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Published by CSU Newsletter Team, 2021-12-29 08:51:16

December 2021 CSU Newsletter

December 2021 CSU Newsletter

December 2021

The Monthly Newsletter for Clinton, El Reno,
and Watonga Indian Health Centers

Santa Claus and the Grinch paid a visit to Clinton Indian Health Center to meet with children from the
Cheyenne and Arapaho Tribes’ Head Start and Child Care facility.

Santa Brightens Head Start Students’

Christmas at Clinton WHAT’S INSIDE:

Santa, Mrs. Claus, and the Grinch took time from their holiday schedule to visit Clinton Indian Health Center 2021
(CIHC) for the clinic’s third annual Sitting with Santa event. Accomplishments

The event, organized by Brianna Sands of the environmental services de- COVID Update
partment and made possible through generous contributions by the Em- El Reno Expansion
ployee Association, provided holiday gifts to each student of the Cheyenne
and Arapaho Tribes’ Head Start and Child Care facilities in Clinton. Table Top Drill
Donna Hill Retires
“I am very pleased with turnout for the event and that we were able to host
it at our facility this year,” said Brianna Sands. Ibarra Obtains
Board Certification
The Head Start students, between the ages of 3 to 5, had the opportunity
to take a photo with Santa, Mrs. Claus, Santa’s Elf, and the Grinch. Staff of POP Awards
CIHC joined in the fun taking individual and department Christmas photos
with Santa.

Santa’s Elf, Brianna Sands, organized the
3rd annual Sitting with Santa Event

What the IHS Mission
Means to Me...

JoAnna “Jo” Perez embodies the mission of Indian Health Service. INDIAN HEALTH
“When I think of words to describe JoAnna “Jo” Perez, I think of reliable, hard- MISSION
working, self-starter, and teamwork mindset,” said Lieutenant Commander
(LCDR) Michael Hunt, point-of-sale pharmacist. “Normal daily tasks for Jo include To raise the physical,
the running of daily point-of-sale (POS) reports, working POS rejections, and initi- mental, social, and
ation/completion of medication prior authorizations. Other tasks she tackles are
the identification and entry of third party coverage for uninsured patients, and a spiritual health of
new PDSA (Plan, Do, Study, Act) on correcting refill too soon rejections. Jo is well American Indians and
versed in all tasks and is willing to do whatever is needed to keep the pharmacy Alaska Natives to the
caught up and on schedule.”
highest level.
“Jo eagerly awaits the start of each new month. This is when we run our list of
uninsured patients who had a pharmacy visit the previous month at either Clinton, CLINTON SERVICE
El Reno, or Watonga Indian Health Center. If I do not have the list for her, she will UNIT
actively prompt me to print this off. She’s eager to begin entering the 600—1500 VISION
names, one-by-one into Cardfinder, in an effort to identify third party coverage the
patient may have that is not listed in their record. Once identified, Jo enters cover- To provide quality health
age and back-bills any existing pharmacy claims. She then tallies up the totals care services focusing
form those paid claims and slaps it on a spreadsheet. Jo schedules an appoint- on prevention,
ment for each of these patients on the Insurance Update schedule, for the Busi- restoration and
ness Office/Registration to follow-up on acquisition of documents and the addition collaborative
of medical insurance.” relationships that are

Over this past year, Jo has entered over 6,000 names into Cardfinder and identi- valued and exceeds the
fied insurance for 825 patients. Her efforts have allowed the service unit to back- needs of our patients,
bill claims totaling $184,378 in initial findings. community, and tribal
“Rewards snowball monthly, as the entered coverage continues to bill claims. Cre-
ating awareness of existing medical insurance provides the opportunity for the
Business Office/Registration staff to increase their collection totals. This is all
above and beyond Jo’s normal POS duties, pharmacy technician duties, among
other collateral duties.”

“Jo’s extra efforts are a huge part on why we continue to set new record collection
totals on a regular basis and what makes Pharmacy and CSU successful!”

2021 Was A Year of Accomplishments

As Clinton Service Unit (CSU) continues to live the mission of Indian Health Service and ensure the strategic goals set forth by the Agency
are met, we take time to reflect on 2021 and the accomplishments, best practices, and outstanding achievements obtained. Here are just a
few of our highlights throughout this past year...

