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P U B L I C AT I O N O F I N D I A N H E A LT H C A R E R E S O U R C E C E N T E R SUMMER/FALL 2013

“Games Along the Way” sculpture in Medicine Wheel Park


Operationally Speaking BY CEO CARMELITA SKEETER AND COO EDDIE HATHCOAT

As IHCRC’s senior officers, we want to take this opportunity to inform our readership of the latest news for our health center. We continue to move forward with the implementation of Electronic Health Records (EHR) and Meaningful Use, as well as with many other exciting projects and developments to enhance our clinical operation. We would like to highlight a few of the announcements and updates featured in this issue of the Healthy Spirit. Three bronze “Woman and Children” statues, created by sculptor John Gooden, have recently been installed in Medicine Wheel Park. This triangle-shaped oasis lies just to the south of the main clinical facility. Completion of the park represents the final phase of our new construction and expansion efforts, including extensive remodeling of the existing clinical facility and the installation of numerous enhancements and equipment upgrades. We are very proud of all of the improvements that have been made to the IHCRC campus over the past three years. Please join us for the unveiling and dedication ceremony of the park and three sculptures on Thursday, September 12 at 9:30 am.

We are particularly proud of five IHCRC employees whose exemplary job performances and dedicated service garnered them recognition at the Oklahoma City Indian Health Service (IHS) Area Director’s Awards Ceremony, held on July 18 at the Oklahoma Cowboy and Western Heritage Museum. Award recipients included Dawanna Wallace, Peer Recognition; Stacie Nutt, Merit Award; Tim Shadlow, Exceptional Performance Individual Health Promotion and Awareness Award; and Ron Robertson, Area Director’s Award for Excellence in Customer Service Individual Urban. “And, our leading lady, Carmelita Skeeter, Chief Executive Officer, received the top honor of receiving the Area Director’s National Impact Award, individually selected by IHS Rear Admiral Kevin Meeks,” adds Eddie. Other announcements or things to look for in this issue: • IHCRC’s first ever Native American Senior Health Fair is scheduled for Wednesday, August 21 in the Jim Cameron Event Center. We encourage our Indian elders to join us to get their health status checked and receive giveaways.

CARMELITA SKEETER, CEO

Continued to page 3 EDDIE HATHCOAT, COO


IN THIS ISSUE OF THE HEALTHY SPIRIT

Indian Health Care Hours of Operation

FEATURE ARTICLES

MEDICAL SERVICES HOURS

Medicine Wheel Park Sculptures to be Dedicated . . . . . 4 Medical Malpractice Insurance Coverage . . . . . . . . . 15 How Attractive is Your Home to a Burglar? . . . . . . . .16 Claremore Indian Hospital – Baby-Friendly . . . . . . . . 58

Monday, Tuesday, Wednesday and Friday 8:00 am-5:00 pm Thursday 10:00 am-7:00 pm 1st Wednesday of the month the Medical clinic opens at 1:00 pm (closed in morning for staff meeting).

BEHAVIORAL HEALTH HOURS SPECIAL EVENTS AND ACTIVITIES

Employee/Company Picnic . . . . . . . . . . . . . . . . 6 Senior Health Fair, August 21 . . . . . . . . . . . . . . . 6 Teddy Bear Clinic, September 21 . . . . . . . . . . . . . 6 Flu Clinic, October 19 . . . . . . . . . . . . . . . . . . . 6 Crohn’s & Colitis Walk, September 21 . . . . . . . . . . 38 Komen Tulsa Race for the Cure, September 28 . . . . .

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THE PULSE OF IHCRC . . . . . . . . . . . . . . . . . . . . . 10

What are the Benefits of Working at IHCRC? . . . . . . . . 20 Employees Receive IHS Area Director’s Awards . . . . . .21 IHCRC Receives Graduate Psychology Education Grant . .31 Future Plans of IHCRC’s Graduate Psychology Interns . .32 Gathering Strength and Restoring Harmony . . . . . . . 34 NATIONAL IMMUNIZATION AWARENESS MONTH . . . . . . .40

HPV Vaccine for Preteens and Teens . . . . . . . . . . . .42 SEPTEMBER IS FRUITS & VEGGIES–MORE MATTERS MONTH

2013 Kids’ State Dinner . . . . . . . . . . . . . . . . . . .44 MyPlate – Fill Half Your Plate . . . . . . . . . . . . . . . .46 SEPTEMBER IS CHILDHOOD OBESITY AWARENESS MONTH

KIDS COUNT Releases 2013 Data Book . . . . . . . . . .50 Basics About Childhood Obesity . . . . . . . . . . . . . .54 SEPTEMBER IS NATIONAL RECOVERY MONTH

Mental and Substance Use Disorders Fast Facts . . . . . .60

Monday - Wednesday 8:00 am-6:00 pm Thursday 10:00 am-7:00 pm Friday 8:00 am-5:00 pm 1st Wednesday of the month the Behavioral Health clinic opens at 1:00 pm (closed in morning for staff meeting).

WIC NUTRITION HOURS Monday - Wednesday; Friday 8:00 am-5:00 pm Thursday 10:00 am-6:30 pm 1st Wednesday of the month WIC opens at 1:00 pm (closed in morning for monthly staff meeting).

SCHEDULED APPOINTMENTS To schedule an appointment, call 918-588-1900, press option 1. If you are unable to get your preferred appointment time, please schedule for the first available appointment. Patients may call back and check to see if an opening becomes available that better suits their needs.

“OPEN ACCESS” OR “SAME DAY” APPOINTMENTS IHCRC has adopted the “open access” appointment policy model to provide patients an appointment with their primary care provider as quickly as schedules allow. This system leaves “open” appointment slots in each primary care provider’s daily schedule – these “open” slots are filled throughout the day with requests for same day appointments. Another significant change from traditional scheduling is the discontinuation of scheduling follow up appointments in advance. Patients need to call in two weeks prior to the recommended follow up date and request an appointment. This approach frees up appointment schedules and allows patients to be seen as quickly as possible.


for Native Americans Need not be a current IHCRC patient to attend

Wednesday, Aug 21 – 9 am-3 pm Health screenings: for high blood pressure, vision and behavioral health, mammography, diabetes and heart disease Information: about Medicare, health insurance education fitness/nutrition education and local community services Testing: for pneumonia immunizations and diabetic lab (current IHCRC patients only) Giveaways: Healthy snacks and demonstration kitchen tours, waterbottles, pillboxes, totebags, first aid kits and rubber jar openers

918-588-1900 | Jim Cameron Event Center, 550 S. Peoria, Tulsa, OK


OPERATIONALLY SPEAKING | Continued from inside cover

• Our ever popular annual pediatric Teddy Bear Clinic is scheduled for Saturday, September 21 from 10 am to noon. We encourage you to bring your children and their favorite stuffed animals to this educational and fun event. It’s a great way to introduce children to a healthcare setting and lower their anxieties towards medical personnel and future clinic visits. • IHCRC will be showing our support for the Tulsa Affiliate of Susan G. Komen for the Cure by participating in the Komen Tulsa Race for the Cure scheduled for Saturday, September 28, in downtown Tulsa at ONEOK Field. • Our second annual Flu Clinic is scheduled for Saturday, October 19 from 9 am to noon in the north IHCRC parking lot. Flu shots will be given in a drive-thru setting just like last year. This is an easy way for IHCRC’s patients to get vaccinated for the flu without leaving the comfort of their vehicle. • We have several new providers who have joined the IHCRC healthcare family. These include in Flu clinic 2012

Jason Menting, Psy.D., Director of Clinical Training in the Behavioral Health department; Carlisa J. Phillips, APRN-CNP-Pediatrics, Pediatric Nurse Practitioner; Carolyn Cobb, MD; Laju Kumar, MD and Meagan Brady, MD, family practice physicians; Mark Alan Medlin, MD, Psychiatrist and Shelby S. Mathew, PharmD, Pharmacist. Although not new faces, we also want to announce that Marisa Feuerman, APRN-CNP-Pediatrics, has moved from a part-time Locum Tenens (contracted) position to a regular, full-time Pediatric Nurse Practitioner and Breanna Brumley, PA-C has moved from family practice to women’s health provider. • We have a new System of Care (SOC) team in place, who are ready to step up our children’s behavioral health care and wraparound support services. Read the bio of Jaime Whorton, the new SOC Project Director, and her article explaining Systems of Care and wraparound services on page 34.

HEALTHY SPIRIT A publication of Indian Health Care Resource Center of Tulsa, Inc. 550 S.Peoria Ave., Tulsa, OK 74120 www.ihcrc.org | 918.588.1900 IHCRC Board of Trustees Janice Edmiston – President, Choctaw and Sac & Fox Jim Cameron – Vice President, Cherokee Bob Bitting – Secretary, Cherokee Herbert P. Haschke, Jr. – Treasurer Dr. Jay Anderson – At Large Executive Committee, Choctaw Joe Neely – At Large Executive Committee, Muscogee (Creek) Dr. David Moon, Chickasaw Goldie Phillips, Comanche Ed Pierce, Citizen Nation Potawatomie Madeline Teague, Cherokee Mary Ann Vassar, Cherokee IHCRC Management Carmelita Wamego Skeeter – Chief Executive Officer Eddie Hathcoat – Chief Operating Officer Judy Gibson – Chief Financial Officer Stacie Nutt – Human Resource Director Healthy Spirit Editorial Staff Russell Burkhart – Editor, rburkhart@ihcrc.org Edward Rogers – Associate Editor, erogers@ihcrc.org Rachele Floyd, PsyD – Copy Editor, rfloyd@ihcrc.org Emily Bolusky – Public Relations Manager, ebolusky@ihcrc.org Design, Production and Photography Celina Anderson Burkhart – Me and MyMac Design, Celina@meandmymac.com

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SPECIAL EVENTS AND ACTIVITIES

Medicine Wheel Park Sculptures to be Dedicated on September 12 BY KATY BROWN

A new set of Native American sculptures was installed July 1 in Medicine Wheel Park, just south of Indian Health Care Resource Center (IHCRC) in the triangle park at South Peoria and Sixth Street. Oklahoma sculptor John Gooden created this sister piece to his sculpture, “The Healer,” located at the IHCRC entrance. This new sculpture, entitled “Games Along the Way,” portrays a Native American woman and her young children walking towards the clinic. With the encouragement of his mother, the boy is playing “Hoop and Pole.” Also known as “Shoot the Hoop,” variations of this game are played by many North American tribes. The girl carries a baby doll on her back and walks in step with her mother, wishing to be like her. The delight between the girl and her baby sister reflects the joy within the family. These sculptures portray the loving interaction of a Native American mother and her children walking across the plains, while capturing the essence of nurture. An embracing approach to care strengthens physical, mental, emotional and spiritual wellness within a family.

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Enjoy a stroll through the park to view these beautiful works of art at your next visit to IHCRC. And mark

your calendars for the Medicine Wheel Park dedication on Thursday, September 12 at 9:30 am.


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SPECIAL EVENTS AND ACTIVITIES Senior Health Fair, August 21 Indian Health Care Resource Center will host a Senior Health Fair on Wednesday, August 21 from 9 am-3 pm in the Jim Cameron Event Center at our facility located at 550 S. Peoria Ave. This event is free and open to all Native seniors in the Tulsa area. The health fair will feature free health screenings, giveaways, healthy snacks and informational booths. Health screenings will be provided for high blood pressure, vision, behavioral health, mammography, diabetes and heart disease. Native seniors can get detailed information about Medicare, health insurance education fitness/nutrition education and local community services. Current patients will also have the opportunity to receive their pneumonia immunizations and diabetic lab work while at the health fair.

Teddy Bear Clinic, September 21 Our ever popular annual pediatric Teddy Bear Clinic is scheduled for Saturday, September 21 from 10 am to noon. We encourage you to bring your children and their favorite stuffed animals to this educational and fun

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event. It’s a great way to introduce children to a healthcare setting and lower their anxieties towards medical personnel and future clinic visits.

Flu Clinic, October 19 Our second annual Flu Clinic is scheduled for Saturday, October 19 from 9 am to noon in the north IHCRC parking lot. Flu shots will be given in a drive-thru setting, just like last year. This is an easy way for IHCRC’s patients to get vaccinated for the flu without having to leave the comfort of their vehicle.

Komen Tulsa Race for the Cure, September 28 The 2013 Komen Tulsa Race for the Cure will be held at ONEOK Field on Saturday, September 28. Holding the Komen Race at ONEOK Field puts the event in a centralized location, where the 5k and 1-mile participants will enjoy a scenic run/walk through downtown Tulsa. Ample parking can be found throughout downtown. The layout of the race course is also designed to encourage patronage of downtown restaurants and businesses. ONEOK Field is located at East Archer Street and North Elgin Avenue.

Since 1997, the Tulsa Chapter of the Susan G. Komen for the Cure foundation has invested nearly $5.9 million into breast cancer screening, education and research. The Komen organization is committed to finding cures for breast cancer and helping all those in the Tulsa area who face this disease. You are invited to join the event, as Tulsans race together to make sure no one faces breast cancer alone. • 75% of every dollar raised by the Tulsa Affiliate of Susan G. Komen for the Cure stays in our community to fund vital education, screening, treatment and support services. Tulsa Komen currently funds local breast cancer programs at Indian Health Care Resource Center of Tulsa, Morton Comprehensive Health Services and Oklahoma Project Women. Photos courtesy Stacie Nutt


Employee/Company Picnic It has become one of the most enjoyed traditions of the employees at Indian Health Care and their families – the annual company picnic. This year, the staff and their families spent the evening of Friday, June 21 together at the extraordinary ONEOK field watching the Tulsa Drillers take on the Northwest Arkansas Naturals. The Refinery Deck was packed full with staff and their families enjoying the wonderful weather, great food and impressive baseball. The evening ended with the spectacular Friday Night Fireworks Show right over ONEOK field. As you can see from the pictures shown here, the staff had a great time! Many of the children were able to enjoy the fun amenities offered for children at the stadium. From the playground to the splash pad, there was never a lack of excitement for the youngest of the guests.

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SPECIAL EVENTS AND ACTIVITIES

FUN FOR NATIVE YOUTH at IHCRC’s Summer Culture and Wellness Camps By Nancy O’Banion, IHCRC Director of Health Education and Wellness

Indian youth had another fun and exciting summer at the IHCRC Summer Camps. Approximately 300 youth took advantage of the free camp programs offered in June and July. Camp activities focus on health, nutrition, fitness and diabetes prevention. IHCRC promotes a healthy and active lifestyle for youth to develop positive habits that last a lifetime. Children learned health concepts through games and activities that are fun, and make learning memorable. Each week-long session was provided at no cost to families, and included a healthy breakfast, lunch, snack and a camp t-shirt. Donations received from the Dance of the Two Moons help fund the summer camps. Youth participated in the Wellness Adventures camp at Tulsa Public School’s HelmZar Challenge Course, learning about diabetes prevention and climbing to new heights on the low and high elements of the course. Youth learned about leadership, teambuilding, problemsolving, and the opportunity to try new adventures. The week was capped with a day of kayaking at Shell Lake. Soccer Camp, coached by Boyna Bear of Sand Springs, was a great success. Youth in grades 1-8 received instruction

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in soccer skills, drills and competitions. Participants engaged in a great deal of physical fitness as well as soccer skills. Native Cultural Camp included field trips to the Cherokee Nation in Tahlequah, Woolaroc Museum near Bartlesville, the Thomas Gilcrease Museum in Tulsa and the Will Rogers Memorial in Claremore. The youth learned about traditional cultural, arts, native foods and history. This special camp fills up very quickly each year. Sports and Recreation Camp prepared Native kids to live strong and healthy futures. The goal is to help kids make the healthy choice the easy choice. Activities included experiential learning, fitness, circuit training, gardening, nutrition and traditional Indian games. The Strong Body Camps took place in both Tulsa and in Broken Arrow. These camps, for youth in grades 1-8 taught fitness concepts, making stickball sticks, cultural lessons and games. Plans for next year’s camps have already begun. Our camp sessions are usually full before June 1, so next year, be sure to get your children enrolled early! These camps educate and provide guidance for youth to make healthy choices for their futures.

