1. Regional Specialty Referral Center Update Mr. Richard Truitt, PE, Director Office of Environmental Health and Engineering October 2015

2.  Overview  The Portland Area Master Healthcare Plan:  Proposes a Network of Three Regional Specialty Referral Centers (RSRC’s)  Illustrates the RSRC’s Will Expand Access to Care  RSRC’s will Conserve PRC Funds for Higher Levels of Care  Examples of Specialty Care Include Dermatology, Cardiology, General Surgery, and Tele-Medicine  IHS Currently Does Not Provide a Mechanism to Construct and Provide Staff for an RSRC.  The Portland Area Solution: Develop a Pilot Project to Demonstrate the Viability of RSRC’s.

3.  Current Approach  Develop a Proposed Project that Demonstrates Readiness for Implementation.  Location  POR/PJD/Business Plan  Strong Tribal Support.  The PAFAC is Meeting Regularly and Developing Recommendations to Strengthen the Pilot Project Proposal.

4.  Positive Developments  Two Tribes Have Expressed Strong Interest in Hosting the Pilot Project  Chehalis  Puyallup  PAFAC Members Visited Both Locations on May 14.  Both Tribes Agree With Four Core Operating Principles.  Any Federal Resources Allocated Will Not be Available for Individual Tribes to Contract.  The Network Will be Federally Operated Initially.  A Qualified Tribal Organization Broadly Representing Portland Area Tribes May Contract Operation of the Network.  Third Party Revenue Will be Used to Improve and Expand Access to Specialty Care Across the Entire Portland Area

5.  Positive Developments  The Area Director Made $110,000 Available to Support Planning and Project Development.  These Funds are Being Utilized to Update the Interim PAFAC Report to consider:  Affordable Care Act Impacts  Comparison of the Chehalis and Puyallup Sites.  The PAFAC will meet October 29 with the Healthcare Consultant OEHE has under Contract to update the Report. This will Assist the PAFAC in their work to Recommend a location for the first of three regional facilities.

6.  Positive Developments  After the IHS Director ‘s Listening Session Held in Issaquah on July 23, Principal Deputy Director Mc Swain provided $150,000 to further Project Development.  U pon completion of the Interim PAFAC Report Update and Site Selection, these additional Funds combined with remaining Area funds will be utilized to develop the PJD, POR, and Business Plan for the proposed facility.

7. 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.