Tribal Epi Center (TEC) Newsletter Jul-Sep2016

COMMITTED TO EXCELLENCE IN TRIBAL PUBLIC HEALTH

T R I B A L T R I B A L

E P I D E M I O L O G Y E P I D E M I O L O G Y

C E N T E R C E N T E R

NEWSLETTER JULY/AUGUST/SEPTEMBER 2016

U.S. SURGEON GENERAL

Vivek Murthy

Discussing culture as prevention with our tribal youth and visiting with our tribal leaders about our current tribal health issues.

■

JULY IS CORD BLOOD AWARENESS MONTH

■

AUGUST IS NATIONAL IMMUNIZATION AWARENESS MONTH

■

SEPTEMBER IS CHILDHOOD CANCER AWARENESS MONTH

Contents

06 08 14 17 2 | OKLAHOMA AREA TRIBAL EPIDEMIOLOGY CENTER NEWSLETTER

U.S. SURGEON GENERAL VISITS INDIAN COUNTRY The Surgeon General met with tribal youth to discuss the use of American Indian culture as a substance abuse prevention method. He also met with tribal leaders from Oklahoma, Kansas and Texas in a roundtable discussion focused on current tribal health issues.

MEETING U.S. SURGEON GENERAL VIVEK MURTHY At the young age of 11, Stevi Johnson is well spoken, astute and very interested in learning how she can advocate for other Native youth on living a safe, healthy and drug-free life. This is the story of her once-in-a-lifetime experience.

THE CARING VAN STORY SPTHB's over-arching goal is to ultimately improve long-term health in Native Communities. The Caring Van mobile unit helps us to achieve this goal. We seek to raise awareness by learning about the causes of health disparities while educating community and policy makers.

YOUTH AND CULTURE SPELL SUCCESS On April 5th, IAMNDN (I AM Native Drug-free Nations) Youth Choir and the Comanche Nation Youth Program participated in the 2016 Oklahoma Native American Youth Language Fair in Norman, Oklahoma.

■

JULY IS CORD BLOOD AWARENESS MONTH

■

AUGUST IS NATIONAL IMMUNIZATION AWARENESS MONTH

■

SEPTEMBER IS CHILDHOOD CANCER AWARENESS MONTH

In this issue: Contents 2–3 National Health Observances

4–5

U.S. Surgeon General Visits Indian Country 6–7 Meeting U.S. Surgeon General Vivek Murthy

8–9

8th Annual Tribal Public Health Conference Was A Success

10–13

The Caring Van Story

14–16

Youth and Culture Spells Success Connecting the Mouth to the Body

17 18–19

Raising Awareness for Rx Abuse Epidemic

20

Zika Virus Fact Sheet

21

CDC-Good Health and Wellness in Indian Country Program Site Visit

22–23

Breaking News: With Tribal Support, the SPTHB Has Passed the Following Resolutions

24–27

JULY/AUGUST/SEPTEMBER 2016 | 3

NATIONAL

HEALTH OBSERVANCES

SUBMITTED BY: VALARIE LAMBERT, OKTEC INTERN

others are injured in accidents and animal attacks, or diagnosed with various oral/head/neck and skin diseases.

July 2016

For more information regarding cleft and craniofacial concerns,

Cord Blood Awareness Month

Source: http://www.ameriface.org

The term "cord blood" is used to describe the blood that remains in the umbilical cord and the placenta after the birth of a baby. Up until recently this afterbirth was discarded as medical waste. Cord blood contains stem cells that may be cryopreserved for later use in medical therapies, such as stem cell transplants or clinical trials of new stem cell therapies. Cord blood donated to a public bank can be the match to give birth to hope.

August 2016

About 70% of patients who need a stem cell transplant do not have a matching donor in their own family. Since genetic types are inherited, patients are most likely to find a matching adult donor in their own racial group. But cord blood does not have to be perfectly matched: a 4 out of 6 (67%) match with cord blood is just as good as a 100% match with an adult donor.

Cord blood stem cells are used to treat many diseases including forms of leukemia, and lymphoma, to name a few.

please visit:

Children's Eye Health and Safety Month Vision plays an important role in children’s physical, cognitive, and social development. More than one in five preschoolage children enrolled in Head Start have a vision disorder.

Uncorrected vision problems can impair child development, interfere with learning, and even lead to permanent vision loss; early detection and treatment are critical. Visual functioning is a strong predictor of academic performance in school-age children, and vision disorders of childhood may continue to affect health and well-being throughout the adult years.

For more information regarding children's eye health and safety, please visit:

Source: http://www.preventblindness.org

For more information regarding

National Breastfeeding Month

Source: https://parentsguidecordblood.org/

One of the most highly effective preventive measures a mother can take to protect the health of her infant and herself is to breastfeed. However, in the U.S., while 75 percent of mothers start out breastfeeding, only 13 percent of babies are exclusively breastfed at the end of six months. The decision to breastfeed is a personal one, and a mother should not be made to feel guilty if she cannot or chooses not to breastfeed. The success rate among mothers who want to breastfeed can be greatly improved through active support from their families, friends, communities, clinicians, health care leaders, employers and policymakers.

cord blood storage and therapies please visit:

World Hepatitis Day Thursday, July 28 Viral hepatitis is inflammation of the liver caused by a virus. There are five different hepatitis viruses, hepatitis A, B, C, D and E. There are 10 million new cases of hepatitis every year. 1.4 million people die worldwide from hepatitis annually. Only 5% of people that have hepatitis are aware and only 1% have access to treatment.

2016 is a pivotal year for viral hepatitis. At the World Health Assembly in May, WHO Member States are set to adopt the first ever Elimination Strategy for Viral Hepatitis, with ambitious targets and a goal to eliminate hepatitis as a public health threat by 2030. This will be the first time national governments sign up and commit to the goal of eliminating viral hepatitis.

For more information regarding hepatitis, please visit: Source: https://www.worldhepatitisday.info

National Cleft & Craniofacial Awareness & Prevention Month Cleft and craniofacial conditions affect thousands of infants, children, teens and adults in the United States each year. Some are born with congenital anomalies like cleft lip and palate, others with more complex, lifethreatening craniofacial conditions. Some are burned;

4 | OKLAHOMA AREA TRIBAL EPIDEMIOLOGY CENTER NEWSLETTER

For more information regarding breastfeeding, please visit: Source: http://www.usbreastfeeding.org

Psoriasis Awareness Month Psoriasis is an autoimmune disease that causes raised, red, scaly patches to appear on the skin. Psoriasis is associated with other serious health conditions, such as diabetes, heart disease and depression.

Living with psoriasis has unique challenges. The good news is health care providers are becoming more aware of the impact psoriasis can have on a person's quality of life. Researchers are focused more now than ever on finding solutions to those challenges.

