Director's Corner

December 5, 2003- The Phoenix Area IHS hosted a reception honoring Dr. Charles Grim on his appointment as Director of Indian Health Service. Since Dr. Grim's confirmation on July 16, 2003, this was his first official visit to the Phoenix Area Indian Health Service in this capacity. Representatives included Phoenix Area staff; Tribes; Urban programs; State and many other organizations who work with Native Americans; and Tucson Area IHS. Several presentations were made, and Dr. Grim shared significant activities within the Agency including initiatives for 2004.

October 17, 2003- Phoenix Area Director, Don J. Davis, and Ms. Fayetta Babby, Director of Education, BIA, Sacramento Program Office, Sacramento, California, signed renewal of Interagency Agreement for the Behavioral Health Program at the Sherman Indian High School, Riverside, California. The Agreement has been in effect since 1994 and provides the framework for provision of behavioral health services to a student population of approximately 600 youth annually through joint coordination. IHS provides direct mental health services through a clinical psychologist and two social workers, as well as health care services provided by a nurse and nurse practitioner stationed at the school. Oversight of the program is provided by the Colorado River Service Unit, Parker, Arizona.

September 3, 2003- In accordance with the Joint Commission on Accreditation of Healthcare Organization's (JCAHO) Random Unannounced Survey Policy, the Phoenix Indian Medical Center (PIMC) was selected for a survey on September 3, 2003. JCAHO conducts mid-cycle random unannounced surveys for 5% of all accredited hospitals. PIMC was selected for survey as part of that process. The purpose of the survey was to assess compliance with selected 2003 hospital functions, processes, and the National Patient Safety Goals.

Hospital functions included in the survey were:

• Infection Control - Surveillance, Prevention, and Control of Infection
• Patient Assessment - Initial Assessment
• Leadership - Role in Improving Performance
• Care of Patients - Medication Use
• Human Resources - Human Resource Planning

On September 2, 2003, Robert and Carmen Hallowell were killed in a car accident near Ashfork, Arizona.

MEMORIAL FUND:
To support the Winnebago Drug Dependency Unit, Omaha Tribe of Nebraska Higher Education Department and other related programs.

Funds can be sent to:
Charter West National Bank
Robert & Carmen Hallowell Memorial Fund
P. O. Box 1A
Walthill, NE 68067

Phoenix Area Hospitals First In IHS To Receive Critical Access Designation.
IHS Press Release, IHS-18-2003, August 21, 2003

In 1997, Congress enacted the Medicare Rural Hospital Flexibility Program. This program created a new provider category, the CAH, with unique Medicare conditions of participation that permit CAHs to be paid on a cost-based, rather than a flat-rate, reimbursement basis. Four IHS and two tribal facilities were surveyed and accredited for the CAH designation by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), with scores ranging from 92 to 97 out of 100. They will be resurveyed in a year to meet JCAHO requirements and will be up for recertification as CAHs in November 2003.

Don J. Davis, the IHS Area Director for the Phoenix Area, stated that “this accreditation helps us improve our performance, raise the level of health care services to American Indians and Alaska Natives, and provide another system for accountability. Accreditation of health care facilities in rural areas and improved financial status are major components in our ongoing efforts to expand patient care services in American Indian and Alaska Native communities.”

The advantage that CAH offers is that Centers for Medicare and Medicaid Services reimburses the facility based on the actual cost of care. The cost of doing business in the rural and remote areas of the country is substantially higher than in metropolitan areas; this cost reimbursement represents a significant source of revenue for Indian healthcare facilities. Under flat-rate reimbursement, for example, a small facility in a remote area would receive the same reimbursement amount for outpatient and inpatient visits as a large facility in a more easily accessible urban area. At a CAH facility, the actual cost of providing the same services would be reimbursed.

The Phoenix Area IHS network component organizations completing the conversion to CAH include the Hopi Health Care Center, the Whiteriver Hospital, the Parker Indian Hospital, and the Fort Yuma IHS Hospital, all located in Arizona. Two tribally managed facilities, the HuHuKam Memorial Hospital in Arizona and the Owyhee Community Health Center in Nevada, also converted to CAH status. The conversions were the first in the nation to be accomplished through the JCAHO CAH Accreditation Program, which was introduced in 2001.