Summer interns opposite page, bottom, left to right: Kortney Harris, Kevin Dorsey, Micara Rice and Kristin Hurst.

Camp photos courtesy Sherry Surrell


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November is National American Indian Heritage Month

The Pulse of IHCRC By Edward Rogers, IHCRC Credentialing Coordinator

This edition of “The Pulse of IHCRC” profiles new staff and contracted providers. We use “The Pulse” feature to make announcements about recent or upcoming changes with staff, the facility or our services. The Pulse also brings focus to individuals or special programs that

New Staff Jason Menting, Psy.D. – DIRECTOR OF CLINICAL TRAINING After recently earning his Doctor of Psychology degree (Psy.D.) in Clinical Psychology, Jason Menting has been hired as IHCRC’s Director of Clinical Training. “For the past year Jason has worked as a counselor psychology intern at IHCRC, while completing the final requirements of his doctoral degree in psychology. He has been a real asset

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have set an outstanding example with their exemplary performance and accomplishments, goal setting and achieving and pursuit of excellence in their service at this health care center for the Tulsa area Native American population.

to our department and the clinic as a whole and we are thrilled to have him join our team,” said Dr. Rachele Floyd, IHCRC Behavioral Health Director. Jason will supervise practicum students and doctoral psychology students participating in the Northeastern Oklahoma Psychology Internship Program (NOPIP). Primary supervision of the interns will be provided by Dr. Floyd until Jason becomes licensed in 2014 after completing a year of supervision. Jason will also host trainings on historical trauma and coordinate provider trainings facilitated by IHCRC’s psychiatrists, primary care providers, and the health education and wellness staff. Jason was born and raised in Antigo, Wisconsin. Jason earned a Bachelor of Arts degree in Psychology with distinction and completed the certificate program in American Indian Studies at the University of Wisconsin at Madison. He earned a Masters of Arts degree in Psychology and a Doctor of Psychology degree in Clinical Psychology from Xavier University in Cincinnati, Ohio.

Carlisa Jane Phillips, APRN-CNP – PEDIATRIC NURSE PRACTITIONER Carlisa Jane Phillips, APRN, CNPPediatrics, joined the Medical department at the Indian Health Care Resource Center as a Pediatric Nurse Practitioner in June. Carlisa comes to IHCRC from Okmulgee Pediatrics and previously worked for Oklahoma State University Physicians Pediatric


Clinic, the Children’s Hospital at Saint Francis in the Pediatric Intensive Care Unit and as a school nurse for Jenks Public Schools. Mrs. Phillips attended the University of Arkansas where she earned a Bachelor of Science degree in Nursing and she received a Master of Science degree in Nursing from the University of Alabama.

Carolyn L. Cobb, MD – FAMILY PRACTICE PHYSICIAN Dr. Carolyn Cobb came to work at IHCRC in June as a Family Practice Physician. Dr. Cobb comes to IHCRC from the Claremore Indian Hospital where she worked as a Staff Physician in Emergency. She worked Locum Tenens for Creek Nation Community Hospital, the Claremore Indian Hospital and the Cleveland Area Hospital. She has also served as a staff physician for Warren Clinic Urgent Care Center, Concentra Medical Center and Tulsa Emergency Physicians. Dr. Cobb received her medical degree from the University of Texas Medical Branch at Galveston, Texas and completed an Internal Medicine Residency at the University of Oklahoma Tulsa Medical College. She is a Diplomat of the American Board of Emergency Medicine and has held or currently holds licenses in Massachusetts, Missouri, Oklahoma and Texas.

Laju Kumar, MD – FAMILY PRACTICE PHYSICIAN Laju Kumar, MD started as a parttime Family Practice Physician in the

Medical department at IHCRC on May 15, 2013. Prior to coming to IHCRC, Dr. Kumar worked for private family practices including the Plattsburgh Health Center in Plattsburgh, New York, Parekh Medical Clinic in Senatobia, Mississippi and was the owner and physician for the Desoto Primary Care Clinic in Olive Branch, Mississippi. Dr. Kumar also worked for Baptist Minor Medical in Olive Branch, Mississippi and Mednow in Dalton, Georgia. She earned her medical degree at

Dr. Kumar is board certified by the American Board of Family Medicine.

Meagan Brady, MD – FAMILY PRACTICE PHYSICIAN

the Dr. Punjabrao Deshmukh Memorial Medical College in Maharashtra, India. She completed a residency program in pediatrics at the BJ Wadia Hospital of Children-KEM Hospital in Mumbai, India, and family practice residency programs at SUNY Buffalo-Buffalo General Hospital in Buffalo, New York and at the Fletcher Allen Health Care in Burlington, Vermont. Dr. Kumar has held or currently holds medical licenses in Georgia, Texas, Mississippi, Tennessee and Oklahoma.

Family Practice Physician Meagan Brady, MD came to work in the Medical department at IHCRC in July. Dr. Brady earned a Doctor of Medicine degree from the University of Oklahoma, College of Medicine in Oklahoma City and completed an Internship and Residency in Family Medicine at the University of Oklahoma Health Sciences Center in Tulsa. She earned a Bachelor of Science degree in Zoology from the University of Oklahoma in Norman. Dr. Brady is licensed by the Oklahoma State Board of Medical Licensure and Supervision and is board certified in Family Medicine by the American Board of Family Medicine. Dr. Brady is a member of the Association of American Indian Continued to page 12 IHCRC SUMMER/FALL 2013

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THE PULSE OF INDIAN HEALTH CARE RESOURCE CENTER | Continued from page 11

as the President of the Psi Chi Honor Society. She received the “Outstanding Student Research” award. Jaime gradu-

Physicians and American Academy of Family Medicine. Dr. Brady received the distinction of being Chief Resident for the final year of her residency program at OU (July 2012 to June 2013). She received The Joseph Salamy, MD Intern of the Year Award (June 2011) and an Indian Health Service Scholarship (August 2002 to June 2010). Dr. Brady previously worked for Health for Friends in Norman and the Comanche Nation Housing Authority in Lawton.

Shelby S. Mathew, PharmD – PHARMACIST Staff Pharmacist Shelby S. Mathew joined the IHCRC pharmacy team in May. He was previously employed by Kmart Pharmacies as the pharmacist in charge and previously served as staff pharmacist at Walmart Pharmacy in Providence, Rhode Island and Target Pharmacy in Dallas, Texas. Shelby earned his Doctor of Pharmacy (Pharm. D.) degree from the Massachusetts College of Pharmacy and Health Sciences in Boston, Massachusetts and a Bachelor of Science degree in biochemistry from Oklahoma State University.

Jaime Whorton, MS – SYSTEMS OF CARE PROJECT DIRECTOR Jaime Whorton, MS, joined IHCRC in June as the Systems of Care Project Director in the Behavioral Health Department. Jaime comes to IHCRC from the Grand Lake Mental Health Center, where she worked eight years. At Grand Lake, Jaime helped develop

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ated Cum Laude from Oklahoma State University, with a Master of Science degree in Community Counseling.

Transitions Congratulations are in order for several of our staff members who have recently transitioned to new positions within our clinical operation.

and expand the SOC program, where she held a variety of positions, including Child and Family Therapist for the Systems of Care program, providing home-based therapy for youth and families with severe emotional and behavioral needs. She also served as a member of the Mobile Crisis Team, Case Manager III, Lead Care Coordinator for SOC, and Behavioral Health Rehabilitation Specialist. Jaime also served as a member of the Rogers Juvenile Graduated Sanctions board for first offenders. From 2011 to 2013, Jaime worked for the Oklahoma Department of Mental Health as the first Regional Coach and Trainer for Systems of Care and supervised 19 SOC sites across the state. Jaime is also near completion of licensure requirements as a Licensed Professional Counselor (LPC); she currently provides therapy under supervision. In 2005, Jaime graduated Magna Cum Laude from Rogers State University with a Bachelor of Science degree in Social Science, and served

Marisa Feuerman, APRN-CNPPediatrics, is now employed as a full-time Pediatric Nurse Practitioner, having previously served as a part-time Locum Tenens (contracted) provider. Breanna Brumley, PA-C, joined IHCRC in January 2011 as a Family Practice Physician Assistant. Recently, Breanna accepted the position of IHCRC’s fulltime women’s health provider, serving under the supervision of Michael Scott, MD, IHCRC Medical Director. (See a short bio on Breanna, page 43.) Terra Denby has transferred from Patient Billing to Medical Assisting. Kelly Henderson has transferred from Medical Reception to serve as the Administrative Assistant to the Public Health Nurse in the Health Education and Wellness Department. We all wish all these valued employees success in their new positions.


Kelly Henderson – PUBLIC HEALTH NURSING ADMINISTRATIVE ASSISTANT They say that location is everything. Kelly Henderson, a familiar front desk face, recently made a change in location and joined IHCRC’s Public Health Nursing project as the Administrative Assistant in the Health Education and Wellness Department. Kelly is a welcome addition to the grant project, not only for her depth of front desk knowledge and experience, but for her love of people and a generous heart. Kelly works together with case manager Melanie Conant, RN, to help patients improve control of chronic health conditions and adopt healthier, more active lifestyles. Kelly assists patients set appointments, makes reminder calls and community referrals and enrolls patients into IHCRC’s exercise and demonstration cooking classes. She will assist staff with tracking all vital program information. Kelly assists Melanie when they make visits to the

homes of patients. These “motivational” home visits help patients make changes where they live and encourage them to continue with their newly developed healthy lifestyles and new activities. Kelly has been married to Michael Henderson for the past 34 years. They have three grown sons, Michael, Drew and Rhett, one daughter-in-law and a two-year-old grandson. Though ΩKelly has lived all over Oklahoma, she was born in Tahlequah. Kelly loves the outdoors and walking with her family. She is an avid reader, especially of old books. Kelly says that she loves the smell and look of the paper and leather of old books.

Psychologist Joanna Shadlow, PhD, RECEIVES LICENSURE IHCRC congratulates Joanna Shadlow, Ph.D. on obtaining her license to practice as a psychologist in the State of Oklahoma. Licensure as a psychologist is a lengthy process. Following graduation from a doctoral program in

psychology, the individual must obtain over 2,000 hours of supervised clinical experience and pass three exams. The Jurisprudence Exam is typically the first exam and requires that the individual display knowledge of relevant legal statues and ethical rules governing the practice of psychology. The Examination for Professional Practice in Psychology is a national exam and requires that the individual display knowledge in eight different topic areas. Lastly, the individual is required to pass an oral exam, where the Board of Examiners of Licensed Psychologists presents the examinee with an example case to discuss. Until licensure is obtained, the trainee works under the supervision of a licensed psychologist. In June, Dr. Shadlow completed the last of these hurdles and was awarded licensure. IHCRC is so proud of Dr. Shadlow, who in addition to working part time in our Behavioral Health Department, is also a fulltime professor at the University of Tulsa. Dr. Shadlow specializes in the treatment and assessment of children and families. She is also a proud member of the Osage Nation.

Employees of the Month Edward E. Rogers, Credentialing Coordinator – April Chana Bivens, Eligibility Clerk – May Lindsay Sottong, Dental Hygienist – June Tom Holt, Data Storage Clerk – July Dewanna Wallace, Referral Specialist – August

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550 S. Peoria Ave 10 am-12 noon Saturday September 21

What is a teddy bear clinic?   Bring your favorite stuffed animal for a complete check-up   and see how everything at the clinic works!

Children’s activities including face painting, storytelling, race cars, games and art. Safe Kids will be on hand to conduct free car seat checks. Door prizes and much, much, more. For more information call 918-382-1206 or ebolusky@ihcrc.org. 16 IHCRC SUMMER/FALL 2013


Medical Malpractice Insurance Coverage: It’s Good to Have a (Jeanette) Budde By Edward Rogers, IHCRC Credentialing Coordinator

Many believe a health provider has to cause severe injury to a patient to face a serious lawsuit as a consequence of his or her actions or failure to act. However, actions as “little” as not following standards of care, indifference and abandonment can be reason enough to prompt litigation in some cases. At its core, malpractice is defined as “the negligent act of a person with specialized training and education.” Unfortunately, mistakes, oversights, accidents, slips, mix-ups or errors do happen in medical settings. They usually occur when least expected. IHCRC has been accredited by the Accreditation Association for Ambulatory Health Care (AAAHC)

since December 2001. As an accredited facility, we facilitate best practices, high standards of care, quality assurance and quality improvement activities which are threaded throughout the fabric of our operations, services and corporate culture. Service areas include medical, lab, x-ray, behavioral health, optometry, dental, pharmacy and health education and wellness. Our policies, procedures and way of doing business collectively create a synergy that ensures we’re in a secure and safe position. As it relates to our ambulatory

clinic and the medical malpractice insurance coverage we have in place for our medical providers, we have worked very closely with Jeanette Budde, formerly with Rich & Cartmill, to ensure we’re protected against the unexpected. “We have benefited from and relied on Jeanette’s extended knowledge and expertise with malpractice-related issues on an ongoing basis. She has provided sound advice and always steered us towards the most secure position for our clinic, our providers and ultimately for our patients,” said Stacie Nutt, IHCRC HR Director.

About Jeanette Budde Jeanette Budde is the Marketing Manager at Mid-Continent Casualty Group. Previously, she contracted with Rich & Cartmill, from 1999 to July 2013. Earlier, she worked for Liberty Mutual Insurance in Richmond, Virginia. Her professional skills include prospecting, relationship development, coverage and exposure analysis, sales, and handling all aspects of account and team management. Her repertoire includes all property and casualty lines of insurance. Her diversified clientele includes manufacturing, contracting, service, healthcare, retail and wholesale companies from one to over 1,000 employees. Jeanette is a results oriented insurance professional with strong technical and business development skills. She has multi-faceted experience in both insurance agency and company positions. IHCRC SUMMER/FALL 2013

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How Attractive is Your Home to a Burglar? By Jeanette Budde, CPCU, Marketing Manager – Mid-Continent Casualty Group

Most burglars don’t put a lot of planning into their work, but understanding how they choose their victims can help you protect your home and belongings. A burglar is going to look for easy access to the home combined with low visibility. He’s also looking for a big payload. HERE ARE SOME TIPS TO HELP KEEP YOU FROM BECOMING A VICTIM:

1. Lights, lights, lights! Lighting, both inside and outside is one of the most effective and least expensive burglar deterrents. Statistics show that burglars are much less likely to enter a well-lit residence. All entryways to the home should be well lit, including porches, outside garage doors and any parking areas. Ideally exterior lights should illuminate 100 feet around your home. Floodlights are a good choice for providing bright light. Motion detector lights turn on automatically if motion is detected nearby, and give neighbors or passers-by notice of unwanted activity. A sudden burst of bright light is

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very effective in scaring away potential burglars. These lights are very economical because they are only on as needed. It’s best to install some lights out of reach so that bulbs can’t be easily removed or broken. Dusk-to-dawn lighting using a photocell control can also be effective in some areas, such as lighting walkways and yards. These sensors can be used to control house mounted floodlights, post lamps or ground mounted landscape lights.