For more information regarding psoriasis, please visit: Source: http://www.psoriasis.org

National Immunization Awareness Month National Immunization Awareness Month (NIAM) provides an opportunity to highlight the value of immunization across the lifespan. Activities focus on encouraging all people to protect their health by being vaccinated against infectious diseases.

While immunizations have significantly reduced the incidence of many serious infectious diseases, vaccination rates for some diseases are not meeting national public health goals. Vaccines are an important step in protecting against serious, and sometimes deadly, diseases. Vaccines are recommended throughout our lives.

For more information regarding immunizations, please visit:

Source: http://www.nphic.org

September 2016 Childhood Cancer Awareness Month Each year, the parents of approximately 15,700 kids will hear the words “your child has cancer.” Across all ages, ethnic groups and socio-economics, this disease remains the number one cause of death by disease in children. Despite major advances – from an overall survival rate of 10 percent just fifty years ago to nearly 90 percent today, for many rare cancers, the survival rate is much lower. Furthermore, the number of diagnosed cases annually has not declined in nearly 20 years.

Every day, 43 children are diagnosed with cancer. Twelve percent of children diagnosed with cancer do not survive. Children’s cancer affects all ethnic, gender and socio-economic groups.

The average age of children diagnosed is six. More than 40,000 children undergo treatment for cancer each year. Sixty percent of children who survive cancer suffer late-effects, such as infertility, heart failure and secondary cancers. There are approximately 375,000 adult survivors of children’s cancer in the United States.

For more information regarding childhood cancer, please visit: Source: http://www.curesearch.org

National Childhood Obesity Awareness Month In the past four decades, obesity rates in the United States have soared among all age groups. This rise in obesity rates has affected our youth in alarming fashion. Childhood obesity has increased more than fourfold among those ages 6 to 11.

More than 23 million children and teenagers in the United States ages 2 to 19 are obese or overweight, a statistic that health and medical experts consider an epidemic. And this epidemic puts nearly one third of America’s children at early risk for Type 2 diabetes, high blood pressure, heart disease and even stroke – conditions usually associated with adulthood.

National Recovery Month The prevalence of mental and/or substance use disorders is high. Among adults aged 18 or older, 43.6 million (18.1 percent of adults) had any mental illness in the past year. Approximately 21.5 million people age 12 or older were classified with a substance use disorder in 2014.

National Recovery Month (Recovery Month) is a national observance held every September to educate Americans that substance use treatment and mental health services can enable those with a mental and/or substance use disorder to live a healthy and rewarding life.

Recovery Month celebrates the gains made by those in recovery, just as we celebrate health improvements made by those who are managing other health conditions such as hypertension, diabetes, asthma, and heart disease. The observance reinforces the positive message that behavioral health is essential to overall health, prevention works, treatment is effective, and people can and do recover.

For more information regarding recovery, please visit: Source: http://www.recoverymonth.org

Ovarian Cancer Awareness Month More than 20,000 women in the United States are diagnosed with ovarian cancer each year, and approximately 15,000 women die annually from the disease. Unfortunately, most cases are diagnosed in their later stages when the prognosis is poor. However, if diagnosed and treated early, when the cancer is confined to the ovary, the five-year survival rate is over 90 percent. That is why it is imperative that the early signs and symptoms of the disease are recognized, not only by women, but also by their families and the medical community. In women age 35-74, ovarian cancer is the fifth leading cause of cancer-related deaths. An estimated one woman in 75 will develop ovarian cancer during her lifetime.

For more information regarding ovarian cancer, please visit:

Source: http://www.ovarian.org

For more information regarding childhood obesity, please visit: Source: http://www.coam-month.org

JULY/AUGUST/SEPTEMBER 2016 | 5

U.S. Surgeon General Visits Indian Country

SOUTHERN PLAINS TRIBAL HEALTH BOARD HOSTS VIVEK MURTHY, US SURGEON GENERAL WRITTEN BY: JENIFER SHIELDCHIEF GOVER, SPTHB EXECUTIVE DIRECTOR AND NICK WAHPEPAH, HR MANAGER PHOTOS BY: CHRIS REED, SPTHB CREATIVE SERVICES COORDINATOR AND LESTER HARRAGARRA

The Southern Plains Tribal Health Board

The visit began with a roundtable

depression and suicide and how that

Murthy on Wednesday, May 18, 2016

Absentee Shawnee Health Center

his and his family’s lives.”

hosted US Surgeon General Vivek

during his tour of the United States.

The Surgeon General met with tribal

youth to discuss the use of American Indian culture as a substance abuse

prevention method. He also met with

tribal leaders from Oklahoma, Kansas, and Texas in a roundtable discussion

focused on current tribal health issues.

Murthy’s visit which coincided with

his national tour focused on efforts

to combat the rising use of opioids

and the abuse of painkillers and other prescription drugs. The Surgeon

General stated, “The opioid crisis cuts across racial/ethnic groups, age, sex,

geography, and socioeconomic status.

discussion with tribal leaders at the in Little Axe, OK. Discussion topics

focused on health issues facing Native

The visit concluded with a town

standpoint. Tribal leaders outlined

Potawatomi Nation Tribal Chairman

America given from a first-hand

health issues facing their communities, methods to combat health disparities,

resources needed, and success stories from their communities.

Murthy then traveled to the Citizen

me.”

round dance and answered questions from audience members regarding

health issues facing American Indians.

forces for building community, and

with eight tribal youth to discuss,

from their standpoint, health issues

facing American Indian families and communities.

Gover said, “Dr. Murthy was more than

epidemic. Their stories have stayed with

The Surgeon General participated in a

youth. The Surgeon General dined

in Shawnee, OK for lunch with tribal

health-care providers, and policy

women who have lost their lives to this

John Barrett and ShieldChief-Gover.

“Tribal communities are recognizing

Southern Plains Tribal Health Board

makers and heard about men and

hall meeting moderated by Citizen

Potawatomi Nation Cultural Center

In my travels as Surgeon General, I have sat with families, community leaders,

profound experience forever touched

that culture and identity are powerful that community is a powerful force for improving health, and that’s a recipe

for success” Murthy stated. "My hope is that we’ll see more programs like this driven by youth across the country."

Executive Director Jenifer ShieldChief-

Under the Strategic Prevention

supportive and empathetic to our tribal

TIG) there is also an Oklahoma Tribal

concerns. He shared that his family

had been struck with the tragedy of

6 | OKLAHOMA AREA TRIBAL EPIDEMIOLOGY CENTER NEWSLETTER

Framework Tribal Incentive Grant (SPFConsortium which is funded by the

Substance Abuse and Mental Health

An excited Stevi Johnson (Sac and Fox) shakes hands with the Surgeon General during his visit to Citizen Potawatomi Nation Pictured clockwise from left: Surgeon General and AST Health System staff; SG with Jefferson Keel, Lieutenant Governor of the Chickasaw Nation and Chickasaw Nation Governor Bill Anoatubby; SG with tribal youth representing Comanche, Chickasaw, Cheyenne and Arapaho, and Absentee Shawnee Tribe

Services Administration (SAMSHA)

“It was a very special moment for me

and Human Services. SPTHB employees

the chance to share a little bit about

under the US Department of Health

Melanie Johnson and Aron Wahkinney are able to work with tribal youth

to develop and carry out programs

focused on using culture as substance abuse prevention under the SPF-TIG Program. Murthy and his staff were

able to view presentations by youth

and hopefully the others. We had

ourselves and our programs.” Roman

Nose also stated, “The Surgeon General seemed very sincere and concerned

about our problems that we face. He

was such a good guy and very likable.

