During August 27 - 30, 2018, Tribal Health (TH) will host a series of public hearings and comment opportunities regarding the 1) Medically Related Recipient Travel Program Policy and  2) Controlled Substance Utilization and Dispensing Limitation Policy.  

“Currently there is a practice, but not a policy, in place regarding medically related travel assistance, in addition to a focus on controlled substance use and dispensing,” said Teresa Wall-McDonald, Tribal Health Department Head.  “Tribal Health is using the Tribal Administrative Process Ordinance to allow the Tribal Membership to have a voice and participate in shaping these policies for the future.  It is why Tribal Health is holding hearings across the entire reservation.  We hope that people who are interested will engage and participate in a meaningful way.”

The hearings will take place on the following dates, times and locations:

 

  • Monday, August 27, 2018

Hot Springs Public Hearing

Hot Springs Senior Center

101 Main St #1 

Hot Springs, MT 59845

1 - 2 pm - Medically Related Recipient Travel Program Policy

2 - 3 pm - Controlled Substance Utilization and Dispensing Limitation Policy

Light refreshments

 

  • Monday, August 27, 2018

Arlee Public Hearing

Arlee Community Center

Pow Wow Road

Arlee, MT 59821

6-7 pm - Medically Related Recipient Travel Program Policy

7-8 pm - Controlled Substance Utilization and Dispensing Limitation Policy

Light refreshments

 

  • Tuesday, August 28, 2018

St. Ignatius Public Hearing

St. Ignatius Community Center

332 Mountain View Drive

St. Ignatius, MT  59865

1 - 2 pm - Medically Related Recipient Travel Program Policy

2 - 3 pm - Controlled Substance Utilization and Dispensing Limitation Policy

Light refreshments

 

  • Tuesday, August 28, 2018

Dixon/Charlo Public Hearing

Dixon School Community Building

411 B. Street

Dixon, MT  59831

6-7 pm - Medically Related Recipient Travel Program Policy

7-8 pm - Controlled Substance Utilization and Dispensing Limitation Policy

Light refreshments

 

  • Wednesday, August 29, 2018

Pablo Public Hearing

CSKT Council Chambers

42487 Complex Blvd.

Pablo, Montana 59855

1 - 2 pm - Medically Related Recipient Travel Program Policy

2 - 3 pm - Controlled Substance Utilization and Dispensing Limitation Policy

Light refreshments

 

  • Wednesday, August 29, 2018

Ronan Public Hearing

Marvin Camel Building/Ronan Senior Center

35806 Terrace Lake Road

Ronan, MT 59864

6-7 pm - Medically Related Recipient Travel Program Policy

7-8 pm - Controlled Substance Utilization and Dispensing Limitation Policy

Light refreshments

 

  • Thursday, August 30, 2018

Polson Public Hearing

Polson Tribal Health Center, 3rd Floor

#5 Fourth Avenue East

Polson, MT 59860

1 - 2 pm - Medically Related Recipient Travel Program Policy

2 - 3 pm - Controlled Substance Utilization and Dispensing Limitation Policy

Light refreshments

 

  • Thursday, August 30, 2018

Elmo Public Hearing

Elmo Health Center

33116 US Highway 93 North

Elmo, MT  59915

6-7 pm - Medically Related Recipient Travel Program Policy

7-8 pm - Controlled Substance Utilization and Dispensing Limitation Policy

Light refreshments

 

Overview:  Proposed Medically Related Recipient Travel Program Policy

Tribal Health of the CSKT manages health care delivery to eligible TH recipients. Health care delivery includes providing health care in established health care centers and paying for purchased care from private providers, through Tribal Health Paid Care (THPC), if the recipient is deemed eligible. 

Federal Indian Health Service budget levels are limited to a fraction of the actual medical need.  Therefore, travel dollars taken from the health care budget impact the provision of health care and are not intended to cover all of the costs associated with medically related travel.  A policy is proposed for public comment to include criteria (such as one room per family per intensive care unit (ICU) incident; one meal ticket per family with meal rates at the Medicaid rate) and processes for authorization of medically related escort travel costs. 