2. Secure doors and windows. Make sure to lock

your doors and windows, including the one from your garage to your house. Don’t rely on your automatic garage door for security. Make sure your exterior doors are of solid construction of wood or metal. Hollow doors can be easily kicked in by burglars. All exterior doors and doors from attached garages should have good quality deadbolt locks, securitytype hinges and door strikes and strong doorframes that can’t be easily spread apart. If you have glass windows on your doors or next to your doors, consider installing a double cylinder deadbolt. Impact resistant glass on any windows within four feet of a door lock may also be beneficial. A qualified locksmith should be consulted to make sure you have the most effective locks on your doors and windows.

3. Secure your tool shed. Many thieves take advantage of a homeowner’s own tools and ladders to break in.

When a criminal looks at your home, what does he see? Is he going to have to work hard to get in your home? What are the chances he’ll be seen? Is there something worth stealing? 4. Eliminate hiding places, and don’t make it easy for them! Large bushes or

hedges may be beautiful, but they also can provide a great hiding place for a burglar who needs only a few seconds to break in through a door or window. Keep shrubbery trimmed away from entrances and walkways. If you do have shrubs or bushes, choose some with thorns to discourage potential burglars. Take a look at your home as if you’ve locked yourself out and you need to break in. Are there tree branches which would allow easy access to a second story window? Have you left the ladder out? Be sure to remove any objects in your yard which would be of assistance to a would-be thief.

5. Is anybody home? Burglars look for opportunities to strike when you’re gone. It’s important to create the illusion that you are home. Interior lighting is needed to show signs of life and activity. Light timers are inexpensive and readily available. Many allow you to set lights to turn on and off at random times, simulating actual

occupancy. These same timers can be used to turn on radios or TVs, making it further appear as if someone is home. If you go away on a trip make sure to never leave clues that you’re gone. Stop delivery of mail and newspapers, or have a trusted neighbor gather them while you’re away. Turn the volume down on your home phone answering machine and ringer so that these cannot be heard outside the house. Don’t leave a message on your telephone answering machine telling people you are away from home. Don’t talk about upcoming trips in public where you may be overheard by a thief looking for his next burglary victim. Also, avoid publicizing your vacation plans on social media such as Facebook or Twitter. Wait until you get home to tell them how much fun you had!

6. Alarm systems. A good

alarm system used properly can help deter would-be burglars. Thieves will often bypass a home with visible alarm signs because of the increased fear of being

Continued to page 19 IHCRC SUMMER/FALL 2013

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Oklahoma’s no cost Children’s Health Insurance Program SoonerCare provides free health insurance for Oklahoma children under age 19 who meet financial income eligibility guidelines. You must reapply annually. You may still qualify for SoonerCare as a secondary insurance even if you have private health insurance.

SoonerCare Income Guidelines Children under the age of 19 may qualify if family gross income is within the following guidelines:

Family Size

Monthly

Yearly

2

$2,333

$27,991

• Social security numbers for all household members

3

$2,944

$35,317

4

$3,554

$42,643

• Income/employment information

5

$4,165

$49,969

• Current health insurance information (if applicable)

6

$4,775

$57,295

7

$5,386

$64,621

• Name of primary care physician

8

$5,996

$71,947

Information needed to apply:

SoonerCare Insurance Benefits Include:

Some applicants may even qualify at slightly higher income! You must reapply annually. (Income guidelines effective April 1, 2012.)

Let us help you apply! Call 918-588-1900. Ask for SoonerCare 550 S. Peoria, Tulsa, OK 74120 www.ihcrc.org soonercare@ihcrc.org

• • • • • • • • • • •

Basic medical care Prescriptions Emergency room care Routine preventive checkups Immunizations Eyeglasses Dental exams SoonerRide medical transportation Behavioral health care Sports physicals And many more specialty services!

18

You can choose an Indian Health Care provider to be your IHCRC SUMMER/FALL 2013 child’s pediatrician/primary care physician.

CHIPRA/SoonerCare Program


IHCRC Wellness Calendar caught in the act. The deterrent value comes from the lawn sign and window stickers from the alarm company. A security alarm system with a loud alarm and flashing lights is particularly effective in scaring off a burglar who has entered the property. All alarm systems should be tested periodically, and all family members should be familiar with its proper use. If your alarm is central station, make sure your call list is up to date.

7. Don’t tempt a thief! Use

some common sense caution in preventing burglary. Don’t leave electronics, money or jewelry lying out in view of a window. Don’t discuss valuables you have in your home with others. When you make a high dollar purchase, such as that of electronics, TVs or target items, make sure to tear up or destroy the box so that it’s not sitting out in the open for trash pickup. Don’t hide spare keys outside your home because burglars know where to look! Consider giving one to a trusted friend or neighbor. Don’t leave notes on your door, such as “gone shopping.” Always lock any outside sheds or storage areas. Don’t leave your garage door open while unattended. It’s an invitation for a thief to walk right in. Keep a detailed inventory of your valuable possessions including date of purchase, original value and serial

numbers. Photographs or a video record of valuable items can be very helpful. Consider marking valuables with an engraver. Marked items are much harder for a burglar to sell. Photocopy the contents of your wallet (front and back of cards) and keep it in a safe or safe deposit box. Don’t give house keys to service providers. When service or delivery people come to your door, ask for an ID to make certain they are legitimate. Before opening the door to anyone, make certain you have identified them.

8. Be a great neighbor. Great neighbors look out for each other. Inform a dependable neighbor of your travel plans and make arrangements with him or her to keep an eye out for any suspicious activity. It’s also good to have them periodically check your yard for any stray papers or flyers. Neighbors working together make one of the best crimefighting teams around!

9. Ensure that your personal and home insurance policies are current. Protecting

your home and your family from criminal intrusion is a high priority. While no single method is 100% effective, I hope these tips will help you and your family reduce your chances of becoming a burglary victim.

Classes are held in the IHCRC Wellness Kitchen at 550 S. Peoria Ave. Please sign-up in person at the Wellness reception office, or by calling Kelly at 918-382-2222.

EXTREME RECIPE MAKEOVER: MEXICAN COOKING CLASS Wednesday Sept. 18, 11 am - 12 noon. Check out these easy changes to make your favorite foods healthier!

AMAZING FAMILY MEALS! Wednesday, October 9, 11 am - 12 noon. Surprise your family with fast, easy and delicious meal ideas!

WINTER WEATHER AND DIABETES Friday, October 18, 10 - 11:30 am. Are You Prepared? Be prepared for winter diabetes care! Topics include sick day management, skin care, stress and being prepared for fall and winter storms.

KIDS’ COOKING CLASSES Fridays – Aug 30, Sept 27, Oct 25, 4-5 pm. Ages 6-16, youth participants learn easy and healthy recipes and try new foods.

TOBACCO CESSATION Classes Every Wednesday. 4-5 pm. Call Stacy Berg at 918-382-2228.

NATIVE NATIONS YOUTH COUNCIL Monthly meetings are held at the IHCRC Satellite Office, 1630 S. Main St. A dinner meeting is held with the Tulsa Indian Community Advisory Team from 6-7 pm. Drum Group Practice from 7-8 pm. For more information call 918-382-2205 or email NNYC@ihcrc.org.

IHCRC General Calendar IHCRC CLINIC CLOSINGS Monthly Staff Training – Closed the first Wednesday morning of every month; clinic opens at 1 pm on these Wednesdays. IHCRC SUMMER/FALL 2013

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THE PULSE OF INDIAN HEALTH CARE RESOURCE CENTER | Continued from page 11

BEHIND THE SCENES

What are the Benefits of Working at IHCRC? By Stacie Nutt, IHCRC Human Resource Director

I

am often asked what are the benefits of working at Indian Health Care Resource Center? As IHCRC’s Human Resource Director, it’s a language I love to speak – most often expressed when I am recruiting new people to consider joining the IHCRC family. Benefits mean different things to different people. By simple definition, according to Merriam Webster, “benefit” is defined as “an act of kindness” and “something that promotes well-being.” State and federal laws require employers to provide employees with certain benefits. IHCRC must: • Give employees time off to vote, serve on a jury and perform military service. • Comply with all workers’ compensation insurance requirements. • Withhold FICA taxes from employees’ paychecks and pay the company portion of FICA taxes, providing employees with Social Security and Medicare benefits. • Pay state and federal unemployment taxes, helping to provide benefits for unemployed workers.

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IHCRC SUMMER/FALL 2013

• Comply with the Federal Family and Medical Leave Act (FMLA). However, employers are not required to provide: • Retirement plans • Health or disability plans • Dental or vision plans • Life insurance plans • Paid vacations, holidays, sick leave, continuing education time or reimbursements for professional development. In reality, most companies offer some or all of these benefits in order to be competitive in their market – this is especially true in the healthcare field where institutions compete for the same quality people who are in high demand and short supply. At IHCRC, we offer a comprehensive benefits program that includes health and dental insurance, short term and long term disability plans, and life insurance. In addition, we offer two retirement plans, a 403(b) plan that employees can start contributing to right away, and a 401(a) plan that IHCRC will contribute to, on the employee’s behalf, after one year and at least 1,000 hours of service.

Our Paid Time Off (PTO) program is one of the best! In addition to the 12 paid holidays that IHCRC observes, we also provide a PTO accrual to employees. Employees with a tenure of under five years earn four weeks of paid time off a year and employees who have been here over five years earn six weeks of paid time off a year. And for those occasions when an employee might need a little extra cash, employees are allowed to “sell back” some of their PTO hours. This benefit has been great for employees who need a little extra cash around the holidays or for a special occasion during the year. IHCRC takes pride in our dedication to supporting the continuing education of all staff. Employees are afforded a generous continuing education benefit for completing licensure CEU/CME requirements, and we also reimburse providers for malpractice premiums and professional memberships. All of the IHCRC tangible benefits are great, but the intangible benefits cannot go unmentioned. Our facility at 6th Street and Peoria Avenue is a proud anchor in the Pearl District revitalization efforts within the neighborhood. Our


CEO takes the utmost pride in the appearance and cleanliness of our facility and it shows from the second you walk through the front door. With Centennial Park right across the street and restaurants and shops within walking distance, it’s easy to see why our employees love spending their work day at our location. With all of our benefits in mind, I would have to say that the best benefit of working at IHCRC is that our leadership, the managing officers of

By simple definition, according to Merriam Webster, “benefit” is defined as “an act of kindness” and “something that promotes well-being.” our organization, place a great deal of value and importance on how we treat the people who make IHCRC what it is each and every day of our lives.

How we take care of each other. Acts of kindness. Benefits. Well-being.

Five IHCRC Employees Receive IHS Area Director’s Annual Awards By Edward Rogers, IHCRC Credentialing Coordinator

The Tenth Annual Oklahoma City Area Indian Health Service Area Director’s Awards Ceremony and Banquet was held on July 18, 2013 in Oklahoma City. This event recognizes individuals and health teams who have helped advance the goal of the Indian Health Service to ensure comprehensive health services are provided in a culturally competent manner to American Indian and Alaskan Native people. The Indian Health Service (IHS), an agency within the Department of Health and Human Services, is responsible for providing health services to American Indians and Alaska Natives. The provision of health services to members of federally-recognized tribes grew

out of the special government-togovernment relationship between the federal government and Indian tribes. The Oklahoma City Indian Health Service Area includes the federal Indian health, tribal health and urban health (I/T/U) facilities located in Oklahoma, Kansas and part of Texas. Individuals working at IHS I/T/U facilities were recognized at the awards ceremony for excellence in job performance. These annual awards honor and recognize Oklahoma City Area I/T/U health care staff whose outstanding performances and hard work have improved the health and quality of life of American Indian and Alaska Native people.

Judy Gibson, CFO at Indian Health Care Resource Center, has served on the IHS awards planning committee for several years. “I enjoy being a part of a group that facilitates recognition for staff members from all facilities throughout our service area who have gone above and beyond in their work performances, regardless of their roles. It’s a very meaningful way to show appreciation to these individuals who work so hard throughout the year. There are so many worthy, deserving nominees, I wish we could recognize them all,” said Judy. Indian Health Care’s staff makes every effort to provide quality Continued to page 23 IHCRC SUMMER/FALL 2013

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Comprehensive health services offered at no cost to you

Medical Care

By working closely together with our medical staff, you can improve your quality of life, prevent potential health problems, manage chronic health conditions and reduce health risks. Women’s health care includes prenatal care, family planning and mammography.

Lab, X-ray and Mammography

An in-house lab, x-ray and mammography department supports the delivery of comprehensive health care.

Health Education and Wellness

Free health promotion and disease prevention classes and individual counseling sessions provide helpful information about nutrition, cooking, exercise, diabetes, heart disease, smoking and various other topics.

Optometry

Routine eye exams help individuals living with diabetes preserve their eyesight. Optometry services include vision testing and eyeglass prescriptions.

Dental Care

Preventive and restorative dental services are provided by our team of dentists, dental assistants and a registered dental hygienist.

Behavioral Health Care

A professional staff of psychologists, psychiatrists, counselors, a nurse practitioner and social workers provides comprehensive mental health care, including psychological testing; medication management; and individual, group and family counseling.

Chemical Dependency Treatment

Outpatient substance abuse and alcohol treatment includes group and individual counseling and supportive counseling for family members affected by a parent or spouse’s substance abuse.

Pharmacy

Our pharmacy provides medications and counseling for prescriptions written by clinic physicians. Two drive-thru lanes help streamline the process. A pharmacy phone line is available for prescription refills.

WIC Nutrition Program

Participants in the Cherokee Nation WIC (Women, Infants and Children) supplemental nutrition program receive nutrition education and free food credits to purchase nutritious foods.

Patient Transportation

Free transportation is available if you need help getting to our health center.

550 South Peoria Avenue, Tulsa OK 74120 – 918-588-1900 – www.ihcrc.org 22

IHCRC SUMMER/FALL 2013


IHCRC EMPLOYEES RECEIVE IHS AREA DIRECTOR’S AWARDS | Continued from page 21

services and exceptional care for the Native American population in the Tulsa and surrounding areas. We have a great team and we believe they deserve to be recognized for all they do. This year is no exception. We are very proud to celebrate the accomplishments of the five IHCRC employees who received the following awards:

• Carmelita Wamego Skeeter, CEO – National Impact Award • Ron Robertson, Network Systems Supervisor – Area Director’s Individual Excellence in Customer Service Award • Tim Shadlow, Youth Program Coordinator – Exceptional Individual Performance

–Health Promotion & Wellness Award (Non-Clinical) • Stacie Nutt, Human Resource Director – Area Director’s Merit Award • Dawanna Wallace, Referral Specialist – Area Director’s Peer Recognition Award

Carmelita Wamego Skeeter, Chief Executive Officer NATIONAL IMPACT AWARD RECIPIENT

Carmelita Skeeter began her career in health care at Indian Health Care Resource Center of Tulsa (IHCRC) in 1976 when she helped survey residents in Tulsa and surrounding areas to assess the health needs of the local urban Indian population. Survey results showed that the medical needs of Tulsa’s Native Americans were not being met. When she was hired as one of IHCRC’s first four employees, the agency only provided referral services, but within a year, the first medical services were offered. During her tenure with IHCRC, Carmelita has worn many hats, including Clinic Administrator and, since 1989, the Chief Executive Officer position. Throughout her career, Carmelita has been recognized numerous times for her tireless efforts to ensure quality, accessible and comprehensive health care to Tulsa’s Indian people. As a proud member of the Citizen Potawatomi Nation she speaks out strongly in support of minority and Indian health needs. Carmelita has distinguished herself both locally and nationally with her advocacy and dedication to a wide range of critical health care issues. She is an activist and strong supporter of aiding underserved populations. She is not a person that sits down in the time of need; she is the one that coordinates the troops. Through her dedicated leadership, IHCRC’s 135

employees provide comprehensive health care services, including primary medical and dental care, preventive services, therapeutic measures, health education and community outreach. Supportive medical services include a diagnostic lab and x-ray, mammography, optometry and pharmacy. Behavioral health services include psychiatry; individual, family and group Continued to page 24 IHCRC SUMMER/FALL 2013

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THE PULSE OF INDIAN HEALTH CARE RESOURCE CENTER | Continued from page 23

approval of the Indian Health Care Improvement Act, dedicating over a decade of her time from 1998 to 2010 to help accomplish this goal, which benefits members of all federally recognized tribes. Carmelita Skeeter’s dedication to the betterment of lives for the Native American population has been the focus of her professional life. Her legacy will always be remembered as one who always stood up for those that couldn’t speak for themselves and one that worked tirelessly to leave circumstances better than she found them. Because of her political finesse, hard work and dedication, she has ensured that the health care needs for Native Americans in Tulsa and the surrounding areas is not only better, but much better.