Net Promoter Score

CSU’s customer service initiative continued with the utilization of the Net Promoter Score (NPS). The service unit’s goal for the fiscal year
was to achieve an average NPS of 70. CSU far exceeded this goal with an average score of 83 in fiscal year 2021. In fact, no lower score
than 83 was achieved from January 2021 to September 2021.


The service unit worked diligently to recognize our staff and their “exceed the need” effort throughout 2021. CSU is committed to fostering
self-care, supporting each other, and looking to our future. Meaningful recognition is part of a healthy work environment. Recognition has
included increasing the number of staff nominated Personal Outstanding Performance (POP) awards by 110 percent and increasing super-
visor recognized On-the-Spot Awards by 86 percent. New for 2021, CSU implemented the Chief Executive Officer (CEO) Awards, to recog-
nize staff through the utilization of the award nomination criteria from the Oklahoma City Area Director’s Awards.
In an effort to foster self-care, the service unit facilitated staff from the Oklahoma College of Massage Therapy to provide a 15 minute mas-
sage to employees. This effort produced extraordinary results with staff extremely appreciative of the thoughtfulness and time to relax.
Walk-abouts were encouraged throughout the year, promoting peer-to-peer or supervisor-to-direct report interaction with no business to be

Case Management/Referral Loop Closure

In 2021, the CSU Case Managers changed the process for tracking referrals and closing the referral loop. Many PDSA (Plan, Do, Study,
Act) changes occurred resulting in a 107 percent increase in referral closures comparing to pre- and post- PDSA data.

2021 Accomplishments Continued…

COVID-19 Vaccination Rates

The service unit worked diligently with the Cheyenne and Arapaho Tribes and community stakeholders to increase access to the COVID-19
vaccine. Our goal was to reach 60 percent of our population. Starting in January 2021, mass outreach through social media and various
media outlets provided dates and locations of mass COVID-19 immunization clinics within the CSU community and Oklahoma City. Using
HealthPic data accessed on November 3, 2021, we determined we met our goal with over 66 percent of the population being vaccinated.

 A total of 12,282 patients were registered at CSU in fiscal year 2020

 10,280 patients over 13 years of age (eligible for vaccine)

 2,002 patients between 5 - 12 years of age (not eligible for vaccine)

 Vaccine Efforts

 COVID vaccines provided to beneficiaries: 6,808

 COVID vaccines provided to non-beneficiaries: 3,038

 Total COVID vaccinations provided: 9,846

 Total registered patients served: 6,808 / 10,280 = 66%

Colorectal Screening Initiative

The service unit partnered with the University of Oklahoma Health Sciences Center, Oklahoma City Indian Clinic, Choctaw Nation, and
Cheyenne and Arapaho Tribes to bring attention to the high percentages of Native Americans with colorectal cancer, with the goal of accel-
erating and improving upon the colorectal screening process for Native Americans.

Colorectal cancer is preventable with early screening and detection. Native Americans show the lowest amongst all minority groups of colo-
rectal screening rates. Low screening rates correlates to the high mortality rate from colorectal cancer.

Colorectal cancer screening is now offered to men and women ages 45 - 75 on a yearly basis. CSU is changing the screening tool form
three stool specimens to one. The test is sent to patients from CSU in the mail, along with a stamped envelope to return testing material.
This project's aim is to increase the number of completed screenings and to increase overall colonoscopy screenings. Patients receive an
automated message with options to either accept the mailing of a screening card or not.

Diagnostic Mammography

Diagnostic mammography began at CSU in July of 2021. It was an overall success and huge accomplishment for the facility and patients.
Prior to providing this in-house service, the average turnaround through an external provider was anywhere between 40 - 120 days.
Through providing diagnostic mammography services in-house, the average turnaround time is within 15 - 20 days.

The Mammography Program overall is working in collaboration with Optometry, Dental, Behavioral Health, Audiology, and Physical Thera-
py to increase referrals. When patients schedule for any of these services, these departments are taking the initiative to advise patients
when they are due for a mammogram and then transferring them to the Radiology department to schedule for this service.