With the proposed policy, assistance will be limited to THPC eligible recipients and family members.  Families will be asked to identify one family member as the representative of the family to receive assistance. One room will be made available in the case of Kalispell and Missoula ICU related assistance. The CSKT have direct bill rooms that will be utilized. 

Meal assistance and privately owned vehicle assistance will be limited to the Medicaid rate/s.  No airline travel will be considered as part of this policy. 

In the event of scheduled medical procedures, if an escort is medically necessary for the safe transport of an elder or a child, medical travel assistance can be requested.  The opinion of the medical provider will be sought as to medical necessity for an escort.  

Recipients needing an escort may be asked to use a “nearby” medical provider if the procedure that is being done is one that is universally available.    

TH medical ICU and medical travel assistance is not intended to cover 100 percent of the costs that a family may incur.   Rather, it is intended to provide limited support to families who have a primary support person in times of medical need.    

TH is proposing to purchase DHRD bus tickets for eligible THPC recipients for reoccurring local medical travel to non-TH medical providers, provided the recipient is ambulatory.  

Medically fragile recipients will still be transported by TH as much as possible.  DHRD and TH are working on a plan to improve dialysis transports with a new vehicle.

 

Overview:  Proposed Controlled Substance Utilization and Dispensing Limitation Policy

Tribal Health Pharmacies of the CSKT have noted increased utilization and a significant disparity in the quantities of specific medications dispensed over the past several years. One of the offending drug classes are opiate medications, specifically those containing hydrocodone in which the prescriptions often meet or exceed quantity limits set by suppliers. 

Pharmacists and medical clinicians also have access to the Montana Prescription Drug Registry online, which provides information regarding prescriptions filled at any pharmacy in Montana and includes the name of the medication, date filled, quantity dispensed and the prescriber's name. This information allows clinicians to identify individuals obtaining prescriptions from multiple clinicians and pharmacies. 

Tribal Health has significant concerns in regard to increasing prescription drug abuse, rates of death secondary to opiate overdose and prevalence of infants born with neonatal abstinence syndrome within our communities. In regard to these public health concerns about opiates and in accordance with fiscal responsibility, our TH pharmacies will benefit from a policy that guides pharmacists, pharmacy technicians, and other medical staff on the best course of action for addressing prescribing practices and dispensing high utilization medications.

Copies of the proposed policies, comment forms, and information about the public hearings, can be found online at www.cskthealth.org under the “Events” tab.  Hard copies can also be picked up at each of the Tribal Health Centers, in addition to CSKT Administration.  Interested members of the public are encouraged to participate and comment on the proposed policies during the hearing. 

 

How to Comment

Comment forms can be downloaded online at www.cskthealth.org under the “Events” tab, or picked up hardcopy, at each of the Tribal Health Centers, or at CSKT Administration.  Members of the public who would like to comment at a hearing are asked to call Yvonne Conko at Tribal Health, 406-745-3525, no later than three days prior to each hearing, to be placed on a scheduled list of commenters during each hearing. 

All public comments will be provided to the CSKT Tribal Council for review and consideration prior to policy adoption.  Additionally, Tribal Health staff, including Medicaid and Veterans Affairs (VA) specialists will be on hand to answer questions at each hearing.

Public hearing oral comment time limit: 5 minutes  

Deadline for written comment: September 14, 2018

Written comment submission: 

EMAIL - This email address is being protected from spambots. You need JavaScript enabled to view it.

DELIVERY - St. Ignatius Health Center 

35401 Mission Drive (physical)

PO Box 880 (mailing)

St. Ignatius, MT 59865

Attn: Yvonne Conko

DELIVERY - Confederated Salish & Kootenai Tribes

42487 Complex Blvd. (physical)

PO Box 278 (mailing)

Pablo, Montana 59855

Attn: Donna Durglo

Proposed effective date:  Fall of 2018.

 

Tribal Health of the Confederated Salish and Kootenai Tribes provides comprehensive health care services to recipients including audiology/speech; behavioral health; dental; medical; nursing; optical; pharmacy; physical therapy; radiology; and wellness across a rich network on the Flathead Indian Reservation.  Tribal Health is dedicated to a promise that every Tribal Health recipient receives high-quality health care grounded in tribal values— supporting each recipient’s journey of          “Being in a Good Way.”

 

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