Ron Robertson, Network Systems Supervisor AREA DIRECTOR’S INDIVIDUAL EXCELLENCE IN CUSTOMER SERVICE AWARD RECIPIENT

counseling; psychological testing; and out-patient substance abuse treatment. This rich mix of services holistically addresses all areas of an individual’s life. Although her involvement and accomplishments are too numerous to individually enumerate, she has made a major difference through her service on the Tribal Technical Advisory Group for the Centers for Medicare and Medicaid Services for the past three years; her service on the Oklahoma Primary Care Board; her service on national and Oklahoma Area Indian Health Service workgroups; and her memberships with the Oklahoma Academy, the National Council of Urban Indian Health and the Iron Gate Advisory Board for Tulsa’s hungry and homeless populations. Her passion for expanding services to the nation’s medically underserved populations has not gone unnoticed. She is without a doubt one of the hardest working individuals when it comes to improving the quality of health care for Native Americans. She has made it her life’s work to understand the health needs of our community and to make sure those needs are being met. Carmelita is most proud of her tireless efforts in Oklahoma and nationally for the permanent

24 IHCRC SUMMER/FALL 2013

Ron Robertson joined IHCRC in 1999 as the Network Systems Supervisor. In this position, he administers and oversees network design, implementation, organization and troubleshooting. He also monitors underlying communication protocols and support network hardware. Ron supervises a staff of four including the Clinical Applications Coordinator, Data Storage Clerk, Network Support Specialist and the Network Support Tech. In addition to Ron’s many responsibilities, he and his team are the “go to” employees or first responders for technical difficulties of any kind within the clinic. Ron and his staff are known for their expeditious handling of these technical problems in order to ensure the integrity and seamlessness of our operations. When the major remodeling and expansion of the IHCRC clinical facility got underway four years ago, a whirlwind of companion upgrade and modernization activities affected every inch of IHCRC’s infrastructure. Few people were more swept up in the windstorm than Ron Robertson. Not only did IHCRC remain open for services during two years of construction and remodeling, but a number of technical/program upgrades and beta testing were also rolled out during this same time.


During this quantum leap forward for IHCRC, Ron served as a key consultant and resource for the building construction with associated information technology (IT) expansion, including new building wiring for all additional square footage and a fully audio visual capable multi-purpose room; the successful deployment of a Kodak digital x-ray unit, a digital mammography unit and associated computer and server hardware; the expansion and reorganization of the communications room; the development, deployment, and training for Indian Health Service’s VISTA Electronic Health Records (EHR) for the clinic as a whole; and the revamping of the phone tree and the Interactive Voice Response. Ron supervises, coordinates or “handles” everything from fixing equipment problems; researching, ordering and installing new equipment and software; facilitating server backup processes and upgrades; spearheading the Clinical Applications Committee’s ongoing agenda items and implementation; facilitating beta testing; accommodating a provider’s special program requests; developing an intranet; and combating a plethora of daily cyber-attacks to our network.

In accord with new Health Insurance Portability and Accountability Act (HIPAA) regulations, Ron is rewriting the IT and HIPAA security policies which must comply with the new additions. Ron has had to take a very deep look at our processes, even as basic as how we destroy antiquated equipment, to comply with these newly expanded privacy laws. Ron has been instrumental in the planning, support and implementation of every software package used at IHCRC. Ron has a great ability to translate technical issues to non-IT people in a way that helps us succeed and fix the problems. He isn’t satisfied with temporary “fixes.” He works hard to find long term solutions to the software challenges. In addition to handling the day to day issues that come about, Ron provides exemplary customer service to the medical staff who utilize the EHR. IHCRC is also in the process of phasing out its HealthPro system with a conversion to the new Intergy practice management system. Ron Robertson is the individual behind the scenes enabling and ensuring our complex network infrastructure is up and running and playing nice with other software programs in the sandbox. He is the IT electronic glue that binds our health care operations together and humming smoothly along.

Stacie Nutt, Human Resource Director AREA DIRECTOR’S MERIT AWARD RECIPIENT

Stacie Nutt has served as IHCRC’s Human Resource Director since March 2007. She is responsible for the ongoing administration of all Human Resource (HR) programs and services. She develops and administers HR policies, practices and procedures. She plans and coordinates recruitment efforts and staffing activities. She serves as a source of guidance, support and assistance to department heads, supervisors and staff in the identification, documentation and resolution of employee relations issues. She provides counsel and mentoring to the management team regarding relevant laws, regulations and requirements. She administers Continued to page 26 IHCRC SUMMER/FALL 2013

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THE PULSE OF INDIAN HEALTH CARE RESOURCE CENTER | Continued from page 25

the performance appraisal program. Under state and federal laws and organizational policy, she interprets and enforces personnel policies fairly and consistently. She conducts periodic assessments of staff training needs and works with the CEO on management development programs. Stacie facilitates positive changes and quality improvements to many operational areas. Early on, she redesigned all job descriptions and performance evaluation forms. In 2008, she was instrumental in creating the Leadership Team (LT) group of department heads, managers and supervisors. The LT members meet monthly to review and discuss employment needs, peer review activities, quality improvement studies, clinical outcomes, credentialing, compliance, HIPAA, AAAHC accreditation, electronic health records and a host of other agenda items. She took a vaguely defined and loosely monitored continuing education reimbursement benefit and drafted a policy which defines three staff categories which qualify for varying amounts of continuing education reimbursement. One of the most popular changes from Stacie came in the form of an accrued leave buyback policy where employees can sell back to the clinic up to 60 hours of leave per year, as long as they meet the guidelines outlined in the policy. She pushed for an employee appreciation program to build

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IHCRC SUMMER/FALL 2013

employee morale and teambuilding. Stacie sets a positive tone at IHCRC’s monthly full staff meetings. By putting a friendly, open and professional face on Human Resources, employees are more likely to ask questions or work collaboratively to resolve identified problems or issues. Stacie’s goal in making business decisions and communicating to staff and management is to never let personal agendas or emotions drive opinions, assumptions or determinations. A huge initiative that Stacie facilitated was a customer service program which provides employees with a means to recognize their peers and management. Words of thanks or appreciation about deserving employees are submitted on cards, which are read and shared at monthly staff meetings. Stacie drafted IHCRC’s Peer Review Policies and Procedures in 2010 and expanded the peer review processes this past year to include a comprehensive set of criteria for tracking and reporting purposes. She has expanded the Credentialing and Privileging Committee’s responsibilities to include overseeing peer review findings and reporting these findings to the Board on all peer review activities. She has worked closely with the Dental and Behavioral Health Departments to expand their peer review activities as well. Stacie recognized the trend in and the importance of clinical data reporting. She pushed for a new staff position, the Clinical

Data Coordinator, to improve and expand our reporting capabilities for GPRA numbers and other data involving clinical measures. Another key process Stacie revamped recently was the patient complaint process and policy. Stacie drafted a new policy which empowered and equipped departmental staff to handle complaints and/or problems occurring in their departments.

Dawanna Wallace, Referral Specialist AREA DIRECTOR’S PEER RECOGNITION AWARD RECIPIENT

Dawanna Wallace joined Indian Health Care’s Patient Billing department as a Patient Registration Clerk on December 1, 2009. In time she was promoted to the Referral Specialist position and facilitates Float coverage in all departments as needed. Dawanna has continually proven


herself as a reliable and competent employee. She learns quickly, retains the knowledge and skills she’s given and has a great attitude about filling in where needed. This is exactly the type of employee Phyllis Pratt, Patient Billing Manager, relies on to ensure coverage for all of the areas in which her staff works. Dawanna works with parents to secure the information needed to enroll newborns as new IHCRC patients. She researches all required correspondence as per requested from providers, HMO plans and vendors. She serves as a prior authorization and referral specialist to verify eligibility, to submit requests for prior authorizations and referrals for Medicaid, Medicare, private and managed care companies. She sets appointments and orders home health equipment and tests. Dawanna also assists patients with social services and resources, CDIB and tribal verification and benefits. She documents the status of applications in patient accounts. As a patient resource, she is knowledgeable of Medicaid and Medicare eligibility requirements and helps determine if a patient qualifies for various health programs. She adds payer codes and updates in IHCRC’s electronic practice management system. Dawanna has worked in the Medical Reception Lead capacity and the Medical Reception Clerk position. She has worked as the Patient Registration Clerk where she performed insurance

verifications and facilitated pharmacy billing tickets. She has worked in the Eligibility department where she processed SoonerCare (Medicaid) referrals and worked with OB patients by explaining what we offer and guiding them through the process. In the Eligibility Department she has assisted with the Prescription Assistance program and patient referrals for medical equipment needs. She has provided coverage in the Dental, Behavioral Health, Pediatrics Medical Reception and Appointments Departments. Having previously worked in Medical Records, she is also well versed in pulling charts and filing. Currently, Dawanna focuses her efforts on tracking the referrals of Claude Denize, Physician Assistant. She helps track his medical records and gives him forms to sign before processing. She coordinates closely with him on the patient cases to help manage pending referrals and follow-up appointments. Because of Dawanna’s vast knowledge and experience in front end office operations and more specific experience in eligibility and billing functions she is a huge asset for the Patient Billing department. Her ability to fill in wherever needed in a reliable, competent manner makes a huge difference in our ability to provide seamless services and an affective front line for our patients. Dawanna works tirelessly to make a positive impact on the

services offered by and responsibilities delegated to the Patient Billing department. She takes pride in her job performance and always performs at a high level. She also takes pride in filling in where needed without having to be asked to fill the gap. She recognizes where the need is and automatically goes to the department needing help and takes on the vacant role.

Tim Shadlow, Youth Program Coordinator EXCEPTIONAL INDIVIDUAL PERFORMANCE – HEALTH PROMOTION AND WELLNESS AWARD (NON-CLINICAL) Tim Shadlow, Osage, joined IHCRC as the Youth Program Coordinator in the Health Education and Wellness department in July 2009. He currently continues in this role, as well as working within the Behavioral Health department on the Methamphetamine Suicide Prevention Initiative. Tim takes great pride in his Osage heritage and incorporates his knowledge of Indian culture into the youth programs he manages. Tim takes the initiative to build bridges with other departments at IHCRC and with community organizations to encourage collaboration and unity for the projects undertaken by our staff. Tim coordinates the program planning activities that support the goals and objectives of the health promotion, physical activity and youth development program. He plans, Continued to page 28 IHCRC SUMMER/FALL 2013

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THE PULSE OF INDIAN HEALTH CARE RESOURCE CENTER | Continued from page 27

Left to right: Sherry Surrell, Courtney Clymer, Tim Shadlow, Trenton Rabbit, Kevin Heeney and Jennie Howard.

Tim and his team facilitate IHCRC’s after school programs where there is an emphasis on exercise every day. The Health Education and Wellness Department hosted ten weeks of summer camps for Native kids. develops, implements and evaluates the health education components of the program with his fellow team members. He participates in meetings and obesity prevention activities with youth and parents at different locations within the community, including evening and weekend activities. Tim and his team facilitate IHCRC’s after school programs where there is an emphasis on exercise every day. The Health Education

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and Wellness Department hosted ten weeks of summer camps for Native kids. Tim and his colleagues incorporate many fun and innovative activities into the annual cultural and wellness camps – placing an emphasis on activities beyond exercise. They teach the youth about nutrition, gardening and tobacco prevention as well. Ultimately, the goal of the youth programs is to teach Native youth to stay active, eat right

and take pride in their heritage. Tim also coordinates the activities of the Native Nations Youth Council (NNYC) drum group. These programs enable Native youth to get involved with other Native people, build strong and lasting friendships, contribute to Native America and make a difference in the community. Tim makes a concerted effort to emphasize the traditional Indian culture to Native youth. “I want to bring culture to these city kids through the drum group and field trips to their native tribes so they can learn more about their culture and history,” explains Tim. The drum group teaches the Native youth songs from the Plains tribes of the Kiowa, Ponca, Kaw, Pawnee and Osage tribes. Not only


IHCRC Wellness Calendar does membership in the drum group give youth a sense of belonging and inclusion in a well-respected group made up of other Native youth and adults, it gives the youth a great learning opportunity as well. One of the goals of the drum group is to teach life skills and cultural etiquette for a wide range of venues. “I want them to be assertive young men and women who know how to look you in the eye, shake your hand with confidence and go on to lead healthy, successful lives,” explained Tim. One cannot put a number or value on instilling in our youth a desire to learn more about their Native culture and to have a positive outlook on healthy living. Tim has a passion for and makes every effort to pique the interest of and to encourage an interest in youth’s Native cultures

and traditions. Their relatives and friends also get involved and come to hear the youth sing and play as part of the Native Nations Youth Council and hopefully someday their own children will be encouraged to pass down these same values. Tim works hard to expose our youth to options other than cell phones, Wii games, Facebook and Twitter. He understands we can’t replace these digital age play things, for they are too deeply imbedded in our culture. But, he makes every attempt to encourage and develop an interest in the Native culture, traditions and in leading a healthier life with the balance of nutrition and activity. He stresses not taking up bad habits like smoking. It’s all about balance.

NURTURING FAMILIES TALKS Offered on the first Wednesday of every at 1 pm in the Middle Meeting Room of IHCRC’s Jim Cameron Event Center. The Nurturing Families Talks provide new or expectant parents with an opportunity to gain practical information about parenting and child care resources. Expectant parents, single moms, grandparents and other family relatives are all invited to attend. We always have very interesting and diverse speakers who give presentations relating to parenting topics, relationships, wellness and healthy living. For more information, please contact LaToyia Williams, IHCRC Healthy Start Case Manager at 918-382-1275.

CIRCLE OF PARENTS This program is offered every Thursday at 1 pm in the West Meeting Room of IHCRC’s Jim Cameron Event Center. This family-friendly program enables parents to come together, discuss parenting in their own words, network with other parents and have a support structure to grow as parents. Parents set the agenda and topics vary weekly. Parents can learn how to confidently care for their babies from infancy to early childhood and entry into elementary school. Groups are facilitated by Brenda Butchee with the Tulsa Health Department. For more information, please contact LaToyia Williams, IHCRC Healthy Start Case Manager at 918-382-1275.

BREASTFEEDING SUPPORT

Camp photo courtesy Sherry Surrell

A breastfeeding support group meets on the first Friday of every month at 1 pm at IHCRC’s Jim Cameron Event Center East Meeting Room. Information is provided by women who are trained in providing breastfeeding support, and who have breastfed themselves. For more information about the breastfeeding support group, please contact LaToyia Williams, IHCRC Healthy Start Case Manager at 918-382-1275 or Dee Knight with the Cherokee Nation WIC program at 918-382-1293. IHCRC SUMMER/FALL 2013

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We can prevent type 2 diabetes...

Why don’t we? we can prevent head injuries we can prevent drownings

we can prevent traffic deaths

• Type 2 diabetes can be prevented or delayed by losing a modest amount of weight, being more active, and making healthier food choices. • Find out if you’re at risk and what you can do now to prevent health problems later. Ask your health care provider if you should be tested for prediabetes. • Please call at 918-382-2222 to learn more about IHCRC Health and Wellness Department diabetes prevention programs.