I-STAR Management

The service unit continued to focus on safety tracking and respond through the IHS-Safety Tracking & Response (I-STAR) incident reporting
system. Processes were refined throughout the year as CSU became more familiar with I-STAR’s many reporting functionalities and ability
to track turnaround times/days to closure. Implementation of this system resulted in the service unit meeting our 30-day goal to close safety
events from report day to closure date. Improvement actions will continue into next fiscal year. This will include educating employees on our
completing I-STAR event templates correctly, ensuring employees include names of individuals involved, tagging the correct safety officer
according to event type, and asking for assistance if unsure on any procedures.

Federal View Point Survey

CSU had a 72.4 percent response rate to the Federal Viewpoint survey. Specifically, CSU outperformed or achieved higher results in 75
percent (46/61) of questions when compared to the Oklahoma City Area average rates of 88 percent (54/61) of questions when compared
to the IHS average rates.
The Executive Leadership Team, along with a few other key staff, met on several occasions to discuss the results and look at areas where
we scored the lowest. Together, this team brainstorm ideas for improvement. As a follow-up to these meetings, CSU has initiated an online
suggestion box which includes probing questions to obtain more information about an area of concern, a blank space for comments and
suggestions, and includes questions from the Net Promoter Score. This tool will be repeated monthly, with a new questions of the month
and continue to recommend for staff to utilize the comments section as needed with ideas for improvement. All responses are anonymous,
with an option for staff to provide their name if they so choose. The team reviews the responses and shares the information with staff, in
anticipation of generating additional action items and ideas to improve areas over time where the service unit had lower scores.

Cheyenne and Arapaho Tribes

CSU Administration and Patient Advocate participated in over 30 joint CSU and Tribal Town Hall events. The Town Halls were developed in
an effort to gain feedback from the community and tribal leadership regarding the service unit’s COVID-19 response.

AudioReminder Initiatives

Staff of the Information Technology department and Registration worked collaboratively to improve the number of patients registered for
CSU’s AudioReminder system. Their efforts produced in increase from 3,471 patient in FY20 to over 4,675 patients in FY21, marking a 34
percent increase!

2021 Accomplishments Continued…

Purchased/Referred Care

In 2021, the Purchase/Referred Care (PRC) department added a Benefits Coordinator to assist in increasing the eligibility rate for patients
who qualify for the Medicaid expansion resource. This resource aids in generating revenue for the service unit and decrease the dollar
amount for PRC funding, which allows patient to receive much needed care and provide greater assistance to those patient without third
party coverage. As the Medicaid expansion has increased the amount of individuals who qualify for assistance, PRC implemented a new
process allowing patient to schedule their own appointments with an outside provider according to their time and availability. This allowed
for a decrease in the amount of no-shows and rescheduled appointment rates.

The department implemented several goals throughout the year to ensure referrals are handled in a more “real-time” manner. Among these
goals are to handle pending referrals within five days of receipt and present to medical review. Upon initiation of this goal, the department
started with over 900 pending referrals at 100—150 days out. The department has worked diligently at reducing these pending referrals to
300 at 10 days out. This is a huge accomplishment, as the amount of referrals written within the service unit averages between 100—125
per day.

In regards to emergency room (ER) referrals, PRC has set a goal of less than 50 ER/72-hour notification referrals at less than 15 days out
for pending self-referrals. At the start of this initiative, the department was at 100 referrals at over 100 days out. Currently, PRC is exceeding
their goal at 30 ER/72-hour referrals at 10.7 days out.

PRC has set an approval referral goal of less than 650 at 30 days out. At the start of this goal, the department was at 1000—1500 approved
referrals at 90 days out. Currently, the department has improved approved referrals to 642 at 26.9 days out. Due to the amount of referrals
written on a daily basis and the amount of appointments in need of scheduling, this is a huge accomplishment as there is much beind the
scenes work taking place to make an appointment happen.

