapproachrespectingandintertwiningbothmodern

andtraditionalhealing.”

CommunityHealthAdministrativeAssistant‐AngelineRoberts.Angeisthegotopersonforschedulingappointmentsandmedicaltransportation.Shecanbereachedat231.242.1601.Sheprettymuchkeepsourdepartmentafloat!RegisteredDietician‐CharlaGordon’siscontractedtoprovidenutritionalassessments,nutritionalcounseling,andmedicalnutritionforindividualsandgroups.SheteachesthenutritionalcomponentofourLaugh,LearnandLiveWellclassesandgroupnutritioneducationclasses.TraditionalHealerservices‐JakeandMaryPinearecontractedtoprovidetraditionalteachings,medicines,healingandceremoniesthreedaysamonth.AppointmentscanbemadebycallingAngelineRobertsat231.242.1601

COMMUNITYHEALTHGRANTS

SpecialDiabetesProgramforIndians–MnoOde(HealthyHeart)OfficiallyendedSeptember30,2017.MarleneGasco,administrativeassistant.ReginaBrubacker‐CarverRN,HealthEducator,andMicheleKeshickProgramDirectorMarlenestayedontotransitionclientsfromHealthyHearttoMnozhyaadaa.WehavehadveryfewjoinMnozhiyaadaafromHealthyHeart.TheytellusthattheyneedabreakfromtherigorsofHealthyHeartprogram.Wehaveimprovedoutcomesforourclient’sbydecreasingtheburdenofparticipation,givingourclientsthetoolsthattheyneedtomakepositivelifestylechangesandalleviatestress.Mnozhiyaadaaisaprogramthatisopentoindividualsandtheirfamilies.

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Yoga‐2classes/week(approx.52)2‐4faithfulparticipants Aquaticexercise‐2xweekx36weeks=72classeswith5‐7

peopleeachclass Woman’snights‐educationandphysicalactivity‐6classesavg.

4participants Men’snight‐co‐edgrouprecruitedfromNativeWay Homegrown‐WeeklyharvestsJuly‐October(16wks.)with10‐75

peopleperharvest Youthevents‐Sweetgrassharvest,strawberryjamandsweet

cornharvest15‐18youth Canningclasses5with6‐10peopleperclass BillsFarmMarketTourandHayride‐Education10participants

HomeHealthNurse‐MichelleDelandRNprovidesthefollowingservices:homevisits,wellnesschecks,medicationmonitoringandsetup,labdraws,catheterchanges,woundassessmentsanddressings,andhealthassessments.Inaddition,thispersonwillalsohelpherpatientsnavigatethehealthcaresystems,aswellas,accompanyherpatientstomedicalappointmentsasneeded.CHR’s‐CarolKiogima,CathyGibsonandHowardMartel.CHR’scontinuetodohomevisits,aswellas,workinfootclinic2daysaweek.Theyaccompanypatientstotheirdoctorappointmentsandhelpthemnavigatethehealthcaresystems.Theyareabletoprovidewellnesschecks,setupmedication/medicationmonitoringandotherhomehealthtasksorderedbytheirdoctorand/ornursingsupervisor.AllthreeCHR’sprovidemedicaltransportationaswell.Theyalsoassistwithallthecommunityhealtheventsthroughouttheyear.

Thisprogramoffersthefollowingservices:

Screeningsandassessmentsformentalhealthandsubstanceabuse/addictions

Outpatientcounselingtoinclude: AddictionsRecoveryCounseling–IndividualandGroups MentalHealthCounseling AngerManagementgroups Individual&FamilyCounseling Prevention&EducationServices ChildrenandAdolescentCounselingpreschoolthruadult CouplesCounseling Aftercare&Follow‐upCounseling AccesstoRecovery(ATR)