He was also very nice to everyone.”

organizations participating in the SPF-

Allen Sioux, Jr. also dined with the

proud that our Strategic Prevention

how much he seemed interested and

TIG Program “I'm very honored and Framework Tribal Incentive Grant/ Oklahoma Tribal Consortium was

chosen by the Surgeon General to visit,” Johnson stated. “It was an epic moment greeting the Surgeon General and

Surgeon General and stated, “I liked

all the questions he was asking. I wish it could’ve been a little longer but it was still a great experience. I just hope he enjoyed it as much as we did.”

introducing him to our tribal partners

SPTHB Executive Director Jenifer

genuine, empathetic, and appreciative

the Strategic Prevention Framework

impact on our native youth prevention

Southern Plains Tribal Health Board

and youth. I found him to be a very

ShieldChief-Gover stated, “Through

human being who made a huge

Tribal Incentive Grant by SAMSHA, the

programs.”

awarded grants to the Comanche

Tribal youth were asked how they felt

Tribes, the Chickasaw Nation, and the

about the Surgeon General’s visit.

Rachelle Roman Nose, Co-president of the Cheyenne/Arapaho Youth

Council dined with Murthy and stated,

Brayden Halberg (Comanche) and Malayna Parker (Comanche) eagerly await the Surgeon General's arrival during his visit to Citizen Potawatomi Nation

Nation, Cheyenne and Arapaho

Absentee Shawnee Tribe. Youth from these four tribal nations have used

this grant to make profound changes

in their communities, by way of using culture and tradition to save lives.”

Christian Wassana (Cheyenne) discussing song and dance with the Surgeon General JULY/AUGUST/SEPTEMBER 2016 | 7

SPTHB SPOTLIGHT STEVI JOHNSON

Stevi Johnson asking the Surgeon General a question during his visit to the Citizen Potawatomi Nation

Meeting U.S. Surgeon General Vivek Murthy At the young age of 11, Stevi Johnson is well spoken, astute, and very interested in learning how she can advocate for other Native youth on living a safe, healthy, and drug-free life.

STORY BY: STEVI JOHNSON, 2016 JR. MISS SAC AND FOX NATION PRINCESS PHOTOS BY: CHRIS REED, SPTHB CREATIVE SERVICES COORDINATOR

SHOSHANNA JOHNSON, SPF-TIG ADMINISTRATIVE ASSISTANT

BIKE PHOTO COURTESY OF THE AST MYDNA PROJECT AND

PHOTOGRAPHY BY STEPHANIE PHILLIPS PHOTOGRAPHY

8 | OKLAHOMA AREA TRIBAL EPIDEMIOLOGY CENTER NEWSLETTER

M

y experience with the Surgeon General, Dr. Vivek Murthy, was an absolutely once in a lifetime experience. In my opinion, he was a very genuine man with a welcoming smile. When he approached me at the Cultural Heritage Center, he asked what my name was and I said Stevi Johnson. Dr. Murthy told me that I had a very beautiful name.

I introduced myself as Stevi Johnson of the Absentee Shawnee tribe and thanked him for coming to Oklahoma. I asked, “What made you want to become a doctor?” I was curious about whether or not there was some type of disease going on at the time that influenced his decision on his career choice.

I learned that what inspired him to be a doctor was his parents who ran a clinic during his childhood.

His interest in becoming a doctor peaked in elementary school which I found very inspiring because I’m currently in elementary school.

Later on that day, the public AS THE SURGEON GENERAL WAS LEAVING had the privilege of asking FOR THE DAY, I RUSHED TO TAKE A Dr. Murthy questions. My PICTURE WITH HIM AND THAT WAS WHEN heart was pounding about whether or not I wanted to SOMETHING EXCITING HAPPENED. ask him a question. When that idea popped into my head, I knew I had to go As the Surgeon General for it. I told a lady I wanted was leaving for the day, I to ask him a question (Note: the lady was Executive rushed to take a picture with him and that was when Director Jenifer ShieldChief Gover of the Southern something exciting happened. He remembered my Plains Tribal Health Board) and after waiting for about name! I am so happy and thankful for all the past ten minutes, it was my turn. opportunities that led me to that moment.

About Me

My Native American name is

Thedahquah which means

“Misty Girl” in the Sac & Fox

language. I am also a member of the Thunder Clan. My

grandpa, Willard “Poncho”

Walker, inspires me to keep my

culture alive when I hear him saying

prayers in our Native language. The

things I do to keep my culture alive involve participating in ceremonies, learning the language of my ancestors,

dancing in my Native regalia, sewing medicine pouches

and learning about our rich history. I’m the 2016 Jr. Miss

Sac and Fox Nation Princess with hopes of using this new platform to speak about substance abuse prevention. I

may be young but that doesn’t stop me from wanting to make a difference. I believe that people should respect

their bodies because you only get one. Although drinking

and smoking may seem “grown up”, it has potential to ruin families and people’s lives. I think some kids start doing

these things because of peer pressure, emotional distress or loneliness. I’ve seen the consequences of substance abuse

in my family which is why I’m so interested in prevention. I try to spread awareness and inspire my peers by being a good example on how to say no to drugs. I say no to drugs by

being involved at school through excelling in my academics, participating in Botball, orchestra, concert chorus, and

being a member in the Gifted and Talented program. When I’m not focusing on school I like to run and ride my bike.

Since I started mountain bike racing, I have won a state

championship and over 20 medals. My biking is what got me featured in the Absentee Shawnee Tribes, “MyDNA”

campaign. This campaign focuses on preventing underage substance abuse and I got to ride my bike in their video. I’m really proud of the things I have accomplished and in the future I hope to

continue to be a good influence on my friends and help combat underage substance abuse.

