2016 September Newsletter

September 2016

Clinton Service Unit

Continuous Improvement on Patient Care

Inside this issue: As part of a continual improvement process to provide our patients the best in health care, CSU is ac-
tively grading the care we provide based on patients’ satisfaction through use of the Net Promoter
Big Event 2 Score” (NPS).

Flu Shot 3 “CSU is continually increasing our NPS”, said Joe Bryant, administrative officer. “As of September, our
NPS has exceeded the mark of 49. This score exceeds the highest mark by many outside health care
Exceed the Need 4 plans. The average NPS in the health plan industry is 14, with the highest score at 48.”

Direct Svs Mtg. 4 The NPS is a research based grading system to gauge customer satisfaction and loyalty. The system
is used by many Fortune 500 companies to measure the likelihood of customers to recommend a com-
Welcome 5 pany, product, or service to a friend or colleague.

Comm. Calendar 6 “As patients register in the department they are receiving services in, they are handed a postcard size
Patient Experience Survey consisting of 12 questions”, said Bryant. “The last question asks for patients
Glasses 7 to answer on a scale of zero to ten how likely they are to recommend our services. A score of nine to
ten means the patient was very satisfied with their overall experience and would highly recommend the
Wi-Fi 7 facility.”

Mail Bag 8 “When a low or high score is received, we either did or did not meet the patient’s needs or expecta-
tions,” said Bryant. “We are using the patient survey to determine what department origin and what
PRC Eligibility 9 areas we may make improvements in. When patients take the time to fill out our Patient Experience
Survey, they let us know what we are doing well and what they feel we could improve upon. We will
Suicide Prevention 10 continue to strive to Exceed our Patient’s Needs.”

Page 2

The Big Event &

“Monster Dash” 5K Fun Run & Walk

In partnership with the Cheyenne & Arapaho (C&A) Tribes of Oklahoma, CSU will host our fourth annual Big Event. The 2016 festivi-
ties will feature a health fair on Friday, October 21st from 9 am to 3 pm and the Monster Dash 5K Fun Run and One Mile Walk on
Saturday, October 22nd at 9 am, with registration beginning at 7:30 am. All activities of the two-day event will be held at Clinton Indi-
an Health Center.

The Health Fair will highlight over 18 health and wellness vendors, including programs of CSU and the Cheyenne & Arapaho Tribes,
Custer County Health Department, and western Oklahoma community. “Participants will find health resources and education, screen-
ings for both blood pressure and blood glucose, HIV/AIDS testing, flu vaccines, Native American Hand Games, and a Basic Life Sup-
port course will be offered”, said Kristie Purdy, event co-organizer.

While visiting the Health Fair, show your school loyalty and find out if you bleed crimson or orange. The Oklahoma Blood Institute
(OBI) will host an on-site blood donation center from 10 am to 3 pm during the Health Fair. OBI has Bedlam-themed T-shirts for all
those who make a donation. Each person who gives will be able to select an OU crimson or OSU orange T-shirt. OBI serves more
than 140 hospitals and medical facilities across Oklahoma.

All ghosts, goblins, and princesses are encouraged to register for the Monster Dash 5K Fun Run and One Mile Walk. Pre-registration
for the Monster Dash is free and may be found at: https://monsterdashclinton.eventbrite.com. Be sure to stay after the race and join
in the fun for the costume contest. Prizes will be awarded for the scariest, funniest, most creative, and cutest costumes through Chey-
enne District #3 Legislator and Arapaho District #3 Legislator. The following categories will be judged: five years and under, six to 12
years of age, 13 to 17 years of age, 18 and older, and family. If your kiddos costume needs a little finishing touch, be sure to stop by
the face painting booth, sponsored by the C&A Tribes’ Health Education program. Little ones are invited to pick out a pumpkin of their
own to decorate from the pumpkin patch.

“Each year momentum and support for the Big Event has grown,” said Purdy. “We would like to thank Arapaho District #3 Legislator
Patrick Spottedwolf, Cheyenne District #3 Legislator Reggie Wassana, C&A Tribal Health Board, C&A Tribes’ Tradition Not Addiction,
and C&A Tribes’ Health Education Programs for partnering with CSU to bring health education to the community”.

Seasonal Flu Vaccine is Here!

Flu season is fast approaching, have you received your flu shot? Fight the flu by
protecting yourself and those around you by getting a flu vaccine, which is now
available at CSU. Stop by the clinic and receive a flu shot today! Appointments
are not needed.