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IHCRC SUMMER/FALL 2013


IHCRC Receives Graduate Psychology Education Grant – Again! By Russell Burkhart, IHCRC Director of Planning and Development

Three years ago, Indian Health Care was fortunate to receive a federal Graduate Psychology Education (GPE) training grant from the Health Resources and Services Administration (HRSA) Bureau of Health Professions. As this grant was about to end on June 30, 2013, IHCRC received word that our application for three more years of GPE funding was awarded to support and strengthen our doctoral psychology internship training program. Although the primary purpose of the intensive year-long internship is to provide professional training to the predoctoral psychology interns – the increased availability of assessment and clinical treatment services provided by the interns also has direct benefit to the American Indian patients served at our health center. During the history of the graduate psychology program at IHCRC, the majority of the interns have been American Indian students. Three full-time interns currently participate in the existing GPE project and three internship positions are planned for each year of the new GPE project. See the related article on pages 32-33, in which our current

interns Scott Drabenstot, Kyle Hill and Jason Menting reflect on their past year and experiences at IHCRC. IHCRC conducts its internship program in partnership with the Northeastern Oklahoma Psychology Internship Program (NOPIP). NOPIP is a consortium comprised of Oklahoma agencies committed to providing quality clinical training in the provision of basic psychological services. Interns are valued members of IHCRC’s multidisciplinary team. They participate in a wide range of clinical experiences and work closely with a variety of mental health and medical professionals. Responsibilities of the interns include psychological assessment, developing treatment plans and providing individual, family and group therapy. Interns also work closely with IHCRC’s medical department, with opportunities for medical consultation and multidisciplinary staffing. IHCRC’s multidisciplinary Behavioral Health Department is comprised of a team of psychologists, licensed professional counselors and social workers, substance abuse counselors, a psychiatric nurse

practitioner and psychiatrists. Services include clinical interviews, diagnostic assessments, substance abuse treatment, medication management, and individual, family and group therapy. The interns regularly attend the monthly meetings of the Tulsa Indian Community Advisory Team, facilitated by IHCRC’s Behavioral Health staff. They are also encouraged to participate in the events and activities of the Native Nations Youth Council. In the year ahead, the interns will have opportunities for involvement in: 1) a state-funded Systems of Care project, which provides community-based services to children and adolescents experiencing behavioral or emotional difficulties; 2) an adolescent-focused Methamphetamine and Suicide Prevention Initiative (MSPI); and 3) a public health nursing (PHN) case management project to provide interdisciplinary care to individuals with pre-diabetes and pre-hypertension. The MSPI and PHN projects are both funded by the Indian Health Service.

IHCRC SUMMER/FALL 2013

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THE PULSE OF INDIAN HEALTH CARE RESOURCE CENTER | Continued from page 31

Left to right: Scott Drabenstot, Jason Menting and Kyle Hill.

Future Plans of IHCRC’s Graduate Psychology Interns – In their own words For all three of us at Indian Health Care Resource Center (IHCRC), completing our psychology internship presented both obstacles and opportunities at the end of a long journey through graduate school. In addition to transitioning into professional status, we each faced challenges such as completing a dissertation, living in a new location and being away from family. We have supported each other through this process and have forged relationships

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IHCRC SUMMER/FALL 2013

that will extend beyond the internship year. This mutual support has allowed us to develop our counseling and assessment skills, to hone our abilities to consult with providers from other disciplines and to become involved in the community. We will take this experience with us as we begin the next stage of our careers. IHCRC works in partnership with the Northeastern Oklahoma Psychology Internship Program (NOPIP) to conduct its graduate

internship program. NOPIP is accredited by the American Psychological Association (APA) and is a member of the Association of Psychology Postdoctoral and Internship Centers (APPIC). NOPIP is a consortium comprised of local mental health agencies who each provide on-site training in basic psychological services. The goal of NOPIP is to develop the critical thinking, conceptualization and problem-solving skills of


the interns to work within multidisciplinary settings. The internship lasts a full year and requires a 40 hour per week time commitment. At IHCRC, we have provided counseling and conducted assessments with clients of various ages and have had an opportunity to consult with other clinical medical providers. We also have unique opportunities not available at other internship sites. Working with IHCRC’s Systems of Care and the Health Education and Wellness staff provided valuable experiences. We’ve also had the opportunity to volunteer and provide instruction to local Indian Education programs. We participated in youth-related activities to educate community members about critical behavioral health issues, such as suicide prevention, substance abuse and depression.

Scott Drabenstot This past year as a graduate psychology intern at IHCRC has been a source of significant personal and professional growth. Personally, it has been challenging to be away from my family members who live in the Oklahoma City area. My fellow interns, coworkers and friends in Tulsa have been a continuing source of support. I have appreciated your warmth and welcome. Professionally, it has been a privilege to learn from and serve with many dedicated individuals from the support staff to administration. I am pleased to say that those around me have challenged me to

provide higher quality services. This experience has been vastly more rewarding than I had imagined. And so, I leave IHCRC with mixed emotions. I am excited to return to my family and friends in the Oklahoma City area. However, I am also sad to say goodbye to my new Tulsa friends. I am also sad to say goodbye to the many individuals who entered my office and invited me to join them in

I am proud to have contributed to the mission of the organization, and to have had an opportunity to effect change at the community level as part of the community. Alas, we have to move on, and I am excited for the next chapter in my career. In September, I will be starting a post-doctoral associate position at the University of Minnesota’s Research for Indigenous Community

their process of growth and change. My consolation is that we share a state that now seems so much smaller. At the conclusion of this internship I will complete my doctorate in Counseling Psychology from the University of Oklahoma. Professionally, I will continue to focus on assessment and treatment of children and adolescents. In addition, I will add a new dimension, training future mental health professionals. Again, thanks for the opportunity to serve.

Health center. I’ll primarily be investigating factors contributing to prescription drug abuse and misuse within the American Indian communities in the tri-state region of Minnesota, Wisconsin and North Dakota. Essentially, I’m going to return to my people and do the work I set out to do from the start. I am looking forward to graduating with a Ph. D (Pow-wow. hard. Daily) in clinical psychology upon completion of my internship. Again, thank you for the support. Toksa (until I see you again), Anpetu Luta Hoksila (Red Day’s Boy).

Kyle Hill My experience in Tulsa this past year has been both engaging and challenging. Perhaps most difficult was leaving my family, friends and community. As I take this time to recollect my thoughts and feelings regarding my time here in Tulsa, I can wholeheartedly say that I will miss my new friends, fellow interns, and coworkers alike. I have realized that people who share a common interest in the beneficence of community, a common goal of caring for others, also share a bond and sense of community stronger than themselves. Therefore,

Jason Menting Following the end of my internship, I will join the behavioral health counseling team at IHCRC as a fulltime employee. In the year ahead, I will complete my postdoctoral training, but my duties will not change much from my current graduate psychology internship activities. A large portion of my time will be devoted to providing therapy and conducting psychological evaluations. Continued to page 37 IHCRC SUMMER/FALL 2013

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GATHERING STRENGTH AND RESTORING HARMONY

Native American Systems of Care and Wraparound at IHCRC By Jaime Whorton, SOC Project Director

Systems of Care refers to a specific framework of providing mental health and support services to at-risk youth and families experiencing severe behavioral and emotional needs. It brings together the individuals, organizations, community members and service providers, who make up a “system” of resources. These providers address the complex

Jaime Whorton, SOC Project Director

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IHCRC SUMMER/FALL 2013

needs of Native American youth and families. Can you imagine school teachers, counselors, DHS workers, juvenile justice workers, faith-based leaders, professionals of all different disciplines, children, teens and families at one table and all working together on a unified treatment and support plan? In the past, a youth and family may have been involved with several different service providers such as mental health, child welfare, the legal system, tribal services, schools, special education, medical services, etc. and these services may have been fragmented, with little or no collaboration in care. Families had to run from one appointment to the next and were told something different by each provider. In addition, providers were often left having to piece information together to get a complete picture of the family’s situation. As a result, families were often not able to get their needs met

and usually gave up after numerous failures, many times believing there was no hope for their family. With Systems of Care, the various agencies involved in providing services to children with severe emotional and behavioral needs act in an integrated fashion so that no matter where the child enters the system, he or she receives all of the services and supports needed. The ultimate goal is for children to remain in their own homes and schools, in their communities, and with their families, as they access resources that truly fit their unique needs.

What is Wraparound? Although “Systems of Care” refers to the greater community of support, the specific model of service that the youth and families experience is called “wraparound.” At Indian Health Care Resource Center, these programs are referred to as “Gathering Strength – Restoring Harmony.”


Wraparound is a strength-based planning process in which children and families identify the important people in their lives and form a unique support system, called a family team. Family teams are what sets wraparound apart from other treatment services for youth and families. The team is made up of natural supports, such as extended family, friends, neighbors, coaches, pastors or other people who are naturally involved in the family’s life. Also part of this family team are “formal” supports, such as teachers, counselors, psychiatrists, juvenile justice workers and any other professionals working with the family. Both natural and professional supports are then brought together, to one table, to address the most pressing issues the family wants to

work on. The youth and family solely decide who will be part of their family team and what information is shared with team members. Each selected team member brings specific strengths to the process such as their experience, abilities, knowledge, education, skills and resources. These strengths are used to create a unified plan to support the family in achieving their goals. The team also provides suggestions of what the youth and family can do for themselves to meet their needs. The focus is on helping the youth and family learn how to resolve their own crisis situations, access needed services in the community, advocate for themselves and teach them how to utilize their support system. The process is completely driven by the youth

and family and seeks to strengthen their connection to their Native American culture and community. The wraparound process demonstrates respect for and builds on the values, preferences, history, beliefs, culture and identity of the youth, family and their community. Native American culture is highly regarded and emphasized throughout the entire process, as families are guided to strengthen their cultural connections, traditions and involvement in the community. With wraparound, a great deal of value is placed upon each unique family, who they are and what’s important to them. The process is family-driven and youth-guided, meaning that the Continued to page 37 IHCRC SUMMER/FALL 2013

35


How to qualify for the Women, Infants and Children (WIC) program at Indian Health Care Resource Center Applicants for the WIC program need to provide identification and proof of income and residency. If an applicant currently receives SNAP, SoonerCare, Food Distribution Program or TANF assistance, the family members are automatically income eligible. Participants must have a nutritional need, be a child less than five years of age, be a pregnant or breastfeeding mother or have been pregnant within the past six months and have a family income less than the WIC guidelines listed below.

Make a WIC appointment by calling (918) 382-1290, (918) 382-1291, (918) 382-1293 or (918) 382-1295. Walk-ins are always welcome. 550 S. Peoria, Tulsa, OK 74120 www.ihcrc.org

Oklahoma WIC Income Eligibility Guidelines for 2012 Family Size

Annual Income

Monthly Income

Twice Monthly

Biweekly

Weekly Income

1

$20,665

$1,723

$ 862

$ 795

$ 398

2

27,991

2,333

1,167

1,077

539

3

35,317

2,944

1,472

1,359

680

4

42,643

3,554

1,777

1,641

821

5

49,969

4,165

2,083

1,922

961

6

57,295

4,775

2,388

2,204

1,102

7

64,621

5,386

2,693

2,486

1,243

8

71,947

5,996

2,998

2,768

1,384

9

79,273

6,607

3,304

3,049

1,525

10

86,599

7,217

3,609

3,331

1,666


GATHERING STRENGTH AND RESTORING HARMONY | Continued from page 35

center of focus is on the family and their goals for themselves, not what others determine to be their goals. The process is also team-based. It simply cannot be called “wraparound” without a family team. Teamwork is vital to the success of wraparound. The wraparound process is also community-based, as staff work in the family’s homes, schools and communities, striving to help the family strengthen their cultural ties. The goal is to “meet the families where they are” and where it is most comfortable and convenient for them. Wraparound builds upon the youth and family’s natural supports, which include people who are naturally present in their lives. This can include extended family, friends, coworkers, neighbors,

pastors or other people they feel are a support for the family. This helps to ensure that the team will continue on to function without formal wraparound staff present once the youth graduates from the program.

How Does This Process Work? Referrals for wraparound can come from any source, including selfreferrals, juvenile court, schools, inpatient hospitals or counseling agencies. The admission criteria for services requires a child or youth (age 4 to 21) to have difficulty in at least two systems (areas) such as at home, daycare, school, Department of Human Services or Office of Juvenile Affairs involvement and have a diagnosable mental disorder.

This process is aimed at children who have been having difficulty for at least one year or more and are at-risk for out-of-home or out-of-school placement. Another very important admission requirement is that the family must be willing to actively participate. Wraparound is driven by the family and cannot be successful without the family being on board. For additional information or to request a referral please contact: Jaime Whorton, MS Gathering Strength – Restoring Harmony Systems of Care Project Director Indian Health Care Resource Center of Tulsa (918) 382-2205 jwhorton@ihcrc.org

THE FUTURE PLANS FOR IHCRC’S GRADUATE PSYCHOLOGY INTERNS | Continued from page 33

Built into the evaluation process are designing test batteries, administering and scoring tests, consulting with other providers, interviewing clients and family members, and writing a psychological report. It is a complex and time-consuming process, but very rewarding because clients and their families typically find the results to be very helpful, particularly for obtaining additional services. My remaining time will be devoted to supervising practicum students, providing training to students and engaging in community outreach. It will take about one year to accrue the necessary hours to become

a licensed psychologist in Oklahoma. As part of the process to become licensed, I must pass a national examination, the Examination for Professional Practice of Psychology (EPPP), as well as the jurisprudence exam and the oral exam through the Oklahoma State Board of Examiners. My goal is to successfully pass these exams and become licensed as soon as possible. After becoming licensed, I plan to stay at IHCRC into the foreseeable future. In addition to my therapeutic work at IHCRC, I plan to become more involved in the Tulsa area Indian community by participating

in outreach projects and attending community events. I have found working with the Tulsa Indian Community Advisory Team (TICAT) to be a rewarding experience and plan to continue doing so. I will also seek out other ways to increase my community involvement. There is a lot to fit into the next year, so I should be very busy. However, I hope to find time to do some scholarly writing. I may try to publish the results from my dissertation. I also have an interest in writing about psychological assessment and evidence-based practices. IHCRC SUMMER/FALL 2013

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HEALTH & WELLNESS CLASSES August – October 2013

Classes are held in the IHCRC Wellness Kitchen at 550 S. Peoria Ave. Please sign-up in person at the Wellness reception office, or by calling Kelly at 918-382-2222. If leaving a message, please leave your name and number for a call back to enroll. Class registration left by voicemail will not be accepted. If interested in specific programs, please call numbers listed below. Classes are limited to clinic patients, ages 18 and over, except for Kids’ Cooking Classes.

Discovering Diabetes

Every Wednesday

2-4 pm

Gabrielle Taylor 918-382-2229

A workshop for people with diabetes. It teaches the skills needed in the day-to-day management of diabetes and to maintain or increase life’s activities!! The workshop is a series of 3 classes held every Wednesday.

Tobacco Cessation Classes

Every Wednesday

4-5 pm

Diabetes Express Tune-Up

2nd Tuesday of month

1-3 pm

Stacy Berg

918-382-2228

For patients who have had diabetes for a while and would like a review of the essential components of diabetes care.

Extreme Recipe Makeover: Mexican Cooking Class

Wednesday Sept. 18

11 am - 12 noon

Check out these easy changes to make your favorite foods healthier!

Amazing Family Meals!

Wednesday, October 9 11 am - 12 noon

Surprise your family with fast, easy and delicious meal ideas!