JULY/AUGUST/SEPTEMBER 2016 | 9

10 | OKLAHOMA AREA TRIBAL EPIDEMIOLOGY CENTER NEWSLETTER

WRITTEN BY: SUSAN S. GAY, OKTEC PUBLIC HEALTH COORDINATOR AND PATRICIA YARHOLAR, OKTEC GRANT LEAD/PUBLIC HEALTH COORDINATOR

PHOTOS BY: CHRIS REED, SPTHB CREATIVE SERVICES COORDINATOR AND LESTER HARRAGARRA

8TH ANNUAL TRIBAL PUBLIC HEALTH

Conference Was A Success CREATE, INSPIRE, AND EMPOWER HEALTHY NATIVE COMMUNITIES

Each spring, the Oklahoma Area Tribal Epidemiology Center hosts a tribal public health conference. The conference is unique in that it is designed to address public health issues facing Native Americans. The theme of this year’s conference was “Create, Inspire, and Empower Healthy Native Communities” and from all indications, attendees came away with knowledge and resources to do just that. Attendees labeled the conference a success with approximately 80% of respondents to the overall conference evaluation giving the conference a grade of an A. When asked the main reason for giving the conference an A, here were some of the responses: “Everything was good-helpful.”, “Enjoyed every speaker and breakout session.”, “It enlightened me on a variety of health issues.”

"Very organized and great agenda.”, “All topics were of use to me and the population I serve."

The conference took place April 19th through April 21st at the Grand Casino Hotel Resort in Shawnee, Oklahoma, located in the Citizen Potawatomi Nation jurisdiction. The three-day event drew attendees from many organizations including tribal, university, nonprofit, and federal and state agencies. During the pre-conference there were five half-day or full-day trainings or workshops with 177 persons pre-registered.

Many attendees actively engaged in these training sessions and voiced their excitement about them via the evaluations. On days one and two of the conference, there were keynote addresses by Dr. R. Murali Krishna and Michael Bird which received extremely positive feedback from attendees, plenary addresses by distinguished speakers on a variety of topics, and 35 breakout sessions. The breakout sessions covered a variety of topics such as suicide prevention, Native men’s health, problem gambling in Native America, and vaping and tanning among Native Youth. There were an estimated 367 attendees who joined in the threeday event. Other highlights from the conference were a first-time poster session, a cultural evening event, and vendor displays. The poster session topics ranged from public health to biomedical research, and demonstrated the necessity to share the needs and progress in Indian Country. The cultural event featured a panel discussion on the AARP Report for American Indian Elders, followed by presentations of native singing, hymns, and dancing

by youth ages 14-18 years of the Comanche Nation’s IAMNDN Culture is Prevention- a Native drug-free youth movement. There were also two classes on cultural art. One was a traditional Cherokee basket weaving workshop and the other was a painting class. Each participant left with a completed basket or a personal work of artistic painting on canvas, but more important, a special experience and memory to share with their communities. There were 26 health organizations and vendors that displayed their information representing tribal, state, university, and national health programs.

The administration and staff of the Oklahoma Area Tribal Epidemiology Center and the Southern Plains Tribal Health Board recognizes the invaluable contributions and support of conference sponsors, presenters, attendees, vendors, and organizations that were instrumental in making this year’s conference a success; without you we could not continue to host this conference annually, especially at no cost to attendees.

Thank you! Let’s continue to work collaboratively to create, inspire, and empower healthy Native communities!

JULY/AUGUST/SEPTEMBER 2016 | 11

8th Annual T R I B A L P U B L I C H E A LT H

CONFERENCE

12 | OKLAHOMA AREA TRIBAL EPIDEMIOLOGY CENTER NEWSLETTER

JULY/AUGUST/SEPTEMBER 2016 | 13

The Caring Van Story THE HISTORY, WHERE WE'VE BEEN, OVERCOMING BARRIERS, SETTING THE STAGE FOR SUCCESS IN 2016

STORY AND PHOTOS BY: JANICE BLACK, PUBLIC HEALTH TRAINING COORDINATOR

THE HISTORY The Caring Van project started in January 2015. The Southern Plains Tribal Health Board (SPTHB) formerly known as Oklahoma City Area Inter-Tribal Health Board (OCAITHB) received a new Caring Van from the Oklahoma Caring Foundation.

This great collaboration provides tremendous preventative health service opportunities for all tribes in the state of Oklahoma. The Caring Van is a mobile unit that travels throughout the state to conduct

health screenings and health education at tribal health events, schools, and community events.

We respect the traditional, cultural, and regional customs and needs of the different tribes we visit. Our focus includes reaching out to adults and children that otherwise would not receive these services due to restrictive health clinic hours and/or inconsistencies with transportation to and from appointments.

14 | OKLAHOMA AREA TRIBAL EPIDEMIOLOGY CENTER NEWSLETTER

The preventative health services offered are; glucose screenings, cholesterol screenings, body mass index (BMI) measurements, routine immunizations for children, adult and children influenza immunizations, foot checks, dental screenings, fluoride varnishes, head lice checks, and HIV/AIDS screenings. We continue to expand services, such as utilization of the van to allow tribal veterans and Veterans Administration staff to help with paperwork and ask health questions or concerns about benefits in a private setting.

Pictured is Deanna McKosato aboard

Van getting her blood T’ata Roberts the is anCaring OU student checked at the 2016 Iowa and member pressure of the Taos Pueblo, Tribal ”Wellness in the Workplace” Chickasaw, and Choctaw Nations. health event at Perkins, Oklahoma

WHERE WE'VE BEEN Our first-year experience was about meeting and forming new partnerships with tribes, Indian Health Services (IHS), and Urban Health Centers.

Here is the list of events we

•

Cheyenne and Arapaho Tribes of OK & Integris Health – “Hooked on Health” men’s health conference

•

Sac and Fox Nation Health Fair

•

Absentee Shawnee Tribe – “2nd Annual Health Awareness for All Generations”

•

•

American Health Association – 4th Annual “Honoring the Beat of Life” health fair

•

Iowa Tribe/Cimarron Casino “Employee Health Day”

Cheyenne and Arapaho Tribes of OK & Indian Health Service (IHS) – “Head Start Health Fair”

•

Cheyenne & Arapaho Tribes of OK Diabetes Wellness Program – “13th Annual Elder’s Conference”

•

Seminole Nation & Veterans Administration – “Warriors Resource and Benefit” health fair

•

White Eagle Health Fair 2015 “In Honor of All Veterans”

•

Iowa Tribe of OK – “Journey to Wellness” health fair

•

City of Perkins & Red Bud Assisted Living Center – Perkins, OK

•

Cheyenne and Arapaho Tribes of OK – 2015 “Inter- Tribal Veterans

attended in 2015.