BEHAVIORALHEALTHGRANTSDepartmentofJusticeGrant‐SubstanceAbusePrevention

In2016,theBehavioralHealthdepartmentlaunchedanewadolescentprogramaimedatreachingat‐riskteens,aswellastheirchosenparents/mentors.Thegroupmeetsfor44weekswiththefocusbeingplacedbuildingthe40developmentalassetsasidentifiedbytheSearchInstituteandeducatingtheadolescentsonculture.TheCTASprojectbeganinJanuaryof2016andwillcontinuetorununtilSeptemberof2018. Inthisprojectyear,theprogramisregularlygettingreferralsfromLTBBTribalCourtandlocalareacourtsystemstoprovideservicestoyouthwhoarestrugglingfromSubstanceUseDisordersand/oryouthwhostrugglewithtruancyorincorrigibility.Thisprogramprovidesthepositivepeerinteractionthattheseadolescentsneedtodealeverydaylife.Italsoprovidespositiveadultrolementorstomodelappropriatebehavior.

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Someoftheparticipantshavebenefitedfromtheprogrambyremainingsubstancefreeandcompletingtheirobligationswiththelocalcourtsystems.Mostotherparticipantshavebenefitedbyloweringand,insomecases,eliminatingtheirdepressionandsuicidalideations.Theprogramdoesn’tonlyofferagrouptherapy,butalsoofferseachindividualaccesstoone‐on‐onecounselingsessionstohelpimprovetheirlives.WorkingalongsidewiththeTraditionalAdvisor,theclinicianhasbeenabletouseculturalteachings,traditionalceremonies,andculturaleducationtoinstillthe40assetsintotheadolescentsthatparticipateingroup.Someoftheseteachings,ceremonies,andeducationinclude:Manoomintoolsforharvesting,medicinegathering,namingceremonies,sweatlodges,moccasinmaking,comingofagetraditionalritespassagesofAnishinaabeyouth,andmanymorethings.Forexample,oneofthe40assetsfromtheSearchInstituteisYouthasResources.Theyouththathavegraduatedfromtheprogramhavecontinuedoninthegroupaspeermentors.Theirstabilityandcontinued

healinghavedemonstratedthereishopeinthosethatcomeinandfeelhopelessabouttheirlives.ThesepeershelpfacilitateTalkingCircles.Theyalsohelpwithallthepreparationsandclean‐upforgroup.Thepeermentorsdemonstrateappropriatebehaviorsandastrongdynamicinthehealingofthe

groupprocess. Inthepicturesabove,thepeermentorsaremaking“Knockers”fortheManoominharvest.

Wealsohostandassistmanyeventsthroughouttheyear.Belowisalistofeventsandthenumberofparticipants:

TheAnnualTribetoTribeChallenge56participants.Wetooksecondplacein2017.

TheOdawaCasinoResortHealthandWellnessfair FallEncampment‐120 YearEndcelebration‐98 AnnualLaborDayBearRiverBridgeWalk‐15 Goongenibig‐120participants MichiganFamilyOlympics‐145participants ProjectConnect‐Fallprevention390attendees Class‐Laugh,LearnandLiveWell(series)1class/monthavg.12

perclass Massage‐4days/6clients/day=24 Canningclasses5with6‐10participantseachclass CrockpotCookingclasses‐4sessionstotalof48participan ts Knifeskills101classes‐2classeswith23participants Fluclinics‐50injections

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COMMUNITYHEALTHWearededicatedtothehealthandwellnessofourcommunity.Therestorationofharmonythatweonceenjoyedasapeopleisparamounttothisprocess.Weworktowardsthisbyincorporatingtraditionandcultureintoourprogramming.aswefocusourprogrammingoneducation,stressreduction,lifestylechanges‐improvingfoodchoicesandincreasingtimespentwithfamilybeingphysicallyactiveareroadsthatleadtomnobimaadizwin‐goodwayoflife.Weprovidecommunitymemberswiththefollowing:

HomeHealthNurse‐limitedhomehealthservicessuchas

medicationsetupandmonitoring,wellnesschecks,nursingassessmentsasordered.