PRC has added several tracking processes to ensure our patients’ needs are met and bills to outside providers are paid. Much of the pro-
cesses within PRC has converted to an electronic format, including the medical review, services requiring an administrative review, and
appeal process. The review and tracking of claims submitted for payment is now in an electronic format. The department no longer has to
manually search for claims. Claims may now be found in an electronic claims folder in a department specific drive. Claims received through
the mail are uploaded into a folder to be worked and researched on a daily basis. Vender reports are also kept in this format for ease in as-
sisting vendors as they require assistance.

Communication amongst staff to inform of general information and department information has improved. Staff are updated and informed on
a regular basis, and they are aware of accomplishments or areas in need of attention. PRC has implemented a communication card to be
implemented in 2022. This card, provided to our patients, will identify the patient receives services through CSU, and any communication on
behalf of the patient from an outside provider may be communicated through CSU’s PRC department. The communication card was devel-
oped in an effort to provide our patients with a sense of belonging to the service unit.

Welcoming Committee

This committee was implemented to enhance the quality experience for new recruits. In collaboration with Human Resources, the Welcome
Committee officially started in February 2021. The goal of this committee is for new employees to feel like they are in integral part of our
organization from the moment they walk through the door. New hire satisfaction has increased from 71% to 91% within the first 60 days of
this committee’s implementation. The committee has implemented the following “welcome” action plan to improve new employee orienta-
tion; Welcome signs located at the point of entry; Point of entry greeters to establish a favorable impression; Complimentary food and
drinks, including lunch; Employee desk starter kit made with basic office supplies; Handwritten notes from the department; and Department
tours with supervisors.


COVID-19 is a virus identified as the cause of an outbreak of respiratory illness first detected in Asia in late 2019 that has since spread
globally into a pandemic. The virus has spread across all 50 states. Clinton Service Unit is tracking how the virus spreads amongst our

community and service unit.

14 Day CSU Total Positive Patients by Age

7 Day Average Number of 0-4 Years 2
New Daily COVID-19 Cases 5-17 Years 3

in the State of Oklahoma 18-35 Years 7

1,035 36-49 Years 6

14 Day 50-64 Years 2
Positive COVID-19 Cases 65+ Years 0

amongst CSU patients 14 Day CSU Total Positive Patients by Gender

20 Male 9

Female 11

14 Day CSU Total Positive Patients by County

Beckham 4
Blaine 4
Caddo 1

Canadian 5
Custer 2
Kiowa 1
Roger Mills 2

Positivity Rate

The overall positivity rate for Clinton Service Unit is approximately 6%.

Positivity Rates









Clinto n El Reno Wato ng a CSU Total

UPDATE: El Reno Expansion

The construction of the new facility for El Reno Indian Health Center is approximately 90 percent complete. Construction crews are finish-
ing the final details, cleaning, and completing punch-list items. The anticipated final completion date for the new facility is late January.
Once certificate of occupancy is obtained from the city of El Reno and access is gained to the building, it is anticipated for the staff to begin
moving equipment and network driven devices in late February. Patient care in the new facility will begin in March, with the opening of pri-
mary care, laboratory services, and pharmacy. Through 2022, the additional services of physical therapy, optometry, dental, and radiology
will be added. Once the existing El Reno facility is cleared, plans are underway for the old building to undergo demolition.

Front view of the new facility for El Reno Indian Health Center

View of the Primary Care area

Emergency Response Table-Top Drill

On December 7, Clinton Indian Health Center hosted a community-wide active shooter table-top drill. Jane Nickel, RN and safety officer for
emergency management, coordinated the event. A number of key personnel from Clinton Service Unit, the surrounding community, county,
and Indian Health Service Oklahoma City Area Office were invited to attend. Those who were unable to attend in-person, had the opportuni-
ty to attend through a virtual format.
An outline of an active shooter scenario was written and color maps were provided to the participants. The representatives were encour-
aged to generate discussion on how they would handle the critical situation and what they may expect from the facilities in need of their
emergency response services. The main areas of focus during the drill was access, communication, and accountability.
“Overall, this was a lively event with plenty of insightful information,” said Nickel.

Clinton Service Unit and community representatives practice a table-top drill in emergency response at
Clinton Indian Health Center.

Thank You Tribal Health Board!