•

Wichita Tribes of Oklahoma – “Heart Health Awareness Day”

•

American Heart Association – “Go Red for Native Women”

•

Oklahoma City Indian Clinic – Spring Turtle Camp

•

Red Earth – Downtown Oklahoma City Parade

•

Oklahoma City Indian Clinic – Native Youth Preventing Diabetes (NYPD) Camp

Stand-Down” participating tribes: Kiowa Tribe of OK, Delaware Nation, and Comanche Nation

JULY/AUGUST/SEPTEMBER 2016 | 15

Picture from left: Kristi Epperly, LPN from the Clinton IHS and Keith Island, a tribal veteran getting his blood pressure checked at the 2015 Inter-Tribal Veteran’s Stand Down in Clinton, Oklahoma

OVERCOMING BARRIERS AND HEALTH DISPARITIES IN INDIAN COUNTRY We learned early on in our mission that we would need to overcome barriers. Poverty continues to be a setback for many families in which health issues are not a priority until they become a problem. Some of the areas we encounter and attempt to address for are environmental threats that include hazardous or degraded environments, inadequate access to health care, and individual and behavioral factors that hinder a healthy lifestyle. Through partnerships with those who offer these services, we also can address tobacco use and tobacco cessation alternatives, along with alcohol consumption, opportunities to increase physical activity, discuss sexual practices, and provide disease screenings. We also seek to understand educational inequalities that include dropouts and children not attending school at an early age.

Pictured: Summertime at the Native Youth Preventing Diabetes (NYPD) Camp 2015

SETTING THE STAGE FOR A SUCCESSFUL 2016 Moving forward, we are attempting to focus on what works and what doesn’t in order to be successful.

Our over-arching goal is to ultimately improve long-term health in Native communities by using the Caring Van mobile unit. We seek to raise awareness by learning about the causes of health disparities while educating community and policy makers. In years to follow, we hope to continue to build new partnerships while strengthening our existing circle and creating strong relationships with the tribes in Oklahoma, Kansas, and Texas, as well as state and local health organizations. How do we measure success? By documenting all aspects of our events from beginning to the end. Document, document, document!

16 | OKLAHOMA AREA TRIBAL EPIDEMIOLOGY CENTER NEWSLETTER

2016 UPDATE For 2016 we have traveled to six events and completed a total of 294 screenings through April. We are looking forward to getting out into the tribal communities this summer and fall. Health awareness and screenings are important to living a healthy lifestyle. These are all rewarding experience for the Caring Van staff.

SCHEDULE THE CARING VAN TO COME OUT TO YOUR EVENT You can schedule the Caring Van for your event by contacting: Janice Black jblack@spthb.org or by phone at (405) 652-9209 Yonavea Hawkins yhawkins@spthb.org or by phone at (405)652-9218.

Youth and Culture Spell Success FOR IAMNDN AND COMANCHE NATION YOUTH PROGRAM

Pictured left to right: Sonnyrose Codynah, Natasha Gooday, Cameille Westselline, Lauren Noriega, Tristan Waqua, Ronald Monoessey Jr., Kaia Tahchawickah, Fialele Lauatai, Alofia Lauatai, Elijah Bender, Kobe Louis, Galu Lauatai, Ashleigh Mithlo, Sierra Minthorn, Brayden Halberg, Alex Akoneto, Arryonna Saupitty, Melanie Whitewolf, Malayna Dinwiddie

Pictured from left: Lauren Noriega, Melanie Whitewolf, Sierra Minthorn

Pictured clockwise from center: Malayna Dinwiddie, Melanie Whitewolf, Arryonna Saupitty, Brayden Halberg Ronald Monoessey Jr.

WRITTEN BY: ARON WAHKINNEY, SPF-TIG COMMUNITY HEALTH SPECIALIST

On April 5th IAMNDN (I AM Native Drug-Free Nations) Youth Choir and the Comanche Nation Youth Program participated in the 2016 Oklahoma Native American Youth Language Fair in Norman, Oklahoma. IAMNDN received the 1st place trophy in the 9th-12th Grade: Large Group Traditional Song category, and the Comanche Nation Youth Program received the 2nd place trophy. The Youth Program also received the 1st place trophy in the 9th-12th Grade: Group Spoken Prayer category.

Pictured front to back: Ronald Monoessey Jr., Kobe Louis, Galu Lauatai

Another spotlight at the event was IAMNDN's Malayna Dinwiddie receiving 1st place within the 9th12th Grade Advocacy Essay category for her untitled essay. She also received Honorable Mention for her poem titled “The Story Teller” within the 9th-12th Grade: Written Poetry category.

JULY/AUGUST/SEPTEMBER 2016 | 17

Connecting the Mouth to the Body STORY BY: JULIE SEWARD, RDH, M. ED., PUBLIC HEALTH SPECIALIST

PHOTOS BY: JANICE BLACK, PUBLIC HEALTH TRAINING COORDINATOR

ORAL HEALTH STATUS NOT ONLY AFFECTS THE ORAL CAVITY BUT IT ALSO AFFECTS OUR OVERALL PHYSICAL, EMOTIONAL, SOCIAL, AND PSYCHOLOGICAL WELL-BEING.

I recently returned from an oral health conference hosted by DentaQuest Foundation. During each day of the three-day meeting, the energy in the room was palpable as people from various public health sectors came together to discuss the need for systems change in order to improve the oral health of America. There was a wealth of information shared from the mouths of so many intelligent, creative individuals that I ended up being the one feverishly taking notes at a pace that I’m sure produced a cloud of smoke hovering over my pen.

As I was reflecting on my experience at the conference while waiting what seemed like days in the security line at the Atlanta airport, I recalled a conversational trend:

18 | OKLAHOMA AREA TRIBAL EPIDEMIOLOGY CENTER NEWSLETTER

"How are we communicating the fact that the oral cavity is, in fact, connected to the rest of the body?"

Oral health status not only affects the oral cavity but it also affects our overall physical, emotional, social, and psychological well-being. Despite the amount of information available that demonstrates the link and connectivity of oral health to the rest of the body, dentistry is often separated from primary care modalities.

The U.S. Surgeon General Vivek H. Murthy recognizes the importance of oral health to overall health through his perspective piece referencing the U.S. Department of Health and Human Services Oral Health Strategic Framework, 2014-2017 publication in the Public Health Reports March/April 2016 issue. The Surgeon General talks about the progress and challenges faced since the first ever report was issued on the oral health of America by then Surgeon General David Satcher in May 2000.

The vision of the Oral Health Strategic Framework, 20142017 (hereinafter, Framework) is the commitment by HHS and other federal partners to increase the public’s understanding that oral health is an integral part of overall health.

Pictured from left: Julie Seward provides an oral health screening to one of the Caring Van’s youngest 2016 Iowa Tribal Health Fair attendees

The Framework consists of five overarching goals: • Integrate oral health and primary health care

Julie Seward and Mr. Eagle from the “The Eagle” book series at the 2016 Iowa Tribal Health Fair

• Prevent disease and promote oral health • Increase access to oral health care and eliminate disparities • Increase the dissemination of oral health information and improve health literacy • Advance oral health in public policy and research The Indian Health Service (IHS) is working to address specific strategies that align with goals of the Framework in order to better sever the oral health needs of the AI/ AN population. Referencing the first goal for the scope of this article, IHS will provide oral health assessment and fluoride varnish application training to primary care providers and support staff. Such staff include IHS and tribal physicians, mid-level providers, public health nurses, Head Start staff members, pharmacists, and community health workers. IHS will also engage in interprofessional collaboratives and work with non-dental health partners to bring renewed attention to oral health and disease disparities in AI/AN populations.

