1. HEALTH, EDUCATION, SOCIAL SERVICES SERVICES DEPARTMENT 2013 Annual General Membership Meeting, Keller, WA Alison J. Boyd-Ball, Ph.D. Services Director

2. HEALTH PROGRAMS Centralized Medical Billing Convalescent Center Diabetes Program Tribal Health Programs Behavioral Health Programs/Mental Health and Chemical Dependency Community Centers (Wellness & Fitness: Inchelium, Keller, Omak, Nespelem)

3. CENTRALIZED MEDICAL BILLING Quality Assurance Referral Consents Assessment Diagnosis Treatment plan Therapy sessions Discharge Coding Data Management RPMS

4. TRIBAL HEALTH PROGRAMS Health Program Management Community Health Nursing Community Health Representatives Health Education Registered Dietitian Speech Language Pathologist Women, Infant and Children (W.I.C.) Suicide Prevention Tribal/Public Health Emergency Preparedness and Response

5. MENTAL HEALTH & TRIBAL HEALTH Suicide Coalition – “Life is Sacred” activities Life is Sacred Prayer Day, November 1, 2013 Developing a Crisis Plan – mental health Crisis response team – mental health Grief & Loss 5-day workshop, Nov 4-8, 2013, Omak Building Bridges for our Future Generation: Training for Program Services on identifying & working with high risk clients, October 22 & 23, 2013 Changing grant to respond to suicide state of emergency by tribe Healthy Lifestyles for Adolescents – December, 2013

6. DIABETES PROGRAM DIABETES SELF-MANAGEMENT EDUCATION & DIABETES PREVENTION PROGRAM Eligibility: IHS, diagnosed with pre-diabetes or with diabetes DSME Services : Certified Diabetic Educator/Registered Dietician (CDE/RD) at each clinic every week. Chronic Disease Self Management Classes – Annually in each community Diabetes Clinics in each community Medical Nutrition and Therapy by a (CDE/RD) upon referral by a health provider Dental to promote annual exam Glasses to promote annual exam Shoes to promote walking and healthy feet DPP Services: 16 week Healthy Lifestyle Balance Classes Promote 7% weight loss by: 150 minutes of physical activity a week, Eat healthy and reduce fat intake Receive tools while attending classes to promote exercise and healthy eating One-on-One Coaching by a Physical Activity Lifestyle Specialist (PALS) Ongoing support through the end of the program (currently 2014 and 2015)

7. WELLNESS CENTERS Goal: increase the health & wellness of the CCT membership on the reservation: Cultural/spiritual Mental Emotional Physical Services Community outreach Promote healthy activities Host healthy events Plan and implement on-going programs to promote wellness

8. HEALTH COALITION PURPOSE: HELP DETERMINE HEALTH PRIORITIES Area Agency on Aging (AAoA) Behavioral Health Program (BHP) Colville Tribal Convalescent Center (CTCC) Diabetes Prevention Program (DPP) Emergency Medical Services (EMS) Indian Health Services (IHS) Lake Roosevelt Health Center (LRHC) Inchelium and Keller Clinics Medical Billing Services Director Tribal Health Programs Community Members

9. HEALTH COALITION ACCOMPLISHMENTS Retreat to identify strengths, challenges, and solutions to barriers in providing quality health services Established a core team to ensure leadership Established and strengthened collaborative efforts among health related entities, including community Developed a work plan to address health needs Comprehensive Health Needs Assessment Conduct health survey to determine health needs Hire temporary Research Assistants to collect archival date from Tribal programs Develop a comprehensive report that will help identify Colville Tribal Health Priorities for 5 years using the health survey, community focus groups, and archival data

10. HEALTH AFFORDABLE CARE ACT: Certification: 2 sessions (on-line & in-person) 16 Tribal Assisters Certified & 7 partial certified: Convalescent Center, Tribal Health, Natural Helpers, LRHC, Indian Health Service, Behavioral Health, Area Agency on Aging, Community Centers, Corrections, Social Services Quail Orr, CHR, Lead Tribal Assister, ph no. 422-7441

11. FUTURE DIRECTION FOR HEALTH PROGRAMS Goal: “Grow a Healthy Colville” Motto: instead of client fit the treatment model, we are pushing for “treatment to fit the client” model Enhance our cultural traditions and incorporate into our models of treatment Explore tribal: Values, beliefs, traditions, practices

