August 2021 CSU Newsletter

August 2021

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

Children and families enjoyed the Back-to-School Health Expo hosted by Clinton Indian Health Center on August 3, 2021.

Back-to-School Health Expo

Clinton Indian Health Center hosted its first Back-to-School Health Expo on August 3. The Back-to-School WHAT’S INSIDE:
Health Expo was a multidisciplinary approach, providing community outreach and health care to American
Indian and Alaska Native youth. The event, held outdoors to promote social distancing measures, created a COVID Update
fun atmosphere through a carnival style environment. Departments within Clinton Service Unit (CSU), Chey- Behavioral Health
enne and Arapaho Tribes, and community programs set-up tents to promote services on health promotion Colorectal Cancer
and disease prevention activities.
Screening
With over 65 children along with their families in attendance, the Back-to-School Health Expo offered sports Eyeglass Options
physicals, wellness exams, COVID-19 vaccination, registration through the CSU Benefits Coordinators to
seek third party funding, and behavioral health programs offered through CSU, the community and tribal El Reno Update
partners to address mental health during a pandemic. COVID Vaccine
Recommendations
The Air Evac Lifeteam landed their helicopter on the grounds just north of the clinic. The children were able
to look inside the air ambulance and ask questions to the Lifeteam. Attendees participated in two hands-on
experiences offered by the Clinton Fire Department. A firehose was available for kids to practice spraying
cones and other objects. The firefighters assisted families in developing a fire escape plan through their in-
flatable house. Families completed fingerprinting kits, offered through the Custer County Sherriff’s Office, to
support preventative measures to provide law enforcement should a child be reported missing

CSU would like to thank all the community partners and CSU staff for making this event successful. Com- Medicaid Expansion
munity partners included: Infant Crisis Services, Cheyenne and Arapaho Diabetes Wellness Program, Tribal New Employees
Opioid Response, Air Evac Lifeteam, Cheyenne and Arapaho Emergency medical Services, Clinton Fire
Department, Red Rock Behavioral Health Services, and the Cheyenne and Arapaho Community Health
Representatives.

What the IHS Mission Means to Me...

Dr. Michael Shields

Clinical Psychologist - Clinton Indian Health Center

INDIAN HEALTH
SERVICE
MISSION

“To me, the IHS mission means providing quality mental health service to our To raise the physical,
local population,” said Dr. Shields. “We are helping to achieve and improve mental, social, and
quality and life relations, as well as life satisfaction. Many times patients come
in and they know they need help, but are not sure how to do it. We help to spiritual health of
give people hope and direction to get back on track and make things better.” American Indians
and Alaska Natives to
the highest level.

What the CUS Vision Means to Me... CLINTON
SERVICE UNIT
Lacey Laurenzana
VISION
Behavioral Health Medical Support Assistant - Clinton Indian Health Center
To provide quality
“The vision of Clinton Service Unit means exceeding the patients' expectations health care services
and empowering them,” said Lacey Laurenzana. “It means educating, provid-
ing resources, and going out of my scope to help. The vision is genuinely caring focusing on
for our patients and their needs, listening, and showing up. It is truly an honor prevention,
to be a part of this service unit and getting to work with some amazing people. restoration and
You can definitely feel the love and compassion our employees have for our collaborative
patients. relationships that are
valued and exceeds
the needs of our
patients, community,
and tribal partners.

Behavioral Health

Compassionate, Effective Care from Our Multidisciplinary Team

The goal of Clinton Service Unit’s (CSU) Behavioral Health department is to exceed the need and provide competent and skilled therapists,
who provide evidenced-based and culturally appropriate therapies to individuals throughout the lifespan. Plans are underway for the team to
increase behavioral health services to adults, children between the ages of two—18 years, and infant mental health.

Currently, the Behavioral Health team is working toward implementation of the following services:

 Zero Suicide: The team is working towards completion of competencies to conduct collaborative assessment and manage-

ment of suicidality. This therapy treats individuals’ suicide ideation in an outpatient therapy session. Currently, CSU has a
trained therapist in dialectical behavior therapy and has incorporated Integrated Behavioral Health services within the primary
care clinic to complement the Zero Suicide program.

