Spotlight: Noreen Jackson-Underwood
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The Roger Saux Health Center, started as a small collection of modular trailers, but today, it has grown into a first-class center for health and wellness for the Quinault Indian Nation on Washington State’s Olympic Peninsula.
Medical Services Manager Noreen Jackson-Underwood says the health center offers a wide range of services, including basic health care, behavioral health care, chemical dependency counseling, diabetes prevention, dentistry, a denture clinic, a fitness center, a pharmacy, and social services, like the Women with Infant Children (WIC) program.
“Because transportation is sometimes an issue for our clients, we try to offer higher levels of care at our facility,” she said.
Much of the expansion in services can be attributed to the health center’s ability to bill Medicare, Medicaid, and private insurance. In early years, some tribal members didn’t understand why they needed to sign up for health insurance, but now they see how much those dollars benefit the community in terms of improved health care.
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"Third-party reimbursements finance a lot of positions. That’s how we are able to hire and retain our medical providers."
- Noreen Jackson-Underwood, Medical Services Manager, Quinault Indian Nation Roger Saux Health Center
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Jackson-Underwood oversees the health center’s medical providers, nursing staff, community health representatives, medical records, and the WIC program and acts as the patients’ advocate. She was recently presented the National Indian Health Board’s Local Impact Award for her 21 years of dedication to meeting the health care needs of every patient.
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Protect the Circle of Life with a flu vaccine
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The Centers for Disease Control and Prevention (CDC) recommends that everyone over the age of 6 months get a flu vaccination each year.
Native people are at high risk for developing serious flu complications. Use CDC’s Protect the Circle of Life resources to encourage American Indians and Alaska Natives to get their flu vaccinations. These resources include fact sheets, brochures, posters, flyers, and postcards.
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"As health care professionals, we need to lead by example. It’s important for us to get vaccinated and remind patients to get a flu vaccine every year, especially before the holidays. Explain the positives of flu vaccination and be transparent about how it affects your body and health."
- Dr. Blythe Winchester, Family Practitioner at Cherokee Indian Hospital
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It is not too late to get a flu vaccine for the 2017-18 flu season. Share the facts.
- After vaccination, it takes about 2 weeks for antibodies to develop and protect people from the most common flu viruses.
- The flu vaccine reduces the risk of getting the flu and developing complications by 40–60%.
- People can spread flu even when they don’t feel sick.
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Stop smoking resources
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With the new year come resolutions to improve health and the perfect opportunity to connect patients to stop smoking programs. These programs are an essential health benefit covered by Medicare, Medicaid, and health insurance.
The National Native Network’s Keep It Sacred campaign features resources with culturally relevant messaging for American Indians and Alaska Native communities.
The Keep It Sacred campaign quit line program provides participants up to 10 calls with a Native coach per attempt to stop smoking and 8 weeks of nicotine replacement therapy. For more information, call 1-855-372-0037.
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StrongHearts Native Helpline offers a lifeline to Native American domestic violence survivors
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The StrongHearts Native Helpline offers culturally appropriate and confidential help to Native Americans affected by domestic and dating violence.
In its first 8 months of operation, the helpline served callers from 53 tribal nations and 38 states. StrongHearts advocates navigate each caller’s abuse situation with a deep understanding of tribal communities, culture, and tradition. The helpline is funded by a grant from the Family Violence Prevention and Services program.
According to the
Rape Abuse & Incest National Network, American Indians are twice as likely to be raped or sexually assaulted as people of other races.
StrongHearts Native Helpline Communications Manager Mallory Black encourages health care workers to refer domestic violence survivors to the StrongHearts Native Helpline. Red flags to watch for include injuries—black eyes and bruises—and stress-related problems, including depression, anxiety, and stomach pain.
Displaying hotline posters and offering brochures in waiting rooms, bathrooms, and exam rooms may reach those who do not feel comfortable talking to their health care provider. “It can really help people who are looking for resources or building up courage,” Black said. “They can call when they are ready.”