Janice Black hands out complimentary coupons to tribal members before they depart the Iowa Tribal Health Fair

To view the Public Health Reports webinar on The Oral Health Strategic Framework (originally aired June 21, 2016) visit www.publichealthreports.org/webinars.cfm or to access the Oral Health Strategic Framework 2014-2017 document in its entirety visit www.hrsa.gov/publichealth/ clinical/oralhealth/oralhealthframework.pdf.

The Caring Van’s sidekick overly excited to demonstrate good brushing techniques

JULY/AUGUST/SEPTEMBER 2016 | 19

Raising Awarness for Rx Abuse Epidemic STORY BY: KARIN LEIMBACH, PFS COORDINATOR DCCCA, INC. PHOTOS BY: CHRIS REED, SPTHB CREATIVE SERVICES COORDINATOR

C

oalition Against Rx drug Epidemic, C.A.Rx.E., began in December 2014. C.A.Rx.E. is a group of dedicated Oklahoma County community members working together to decrease Oklahoma County’s prescription drug epidemic through education, awareness, and other prevention activities. Agency partners with C.A.Rx.E. worked together to spread awareness during National Prevention Week, May 15-21, 2016. Last year in Oklahoma County, prescription drug overdoses claimed the lives of 118 people. C.A.Rx.E. wrapped trees with ribbons to represent these 118 people who died last year. Posters were hung on the trees to remind community members they can prevent this epidemic through safe use, storage, and disposal of their prescription medication.

We want to thank the Southern Plains Tribal Health Board for their continued partnership and for participating in this activity!

To learn more about C.A.Rx.E. or to join please visit our website www.wecarxe.org or contact Karin Leimbach at (405) 708-7927 or at kleimbach@dccca.org .

Pictured from top left: Gerri Randolph, Melanie Johnson, Tanya Henson, August Rivera

20 | OKLAHOMA AREA TRIBAL EPIDEMIOLOGY CENTER NEWSLETTER

Pictured from left: Shoshanna Johnson, Jeanette Cosby, Sucharat "Gift" Tayarachakul, Gerri Randolph, Tanya Henson

What you should know: 

Zika is primarily spread by mosquitoes, but a man with Zika can spread it to his sex partners as well.



Most people will not know they have the Zika virus because they won’t have symptoms.



People infected with Zika that do develop symptoms usually experience a mild illness that lasts several days to a week.



The most common symptoms of Zika include fever, rash, joint pain, conjunctivitis (red eyes), muscle pain, and headache.



Pregnant? Consider postponing travel to any area with Zika. If your male partner travels to these areas, either use condoms or don’t have sex for the rest of your pregnancy. Zika can cause severe birth defects, such as microcephaly (the brain is not fully developed at birth).



There is currently no medicine to treat or vaccine to prevent Zika.



If you have recently traveled, tell your doctor or other healthcare provider where you traveled.



It is very important to use insect repellant for 3 weeks after you return from Zika infected areas to prevent the local spread of Zika in the US.

How to prevent Zika infection while in a Zika-infected area:  Wear long-sleeve shirts or long pants.  Stay in places with air conditioning and windows and door screens.  Take steps to control mosquitoes inside and outside.  Use EPA-registered insect repellents with one of the following ingredients: DEET, picaridin, IR3535, oil of lemon eucalyptus, or para-methane-diol.  Do NOT use insect repellents on babies younger than 2 MONTHS old.  Do NOT use oil of lemon eucalyptus on children younger than 3 YEARS old.  Children and babies too young for EPA-registered repellent should use mosquito nets and wear long-sleeve shirts and long pants.  Treat clothing and gear with permethrin or buy permethrin -treated items (do NOT use permethrin products directly on the skin).

Source: Centers for Disease Control and Prevention

JULY/AUGUST/SEPTEMBER 2016 | 21

CDC-Good Health and Wellness in Indian Country Program Site Visit WRITTEN BY: TRACY PRATHER, OKTEC DEPUTY DIRECTOR

PHOTOS BY: CHRIS REED, SPTHB CREATIVE SERVICES COORDINATOR

The Southern Plains Tribal Health Board (SPTHB) was recently visited

by Centers for Disease Control and Prevention (CDC) staff, Dr. David Espey, Medical Officer, National Center for Chronic Disease Prevention and Health Promotion – CDC; Shawna Howell, Project Officer, Division of Heart Disease and Stroke Prevention – CDC and Aisha TuckerBrown, Evaluator, Division of Heart Disease and Stroke Prevention – CDC. The purpose of the visit was to review the Good Health and Wellness in Indian Country grant initiative program.

SPTHB staff hosted the CDC staff, along with several grantee participants, key partners, sub awardees tribes and tribal oranizations to review programmatic details for years one and two of this five-year award. This visit was focused

on highlighting the outreach, inclusion of tribes and continued spread within the Oklahoma, Kansas, and Texas areas. This two-day site visit started with a requested review of the grant purpose and objectives.

SPTHB staff presented an overview of the organization's achievements and success within the grant, discussed the development, completion, and distribution of Community Health Profiles, showcased our existing partnerships, and an introduced our facilitators of success. We illustrated our challenges and obstacles, displayed our provision of technical assistance, celebrated milestones, achievements and successes with the tribes and tribal organizations we serve in this grant award and displayed our flexibility to adapt and make changes in the program as identified and requested by the tribes we serve.

22 | OKLAHOMA AREA TRIBAL EPIDEMIOLOGY CENTER NEWSLETTER

This site visit required a Work Plan Review, the overview of each key activity, and assistance provided to the tribes, funding, team based trainings, Tribal Community Health Assessment, and the different phase of development each sub awardee tribe is currently in. We displayed the new (first year) sub awardees with their program, and we displayed continuing (second year) awardees with their progress. SPTHB staff outlined the continuum of process for sub awardees for CDC review.

The process includes assisting with collection of a Tribal Community Health Assessment, working with data identified in assessment to determine health priorities, begin strategic planning with details and information acquired from assessments, and development of implementation models.

Pictured from left: Aisha Tucker-Brown, Tom Anderson, Marty Wafford, Jenifer ShieldChief-Gover, Shawna Howell

SPTHB was fortunate to have sub award grantees Chickasaw Nation and Cheyenne and Arapaho Tribes with the CDC staff about their Good Health and Wellness programs.

This was well received by the CDC Staff, as they noted that this rarely happens on these type visits. CDC officials were appreciative and impressed with the tribes’ progress and presentations and very glad that SPTHB let the tribes speak for themselves. Another of the sub awardee tribal organizations also hosted the CDC visit at their Facility.

The Oklahoma City Indian Clinic was gracious and inviting, and again the CDC staff found it remarkable that these sub awardees were included in the visit to speak about their experience in the program.