 Parent Child Interaction Therapy: One therapist has begun training towards certification for Parent Child Interaction

Therapy. This training focuses on caregivers and their child, ages two - six years of age, who display disruptive behaviors or
Attention Deficit Hyperactivity Disorder (ADHD). The goal of this evidence-based therapy is to provide coaching to caregivers to
help improve their child’s behavior. This type of therapy has been used in child protection cases for over 40 years.

 Eye Desensitization and Reprocessing: The team is working towards certification in this psychotherapy treatment

to assist in enabling individuals to heal form the symptoms and emotional distress, resulting from disturbing life experiences.
This therapy shows the mind it can heal from the psychological trauma, much as the body recovers from physical trauma.

 Trauma-Focused Cognitive Behavioral Therapy: The entire Behavioral Health team is trained and working to-

wards certification on evidenced-based treatment for children/adolescents and their caregivers impacted by trauma. This thera-
py helps to resolve a broad array of emotional and behavioral difficulties associated with single, multiple, and complex trauma
experiences.

 Pain Management: Working alongside Physical Therapy and the Pain Management Program, the Behavioral Health team

is working to provide neuroscience education to individuals in a group format. Educational topic for discussion include: pain and
the brain, neuroplasticity, action plans, and skills to cope with pain. The therapy incorporates the Adriaan Louw neuroscience
research, which has been used for over 20 years.

 Substance Use: The team consists of a licensed alcohol and drug counselor and three additional members who are com-

pleting training through the state of Oklahoma to gain ability to complete assessments on substance use disorder. The team is
working in collaboration with both Tribal Opioid Response and George Hawkins Memorial Treatment Center and are in the be-
ginning stages of medication-assisted treatment services in combination with counseling and behavioral therapies.



CLINTON SERVICE UNIT COVID-19 UPDATE

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.

Positive COVID-19 Cases CSU Total Positive Patients by County
in the State of Oklahoma
Alameda 1 Grady 4
546,257
Alfalfa 2 Greer 2
Positive COVID-19 Cases
amongst CSU patients Beckham 51 Jackson 1
1,184
Bernalillo 5 Kingfisher 19

Blaine 142 Kiowa 6

CSU Total Positive Patients by Age Caddo 30 Major 8

0-4 Years 22

5-17 Years 236 Canadian 343 Oklahoma 60

18-35 Years 385 Cleveland 5 Payne 1

36-49 Years 241

50-64 Years 215 Comanche 2 Roger Mills 18

65+ Years 65 Custer 397 Texas Unk 4

CSU Total Positive Patients by Gender Dewey 24 Washita 42

Male 499 Ellis 1 Woodward 7
Female 684

Garfield 2 Unknown 1

Positivity Rate

There has been an increasing number of COVID-19 cases within the state of Oklahoma.
The overall positivity rate for Clinton Service Unit is approximately 10%.

Positivity Rates

35%

30%

25%

20%

15%

10%

5%

0% 12/8/2020 1/8/2 021 2/8/2 021 3/8/2 021 4/8/2 021 5/8/2 021 6/8/2 021 7/8/2 021 8/8/2 021
11/8/2020 Clinton El Reno Watonga CSU Total

Partnership with OU and Tribal Community for

Colorectal Cancer Screening

Clinton Service Unit (CSU) has partnered with OU Health Stephenson Cancer Center, Indian Health Service Oklahoma City Area, and the
Cheyenne and Arapaho Tribes to bring attention to the high percentage of American Indians and Alaska Natives with colon and rectal can-
cers.

Colon and rectal cancers are cancers that begin in the lower part of your digestive tract, either in the colon or in the rectum, and show many
commonalities. Often known as colorectal cancer, these conditions appear when the cells in the body grow out of control.

Colorectal cancer is a great concern for the Native community. Colorectal cancer is the second leading cause of cancer death for men and
women in the United States. According to the National Institutes of Health, American Indians and Alaska Natives have disproportionately
higher rates of colorectal cancer and screening rates are low amongst Natives.

“Colorectal cancer is preventable with early screening and recognition,” said Cory Williamson, CSU nurse case manager. “The goal of the
collaboration amongst CSU, tribal partners, and OU Health Stephenson Cancer Center is to accelerate and improve the colorectal screen-
ing process for Native Americans in Oklahoma.”