Thank you to the Cheyenne and Arapaho Health Board, who generously
provided lunch to all three facilities within Clinton Service Unit. The
Health Board expressed their words of encouragement and gratitude to
staff’s service throughout this past year.

Pictured left: Staff of El Reno Indian Health Center meet with
Tribal Health Board Member Charles Fletcher (second from the right).

Donna Hill Retires After 29 Years of Service

Donna Hill, medical records technician/coder, started her career with Indian Health Service in the Medical Records department at Lawton
Indian Hospital in August 1994 as a temporary Medical Records Technician. In July 1996, she moved to the position of permanent coder. In
1997, she was selected as the Lead Medical Records Technician and served as lead coder and patient resources management, serving
over seven coders and one contract coder. In January 2011, Hill moved to Clinton Indian Health Center to serve in the role of Contact Rep-
resentative. In this position, Hill loved meeting and helping patients find alternative resources, but she found herself missing the word of
coding. In May 2015, went back to the Medical Records department, where she has served ever since.
“It has been a great experience to be here in Clinton,” said Hill. “All of my family are happy I’m taking time for me.”

Congratulations Donna Hill on 29 years of service
to Indian Health Service!

El Reno Pharmacist obtains Board Certified
Pharmocotherapy Specialist

Dr. Jordan Ibarra, El Reno pharmacist, recently completed the rigorous gauntlet of
studying for and passing the exam to become a Board Certified Pharmacotherapy
Specialist (BCPS). We are incredibly excited for Jordan, as the Board of Pharmacy
Specialties’ certifications are recognized as the gold standard for identifying phar-
macists who are qualified to provide advanced practice pharmaceutical care. Next
time you see Jordan, take a moment to congratulate her—not only on the extra four
letters behind her name, but for the momentous achievement she has undertaken
in pursuit of providing the highest level of care for our patients.

Jordan Ibarra, PharmD, BCPS

Holiday Meal

On December 9, staff of Clinton, El Reno, and Watonga Indian Health Centers gathered at their respective facilities for some food and fel-
lowship. A holiday meal was sponsored by Clinton Service Unit’s Employee Association, along with donated food from employees.

Holiday Door Decorating

The Employee Association sponsored Clinton Service Unit’s annual Holiday Door Decorating Contest. Strolling through halls of each facility,
patients, visitors, and staff alike were shown holiday spirit through themed doors from the likes of the Christmas Story, Rudolf the Red
Nosed Reindeer, Elf, the Grinch, and many more. Check out some of the fantastic designs developed by our staff!

Clinton Dental Hygienist Deploys to

Lieutenant (LT) Alyssa Rowe, Clinton dental hygienist, recently had the opportunity of deploying to Hoopa, California. During this month-long
deployment, LT Rowe was stationed at the K’ima:w Medical Center serving the Hoopa Valley Tribe, made up of the Hoopa and Yurok
LT Rowe served the K’ima:w Medical Center providing dental hygiene, including dental cleanings, deep cleanings, dental sealants, and flu-
oride varnish treatments. She took the opportunity to provide dental education to patients on cavity prevention and baby bottle tooth decay.

LT Alyssa Rowe outside the K’ima:w Dental Clinic

The POP Award recognizes Clinton Service Unit employees who exhibit
Personal Outstanding Performance. It is designed to encourage and
acknowledge employees for their everyday efforts and customer service.

Congratulations to all of our POP Stars!

Scott Kellogg

“I was passing the Dental department and observed a patient in a wheel chair,” said Stevi Brown, radiology supervisor. “Scott bent
over and asked the patient what was going on. The patient was noticeably in pain and crying, describing why she was there. Scott
was so nice and compassionate with this individual, assuring the patient he would take her back to figure out what was going on. It

was nice to see how good he was with this patient. This is how I want for my family to be treated. Great job, Scott!”

Daniel Hibbert

“There was a difficult situation taking place with a patient in the building,” said Stevi Brown, radiology supervisor. “Daniel stepped in
to help the best he could and absorb some of the harassment placed on the staff and visitors in the building. I’d like to thank Daniel

for stepping up to diffuse the situation and help out his fellow coworkers and patients in the area at the time of the incident.”