While entertaining the CDC officials, SPTHB staff introduced Good Health and Wellness Steering Committee members, along with several project investigators, evaluators, Tribal Epidemiology Center staff, consultants, partners, and fiscal management team to provide details specific to questions, needs or requirements the CDC might have.

At the conclusion of the two-day visit, SPTHB Senior Administration, Executive Director Jenifer ShieldChief-Gover, and TEC Director Tom Anderson joined with SPTHB

Chairwoman, Marty Wafford to present the CDC contingent with an embroidered Pendleton blanket to commemorate their visit to Oklahoma City.

Pictured from front to back: Aisha Tucker-Brown, Evaluator, CDC Shawna Howell, Project Officer, CDC

The initial feedback from the site visit and review was extremely positive.

The CDC recognizes our organization's steadfast commitment and dedication to the Good Health and Wellness in Indian Country initiative. They stated this was their best visit to date and wanted to express thanks and congratulations to all SPTHB staff. They stated they were very impressed with the TEC, all presentations, coordination, and organization of the visit. They wanted to convey this was the first visit ever where staff made them “feel like family”, truly an honor indeed.

Lastly, the CDC report stated that this was a visit with commendation and no recommendations, extremely enjoyable, and very well designed and orchestrated.

Pictured: Marty Wafford Southern Plains Tribal Health Board Chairperson

Pictured from left: Dr. DeeAnn DeRoin, Tracy Prather

It is both an honor and a pleasure to serve our tribes and tribal communities in this capacity. We remain ready to increase the spread of this opportunity.

JULY/AUGUST/SEPTEMBER 2016 | 23

BY: JENIFER SHIELDCHIEF GOVER, SPTHB EXECUTIVE DIRECTOR

With Tribal Support, the Southern Plains Tribal Health Board Has Passed the Following Resolutions: RESOLUTION NO. 2015 – 16 A Resolution to change the current name of the Oklahoma City Area Inter-Tribal Health Board to reflect the changes within the organization and revitalize our image and repositon the organization to reflect who we are today and who we strive to be tomorrow- to be a leading public health authority for all tribal nations within the Oklahoma, Texas, and Kansas areas.

Pursuant to O.S. Title 18 section 1077 “Amendment of Certificate of Incorporation for Non-Stock Corporation” a corporation may amend its certification of incorporation from time to time, so as to change its corporate

name; the Oklahoma City Area Inter-Tribal Heal Board has carried this name since its inception as a 501(c) (3) since February of 2001 and voting members of the board desire to change the legal name of the organization to reflect the reorganization and re-branding efforts of its board and staff.

The Oklahoma City Area Inter-Tribal Health Board on behalf of the 43 federally recognized tribes it serves, wishes to change its name to the “Southern Plains Tribal Health Board” and hereby affirms its continued support for all federally recognized tribes in the Kansas, Oklahoma, and Texas areas.

24 | OKLAHOMA AREA TRIBAL EPIDEMIOLOGY CENTER NEWSLETTER

RESOLUTION NO. 2015 – 17 A Resolution in support of H.R. 592/S. 314 The Pharmacy and Medically Underserved Areas Enhancement Act This legislation would recognize pharmacists as non-physician providers under Medicare Part B and make them eligible for reimbursement of services they provide to seniors in underserved areas.

The legislation seeks to increase access and improve quality of care by enabling pharmacists to provide care services as consistent with their education, training, and license. Also enabling pharmacists to practice at the top of their education and training, and get better integrated into the patient’s health care team, will improve health outcomes and greatly benefit our populations.

The Southern Plains Tribal Health Board supports the passage of H.R. 592/S. 314, The Pharmacy and Medically Underserved Areas Enhancement Act to recognize pharmacists as non-physician providers under Medicare Part B and make them eligible for reimbursement for services they provide to seniors served in our health systems.

RESOLUTION NO. 2015 – 18 A Resolution in support of the Indian Health Service to purchase health insurance for eligible patients on the health insurance marketplace The historic allocations of resource appropriated to all Indian health systems have created a disparity and underfunding for the Oklahoma Area compared to all other Areas in the United Sates. The Oklahoma Area has been in the bottom 25% of all Indian Health Areas and consistently rates as one of the lowest-funded areas within the IHS system. The delivery of care is substantially complicated within the direct services system is at such an inadequate level of funding.

Tribes are authorized under Public Law 93-638 to purchase health insurance for their tribal members.

This choice is not limited as they may purchase a group policy they wish, or they can purchase on behalf of individuals. These plans would include health insurance purchased through the Health Insurance Marketplace.

Tribes who operate their health program under Public Law 93-638 may choose to use tribal funds or IHS-appropriated funds to purchase health insurance for their tribal

members. Direct Service Tribes can certainly use tribal funds to purchase insurance for their tribal members, but IHS cannot purchase insurance on behalf of their tribal members.

On May 13, 2015, the Direct Service Tribal Advisory Committee (DSTAC) and the Tribal Self-Governance Advisory Committee (TSGAC) held their first joint meeting.

With the inadequate funding of Purchased Referred Care, if Indian Health Service could purchase insurance from the Health Insurance Marketplace for patients needing contract care, more Purchased Referred Care funding would be available or patients who do not meet the eligibility requirements for the Health Insurance Marketplace.

The meeting focused on areas of mutual concern and interest, and access to care and how the two groups can work together to achieve a success. Whether the tribal choice is to enter into self-governance to deliver health care or remain a direct service tribe, both choices are selfdetermination.

The ability to purchase insurance plans for individuals would allow Indian Health Service to leverage the limited Purchased Referred Care funding received each year and would directly improve the health of some of our more seriously ill or injured patients. These patients could be enrolled in a plan, obtain the care they need, and then cancel the policy, as AI/AN patients can enroll and dis-enroll on a monthly basis. Once their medical condition was addressed, the plan could be cancelled unless the patient wanted to continue at their own expense.

The Southern Plains Tribal Health Board requests the Indian Health Service to reconsider their position and allow their service units to purchase health insurance for their eligible patients on the health insurance exchange to further their limited resources.

RESOLUTION NO. 2015 – 19 A Resolution in support of the Direct Service Tribal Advisory Committee and the Tribal Self-Governance Advisory Committee Joint Meetings

Some of the initiatives discussed were better lines of communication, in-depth analysis of common issues, improve budget process, advanced appropriations for IHS, seek to make IHS budget mandatory, contract support cost, premium sponsorship, purchased and referred care, and Medicare-like rates.

Both groups could learn from each other by the sharing of best practices and success stores. We acknowledge that we all serve the same patients, as our patients are eligible to receive care at direct service facilities and self-governance facilities.

It would be beneficial to have breakout sessions at national meetings, one for each of the IHS areas, to discuss the joint initiatives and to gather input from the audience on suggested optics.