Winter Weather and Diabetes: Friday, October 18 10 - 11:30 am Are You Prepared? Be prepared for winter diabetes care! Topics include sick day management, skin care, stress and being prepared for fall and winter storms.

Kid’s Cooking Classes

Fridays – Aug 30, Sept 27, Oct 25, 4-5 pm

Youth participants learn easy and healthy recipes and try new foods.

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IHCRC SUMMER/FALL 2013

Ages 6-16


Raising Awareness and Funds for Chronic Digestive Diseases Source: National Partnership for Immunization and the Centers for Disease Control and Prevention

Tulsa’s third annual “Take Steps for Crohn’s & Colitis Walk” will be held Saturday, September 21 at ONEOK Field in downtown Tulsa. Registration is at 4 pm and the Walk will begin at 5 pm. The event will raise money to support crucial research about Crohn’s disease and Ulcerative Colitis. More than 80 cents of every dollar raised through the Take Steps campaign will directly fund research and patient aide programs in the Tulsa area. In the last two years, over $13 million has been raised nationally. Money is raised through corporate sponsorships, as well as corporate and family walk teams. Take Steps for Crohn’s & Colitis is the nation’s largest annual event dedicated to finding cures for digestive diseases. Through this family-friendly program which includes a festival and walk, thousands of walkers across the country raise crucial research dol-

lars to help the 1 in 200 Americans fighting Crohn’s disease and Ulcerative Colitis. Take Steps for Crohn’s & Colitis brings together the Crohn’s and Colitis community in a fun and energetic atmosphere where participants are encouraged to make noise and be heard – raising awareness of these little-known diseases in their community and across the nation. Known collectively as inflammatory bowel diseases (IBD), Crohn’s disease and Ulcerative Colitis affects 1.4 million Americans. They are painful, medically incurable diseases that attack the digestive system. Crohn’s disease may attack anywhere along the digestive tract, while ulcerative colitis inflames only the large intestine (colon). Symptoms may include abdominal pain, persistent diarrhea, rectal bleeding, fever, weight loss and fatigue. Many patients require numerous hospitalizations and surgery. These

are common disorders with bad consequences if not detected and treated early, yet long delays in diagnosis and effective treatment are common because people, including primary care physicians, are not familiar with the symptoms. The average delay in diagnosis is one to three years and the average patient is misdiagnosed twice. Most people develop the diseases between 15 and 35, however the diseases are becoming increasingly more common in children. For more information about this and other events, services and programs with the Oklahoma Chapter of the Crohn’s & Colitis Foundation of America contact the Community Development Manager, Clayton Smith, at (918) 791-8431 or csmith@ccfa.org. You can register for the “Take Steps for Crohn’s & Colitis Walk” at www.cctakesteps.org/tulsa.

JOIN TEAM IHCRC For questions contact Elizabeth Fair at efair@ihcrc.org, Team Captain at Indian Health Care Resource Center. Customize your Walk page and send e-mails to all your friends and families, asking them to join you in your fight against digestive disease. IHCRC SUMMER/FALL 2013

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AUGUST IS NATIONAL IMMUNIZATION AWARENESS MONTH

NATIONAL IMMUNIZATION AWARENESS MONTH Source: National Partnership for Immunization and the Centers for Disease Control and Prevention

A

ugust is National Immunization Awareness Month. This observance provides the opportunity to remind the community of the importance of immunization. Make sure that your family and friends are up-to-date on their immunizations. In August, parents are enrolling children in school, older students are entering college and adults and the health care community are preparing for the upcoming flu season. This makes August a particularly good time to focus community attention on the value of immunization. Vaccines are responsible for the control of many infectious diseases that were once common in this country. Vaccines have reduced and, in some cases, eliminated many diseases that once routinely killed or harmed tens of thousands of infants, children and adults. The viruses and bacteria that cause vaccine-preventable diseases and death still exist and can infect people who are not protected by vaccines. Vaccine-preventable diseases have a costly impact, resulting in doctors’ visits, hospitalizations and premature

40 IHCRC SUMMER/FALL 2013

deaths. Sick children can also cause parents to lose time from work. Vaccines are safe and effective protection. By staying up-to-date on recommended vaccinations, individuals can protect themselves, their families, and loved ones from disease. Because children are particularly vulnerable to infection, most vaccines are given during the first five to six years of life. Some immunizations are recommended throughout adolescent and adult years; while special vaccines may also be administered to international travelers.

Vaccinations work best when they are given at certain ages. Here are some general guidelines: Children: The CDC recommends that children receive vaccines against diphtheria, influenza, tetanus, pertussis, measles, mumps, rubella, chickenpox, polio and others.

Adolescents: Adolescents should receive vaccines against influenza, hepatitis A, hepati-

tis B, meningococcal disease, pertussis, human papillomavirus, and any missed vaccinations.

Adults: • All adults need a tetanus shot every 10 years. • Adults age 50 and older need an influenza shot every year. • People age 65 need a one-time pneumococcal shot. • Talk to your doctor or nurse about which shots you and your family need.

Vaccines require more than one dose There are four reasons that babies – and even teens or adults for that matter – who receive a vaccine for the first time may need more than one dose: For some vaccines (primarily inactivated vaccines), the first dose does not provide as much immunity as possible. So, more than one dose is needed to build more complete immunity. The vaccine that protects against the bacteria Hib, which causes meningitis, is a good example.


In other cases, such as the DTaP vaccine, which protects against diphtheria, tetanus, and pertussis, the initial series of four shots that children receive as part of their infant immunizations helps them build immunity. After a while, however, that immunity begins to wear off. At that point, a “booster” dose is needed to bring immunity levels back up. This booster dose is needed at 4 years through 6 years old for DTaP. Another booster against these diseases is needed at 11 years or 12 years of age. This booster for older children—and teens and adults, too—is called Tdap. For some vaccines (primarily live vaccines), studies have shown that more than one dose is needed for everyone to develop the best immune response. For example, after one dose of the MMR vaccine, some people may not develop enough antibodies to fight off infection. The second dose helps make sure that almost everyone is protected. Finally, in the case of the flu vaccine, adults and children (older than 6 months) need to get a dose every year. Children 6 months through 8 years old who have never gotten the flu vaccine in the past or have only gotten one dose in past years need two doses the first year they are vaccinated against flu for best protection. Then, annual flu shots are needed because the disease-causing viruses may be

different from year to year. Every year, the flu vaccine is designed to prevent the specific viruses that experts predict will be circulating.

The Bottom Line Some people believe that naturally acquired immunity – immunity from having the disease itself – is better than the immunity provided by vaccines. However, natural infections can cause severe complications and be deadly. This is true even for diseases that most people consider mild, like chickenpox. It is impossible to predict who will get serious infections that may lead to hospitalization. Vaccines, like any medication, can cause side effects. The most common side effects are mild. However, many vaccine-preventable disease symptoms can be serious, or even deadly. Although many of these diseases are rare in this country, they do circulate around the world and can be brought into the U.S., putting unvaccinated children at risk. Even with advances in health care, the diseases that vaccines prevent can still be very serious – and vaccination is the best way to prevent them. Adapted from the National Institute of Allergy and Infectious Diseases, Understanding Vaccines http://www. niaid.nih.gov/topics/vaccines/ Continued to page 43 IHCRC SUMMER/FALL 2013

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AUGUST IS NATIONAL IMMUNIZATION AWARENESS MONTH

HPV Vaccine for Preteens and Teens Source: Centers for Disease Control and Prevention

Human papillomavirus, or HPV, is the most common sexually transmitted infection, representing nearly threequarters of all newly acquired sexually transmitted infections. While the vast majority of HPV infections will not cause serious harm, some infections will persist and can lead to cervical cancer. Most infected persons do not realize they are infected, or that they are passing HPV on to a sex partner. Luckily, there is a vaccine to protect against HPV infection and the diseases that are caused by HPV. HPV vaccination is recommended for preteen

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girls and boys at age 11 or 12 years, long before their first sexual contact, so they have time to develop protection from the vaccine. There are two different HPV vaccines that can be given to girls and young women. These vaccines are Cervarix (made by GlaxoSmithKline) and Gardasil (made by Merck).

Only one HPV vaccine – Gardasil – can be given to boys and young men. Both Cervarix and Gardasil protect against HPV types that cause most cervical cancer and have been shown to prevent cervical cancer. Gardasil has been studied and shown to protect against cervical, anal, vaginal and vulvar cancers. Gardasil also protects against HPV types that cause most genital warts and has been shown to prevent genital warts. Talk with your doctor about HPV vaccination and safe sex practices.


Both of the HPV vaccines are licensed by the Food and Drug Administration (FDA) and recommended by the Centers for Disease Control and Prevention (CDC). Cervarix and Gardasil are licensed, safe, and effective for females ages 9 through 26 years. CDC recommends that all 11 or 12 year old girls get the 3 doses (shots) of either brand of HPV vaccine to protect against cervical cancer. Gardasil also protects against most genital warts, as well as some cancers of the vulva, vagina

and anus. Girls and young women ages 13 through 26 should get HPV vaccine if they have not received any or all doses when they were younger. Gardasil is also licensed, safe, and effective for males ages 9 through 26 years. CDC recommends Gardasil for all boys aged 11 or 12 years, and for males aged 13 through 21 years, who did not get any or all of the three recommended doses when they were younger. All men may receive the vaccine through age 26, and should speak with their doctor to find out if

getting vaccinated is right for them. For the HPV vaccine to work best, it is very important for preteens to get all 3 doses (shots) long before any sexual activity with another person begins. It is possible to be infected with HPV the very first time sexual contact occurs with another person. Also, the vaccine produces higher antibody that fights infection when given at this age compared to older ages.

New Women’s Health Provider – Breanna Brumley, PA-C Breanna Brumley, PA-C, joined IHCRC in January 2011 as a Family Practice Physician Assistant. Breanna has recently accepted the position of fulltime women’s health provider, under the supervision of Michael Scott, MD, IHCRC Medical Director. Breanna Brumley completed her Master of Science degree in Physician Assistant studies at the University of Oklahoma’s School of Community Medicine in Tulsa in December 2010. She earned a Bachelor of Science degree in Cellular Biology from the Northeastern State University (NSU) in 2007. She is board certified by the National Commission of Certified Physician Assistants (NCCPA). Ms. Brumley has completed specialty clinical rotations in obstetrics and gynecology at the Hillcrest Medical Center and in family medicine, obstetrics and gynecology at the University of Oklahoma Pediatric Clinic. IHCRC SUMMER/FALL 2013

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SEPTEMBER IS FRUITS & VEGGIES–MORE MATTERS MONTH

Healthy Lunchtime Challenge Winners attend the 2013 Kids’ State Dinner

O

n July 9th, 54 children and their parent or guardian (one pair from each of the 50 states, plus some of the U.S. Territories, D.C., and Puerto Rico) attended a Kids’ “State Dinner” at the White House, hosted by First Lady Michelle Obama. Each child (and their parents) submitted a healthy recipe as part of the Healthy Lunchtime Challenge. On the menu were nine dishes selected from the winning recipes. President Barack Obama made a surprise appearance at the Kids’ “State Dinner.” The President gave a short impromptu speech before shaking the hands of many guests in the room. By “eating healthy, living healthy, you are setting up habits that are going to be great for your entire life, and you’re setting a great example for your classmates,” the President told the winners. “You’re really making a difference in all the communities, all the states

across the country – we could not be prouder of you.” The Healthy Lunchtime Challenge invited children between the ages of 8-12 and their families to create an original lunchtime recipe that is healthy, affordable and delicious, and follows the nutritional guidelines of MyPlate. The winners of the kids’ recipe contest were selected from over 1,300 delicious entries, which were evaluated in Washington, D.C., by a panel of judges that included Let’s Move! executive director and assistant White House chef Sam Kass; Epicurious editor-in-chief Tanya Steel; representatives from the USDA and the Department of Education; two children who recently graduated from Share Our Strength’s Cooking Matters program; and D.C. Central Kitchen’s Michael F. Curtin, Jr., whose organization prepared the food for tasting.

First Lady Michelle Obama and guests applaud as Big Time Rush performs during the Kids’ State Dinner in the East Room of the White House, Aug. 20, 2012. (Official White House Photo by Sonya N. Hebert)

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“One of my favorite foods is shrimp and we eat a lot of tacos,” says Ogden Johnson, Kids’ Recipe contest representative for Oklahoma. “We like to eat it with corn tortillas because they are gluten-free. My other favorite food is broccoli and I like that I can heat it up all by myself. Pico de gallo is what my dad always makes with tacos and I love the fresh cilantro from our garden. He leaves the jalapeños out of mine. Cheese and sour cream are both good on tacos, too.”

Taco de Camarón

Ogden Johnson

Recipe Created by Ogden Johnson, Age 10, Oklahoma

INGREDIENTS For the pico de gallo: 6 medium plum tomatoes, diced 1/2 medium red onion, minced 3 tablespoons chopped fresh cilantro leaves 1/2 jalapeño, seeded and minced (optional) Juice of 1/2 lime 1 clove garlic, minced 1 pinch garlic powder 1 pinch ground cumin Salt and freshly ground black pepper For the shrimp tacos: 2 tablespoons olive oil 2 pounds shrimp, peeled and deveined 1/4 cup water 1 1/2 teaspoons chili powder 1 1/4 teaspoons paprika 1 1/4 teaspoons ground cumin 1 teaspoon onion powder 1 teaspoon salt 1/2 teaspoon garlic powder 1/2 head of fresh broccoli 12 corn tortillas PREPARATION Make the pico de gallo: 1. In a medium bowl, stir together the tomatoes, red onion, cilantro, jalapeño, lime juice, fresh garlic, garlic powder, cumin, salt and pepper. 2. Cover and chill in the refrigerator for at least 3 hours before serving.

MAKE THE SHRIMP TACOS: 1. In a medium sauté pan over moderate heat, warm the oil. Add the shrimp, water, chili powder, paprika, cumin, onion powder, salt and garlic powder and sauté, stirring occasionally, until the shrimp is no longer pink, about 5 minutes. 2. In a microwave-safe dish, steam the broccoli in the microwave until tender, about 3 minutes. 3. Warm the corn tortillas in the microwave. 4. Divide the shrimp mixture among the tortillas and serve with broccoli and pico de gallo. Makes 6 servings; 238 calories; 33g protein; 18g carbohydrates; 3g fat (.5g saturated fat); 790mg sodium


SEPTEMBER IS FRUITS & VEGGIES–MORE MATTERS MONTH

What is a Serving of Fruits and Vegetables?

Fill Half Your Plate

Source: Centers for Disease Control and Prevention

MAKING IT SIMPLE: THE HALFYOUR-PLATE CONCEPT. What does a serving of broccoli look like? How many baby carrots are in a cup? Even the most well-versed nutrition professionals don’t have all these measurements memorized! So let’s make it easier: fill half your plate with fruits and vegetables at each meal or eating occasion. Making fruits and vegetables the focal point of every meal will help you meet your recommended amount each day—and you won’t have to do all the math! The new healthy MyPlate icon developed by the USDA supports this concept … fill half your plate with colorful fruits and vegetables at every meal! HOW TO USE FRUITS AND VEGETABLES TO HELP MANAGE YOUR WEIGHT “Eat your fruits and vegetables.” You’ve likely heard this statement since childhood. Research shows why it is good advice: • Healthy diets rich in fruits and vegetables may reduce the risk of cancer and other chronic diseases. • Fruits and vegetables also provide essential vitamins and minerals, fiber and other substances that are important for good health. • Most fruits and vegetables are naturally low in fat and calories and are filling. FRUITS AND VEGETABLES ARE PART OF A WELL-BALANCED AND HEALTHY EATING PLAN. There are many different ways to lose or maintain a healthy weight. Using more fruits and

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IHCRC SUMMER/FALL 2013

vegetables along with whole grains and lean meats, nuts and beans is a safe and healthy one. TO LOSE WEIGHT, YOU MUST EAT FEWER CALORIES THAN YOUR BODY USES. This doesn’t necessarily mean that you have to eat less food. You can create lower-calorie versions of some of your favorite dishes by substituting low-calorie fruits and vegetables in place of higher-calorie ingredients. The water and fiber in fruits and vegetables will add volume to your dishes, so you can eat the same amount of food with fewer calories. Most fruits and vegetables are naturally low in fat and calories and are filling. Here are some simple ways to cut calories and eat fruits and vegetables throughout your day.


as broccoli, carrots, beans or red peppers, in place of 2 ounces of the meat or 1 cup of noodles in your favorite broth-based soup. The vegetables will help fill you up, so you won’t miss those extra calories.