Indian Health Service (IHS) is committed to protecting our patients, visitors and
employees through requiring mandatory seasonal flu vaccines of all staff, stu-
dents, and volunteers who work in IHS health care facilities. Any staff member
who chooses not to receive a flu vaccine will be required to wear a protective
mask for the duration of flu season.

Page 3

“Exceeding the Need”

CSU is passionate about improving the health of our patients. Everyday, our employees “Exceed the Need” in providing
excellent customer service and great care. Below are just a few highlights from staff and patients:

“Francisco Castellano, CSU health technician, received a call from a patient who complained of recent dimming and foggi-
ness in his right eye for one day”, said Dr. Goldwasser. “Francisco triaged the patient over the phone and determined he
needed a higher level of care. He contacted Todd Lawrence, RN to make a same-day appointment with Physician Assistant
Richard Witt, so the patient could receive a referral to Dean McGee Eye Institute (DMEI). After further discussing the
patient, it was determined he should go directly to the emergency room to receive a Computed Tomography (CT) scan. The
CT scan was considered to be normal, but the patient was still referred to DMEI where he had an appointment later in the
afternoon. Francisco called the patient a little later and was informed he had undergone an ocular stroke. This patient was
informed by the ophthalmologists at DMEI if he had waited another 12 hours, he may of the lost his vision or even his life.”

“Leslie Panana of CSU’s Purchase Referred Care (PRC) is consistently willing to take time to assist both patients and fellow
employees as issues arise,” said Julie Hoover, PRC director. “Her diligence in assisting others and catching potential billing

errors has saved the service unit over $80,000 in funds.”

“Thank you to all of the staff who provided services at the annual Head Start Health Fair for the Cheyenne & Arapaho
Tribes Head Start program,” said Director of Public Health Nursing Bonnie Kraft. “CSU took to the communities of Clinton,

Concho, and Watonga to lessen the burden on parents by providing multiple medical appointments in one setting.
Our providers screened over 125 Head Start students.”

Direct Services Tribal Meeting

CSU CEO April Wazhaxi and Cheyenne & Arapaho Tribe’s “Empowering Indian Health for Future Generation” was the theme of
Department of Health Executive Director Nick Barton at the the 13th Annual Direct Service Tribes (DST) National Meeting hosted
by Indian Health Service (IHS) in Rapid City, SD on August 31—
13th Annual Direct Service Tribes National Meeting. September 1. Cheyenne and Arapaho Tribes’ Department of Health
Executive Director Nick Barton, served as the Oklahoma Area repre-
Page 4 sentative and Chairman of the IHS Direct Service Tribes Advisory
Committee,

The DST National Meeting is held to discuss and address health is-
sues and challenges affecting the DST and Indian Country. The DST
are tribes who receive primary health care services from IHS. These
services includes: direct patient care such as internal medicine, pedi-
atrics, women’s health, dental and optometry services. The two day
event encompassed three learning tracks, including: Quality & Innova-
tion, Workforce & Systems Development, and Best Practices in Indian
Health.

Welcome to Clinton Service Unit!

Alexis Arriaga
Medical Support Assistant — Clinton

Alyssa Barcindebar Dr. John Warrick
Purchase Referred Care Podiatrist — Clinton
Medical Support Assistant
Page 5
Clinton

Clinton Service Unit’s

Community Activity Calendar

October

3rd Dental Screening / Watonga Elementary
5th Dental Screening / Nance Elementary (Clinton)

Dental Screening / Watonga Elementary
7th C&A Tribes’ Breast Cancer Awareness Health Fair (Geary)

Dental Screening / Watonga Elementary
8th C&A Tribes’ Breast Cancer Awareness Powwow (Geary)
17th Dental Screening / Washington Elementary (Clinton)
18th Dental Screening / Washington Elementary (Clinton)
19th Dental Screening / Washington Elementary (Clinton)
21st Big Event Health Fair, Blood Drive, BLS / Clinton Indian Health Center
22nd Big Event—Monster Dash 5K Fun Run & Walk / Clinton Indian Health Center
25th Dental Screening / Lincoln Elementary (El Reno)
26th Dental Screening / Lincoln Elementary (El Reno)
27th Dental Screening / Lincoln Elementary (El Reno)

November

3rd C&A Tribes’ Elder’s Conference / Frisco Center (Clinton)
4th Veterans Affairs Stand Down / Cox Convention Center (Oklahoma City)
8th Dental Screening / Clinton Middle School