The Southern Plains Tribal Health Board fully supports the joint meetings of the DSTAC and the TSGAC and request consideration be given to area breakout sessions at national meetings on this topic of interest.

JULY/AUGUST/SEPTEMBER 2016 | 25

RESOLUTION NO. 2016 – 01

RESOLUTION NO. 2016 – 02

A Resolution in support of H.R. 2759 Mental Health Access Improvement Act of 2015

A Resolution in support of a S. 1830 Seniors Mental Health Access Improvement Act of 2015

H.R. 2759, Mental Health Access Improvement Act of 2015 would amend Title XVIII of the Social Security Act to provide for the coverage of marriage and family therapist services and mental health counselor services under Part B of the Medicare program which amends Medicare Part E to exclude such services from the skilled nursing facility prospective payment system and authorizes marriage and family therapists and mental health counselors to develop discharge plans for post-hospital services.

S. 1830 Seniors Mental Health Access improvement Act of 2015 seeks to increase healthcare access, improve quality of care, reduce overall healthcare costs, and meet critical health needs by enabling licensed professional counselors and licensed marriage family therapists to provide patient care services as consistent with their education and training, competencies, and clinical license.

Enabling these providers to practice and be reimbursed for services within the scope of their education, training, and competencies, and participating fully as an integral part of the patient’s health care team will improve health outcomes and greatly benefit our patient populations.

H.R. 2759, Mental Health Improvement Act of 2015 seeks to increase access and improve quality of care by enabling licensed professional counselors and licensed marriage family therapists to provide patients care services as consistent with their education, training, competencies and clinical license.

Enabling these providers to practice and be reimbursed for services within the scope of their education, training, competencies, and participate fully as an integral part of the patient’s health care team will improve health outcomes and greatly benefit our patient populations.

The Southern Plains Tribal Health Board supports the passage of H.R. 2759, Mental Health Access Improvement Act of 2015 to provide for the coverage of licensed professional counselors and licensed marriage family therapists under Part B of the Medicare program, and for other purposes.

S. 1830 Senior Mental Health Access Improvement Act of 2015 promotes increased access to care for underserved beneficiaries in medically underserved areas, medically underservedpopulations, and Health Professionals Shortage Areas, as designated by the Health Resources Services Administration.

As the shortage of primary care physicians increase, so too will the challenges that patients in underserved communities face, especially those related to access.

This legislation can help address provider shortages and access issues in underserved areas.

The Southern Plains Tribal Health Board supports the passage of S. 1830, Seniors Mental Health Access Improvement Act of 2015 to provide for the coverage of licensed

26 | OKLAHOMA AREA TRIBAL EPIDEMIOLOGY CENTER NEWSLETTER

professional counselors and licensed marriage family therapists under Part B of the Medicare program, and for other purposes.

RESOLUTION NO. 2016 – 009 A Resolution requesting Oklahoma City Area IHS public health officials not be temporarily detailed to other areas The Oklahoma City Area Indian Health Service has developed great leaders over the past years and the SPTHB recognizes the importance of those leaders and their role in the delivery of quality health care for the Oklahoma City Area. Therefore, it is understandable why these leaders are being detailed to assist other IHS Areas.

Over the last six months there has been a great number of our leaders detailed to other IHS areas, disproportionately to their IHS areas having staff detailed, and each time that leaves our Oklahoma IHS facilities in flux and without the continuity of leadership. We believe our quality of leadership here in the Oklahoma City Area is one of the reasons our IHS facilities performs well.

The Oklahoma City Area Indian Health Service region serves the largest number of American Indian’s by user-population count in the U.S. The Southern Plains Tribal Health Board requests that Oklahoma City Area IHS public health officials not be temporarily detailed to other IHS Areas, as we are in great need of these leaders her in the Oklahoma City Area.

RESOLUTION NO. 2016 – 0010 A Resolution in support of maintaining the 2016 fiscal year funding level of $210 Million for Centers for Disease Control and Prevention Office on Smoking and Health Tobacco use is disproportionately high within Oklahoma, Kansas, and Texas tribes and this funding supports crucial tobacco cessation programs, including tobacco prevention and tobacco quit lines.

American Indian/Alaska Natives (AI/ AN) have higher smoking prevalence than any other racial or ethnic subgroups, with 29.2% of adults and 24.6% of youths being active smokers.

Investing in tobacco prevention at the state and federal levels has proven successful in reducing tobacco-related death and disease.

The Center of Disease Control and Prevention (CDC) tobacco prevention work is a vital component of the effort to help adult tobacco users quit and prevent young people from starting the habit.

The CDC works with tribes and tribal support centers to combat tobacco use among Native Americans. The CDC grantees must work with AI/ AN partners to address disparities

among the Native American population, and provide leadership, training, guidance, consultative support, and technical assistance to tribes in their tobacco prevention work. Supporting level funding for the CDC tobacco prevention work would continue CDC’s positive relationship with tribes.

Fiscal Year 2016 Funding level of CDC OSH.

Maintaining Fiscal Year 2016’s funding of CDC Office on Smoking and Health (OSH) will also allow the highly successful and cost-effective Tips from Former Smokers Campaign to continue. During a nine-week phase of the Tips Campaign in 2014, 1.8 million Americans were motivated to make a quit attempt and 104,000 smokers quitted.

Oklahoma ranks 49th in the nation in access to primary care physicians.

Oklahoma does not import many physicians; we therefore, must train and retain own own primary care physicians.

Last year, the Appropriations Subcommittee Bill proposed a 50% cut to OSH, which would have had a catastrophic impact on the work that OSH does. Thankfully, the Senate did not have such a cut in their proposed bill and after final negotiations; there was only a 3% cut. Because of what happened last year, we are concerned another significant cut might be proposed.

Therefore, the Southern Plains Tribal Health supports maintaining the

RESOLUTION NO. 2016 – 0011 A Resolution in support of the establishment of a funding stream for tribal medical residency programs

There is an urgent need in rural Indian communities for family practice physicians and many tribes have or have been approved to have medical residency programs in their Indian health systems.

The Department of Health and Human Services currently does not have any funding stream for tribal medical residency programs in Indian Country. The funding streams that are or have been available do not have set-asides for tribes to participate which results in no funding stream to support tribal medical residency programs.

The Southern Plains Tribal Health Board hereby requests the Department of Health and Human Services to establish a start-up funding stream for tribal medical residency programs in rural America.

JULY/AUGUST/SEPTEMBER 2016 | 27

SOUTHERN PLAINS TRIBAL HEALTH BOARD ■ 9705 N. BROADWAY EXTENSION, STE. 150 ■ OKLAHOMA CITY, OK. 73114 PHONE (405) 652-9200 ■ FAX (405) 840-7052 ■ WEBSITE COMING SOON! For newsletter submissions, questions, or to be placed on the mailing list email: asmith@spthb.org or creed@spthb.org • Subject NEWSLETTER