Colorectal cancer screening tests are offered to patients between 45—75 years of age. Previously, patients were requested to provide three
screening samples to send in for testing. Through new technology, patients are only required to obtain one screening sample to send in for
testing. The test kits are sent to patients through the mail. Patients are encouraged to obtain a sample at home and send back to the clinic
through the return envelope provided. The test is quick and convenient, taking approximately 5 minutes to complete. Patients are encour-
aged to screen for colorectal cancer on a yearly basis.

“It is our hopes, through this quick and easy process, the service unit will increase the number of screening kits returned for testing,” said
Williamson. “In doing so, we’re able to help more people prevent colorectal cancer.”

Because early detection of colorectal and gastrointestinal cancers leads to better treatment and recovery, it’s important to know
your risk factors and the early warning signs. Tell your provider about your family history with colorectal cancer. Remain alert for
symptoms of colon and rectal cancer, including:

 Changes in the bowel habits, diarrhea, constipation

 Blood in stool

 Persistent feeling of fullness in the abdomen

 Pain and bloating in the abdomen

 Unexpected weight loss

 Feeling that the bowel doesn’t completely empty

 Fatigue

Oncology patients may call (405) 362-6553 for information

Eyeglass Options

For nearly ten years, the Optometry department of Clinton Service Unit (CSU) has provided glasses to many of our patients through the Eye-
glass Program. In recent years, features such as transition lens were discontinued, as it nearly doubled the cost for a pair of glasses. This
past year, a new vendor was selected, allowing the department to reintroduce features to the Eyeglass Program benefitting many patients.
Patients who live within the CSU delivery area are eligible to obtain one pair of glasses per year at no charge. In order to receive the free
pair of glasses, patients must have an active prescription and provide an updated proof-of residency (current gas water, or electric bill; mort-
gage statement; rental lease; or tax documents containing the patient's name and address).
Services offered through the new eyeglass vendor allow for patients to add additional features to their eyeglasses if the patient chooses to
pay for the additional costs above the price of the eyeglasses. An on-line portal allows patients to provide card payment (credit, debit, or pre-
paid) for transition lenses, blue-light filters, as well as any additional pairs of glasses for purchase at a reasonable cost. Prices may range
anywhere from $40—$90. An additional pair of glasses may vary, but on average may be around $20.
Patients living outside the CSU delivery area may be eligible for eyeglasses and should check with the Optometry department for eligibility
status at 580.331.3413.

Dr. Devyn Staggs, optometrist

UPDATE: El Reno Expansion

The construction of the new facility for El Reno Indian Health Center continues to be on schedule, with an anticipated completion date for
early 2022. Over the past month, crews have continued to work on electrical rough-in, installing dry-wall, framing the ceilings, and installing
doors and frames. Below are pictures of the existing construction.

Mammography

While National Breast Cancer Awareness Month is celebrated in the month of October, now is as good of time as any to increase aware-
ness of breast cancer and remind the women amongst us to be proactive with their breast health. Knowledge and early detection saves
lives.
According to the American Cancer Society, when breast cancer is detected early and is in the localized stage, the 5-year relative survival
rate is 99 percent. Early detection includes doing monthly breast self-exams, scheduling regular clinical breast exams, and mammograms.
Clinton Service Unit’s (CSU) Radiology department offers both 3D mammography and diagnostic mammography services.
A 3D mammogram is an imaging test combining multiple low dose breast x-rays at multiple angles to create a three-dimensional picture of
the breast. When used for breast cancer screening, 3D mammography creates both a 3D and a 2D image. Studies show, combining 3D
images with standard 2D images reduces the need for additional imaging and slightly increases the number of cancers detected during
screening.
A 3D mammogram offers advantages in detecting breast cancer in people with any breast tissue density, but especially in patients with
dense breast tissue. 3D images allow for providers to see beyond areas of dense breast tissue. Breast tissue is composed of milk glands,
milk ducts, supportive tissue, and fatty tissue. Dense breasts have greater amounts of dense breast tissue than fatty tissue. Both dense
breast tissue and cancers may have the same appearance on a standard 2D image, which may make breast cancer more difficult to detect
in dense breasts.
“The 3D mammogram technology allows for us to create a more complete picture of the breast,” said Stevi Brown, radiology supervisor.
“3D mammography has been shown to improve breast cancer detection by 27—50 percent.”
In July 2021, CSU began to offer services for diagnostic mammography. Diagnostic mammography is performed when additional images
of the breast are needed to further check for cancer, and when the patient or provider feels a lump or thickening of the breast tissue.
“With the addition of diagnostic mammography, patients are now able to obtain the needed x-rays of the breast from different angles, mag-
nification views or compression of a small area of the breast to maximize detail, and provide ultrasound when indicated all within CSU’s
Radiology department,” said Brown.
Adult women of all ages are encouraged to perform breast self-exams at least once a month. While mammograms can help you to detect
cancer before you can feel a lump, breast self-exams help you to be familiar with how your breasts look and feel, so you can alert your
health care professional if there are any changes.
Women should begin scheduling their annual mammograms at the age of 40. Detecting breast cancer at its earliest stage is crucial to sur-
vival. Having an annual mammogram is an important first step in diagnosing breast cancer. To schedule a mammogram, call the Radiology
department at 580.331.3415.