CHR’saccompanypatientstodoctor’sappointmentsassuringcontinuityofcareProvideassistancewithnavigatingthehealthcaresystem‐548

medicaltransportation‐805 registereddieticianCharlaGordon‐155 GchinendamZidan(footclinic)‐267 Accesstotraditionalhealer(healing)390clients NativeWayWellnessCenter1&Too145usersaveraging205

clientsaccessinginonemonth.Itwasaccessed2457timesduring2017

Mnozhiyaa

(Liveingoodhealth)

Inthefuture,youthhavebeenaskedtotakeonmoreofaroleindifferentleadershippositionstocarryonthemedicines,teachings,andceremoniesoftheAnishinaabeCulture.Theyouthhavebeenaskedtoapprenticewithpipeceremonies,tendingfireatsweatlodges,andStick‐manatthesecondannualRoundDance.OneofthemostimportantassetsthatthegroupfocuseshighlyonisAdultRoleModels.Manymembersofthecommunitycometogethertobeastrongsupportsystemfortheadolescentsinthegroup.Theapproachbehindbringinginadultrolemodelsonaregularbasisistooffertheadolescentssomeonetoreachouttointimesofneed.Numerousadultshavesteppeduptoofferastrongpositivesupportfortheadolescentsthatareinatimeofneed.JakeandMaryPineworkwiththeadolescentstohelpgathermedicineattheWildernessStatePark.Thegroupmemberswereeducatedondifferentmedicinesthathelpwithdifferentailmentsandhelpedtoharvestthem.Inthepictureaboveontheright,TonyMironandJoeMitchellhelpedadolescentsdigforSumacWalkingSticksandinreturntheadolescentsharvestedSumacBerriesforteaasanappreciationforTonyMiron.ThisdemonstrateshowimportantthegiveandtakeisintheAdultRoleModelasset.Inreturn,theadolescentsareusingtheassetofYouthsasResources.

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InterpersonalCompetenceisanotherassetthattheadolescentsuseinthegroupsettingandbeyond.Withthisasset,ayoungpersonhasempathy,sensitivity,andfriendshipskills.Allofthegroupmembersreachoutandencourageandshowempathy,sensitivity,andfriendshipskillstoothermembers,aswellas,newmembersenteringgroup.Inthepicturesbelow,thegroupmembersbondandcometogether.Notjustingroup,butalsoinschoolandlife.Theyreachouttoeachotherintimesofneedandmaintainfriendshipsthatwilllastalifetime.Asaresultofintegratingmoreculturaltraditions,teachings,andculturaleducationintothecurriculum,theadolescentsareengagedeachweekandlearningmoreabouttheirancestralheritage.Thishashelpedinotherareasofhealing.Notonlydotheadolescentsconnectontheirculture,butalsohaveotherpeersthatcanrelatetothevariouscircumstancesthateachadolescentisfacingdaily.Theadolescentsdon’tfeelaloneintheirwalkingoftwolives,thatoftheNativeAmericanandWhite.Inthefuture,thegroupisgoingtobeattendingtheMichiganIndianFamilyOlympics,maintainingthemedicinegarden,doingateambuildingactivity,makinghanddrumsalongwithcontractingtoteachtheadolescentsAnishinaabeNativesongstosinganddrum,andaprogramendcelebrationatWolverineCampinWolverine,Michigan.Atthiscamp,theadolescentswillbelearningmoreculturalteachings,survivalskills,ziplining,ropes,andmany,manymoreeducationaltoolstotakewiththeminlife.Thiswillonlyreinforcetheassetsthattheywerebeingtaughtthroughoutthelengthofthegroup.Asexpected,thisprojectgrowthincreasedto30adolescentswhoactivelyparticipateinthegrouponaweeklybasis.TheBehavioralHealthdepartmentanticipatesthisgrowthtocontinueatasteadypaceaswordcirculatesabouttheeffectivenessofthisformofatherapeuticapproachtoat‐riskadolescentswithMentalHealthissuesorSubstanceUseDisorders.

“My dreams are my dress rehearsals for my future.” 