BREAKFAST: START THE DAY RIGHT • Substitute some spinach, onions, or mushrooms for one of the eggs or half of the cheese in your morning omelet. The vegetables will add volume and flavor to the dish with fewer calories than the egg or cheese. • Cut back on the amount of cereal in your bowl to make room for some cut-up bananas, peaches, or strawberries. You can still eat a full bowl, but with fewer calories. LIGHTEN UP YOUR LUNCH • Substitute vegetables such as lettuce, tomatoes, cucumbers, or onions for 2 ounces of the cheese and 2 ounces of the meat in your sandwich, wrap or burrito. The new version will fill you up with fewer calories than the original. Add a cup of chopped vegetables, such

DINNER • Add in 1 cup of chopped vegetables such as broccoli, tomatoes, squash, onions or peppers, while removing 1 cup of the rice or pasta in your favorite dish. The dish with the vegetables will be just as satisfying but have fewer calories than the same amount of the original version. • Take a good look at your dinner plate. Vegetables, fruit and whole grains should take up the largest portion of your plate. If they do not, replace some of the meat, cheese, white pasta, or rice with legumes, steamed broccoli, asparagus, greens or another favorite vegetable. This will reduce the total calories in your meal without reducing the amount of food you eat. BUT remember to use a normal- or small-size plate – not a platter. The total number of calories that you eat counts, even if a good proportion of them come from fruits and vegetables. SMART SNACKS. Most healthy eating plans allow for one or two small snacks a day. Choosing most fruits and vegetables will allow you to eat a snack with only 100 calories.

About 100 calories or less • a medium-size apple (72 calories) • a medium-size banana (105 calories) • 1 cup steamed green beans (44 calories) • 1 cup blueberries (83 calories) • 1 cup grapes (100 calories) • 1 cup carrots (45 calories), broccoli (30 calories) or bell peppers (30 calories) with 2 tbsp. hummus (46 calories)

Continued to page 48 IHCRC SUMMER/FALL 2013

47


10 tips

Nutrition

Education Series

kid-friendly veggies and fruits

10 tips for making healthy foods more fun for children

Encourage children to eat vegetables and fruits by making it fun. Provide healthy ingredients and let kids help with preparation, based on their age and skills. Kids may try foods they avoided in the past if they helped make them.

1

Blend fat-free or low-fat yogurt or milk with fruit pieces and crushed ice. Use fresh, frozen, canned, and even overripe fruits. Try bananas, berries, peaches, and/or pineapple. If you freeze the fruit first, you can even skip the ice!

2

delicious dippers

Kids love to dip their foods. Whip up a quick dip for veggies with yogurt and seasonings such as herbs or garlic. Serve with raw vegetables like broccoli, carrots, or cauliflower. Fruit chunks go great with a yogurt and cinnamon or vanilla dip.

3

caterpillar kabobs

Assemble chunks of melon, apple, orange, and pear on skewers for a fruity kabob. For a raw veggie version, use vegetables like zucchini, cucumber, squash, sweet peppers, or tomatoes.

4

personalized pizzas

Set up a pizza-making station in the kitchen. Use whole-wheat English muffins, bagels, or pita bread as the crust. Have tomato sauce, low-fat cheese, and cut-up vegetables or fruits for toppings. Let kids choose their own favorites. Then pop the pizzas into the oven to warm.

5

6

frosty fruits

smoothie creations

Frozen treats are bound to be popular in the warm months. Just put fresh fruits such as melon chunks in the freezer (rinse first). Make “popsicles� by inserting sticks into peeled bananas and freezing.

7 8

bugs on a log

Use celery, cucumber, or carrot sticks as the log and add peanut butter. Top with dried fruit such as raisins, cranberries, or cherries, depending on what bugs you want!

homemade trail mix

Skip the pre-made trail mix and make your own. Use your favorite nuts and dried fruits, such as unsalted peanuts, cashews, walnuts, or sunflower seeds mixed with dried apples, pineapple, cherries, apricots, or raisins. Add whole-grain cereals to the mix, too.

9 10

potato person

Decorate half a baked potato. Use sliced cherry tomatoes, peas, and low-fat cheese on the potato to make a funny face.

put kids in charge

Ask your child to name new veggie or fruit creations. Let them arrange raw veggies or fruits into a fun shape or design.

fruity peanut butterfly

Start with carrot sticks or celery for the body. Attach wings made of thinly sliced apples with peanut butter and decorate with halved grapes or dried fruit. DG TipSheet No. 11 June 2011

United States Department of Agriculture Center for Nutrition Policy and Promotion

Go to www.ChooseMyPlate.gov for more information.

USDA is an equal opportunity provider and employer.


SEPTEMBER IS FRUITS & VEGGIES–MORE MATTERS MONTH | Continued from page 47

Instead of a high-calorie snack from a vending machine, bring some cut-up vegetables or fruit from home.

Canned or frozen fruits and vegetables are good options when fresh produce is not available.

One snack-sized bag of corn chips (1 ounce) has the same number of calories as a small apple, 1 cup of whole strawberries, and 1 cup of carrots with 1/4 cup of low-calorie dip. Substitute one or two of these options for the chips, and you will have a satisfying snack with fewer calories. Remember, substitution is the key. It’s true that fruits and vegetables are lower in calories than many other foods, but they do contain some calories. If you start eating fruits and vegetables in addition to what you usually eat, you are adding calories and may gain weight. The key is substitution. Eat fruits and vegetables instead of some other higher-calorie food.

However, be careful to choose those without added sugar, syrup, cream sauces or other ingredients that will add calories.

Eat fruits and vegetables the way nature provided – or with fat-free or low-fat cooking techniques. Try steaming your vegetables, using low-calorie or low-fat dressings, and using herbs and spices to add flavor. Some cooking techniques, such as breading and frying, or using high-fat dressings or sauces will greatly increase the calories and fat in the dish. And eat your fruit raw to enjoy its natural sweetness.

Choose whole fruit over fruit drinks and juices. Fruit juices have lost fiber from the fruit. It is better to eat the whole fruit because it contains the added fiber that helps you feel full. One 6-ounce serving of orange juice has 85 calories, compared to just 65 calories in a medium orange.

Whole fruit gives you a bigger size snack than the same fruit dried – for the same number of calories. A small box of raisins (1/4 cup) is about 100 calories. For the same number of calories, you can eat 1 cup of grapes. For nutritional advice designed just for you, ask your medical provider for a referral to one of IHCRC’s dietitians. Working with the dietitian will provide you with great advice on making healthier food choices.

http://www.fruitsandveggiesmorematters.org/September+is+Fruits+%26+Veggies-More+Matters+Month IHCRC SUMMER/FALL 2013

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SEPTEMBER IS CHILDHOOD OBESITY AWARENESS MONTH

The Annie E. Casey Foundation KIDS COUNT Releases 2013 Data Book — Some improvement in Oklahoma, while child poverty remains high CRITICAL INVESTMENTS IN CHILDREN ARE REQUIRED TO SUPPORT OKLAHOMA’S FUTURE WORKFORCE NEEDS AND CONTINUED ECONOMIC GROWTH Investments in education and school readiness, access to health care and moving more families out of poverty and into the middle class appear to be key policy issues for Oklahoma to address to improve the well-being of the state’s children, according to new data in the Annie E. Casey Foundation’s 2013 KIDS COUNT Data Book. Though Oklahoma weathered the recent recession better than many states, key indicators tracking childhood poverty have worsened in recent years – particularly among the youngest children – reflecting the increasing child poverty rate nationally. There is some good news. Oklahoma’s ranking on overall child well-being improved to 36th, up from 40th in 2012, making it one of two states showing the biggest improvement from last year. State ranking is determined by 16 indicators, which are divided into four core areas. Oklahoma improved its ranking in three of the four areas: Economic Well-being moved up to 25th from 29th; Health moved to 43rd from 44th; and Family/Community

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IHCRC SUMMER/FALL 2013

Continued to page 52


2013 KIDS COUNT PROFILE

OKLAHOMA

OVERALL RANK

36

Children in poverty

Children whose parents lack secure employment

Children living in households with a high housing cost burden

Teens not in school and not working

2011

2011

2011

2011

ECONOMIC WELL-BEING

23%

30%

30%

9%

DOMAIN RANK

216,000 CHILDREN

282,000 CHILDREN

282,000 CHILDREN

19,000 TEENS

25

UNCHANGED

WORSENED

WORSENED

WORSENED

23%

2005

29%

2008

29%

2005

8%

2008

Children not attending preschool

Fourth graders not proficient in reading

Eighth graders not proficient in math

High school students not graduating on time

2009–11

2011

2011

2009/10

EDUCATION

59%

73%

73%

21%

DOMAIN RANK

61,000 CHILDREN

N.A.

N.A.

10,529 STUDENTS

40

IMPROVED

IMPROVED

IMPROVED

IMPROVED

2005–07 62%

75%

2005

79%

2005

2005/06 22% N.A. Not Available.

Low-birthweight babies

Children without health insurance

Child and teen deaths per 100,000

Teens who abuse alcohol or drugs

2010

2011

2010

2010–11

HEALTH

8.4%

11%

36

6%

DOMAIN RANK

4,458 BABIES

99,000 CHILDREN

352 DEATHS

19,000 TEENS

43

WORSENED

IMPROVED

IMPROVED

IMPROVED

8.0%

2005

13%

2008

45

2005

2005–06

8%

Children in single-parent families

Children in families where the household head lacks a high school diploma

Children living in high-poverty areas

Teen births per 1,000

2011

2011

2007-11

2010

FAMILY AND COMMUNITY

36%

13%

12%

50

DOMAIN RANK

316,000 CHILDREN

126,000 CHILDREN

109,000 CHILDREN

6,496 BIRTHS

39

WORSENED

IMPROVED

WORSENED

IMPROVED

2005

32%

2005

Oklahoma Institute for Child Advocacy | www.oica.org | 405.236.5437

14%

2000

5%

2005

54

Learn more at: datacenter.kidscount.org/OK IHCRC SPRING 2013

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SEPTEMBER IS CHILDHOOD OBESITY AWARENESS MONTH | Continued from page 50

moved to 39th from 40th. Education was the only area where Oklahoma failed to improve this year, dropping to 40th from 39th. “We are pleased that Oklahoma is moving up from the bottom of the barrel on some key indicators for child well-being, however, our state is not even close to the national average for most of our rankings,” said Doug Gibson, Interim Executive Director for the Oklahoma Institute for Child Advocacy, the organization that directs Oklahoma KIDS COUNT. “The persistently high child poverty rate remains a serious concern, as poverty impacts a child’s health, education and family stability in so many ways – often, for a lifetime,” Gibson said. When the current indicators (2010-11 data) are compared to the same data from 2005, nine indicators improved, six indicators worsened and one remained the OF THE 16 INDICATORS, THE TWO SHOWING THE MOST IMPROVEMENT SINCE 2005 WERE: • Child and teen deaths (per 100,000) with Oklahoma now ranking 36th, compared to 45th. • Teen birth rate (15-19 year-olds) at 50 per 1,000, compared to 54 per 1,000.

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IHCRC SUMMER/FALL 2013

THE INDICATORS THAT WORSENED MOST SIGNIFICANTLY IN OKLAHOMA SINCE 2005 WERE: • Children living in high poverty areas, which more than doubled – jumping from 5 percent in 2005 to 12 percent in current data. • The number of children living in single-parent families rose from 32% to 36%.

same. Unfortunately, the indicators that worsened or showed no change all relate to poverty and economic well-being. In addition to presenting state and national data on key indicators and looking at trends over time, the 2013 KIDS COUNT Data Book highlights how the country’s youngest children are faring. That picture is not good. Nationally, the poverty rate for children under age 3 is 26%, and among children ages 3-5 it is 25% – higher than the national average for all children. These figures support the need to expand high quality early childhood care and education programs for all children, especially the children growing up in poverty. “Oklahoma’s ranking has been so low for so long on most health, education and economic well-being indicators for children, which directly impacts the well-being of our state and its economic

potential,” Gibson said. “Investing in children is a smart investment for future economic growth.” On the newly redesigned KIDS COUNT Data Center users can download the complete Data Book, access hundreds of other measures of child well-being and view realtime information on mobile devices; check: datacenter.kidscount.org/. The Oklahoma Institute for Child Advocacy is Oklahoma’s KIDS COUNT partner with the Annie E. Casey Foundation. Oklahoma KIDS COUNT information is available on OICA’s website at www.oica.org. The Oklahoma Institute for Child Advocacy is the statewide, nonprofit organization that creates awareness, takes action and changes policy to promote the health, safety, education and economic well-being of Oklahoma’s children and youth. The Institute directs Oklahoma KIDS COUNT. The Annie E. Casey Foundation creates a brighter future for the nation’s children by developing solutions to strengthen families, build paths to economic opportunity and transform struggling communities into safer, healthier places to live, work and grow. For more information, visit www.aecf.org. KIDS COUNT is a registered trademark of the Annie E. Casey Foundation. For more information, contact Doug Gibson, 405-204-5743; dgibson@oica.org or Tiffany Brown, 405-236-5437 x 119; tbrown@oica.org. www.oica.org.


IHCRC SUMMER/FALL 2013

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SEPTEMBER IS CHILDHOOD OBESITY AWARENESS MONTH

Basics About Childhood Obesity –

A GROWING PROBLEM

Sources: Center for Disease Control and Prevention and Indian Health Service, Division of Diabetes Treatment and Prevention

You’ve probably read about it in newspapers and seen it on the news – in the United States, the number of obese children and teens has continued to rise over the past two decades. You may wonder: Why are doctors and scientists troubled by this trend? And as parents, you may also ask: What steps can we take to help prevent obesity in our children?

What causes childhood obesity? Childhood obesity is the result of eating too many calories and not getting enough physical activity.

What are the consequences of childhood obesity? Childhood obesity is associated with various health-related consequences. Obese children and adolescents may experience immediate health consequences and may be at risk for weight-related health problems in adulthood.

Health risks now. Childhood obesity can have a harmful effect on the body in a variety of ways. Obese children are more likely to have: • High blood pressure and high cholesterol, which are risk factors for cardiovascular disease (CVD). In one study, 70% of obese children had at least one CVD risk factor, and 39% had two or more. • Increased risk of impaired glucose tolerance, insulin resistance and type 2 diabetes. • Breathing problems, such as sleep apnea, and asthma. • Joint problems and musculoskeletal discomfort. • Fatty liver disease, gallstones and gastro-esophageal reflux (i.e., heartburn).

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IHCRC SUMMER/FALL 2013


• Overweight and obese children and adolescents have a greater risk of social and psychological problems, such as discrimination and poor self-esteem, which can continue into adulthood. The psychological stress of social stigmatization can cause low self-esteem which, in turn, can hinder academic and social functioning, and persist into adulthood.