Resources:
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New report details mental health disparities for Native American elders
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American Indians and Alaska Native Medicare Advantage beneficiaries reported worse mental health than other racial groups, according to a new report from the CMS Office of Minority Health.
The data highlight examines physical and mental health outcomes for Medicare Advantage beneficiaries by race and ethnicity. Data show that American Indians and Alaska Natives reported more depression, more days of missed activities because of poor physical and mental health, and worse mental health functioning than other racial groups
The study was undertaken to better understand the diagnosis and treatment of mental health in older adults.
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U.S Transgender Survey: Health experiences of Native respondents
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Of transgender American Indians and Alaska Natives, 50% report having at least one negative experience when getting health care, according to the 2015 U.S Transgender Survey: Report on the Experience of American Indian & Alaska Native Respondents (PDF, 3.9 MB, 38 pp).
When getting health care, transgender American Indians and Alaska Natives reported:
- being refused treatment,
- being verbally abused,
- being physically or sexually assaulted, and
- teaching a provider about how to give care to transgender people.
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2017 State of Native Youth Report: Our Identities as Civic Power
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Mental health is a top concern for American Indian and Alaska Native (AI/AN) youth, according to the 2017 State of Native Youth Report: Our Identities As Civic Power (PDF, 12 MB, 29 pp).
According to the report from the Aspen Institute’s Center for Native American Youth, 18 to 24-year-old AI/AN youth want more mental health clinics, therapists, and support groups to help them overcome mental health issues, like suicide.
The Centers for Disease Control and Prevention’s Suicide Facts at a Glance 2015 (PDF, 107 KB, 2 pp), lists suicide as the second-leading cause of death among AI/AN youth.
Mental health issues among AI/AN youth are often associated with historical and intergenerational trauma, depression, and alcohol or substance abuse.
Data for the State of Native Youth Report was gathered from the Generation Indigenous online roundtable survey.
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Responding to the opioid crisis
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Opioid abuse affects individuals, their loved ones, and entire communities. According to the Centers for Disease Control and Prevention, Native Americans died of opioid drug overdoses in 2014 at a rate of 8.4 per 1,000 people—the highest rate of any racial group.
Learn more:
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HHS, Administration for Community Living Older Americas webinars
View upcoming webinars:
January 17, 2018
Title VI Webinar: Responding to Long-Term Supports and Services Needs
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CMS Indian Health Service, Tribal Health Programs, and Urban Indian Health trainings
These trainings are for business staff, benefits coordinators, medical records staff, and patient registration staff. They cover CMS Tribal Affairs updates, Medicare, Medicaid, CHIP, the Health Insurance Marketplace, state-administered programs, Social Security, and Veterans Affairs. Each training lasts 3 days. The third day, hosted by Indian Health Service, focuses on how to maximize access to third-party resources and improve access to quality health care.
Trainings in 2018
- March 20–22 in Denver, CO
- April 3–4 in Seattle, WA
- April 17–19 in Sacramento, CA
- April 23–24 in Albuquerque, NM
- May 8–9 in Dallas, TX
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2018 Native Women and Men’s Wellness and Diabetes Prevention Conference
March 25–28, 2018
New Orleans, LA
Learn more
The American Indian Institute at the University of Oklahoma conference will offer presentations by national speakers, continuing education, networking opportunities, and resources to enhance diabetes prevention services.
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Native American Child and Family Conference
March 12–15, 2018
Las Vegas, NV
Learn more
This conference will provide training opportunities related to Head Start, Early Head Start, and child care programs.
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2018 Tribal Self-Governance Annual Conference
April 22–26, 2018
Albuquerque, NM
Learn more
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About the Newsletter
Covering Indian Country is published by the Centers for Medicare & Medicaid Services (CMS) Division of Tribal Affairs to share resources, success stories, and best practices with the people who connect tribal communities to health insurance.
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