CSU mammography team (pictured left to right): Toni Ward and Maci Brooks

COVID-19 vaccination is recommended for all people aged 12 years and older, including people who
are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future. Preg-
nant and recently pregnant people are more likely to get severely ill with COVID-19 compared with non-
pregnant people. Getting a COVID-19 vaccine during pregnancy can protect you from severe illness from
COVID-19.

 Based on new evidence about the safety of the COVID-19 vaccines, the Centers for Disease Control
and Prevention (CDC) is strengthening its recommendation for COVID-19 vaccination during preg-
nancy.

 In a new analysis of current data from the v-safe pregnancy registry, scientists did not find an in-
creased risk for miscarriage among people who received an mRNA COVID-19 vaccine before 20
weeks of pregnancy.

 Previous findings from three safety monitoring systems did not find any safety concerns for pregnant
people who were vaccinated late in pregnancy or for their babies.

 Growing evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy
demonstrates that the benefits of receiving a CVOID-19 vaccine outweigh any known or potential
risks.

 COVID-19 vaccination is recommended for all people 12 years and older, including people who are
pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future.

 The increased circulation of the highly contagious Delta variant, the low vaccine uptake among preg-
nant people, and the increased risk of severe illness and pregnancy complications related to COVID-
19 infection among pregnant people make vaccination for his population more urgent than ever.

Medicaid Expansion

Medicaid eligibility expanded for adults ages 19-64, with coverage for this expansion beginning on July 1, 2021. While American Indian and
Alaska Natives are not required to enroll or opt-in to the new SoonerSelect managed care plan, they are highly encouraged to do so. To
date, Clinton Service Unit has screened 764 patients, with 335 of these patients approved for Medicaid coverage. This has an estimated
impact of bringing in an additional $848,565 annually, which may be used to fund additional services throughout the service unit. Benefit
coordinators will continue to screen and contact patients for Medicaid eligibility.

Contact a Clinton Service Unit Patient Benefit Coordinator to see if you qualify or have questions about your existing coverage.

Clinton Indian Health Center PRC Benefit Coordinator El Reno/Watonga Indian Health Center
Benefit Coordinators Angela Vaughan Benefit Coordinator
Teresa Murray (580) 331-3419
(580) 331-3364 Juanita Benally Morsette
Leslie Panana (405) 234-8425
(580) 331-3340

Visit the Oklahoma Healthcare Authority website for more details about the new
SoonerSelect program at

https://www.oklahoma.gov/ohca/about/medicaid-expansion/expansion.html.

Danna Watson

Laboratory Medical Technician | Clinton Indian Health Center

Danna Watson has been a medical technologist for many years. She is a
mother of three grown children. Currently, Danna and her husband farm
near Weatherford, Oklahoma. Prior to returning to Custer County in 2004,
they lived several places over the years, including Indonesia and Malaysia.

“I’m excited to work with CSU.”

Natalie Haworth

Dental Hygienist| Clinton Indian Health Center

Natalie Haworth, dental hygienist, is from Weatherford, Oklahoma. While in
hygiene school, she worked for CSU as a dental assistant. In her free time, you
can find Natalie with family or with her chocolate lab, Barrett. “I’m excited to
be back at IHS and I’m looking forward to all the opportunities it will bring!”