Andrea Hammer

“Andrea took on the duty of assisting Dr. Warrick in submitting forms and documentation for his annual continuing education course,”
said Susan Rose, physical therapy director. “She obtained all the needed information from Dr. Warrick and contacted the continuing

education provider for the needed details and followed through with the needed process.”

Narcisso Soliz

“Narcisso provided me with additional guidance and direction in the completion of the annual Commissioned Corps’ documentation
for my department staff,” said Susan Rose, physical therapy director. “He is always willing to set time aside for this annual process to

assure timely and proper submission.”

Elverna Spottedwolf & Jeff Blackmon

“Dental had a recent issue with the sterilizers breaking down and leaking,” said Dr. Matthew Fell, dental chief. “Jeff did not hesitate to
step-in and handle our equipment needs to get things back to normal. Elverna came in on both a Saturday and Sunday to ensure the

necessary equipment was properly sterilized and the biological indicators were used to verify sterilization so direct patient care did
not suffer. These two individuals deserve recognition for their efforts!”

Jeff Blackmon

“Jeff assisted a member of the Environmental Services team in clocking in and out,” said Tina Scott, administrative officer. “Jeff as-
sisted the employee to figure out who to contact and what needed to be done to fix her time. He continues to help with anything

needed and volunteered to assist in the situation if needed again. Jeff went out of his way to explain the situation to me, so we may
try to help the contract worker figure out the new time system.”

Clinton Service Unit

Department Directory

10321 N. 2274 Road ~ Clinton, OK ~ 73601

Request to establish chart: 580.331.3369

Cedar Medical Home SweetGrass Medical Home Willow Medical Home

Dr. Garner, Ginger Woodall Dr. Maqbool Dr. Egan, Dr. Middleton, &
& Michelle Beshaw & Jessica Van Den Berg Dr. Skelly
Apts: 580.331.3424 Apts. 580. 331.3412 Apts: 580.331.3466
Nurse: 580.331.3424 Nurse: 580.331.3412 Nurse: 580.331.3466
PRC: 580.331.3363 PRC: 580.331.3513 PRC: 580.331.3307


Audiology: 580.331-3482 DEPARTMENTS Chiropractic: 580.331.3439
Dental: 580.331.3423 Optometry: 580.331.3413
Pharmacy: 580.331.3351 Behavioral Health: 580.331.3485 Podiatry: 580.331.3439
PHN: 580.331.3471 Nutrition: 580.331.3458 Radiology: 580.331.3415
Release of Info: 580.331.3377 Physical Therapy: 580.331.3439
PRC: 580.331.3590
Wound Care: 580.331.3439

1801 Parkview Drive ~ El Reno, OK ~ 73036
Request to establish chart: 405.234.8427

Eagle Medical Home Otter Medical Home Pediatrics

Dr. Garcia, Monica Holcomb Dr. Renshaw & Fayth-An Hope Gray Dr. Mejias
& Michelle Tippeconnic Apts: 405.234.8411 Apts: 405. 234.8411
Apts: 405.234-8439 Nurse: 405.234.8411 Nurse: 405.234.8411
Nurse: 405.234.8439 PRC: 580.331.3336 PRC: 580. 331.3307
PRC: 580.331.3336

Behavioral Health: 405.234.8426 DEPARTMENTS PHN: 405.234.8430
PRC: 580.331.3590
Pharmacy: 405.234.8423
Release of Info: 405.234.8403

1305 S. Clarence Nash Boulevard ~ Watonga, OK ~ 73772

Request to establish chart: (580) 623-4991 ext. 3000

Turtle Medical Home Pediatrics

Dr. Ali & Fayth-An Hope Gray Dr. Mejias
Apts: 580.623-4991 Apts: 580.623.4991
Nurse: 580.623.4991 Nurse: 580.623.4991
PRC: 580.331.3336 PRC: 580.331.3307

DEPARTMENTS PRC: 580.331.3590
Pharmacy: 580.623.4991 PHN: 580.623.4991
Dental: 580.623.4991 ext. 3007 Release of Info: 580.623.4991


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