David Copperfield 

SPRING’sAnnualSurvey:SPRINGcontinuestoupdateourEpidemiologicalprofilefortheLittleTraverseBayBandsofOdawaIndians.TheSPRINGProjectimplementsanannualsurveyeachgrantyear.The2017SPRINGsurveycollectedapproximately111youthsurveysthatwillbeputintoadatabasesystem,theywillbeanalyzed,andwewillhavetheresultsplacedwithinafinishedreport.ThiswasourfirstyeartodeliveranRxAdultsurvey.Wereceived588adultsurveys.TheSPRINGteamcameupwiththeinterveningvariablesmeaningstrategieswerechosentoreducethemisuseandabuseofprescriptiondrugs.Capacitybuilding:SPRINGcontinuestobuildcapacitywithcommunitypartnersandweareapartofanexistingcoalitionentitled,SubstanceAbuseFreeEnvironmentofNorthernMichigan,commonlyknownasSAFESPRINGalsoworkscloselywithothertribaldepartmentstobuildcapacity,promoteculturalaspectsofpreventionandplansustainabilitytocontinueafterthegrantends.SPRINGhastwomaineventsthroughouttheyearforcapacitybuilding.TheYear‐EndCelebration;theschoolsgathertogetherattheLTBBGovernmentCenterforafulldayofculturalteachings,typicallythereareatleast100studentsandschoolrepresentativeswhoparticipateforthatday.Thesecondeventisafallencampment;theencampmentisfullofculturalactivitieswherewebringfamiliestogethertointeractwithoneanotherinafunandpositiveway.BotheventsareincollaborationwithotherLTBBdepartments.

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NishFishThisprogramstartedoutbeingasummeryouthprogram.NishFishhasnowturnedalsoturnedintoanafter‐schoolprogram.ThegoalofNishFish:LTBByouthlivesuccessfulhealthylivesbymakingthechoicetostaydrugfree.Inordertoknowifwearemovingtowardourgoal,weexplored:“Forourtargetpopulation,youthaged12‐16intheNishFishprogram,whatdoessuccesslooklikeforus?”Youth:•Haveapositiveoutlookandattitudeontheircommunityandtheirculture•Increaseself‐acceptanceandaprideinwhotheyare•Haveapersonalsenseofpositivefutureandfeeltheyarethelocusofcontrolintheirlives•Developnewskills,hobbies,andinterests•Increaseinself‐awareness(maturityandsmarterchoices)•AremoreawareofSPRINGpreventionmessagesSPRINGPreventionTeam:•ReachaconsistentnumberofyouthwhoregularlyattendNishFish•DiscoverseffectivemethodstoteachcultureIfyouareinterestedinbeingapartoftheSummerNishFishProgramcontactAngieWoodin,231‐242‐1649orDavisTimmerat231‐242‐1710.

DepartmentofHealth&HumanServices‐ SignificantPreventionResultinginNewGenerations(Spring)&SPFRXGrants

TheLittleTraverseBayBandsofOdawaIndians(LTBB)wasawardedtheStrategicPreventionFrameworkTribalIncentiveGrant(SPFTIG)attheendofJuly2009.Thisproject,knownlocallyasSPRING(SignificantPreventionResultinginNewGenerations)isthefirstsubstanceabusepreventioneffortinwhichthetribehasparticipated.SPRINGiscurrentlyworkingundertwograntsthisyear.ThefirstisthePartnershipsForSuccessGrant(currentlythirdyear)andtheotheristhePrescriptionDrugPreventiongrant(currentlyinfirstyear),commonlyreferredtoastheRxGrant.ThetargetpopulationforthePFSGrantis12through20yearsoldandtheRxGranttargetsages12andabove.SPRINGcurrentlyhasfourfulltimestaffmembers:�Coordinator:AngieWoodin,hiredonOctober24,2011.�CommunityOrganizer:DavisTimmer,hiredonJuly16,2015�OutreachWorker:KennyDewey,hiredonOctober20,2017�OutreachWorker:SunneseGranados,hiredonNovember20,2017TheprioritiesfortheRxGrantaretoraiseawarenessaboutprescriptiondrugmisuse,thedangersofsharingmedicationsandworkwithpharmaceuticalandmedicalcommunitiesontherisksofoverprescribingtoyoungadults.