12. EDUCATION CTEAP/Higher Education Library Employment & Training Attendance Daycare JOM Inchelium Childcare Language Nest Project Head Start, Early Childhood Program Language Program Tribal Assistance for Needy Families (TANF) Vocational Rehabilitation (Voc Rehab) Tribal College Paschal Sherman Indian School

13. EDUCATION & EMPLOYMENT Eligibility requirements Services: Employment: career planning, on-the-job-training, work experience, direct placement, hiring hall system Education: basic & remedial education, vocational training, running start program for students, college/university program Economic development: assist new businesses & expansion to provide employment opportunities for tribal members Childcare services: childcare, language immersion, after school program, economic development for new child care facilities Welfare assistance (GA) Youth Services: after school work experience

14. COLVILLE TRIBAL LANGUAGE PRESERVATION PROGRAM Inception 1988 Includes 3-band or tribal languages: nselxcin (Okanogan and/or Arrow Lakes), nxa?amxcin (Moses-Columbia), and nimipu (Nez Perce) Past: approximately 25 elder speakers, 8-20 were considered fluent elder speakers Current: 3 fluent elder speakers remaining, 6 are considered “semi-fluent” Preservation efforts: tapes, videos, written materials Future direction: include revitalization efforts that will help in the creation of new speakers

15. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF) TANF primary goal is to help families become self-sufficient by: Provide work experience (WEX) to gain the experience needed to acquire a job Provide on-the job-training (OJT’s) Assists clients with education, whether it’s GED or higher education to obtain successful employment Assists clients in Individual Development Accounts (IDA’s) where the client saves funds for any of the 4 allowable items 1. House; 2. Education; 3. Small business; 4. Vehicle. TANF will match client funds saved at a rate of 3 to 1, for every $1 the client saves; TANF will match $3 up to a total of $10,000. You must be eligible for TANF (not necessarily on TANF but eligible) and a way to save money (it can’t come from your TANF grant)

16. VOCATIONAL REHABILITATION Goal: to provide culturally appropriate services to Native Americans with disabilities that have functional limitations that interfere with obtaining, maintaining, or regaining employment Disability: physical, psychological, developmental, sensory Progress: have served 90 clients with 27 successfully employed

17. HEAD START PROGRAM 4 sites, 1 in each district Part-time, center based classrooms, mix of 3 and 4 year olds students Tribal commitment: tribe funds more than ½ the cost This year a 3 rd classroom will be added to increase enrollment by 17-20 children served Currently there are 115 children being served, with 30 staff

18. FUTURE DIRECTION Educate and/or orientate potential clients about eligibility and criteria to services Develop program policies, procedures & practices that enhance consumer satisfaction Create culture based services Build leadership in K-12 education Develop a stronger pipeline from school to work Model best practices in Indian Country

19. SOCIAL SERVICES Area Agency on Aging Child Support Enforcement Children & Family Services Donable Foods Social Services Veterans program

20. AREA AGENCY ON AGING New Program Director: Brian Nissen Services: nutrition, access, information & assistance, legal assistance, visiting & telephone reassurance, family caregiver support program, in-home services, disease prevention & health promotion, elder abuse prevention, case management & nursing services, social & respite services Caseload ranged from 95-104 clients, with a decline in caseload 2,395 seniors age 60 and older who live on the reservation, with approximately 741 identified as Colville or other Indian

21. CHILDREN & FAMILY SERVICES Tribal standards & state standards Tribal court & state court Prevent removal of child from home Reunify child with parent

22. WOOD/FOOD DISTRIBUTION PROGRAM Services: Food distribution Food bank Tribal emergency food vouchers Salmon/beef/buffalo, etc. Clothing bank Senior heating program Low income home energy program

23. VETERAN’S RESOURCE PROGRAM Serve 96 veterans Services: emergency food, medical transportation, assist in veteran benefits coordination Events: 2 nd annual veterans symposium at Coeur d’Alene Resort & Hotel, Okanogan Armory Stand- down for veterans and their families Outreach: various governmental agencies and resources Support Honor/Color Guard activities Future goals: more outreach & services

24. FUTURE DIRECTION FOR SERVICE PROGRAMS: BUILDING EXCELLENCE WITHIN SERVICE PROGRAMS Building a supportive structure: providing internal training based on needs, supervision, managing multiple locations, conflict resolution, corrective action planning, individual program policies, procedures, & practices Strengthening collaboration among programs Consumer satisfaction – positive atmosphere, staff competency, community orientation of programs