Dental Screening / Darlington Elementary (El Reno)
9th Dental Screening / Clinton Middle School

Dental Screening / Darlington Elementary (El Reno)

December

1st Dental Screening / Geary Elementary
2nd Dental Screening / Geary Elementary

Page 6

Eyeglasses Audioreminder

Patients who are waiting to receive eyeglasses from the Optometry Department will now receive an Audioreminder call or text to
inform them their glasses are ready for pick-up.
Previously, patients were informed on the status of their glasses by a call from the optometry technician. “What would normally
take over an hour to contact each patient on their eyeglasses, now takes 5-7 minutes,” said Francisco Castellano, optometry tech-
nician. “The Audioreminder calls or texts the patient to let them know their glasses are in, and documents in their chart they have
been contacted”.
Patients interested in receiving a text message appointment reminder may request to do so through completing the “Appointment
Reminder Messages Opt-In” form available through registration in each department. The text messaging Audioreminder will notify
patients of upcoming appointments. Patients may instantly respond to the message by confirming, canceling, or rescheduling their
appointment.

CSU is pleased to announce Wi-Fi
service is now available for use at our
Clinton, El Reno, and Watonga clinics.

Patients and visitors may stay
connected while in our facilities by

connecting to IHS-Guest.

Page 7

From the Mailbag...

“100% satisfied, love this clinic! Love this facility! They go above and beyond to give you all
the care they can.” ~ Watonga Indian Health Center Patient

“This is the best IHS I’ve been to in all of Oklahoma. Staff treatment is great. I’m coming
from Anadarko, It’s worth the trip! ~CSU Patient

“Staff is professional and nice, always willing to go beyond tier duties.” ~CSU Patient

Page 8

PRC Eligibility and Patient Registration

The Purchased Referred Care (PRC) program is designated for primary and specialty health care services not available within an
IHS health care facility. This includes services such as hospital care, specialty physician services, radiology, transportation, and
many other specialized services. Authorization for services is administered through local PRC programs based upon geographical
location.
The CSU delivery area consists of 18 counties, including: Alfalfa, Beaver, Beckham, Blain, Canadian, Cimarron, Custer, Dewey,
Ellis, Greer, Harper, Kingfisher, Major, Roger Mills, Texas, Washita, Woods, and Woodward.
PRC has established guidelines to determine the level and services authorized. There guidelines determine PRC’s most effective
manner for prioritizing and authorizing services. When authorized, services are identified through a referral to qualifies and quanti-
fy the services approved.
PRC is not an entitlement or an insurance program. PRC is the payer of last resort and does not guarantee payment. This means
all other available resources, such as: services available elsewhere within IHS; and alternate resources, including: private insur-
ance, Medicare, Medicaid, and VA must be used first.
To maximize utilization of funding, patients who have other resource are asked to provide this information along with other eligibil-
ity documents to CSU Registration. We understand things change, and this is why we ask every patient to ensure their infor-
mation is current at each visit. Doing so will allow for us to communicate with patients for any follow-up, pharmacy refills, or PRC
referrals.
The required documents for establishing and maintaining eligibility, include:

 Certificate of Degree of Indian Blood (CDIB) or Letter of Descendancy signed by a tribal or Bureau of Indian Affairs
official on formal letterhead

 Social Security Number

 State Identification or Driver’s License

 Birth Certificate for children less than 18 years of age

 Proof of Residency verified (with physical address, no PO Box), including:

 Utility bill (bass, water, electric) or lease agreement

 Notarized physical address verification form with copy of utility bill from individual attesting to residency

 Property deed

CSU is updating our records for full implementation of Electronic Health Records (EHR). This will require for most patients to pro-
vide updated eligibility documents to be scanned into the EHR system, as many of the chart copies have a poor image quality.
Thank you for your patience and assisting us in this transition!

Page 9

Suicide Prevention

Contributed by Aaron Edenshaw and Jonell James — CSU Licensed Clinical Social Workers

“The person who completes suicide, dies once. Those left behind die a thousand deaths,
trying to relive those terrible moments and understand… Why?” - Clark (2001)

September is the national awareness month for suicide prevention. What once was a random act, is now prevalent in Oklahoma
communities. Different sources reveal suicide is among the leading causes of death among the youth.
In 2012, statistics indicate the State of Oklahoma ranked third in the Nation for mental health disorders, including both youth and
adults. Oklahoma youth between the ages of 12 to 17 years of age, suffered with mental health and substance use disorders. Alt-
hough suicide ranked fourth (1999 to 2006) as the leading cause of death among the youth, it’s an intentional act in contrast to
unintentional injuries, which increases the devastation (National Vital Statistics System, 2012).