Health risks later • Obese children are more likely to become obese adults. Adult obesity is associated with a number of serious health conditions including heart disease, diabetes and some cancers. • If children are overweight, obesity in adulthood is likely to be more severe.

You Can Help Your Children Stay Strong and Healthy Tips for Parents – Ideas to Help Children Maintain a Healthy Weight As a parent or caregiver, you are the most important teacher for your children. You can show them how to stay healthy. You can give them information and model good habits to lead healthy, happy lives. To help your child maintain a healthy weight, balance the calories your child consumes from foods and beverages with the calories your child uses through physical activity and normal growth. Remember that the goal for over-

weight and obese children and teens is to reduce the rate of weight gain while allowing normal growth and development. Children and teens should NOT be placed on a weight reduction diet without the consultation of a health care provider.

Balance calories to help kids develop healthy eating habits. One part of balancing calories is to eat foods that provide adequate nutrition and an appropriate number of calories. You can help children learn to be aware of what

they eat by developing healthy eating habits, looking for ways to make favorite dishes healthier, and reducing calorie-rich temptations.

Encourage healthy eating habits. There’s no great secret to healthy eating. To help your children and family develop healthy eating habits: • Establish regular meal times and offer healthy snacks between meals. Continued to page 56

IHCRC SUMMER/FALL 2013

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SEPTEMBER IS CHILDHOOD OBESITY AWARENESS MONTH | Continued from page 55

• Eat at least one meal a day together as a family and talk about pleasant topics.

Be active. Another part of balancing calories is to engage in an appropriate amount of physical activity and avoid too much sedentary time. In addition to being fun for children and teens, regular physical activity has many health benefits, including: • Strengthening bones

• Eat at a table away from televisions, cell phones and computers. • Teach your children to pay attention to their bodies’ hunger and fullness messages. Let them know it is OK to stop eating when they feel full.

• Decreasing blood pressure • Reducing stress and anxiety

• Have your children join you in menu planning, preparing meals and cleaning up.

Eat healthy foods and look for ways to make favorite dishes healthier. The recipes that you may prepare regularly, and that your family enjoys, with just a few changes can be healthier and just as satisfying. • Provide plenty of vegetables, fruits and whole-grain products. • Include low-fat or non-fat milk or dairy products. • Choose lean meats, poultry, fish, lentils and beans for protein.

• Increasing self-esteem • Helping with weight management • Serve reasonably-sized portions. • Encourage your family to drink lots of water. • Limit sugar-sweetened beverages. • Limit consumption of sugar and saturated fat.

Remove calorie-rich temptations! Although everything can be enjoyed in moderation, reducing the calorie-rich temptations of highfat and high-sugar, or salty snacks can also help your children develop healthy eating habits. Instead only allow your children to eat them sometimes, so that they truly will be treats! Here are examples of easy-to-prepare, low-fat and low-sugar treats that are 100 calories or less: • A medium-size apple • A medium-size banana • 1 cup blueberries • 1 cup grapes • 1 cup carrots, broccoli or bell peppers with 2 tbsp. hummus

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IHCRC SUMMER/FALL 2013

Reduce sedentary time. In addition to encouraging physical activity, help children avoid too much sedentary time. Although quiet time for reading and homework is fine, limit the time your children watch television, play video games, or surf the web to no more than 2 hours per day. Additionally, the American Academy of Pediatrics (AAP) does not recommend television viewing for children age 2 or younger. Instead, encourage your children to find fun activities to do with family members or on their own that simply involve more activity.


Be physically active every day. Do some type of physical activity every day. Make it a family activity, like riding bikes, going for walks or playing basketball. Have fun with your children and help them stay active. Children and teens should participate in at least 60 minutes of moderate intensity physical activity most days of the week, preferably daily. Remember that children imitate adults. Start adding physical activity to your own daily routine and encourage your child to join you. Some examples of moderate intensity physical activity include:

• BRISK WALKING • PLAYING TAG • JUMPING ROPE • PLAYING SOCCER • SWIMMING • DANCING

Get enough sleep. Have regular bedtimes. Set a routine that happens every night, like brushing teeth, reading a story, then going to bed. IHCRC’s Health and Wellness Department has a team of dietitians who can assist you with weight management, both for children and adults. When you see your medical provider,

ask them for a referral to the dietitian. Some small changes can give big results and help your family be healthier!

Call 918-588-1900 to make an appointment with one of our new pediatric providers.

Pediatric Health Services Medical Care | Well Child Care Immunizations | Physicals Dental Care | Optometry | WIC Breastfeeding Support Group Maternal Child Health Native Nations Youth Council Spring Break and Summer Camps Health Education and Wellness Behavioral Health Care In-house Pharmacy Services

We are pleased to announce Carlisa Phillips, APRN, CNP and Marisa Feuerman, APRN, CNP have joined the IHCRC pediatric team.

550 S. Peoria Ave., Tulsa, OK 74120 | 918.588.1900 | ihcrc.org

IHCRC SUMMER/FALL 2013

57


Claremore Indian Hospital – Oklahoma’s First Baby-Friendly Hospital Source: Oklahoma State Department of Health

T

he Oklahoma State Department of Health (OSDH) announced that the Claremore Indian Hospital has received the first-in-Oklahoma designation as a “Baby Friendly” hospital. Caring is St Baby-Friendly designation is the gold standard The vision of IHCRC is t bestowed by Baby-Friendly USA, Inc., the national expand innovative authority for the Baby-Friendly Hospital Initiative, a promote an em strengthens physical, m global initiative of the World Health Organization and wellness the United Nations Children’s Fund. This is the highCaring is Strong Medicine. est designation afforded to hospitals by an accrediting body that promotes best practices for maternity care. “Trailblazer” group working to achieve this designation The vision of IHCRC is to eliminate health disparities, expand Only seven percent of U.S. babies are born in Babyofinnovative quality maternal/newborn care. Other family-focused practices and promote an hospitals embracing curFriendly hospitals. Hospitals that are designated as Babyrently participating in this group aremental, the following: approach to care that strengthens physical, emotional Friendly have demonstrated best practice in the care of and spiritual wellness withinCenter, the Indian Ada community. • Chickasaw Nation Medical mothers and newborns and improved breastfeeding rates. • Comanche County Memorial Hospital, Lawton In addition, Baby-Friendly hospitals support mother-baby Health Services bonding by keeping mothers and babies together, putting • Hillcrest Medical Center, Tulsa Medical Care • Health Education and Wellness babies in skin-to-skin contact right after birth, educating Well Child Care • Optometry • Dental Care • Lab • X-ray • INTEGRIS Baptist Medical Center, Oklahoma City all families on best infant feeding practices and educating Mammogrphy • In-house Pharmacy • Behavioral Health Care • INTEGRIS Health Edmond, Edmond hospital staff on procedures to better support new families. Substance Abuse Treatment • The Children’s Hospital at OU Medical “We appreciate Claremore Indian Hospital’s vigorous Center, Oklahoma City efforts to promote maternal and infant health as part of • OU Medical Center, Edmond Oklahoma’s efforts to reduce infant mortality,” said OSDH State Health Commissioner Dr. Terry Cline. “Oklahoma • St. Anthony Hospital, Oklahoma City 550 S. Peoria Avenue, Tulsa, OK 74120 • 918-588-1900 • ihcrc.org has an opportunity to be a leader in promoting the best care for babies and families as we provide support for delivIn addition to the support from the OSDH, partering hospitals in achieving the Baby-Friendly designation.” ner organizations supporting the Becoming BabyThe OSDH is encouraging other hospitals to follow in Friendly in Oklahoma project include the Oklahoma Claremore Indian Hospital’s footsteps. Claremore Indian Hospital Association, the Oklahoma Health Care Hospital participated in the statewide Becoming BabyAuthority, the OU Health Sciences Center and the Friendly in Oklahoma project as a member of the initial OU Office of Perinatal Quality Improvement.

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IHCRC SUMMER/FALL 2013


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This September marks the 24th annual celebration of National Recovery Month ( Recovery Month), an observance that increases awareness and understanding of mental and substance use disorders. This year’s theme, “Join the Voices for Recovery: Together on Pathways to Wellness,” represents the many ways that people can prevent behavioral health issues, seek treatment, and sustain recovery as part of a commitment to living a mentally, physically, emotionally, and spiritually healthy life. In 2013, Recovery Month will:

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join the voices for recovery

This year’s National Recovery Month (Recovery Month) observance will include: ■

An extensive toolkit for event organizers and attendees, featuring infographics showing audience-specific data; media templates; current data on behavioral health conditions; resources for prevention, treatment, and recovery support services; and tips to assist in event planning and community outreach, available online at http://www.recoverymonth.gov;

Spread the message that behavioral health is essential to health, prevention works, treatment is effective, and people recover from mental and/or substance use disorders;

SAMHSA-produced television and radio public service announcements (PSAs) and the Road to Recovery television and radio series (http://www.recoverymonth.gov/Multimedia/Roadto-Recovery-Television-Series.aspx);

Educate Americans that people in recovery can achieve healthy lifestyles, both physically and emotionally, and contribute in positive ways to their communities;

Guide community leaders, young adults, health care providers, and families and caregivers in providing support and encouraging people to find their own unique path toward better health and well-being; and

A Recovery Month website and accompanying social networking websites, including Facebook (http://www.facebook.com/ RecoveryMonth), Twitter (http://www.twitter.com/RecoveryMonth), and YouTube (http://www.youtube.com/user/RecoveryMonth); and widgets to add to a website or Facebook page to showcase events and inspirational quotes, available at http:// recoverymonth.gov/Multimedia/Widgets-Landing-Page.aspx;

Celebrate people in long-term recovery and recognize the dedication of prevention, treatment, and recovery support providers.

Opportunities to make a Pledge for Recovery, located on the Facebook page (https://www.facebook.com/RecoveryMonth), and share personal examples of recovery on the Recovery Month website at http://recoverymonth.gov/Voices-for-Recovery/ Your-Story.aspx;

Recovery Month e-cards, which can be customized to give everyone an opportunity to thank, congratulate, or offer support, available at http://www.recoverymonth.gov/Home/ECards/ ChooseDesign.aspx;

A national Recovery Month kickoff in Washington, D.C., and more than 1,000 national, local, and community events held throughout the country and online, celebrating people in recovery from mental and/or substance use disorders, as well as their support systems, and their prevention, treatment, and recovery providers; and

A commemorative poster and brochure.

Materials will be available by spring 2013 through the Recovery Month website: http://www.recoverymonth.gov. Please contact the Substance Abuse and Mental Health Services Administration (SAMHSA) at 240-276-2750 for more details.

SMA-13-4743Eng

IHCRC SUMMER/FALL 2013

59


SEPTEMBER IS NATIONAL RECOVERY MONTH

Mental and Substance Use Disorders

FAST FACTS

Source: Substance Abuse and Mental Health Services Administration

N

ational Recovery Month, formerly National Alcohol and Drug Addiction Recovery Month, is a national observance sponsored by the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Treatment (CSAT) each September. Recovery Month promotes the societal benefits of prevention, treatment

and recovery for substance use and mental disorders; celebrates people in recovery; lauds the contributions of treatment and service providers; and promotes the message that recovery in all its forms is possible. Recovery Month spreads the positive message that behavioral health is essential to overall health, that prevention works, treatment is effective and people can and do recover.

INTRODUCTION Each September during the National Recovery Month observance, SAMHSA, releases the National Survey on Drug Use and Health. The survey is a prime source of information on the prevalence and impact of mental and substance use disorders across the country. The following facts illustrate that behavioral health is essential to health, prevention works, treatment is effective and people recover from these conditions. MENTAL ILLNESS • In 2011, 45.6 million U.S. adults aged 18 or older had a mental illness in the past year. • In 2011, 31.6 million adults aged 18 or older reported receiving mental health services in the past year. • Serious mental illness is associated with an estimated total economic cost of $317 billion per year. • In the United States, a person dies from suicide every 15 minutes. SUBSTANCE USE DISORDERS • In 2011, 20.6 million people aged 12 or older were classified with substance dependence or abuse in the past year. In 2011, 19.3

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IHCRC SUMMER/FALL 2013


million people aged 12 or older needed treatment for an illicit drug or alcohol use problem, but did not receive treatment at a specialty facility in the past year. • Substance use costs the country an estimated $510 billion annually, including specialty alcohol and drug services, medical consequences, lost productivity due to death and illness, and injury or legal costs. BEHAVIORAL HEALTH IS ESSENTIAL TO HEALTH • In 2011, eight million adults reported having co-occurring disorders, meaning they have both a mental and a substance use disorder. • Individuals with mental illnesses have increased risk for a number of physical health problems, including diabetes, cardiovascular disease, obesity and smoking. Half of all lifetime cases of mental and substance use disorders begin by age 14 and three-fourths by age 24. • Untreated mental and substance use disorders lead to more deaths than traffic accidents, HIV/AIDS and breast cancer combined. PREVENTION WORKS • The first symptoms typically precede a mental and/or substance use disorder by two to four years, offering a window of opportunity to intervene early and often. • Research shows that for every $1.00 invested in prevention and early treatment programs, $2.00 to $10.00 could be saved

in health costs, criminal and juvenile justice costs, educational costs and lost productivity. • A well-implemented public awareness campaign raises cognizance of the signs and symptoms of mental disorders and risks for suicide. • In 2011, approximately one in eight youths aged 12 to 17 reported that they had participated in drug, tobacco, or alcohol prevention programs outside of school in the past year. • In 2011, the prevalence of past month use of illicit drugs or marijuana was lower among those who reported having exposure to drug or alcohol prevention messages. TREATMENT IS EFFECTIVE • Scientific research shows that treatment can help patients addicted to drugs stop using, avoid relapse, and successfully recover their lives. • Approximately 80 percent of patients with depressive disorders improve significantly with treatment and recovery support services. PEOPLE RECOVER • Recovery is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. • Approximately three-quarters of Americans believe that recovery is possible from addiction to substances such as alcohol, prescription drugs and marijuana.

• Two-thirds of Americans believe that treatment and support can help people with mental illnesses lead normal lives. YOUTH AND YOUNG ADULTS ARE AFFECTED Young adults: • In 2011, the percentage of young adults 18 to 25 (29.8 percent) who had a mental illness was the highest among all adult age groups. • In 2011, the rate of substance dependence or abuse among adults aged 18 to 25 (18.6 percent) was higher than that among youths aged 12 to 17 (6.9 percent) and among adults aged 26 or older (6.3 percent). Families and caregivers of young people: • For youth aged 9 to 13, moms, dads and grandparents are considered the most trusted sources of information. • Youths aged 12 to 17 who believed their parents would strongly disapprove of their using substances were less likely to use that substance than were youths who believed their parents would somewhat disapprove or neither approve nor disapprove. • In 2011, 1.4 million youths (5.7 percent) had a past year major depressive episode with severe impairment in one or more role domains, such as doing chores at home, school or work; relationships with family members or caregivers; or social life.

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550 S. Peoria Avenue, Tulsa, OK 74120

If you would like to be removed from our mailing list, contact Emily Bolusky at 918-382-1206 or ebolusky@ihcrc.org 918-588-1900

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www.ihcrc.org

Saturday, Oct. 19 9 am to 12 noon in the IHCRC Parking Lot, 550 S. Peoria Ave.

Established Indian Health Care Resource Center of Tulsa Patients

This year, a special drivethru flu shot clinic will be offered in the parking lot on the north side of our main clinical facility. We encourage patients of all ages to take advantage of this convenient and easy process – including children, adults, seniors and prenatal patients. To save time at the flu clinic you can fill out the required vaccine form ahead of time and bring it with you. You can download the form at www.ihcrc.org or pick up a form at IHCRC.


Indian Health Care Healthy Spirit 8 2013