Indian Health Service Portland Area Director’s Update Dean M Seyler - Area Director April 19, 2016 NPAIHB Quarterly Board Meeting Clearwater River Casino & Lodge

Renew And Strengthen Our Partnership With Tribes /The Federal Deficit Reduction Action (DRA) of 2005 requires any entity receiving or making annual Medicaid payments of $5 million or more to establish and adopt written policies about federal and state false claims laws for all employees, contractors and/or agents as stated in the 1902(a)(68) Social Security Act. State of Washington Healthcare Authority has sent out two letters that we are aware of to date, requiring a compliance plan. Portland Area Business Office is working on guidance that can be provided if you receive a letter. https://www.ssa.gov/OP_Home/ssact/title19/1902.htm

Renew And Strengthen Our Partnership With Tribes /FY16 CHEF Balance – $46,422,518.00 As Of 04/05/2016 Submitted 8 CHEFs, All Reimbursed At 100% $282,248.00 - Four Distributions To Date. FY15 CHEF Balance - $0 Total Cases Submitted 0 62 17 Amendments $2,430,396 Reimbursed To Portland Area.

To Improve the Quality of and Access to Care Strategic Change Plan-Portland Area Office 2.0 What is it? The Strategic Plan is a Roadmap The destination is excellence in Healthcare Delivery Why Now? The Mission The Unmet Needs (i.e. Disparities of Health Status) Who? The Area Office All employees “The primary purpose for the Portland Area Office is to provide critical support products and services to our customers, who are providing . . . care. . . .”

To Improve the Quality of and Access to Care Strategic Change Plan-Portland Area Office Focus Areas or Strategic Objectives (3): Healthcare Delivery Customer Service Continuous Improvement Practical Values (Necessary to Achieve Improvement) Service – acting to serve others, without expectation Respect – the ethic of finding positive feelings of esteem/deference Trust - the trust others place in us to uphold our responsibilities Culture – changing the office culture to be collaborative Integrity – honesty, doing the right thing, whether or not anyone is looking

“Strategic Changes Occurs One Improvement Project at a Time” We will use the Model for Improvement as our method to make improvements and simultaneously create improvement capability

To Improve the Quality of and Access to Care Regional Specialty Referral Network Demonstration Project Expedited Planning Documents for the First of Three Facilities Serving the Portland Area. Program Justification Document Program of Requirements Site Selection Evaluation Report – Phase I Business Plan The Planning Documents are the Basis of My Request for a Demonstration Project Modeling an Innovative Approach to Healthcare Service Delivery. Achieved Our Goal of Presenting a Viable Project for Consideration.

To Improve the Quality of and Access to Care Regional Specialty Referral Network Demonstration Project Proposed Facility Characteristics: 172,000 square feet $102,000,000 Estimated Design, Construction, and Equipment 392 FTE (Including 17 Surgical Specialists FTE and 12 Medical Specialist FTE) 55,000 Estimated Users Estimated 81,000 Specialty Care Patient Visits, Annually Estimated 53,000 Telemedicine Visits, Annually

To Improve the Quality of and Access to Care Lead and Copper Rule: Tribal water systems are compliant in WA, OR, ID. EPA compiled sampling data from January 2013 through February 2016. Sampling is occurring as it should. If a required sample or re-sample is missed EPA follows up. Over the past 20-years, IHS Division of Sanitation Facilities Construction has designed and constructed facilities to prevent the kind of corrosion that might draw lead out of old plumbing.

Renew And Strengthen Our Partnership With Tribes and Urban Indian Health Programs Fund Distribution Work Group (FDWG) A Meeting To Called in Near Future CHSDA Discussion User Pop Methodology Review Current FDWG Members: Devon Boyer (DST) Dan Gleason (T1) Sharon Stanphill (T5) Janice Clements (DST) Marilyn Scott (T1) Mark Johnston (T5) Frank Mesplie (DST) Shawn Yanity (T1) Leslie Wosnig (T5)

Renew And Strengthen Our Partnership With Tribes and Urban Indian Health Programs All Tribes Call PRC Rates – Federal Register Publication Hosted by Ms. Elizabeth Fowler, Deputy Director of Mgt. Operations Thursday, April 21st – 3:00PM to 4:00PM Eastern time 888-323-9705 Passcode – 8647683 Note: This call is off the record and not for press purposes. Please dial in 5- 10 minutes early to avoid any delays in joining the call.

Renew And Strengthen Our Partnership With Tribes and Urban Indian Health Programs Tribal Management Grant: Fiscal Year (FY) 2016 Application Deadline – Wednesday, June 8, 2016 Review Dates – June 20-24, 2016 Earliest Anticipated Start Date: Thursday, September 1, 2016 Federal Register / Vol. 81, No. 67 / Thursday, April 7, 2016 / Notices

To Improve the Quality of and Access to Care Zika Virus Disease Discovered in 1947 in Zika Forest region in Uganda. 14 cases prior to 2007 (under reported) May 2015- PAHO alert of Zika in Brazil. US States- 312 travel-associated cases. Symptoms: Fever, rash, joint pain, and conjunctivitis. Duration/Severity: Typically mild illness lasting 3-7 days. Transmission: Mosquito bite- Aedes aegypti and A. albopictus Maternal-child Sexual contact Blood transfusion Treatment: No vaccines or antiviral, supportive therapy only Prevention: Mosquito avoidance, condom use. Complications: Guillain-Barré Syndrome and pregnancy complications (pregnancy loss, microcephaly, brain/eye damage).

Questions or Comments Our Mission... to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level. Our Goal... to assure that comprehensive, culturally acceptable personal and public health services are available and accessible to American Indian and Alaska Native people. Our Foundation... to uphold the Federal Government's obligation to promote healthy American Indian and Alaska Native people, communities, and cultures and to honor and protect the inherent sovereign rights of Tribes.