 Any Mental illness2 — 20% (103,630)
 Seriously considered attempting suicide5—15% (47,106)
 Made a plan about how they would attempt suicide5 — 14.6% (45,546)
 Attempted suicide5 — 7.4% (23,085)
 Attempted suicide resulting in an injury, poisoning, or overdose having to be treated by a doctor or nurse — 2%

(6,239)

 Dependence or abuse of illicit drugs or alcohol1 — 4.9% (25,234)
 Dependence or abuse of illicit drugs1 — 2.4%
 Non-medical use of pain relievers1 — 6%

There are many reasons our loved ones commit suicide. To the one contemplating suicide, it is the only option to stop the pain. A
person may feel helpless and powerless to change a situation and suicide is the escape. Anyone can experience suicidal thoughts:
race, gender, age, or economic status does not matter. After a suicide, families are then left to carry the burden of the sudden and
unexpected loss.
If you are needing help, please contact 1-800-273-TALK (National Suicide Prevention Lifeline)
If needing to schedule a Behavioral Health appointment, please call 580.331.3485.

Page 10

Teen Suicide

“Suicide doesn’t end the chances of life getting worse, it eliminates the possibility of
it ever getting any better.” – Unknown

Teen Suicide Risk Factors and Protective Factors

Suicide prevention seeks to reduce risk factors and strengthen protective factors to help protect teens from suicide.

Risk factors
 Depression and other mental health problems
 Substance abuse
 Lack of social connectedness (social isolation)
 Lack of direction and establishment of life goals
 Adverse life situations (abuse, bullying, poverty, and major loss)

Protective factors
 Positive life skills (problem-solving and healthy coping)
 Social connectedness (sports, teams, groups, and clubs)
 Positive social support from family, friends, and community
 Positive academic experience and achievement

Suicide Warning Signs
 Social withdrawal
 Severe depression (not eating, sleeping, talking, or engaging in activity)
 Not taking medication (anti-depressant/psychotropic medication)
 Complaints of feeling depressed, hopeless, and/or worthless
 Giving away items of worth (video games, skate board, collections, etc.)
 Writing goodbye letters
 Medication gone missing or finding empty pill bottles I the home
 Physical evidence of cutting (forearm, shoulders, thighs, and abdomen)
 Lack of emotion and lack of expression (chronic unhappiness)

For when the unexpected happens...

Clinton’s Saturday Convenient Care Clinic

9 am to 1 pm

Walk-ins Only
No appointment needed

Clinton’s Saturday Convenient Care Clinic provides treatment for minor medical needs:

Sore Throat Eye and Skin Infections Earaches

Insect Bites and Rashes Sinus Congestion Minor Cuts and Wounds
Cough Nausea, Vomiting, Diarrhea Fever

Pregnancy Tests Bladder Infections Allergies

Chronic health needs such as diabetes, follow-up appointments, routine prenatal care, pain management, and chronic medication refill renewals will require an
appointment in the primary care clinic, and will not be seen in the Saturday Convenient Care Clinic.

Page 11

Clinton
Service Unit

CLINTON Tell us how we’re doing...

10321 N. 2274 Road We invite you tell us how we’re doing and take
Clinton, OK 73601 our short online patient survey.
(580) 331.3300
For a paper copy, please stop by registration.
Cedar (580) 331.3424
Sage (580) 331.3389 2016 CSU Patient Survey
SweetGrass (580) 331.3376
Peds (580) 331.3466 https://www.surveymonkey.com/r/CSUptsurvey2015
Fax (580) 323.2579
Hours of Operation CSU VISION

Monday—Friday Provide quality health care services focusing on prevention, restoration and
8 am to 5 pm collaborative relationships that are valued and “exceed the needs” of our
Saturday patients, community and tribal partners.

Convenient Care Clinic
9 am to 1 pm

EL RENO

1801 Parkview Drive
El Reno, OK 73036

(405) 234.8400
Eagle, Otter & Peds

(405) 234.8411
Fax (405) 234-8435
Hours of Operation

Monday—Friday
8 am to 5 pm

WATONGA

1305 S Clarence Nash Blvd.
Watonga, OK 73772
(580) 623-4991
Turtle & Peds
(580) 623-4991
Fax (580) 623-5490
Hours of Operation
Monday — Friday
8 am to 5 pm