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TheSixstrategiesSPRINGstaffiscurrentlyworkingoninclude:ParentsWhoHostLosetheMost:ThisisanenvironmentalstrategythatwasvotedinbySPRING’sAdvisoryCouncilonJune28,2011.“ParentsWhoHostLosetheMost”campaignbringsforthasenseofcommunityawarenessaboutthelegalconsequencesforthosewhoprovidealcoholtoyouthundertheageof21yearsold.Thesevencommunities(Petoskey,HarborSprings,Alanson,Pellston,MackinawCity,InlandLakes,andWolverine)receivesignstwiceeachyear.Thefirstimplementationphaseisduringthehomecomingtimesofsurroundingschools.Thesecondtimesignsareimplementedisduringtheperiodofgraduationandpromfortheschools.Therearehomesandbusinessesthathavecommittedtowardstheimportanceofkeepingouryouthsafe.MooseTrackMediaisanenvironmentalstrategythatwasvotedinbySPRING’sAdvisoryCouncilonJune28,2011.SPRINGhasgrownintoexpandingtheirsocialmediaandsocialmarketingaspect.Theyhavethefollowingitemsbannersthatareplacedathighschoolfootballfields,BathroommediathatareposterswithpreventionmessagesthatcanbefoundwithintheLTBBGovernmentalCenterbathrooms,FacebookandInstagram,FlatScreenmedia,andHallofFame.VerticalIDTribalEnrollmentCards:AnenvironmentalstrategythatSPRING’sAdvisoryCouncilvotedinonMarch20,2012.Thisstrategywasimplementedinthesummerof2012.Therehavebeenapproximately146tribalenrollmentcardsissuedtominorsduring2017todate.TheverticalIDcardsalsohelpinthepreventionofcreatingfalseIDcards,duetotheghostimageapproachthatmakesitharderforduplication.FactSheets:Thefactsheetsconsistofvariousfactsandstatisticsthataregatheredaswellasourcontributingfactors.ThesearesubmittedmonthlytotheOdawaTrailsforpublication.TheSPRINGteamworkedwiththeirevaluatortofinalizedetailsoftheirfirstthreefactsheetsbasedonpreventionmessagesandfactsaroundunderagedrinkingandusageofmarijuanaamongtheyouth.ThefactsheetswillbesubmittedintotheTribalOdawaTrails.

PaddleIntoNewGenerationsTheLittleTraverseBayBandsofOdawaIndiansareconsideredtobewaterpeople.Fromgenerations,variousOdawapeoplelivearoundorneartheGreatLakesofMichigan.ThewaterisverypreciousandholdsastrongconnectiontotheOdawaNation.Programsandactivitiesgenerallyareheldclosetowaterwaysincelebrationofareminderofhowimportantwateristotheirculture.PaddleintoNewGenerationscomponents:LessonsincludingtheSevenGrandfathersTeachings,preventionmessages,anddiscussionofwhattheyhavelearned.Second:ahandsonproject(thisisoptional)andthethirdisexperiencingajiimaanjourney(thisisoptional).Duringeachsession,communitymemberswilljointhemtotalkaboutourheritage,culture,valuesandthehealthylifechoicesforthemselvesandourcommunity.TheprojectwillculminateinaJiimaan(canoe)journey.Thefocusesonreducingunderagedrinkingamongtheyouthbyaddressingtheaspectofourinterveningvariables:socialaccess,socialnorms‐acceptanceofunderagedrinking,andlowperceptionofriskofunderagedrinking.Thisprojectemphasizestheideathatonemustbesubstanceabusefreestrong,meaningthatonemustworktowardachievingnotonlyphysicalstrength,butalsomentally,emotional,spiritualgrounded.ThecommunitymemberswilltakepartinhandsonprojectandJiimaan,lendingtheirsupportandexpertiseandofferasenseofempowermenttotheyouth.PaddleintoNewGeneration’scurriculum:Therewillbesevenweeksfortheindividualstoworkoncompletingtheirhandsonproduct.EachsessionwillbeinhonoroftheteachingsoftheSevenGrandfathers:Humility,Respect,Truth,Honesty,Wisdom,Love,andBraveryandhoweachonefitsintothephilosophyofthisproject.

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