Quarantine & Isolation

Recommendation provided by Centers for Disease Control and Prevention

Quarantine

Quarantine if you have been in close contact (within 6 feet of someone for a cumulative total of 15 minutes or more over a 24-hour period)
with someone who has COVID-19, unless you have been fully vaccinated. People who are fully vaccinated do NOT need to quarantine
after contact with someone who had COVID-19 unless they have symptoms. However, fully vaccinated people should get tested 3-5 days
after their exposure, even if they don’t have symptoms and wear a mask indoors in public for 14 days following exposure or until their test
result is negative.

What to do

 Stay home for 14 days after your last contact with a person who has COVID-19

 Watch for fever (100.4° F), cough, shortness of breath, or other symptoms of COVID-19

 If possible, stay away from people you live with, especially people who are at higher risk for getting very sick from COVID-19

After quarantine

 Watch for symptoms until 14 days after exposure

 If you have symptoms, immediately self-isolate and contact your local public health authority or health care provider

Isolation

Isolation is used to separate people infected with COVID-19 from those who are not infected. People who are in isolation should stay home
until it’s safe for them to be around others. At home, anyone sick or infected should separate from others, stay in a specific “sick room” or
area, and use a separate bathroom (if available).

What to do

 Monitor your symptoms. If you have an emergency warning sign (including trouble breathing), seek emergency medical care
immediately

 Stay in a separate room from other household members, if possible

 Use a separate bathroom, if possible

 Avoid contact with other members of the household and pets

 Don’t share personal household items, like cups, towels, and utensils

 Wear a mask when around other people if able

Guidelines for those who are fully vaccinated

Those who are fully vaccinated do NOT need to quarantine after contact with someone who had COVID-19 unless they have
symptoms. However, fully vaccinated people should get tested 3-5 days after their exposure. Even if those who are fully vac-
cinated do not have symptoms, they are to wear a mask indoors in public for 14 days following exposure or until their test result
is negative.

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!

Arlena Miles

“Arlena is an absolute joy to be around,” said the environmental services (EVS) crew. “Her customer service skills are immeasurable.
She is constantly busy and always ready to meet the needs of each and every patient that comes her way. While on the phone with
patients, you can see her smile and you can defiantly see the care and concern she has for the patients. The EVS team has all en-
countered Arlena welcoming a patient into the Pediatric department. She greet patients and makes them feel at ease. Arlena always
has a pep in her step and a friendly word to speak anywhere you may encounter her in the facility. She is a true example of what it

means to exceed the need.”

Gerald Chasenah, Harry Ynguanzo & Jacob Brice

“I’d like to thank these gentlemen for taking time out of their daily lives to retrieve my keys out of my locked care due to my severe
forgetfulness,” said Leanna Bailey.

Radiology Department

“I would like to recognize the Radiology staff for their diligence in collecting Assignment of Benefits (AOB) in their department,” said
Kala Rodgers, ancillary services director. “As an ancillary service, where patients are typically coming to the department from anoth-
er service, they should not have to collect many of these. They still take the time and effort to look for the AOB and get the patients’
signature. Radiology knows how important this process is to Clinton Service Unit’s revenue, as collections plays a huge role in the
services we are able to offer. The staff reviews each patients' record and makes note on which patient will need an AOB. Together,

they work as a team to obtain the patient's signature prior to them leaving their department.”













Clinton Service Unit

Department Directory

CLINTON INDIAN HEALTH CENTER 580.331.3300
10321 N. 2274 Road ~ Clinton, OK ~ 73601

Request to establish chart: 580.331.3369

Cedar Medical Home SweetGrass Medical Home Willow Medical Home

Ginger Woodall & Michelle Beshaw Dr. Maqbool, Dr. Garner Dr. Egan, Dr. Middleton, & Dr. Skelly
Apts: 580.331.3424 & Jessica Van Den Berg Apts: 580.331.3466
Nurse: 580.331.3424 Apts: 580. 331.3412 Nurse: 580.331.3466
PRC: 580.331.3363 Nurse: 580.331.3412 PRC: 580.331.3307
PRC: 580.331.3513
580.331.3420

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

EL RENO INDIAN HEALTH CENTER 405.234.8400
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

WATONGA INDIAN HEALTH CENTER 580.623.4991
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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