Indian Health Service Colville Service Unit
Contract Health Services
Medical Priority ONE Status

The Colville Service Unit is on Medical Priority One. Priority One care is limited to life or limb emergencies. These are services that are necessary to prevent the immediate death or serious impairment of the health of the individual, and, if left untreated, would result in an uncertain but potentially grave outcome.

Indian Health Service Medical Priorities must be consistent and integrated with annual spending plans since the availability of funds determines the level of medical care that can be provided. There is no authority to provide payment for services under the CHS program unless funds are, in fact, “available”.

The Colville Service Unit is on Priority One. Priority One care is limited to life or limb emergencies. Some examples of Priority One that would be considered emergent or acutely urgent care services are:
Airway obstruction
Amputation, traumatic
Appendicitis
Heart Problems
Severe Burns
Coma
Congestive heart failure
Dehydration, severe
Delirium tremens
Diabetic ketoacidosis
Eye disease, acute
Eye injuries
Fractures
Gunshot wounds
Head injury or concussion
Heart attacks
Kidney stones, acute
Lacerations
Meningitis or other serious infections
Obstetrical emergencies
Pneumonia, acute
Premature infant
Puncture or stab wounds
Renal failure
Respiratory failure
Spinal cord injuries

When funds are insufficient to provide the volume of CHS care, priorities for service shall be determined on the basis of “relative medical need.” Right now, due to insufficient funds, our number one priority is to the population residing on the reservation.

The following services will not be considered unless appropriations increase.

Medical Priority 2: Is primary health care that is aimed at the prevention of disease or disability. These are services proven effective in avoiding the occurrence of a disease or in mitigating the consequences of an illness or condition. These are Direct Care services and are available at IHS facilities.

Medical Priority 3: This level of care is chronic primary and secondary medical services. Services that involve the treatment of prevalent illnesses or conditions that have a significant impact on morbidity and mortality. This involves treatment for conditions that may be delayed without Progressive loss of function or risk of life. These are Direct Care services and are available at IHS facilities.

Medical Priority 4: Is chronic tertiary and extended care services. Which are not essential for initial and emergent diagnosis or therapy and have less impact. These services are not available at IHS facilities and typically include cosmetic services and long term care.

Patient Referrals: In order to get an IHS Referral, patients must be seen at the Colville Service Unit by an Indian Health Provider for an evaluation. This is where and when the level of care is determined. If the care is considered Urgent Care Services, a referral will be initiated for authorization. The Managed Care Committee reviews for priority status and approves or denies the referral. Typically, however, all urgent care initiated by the IHS physician is approved. No payment is made for medical care and services obtained from non-IHS providers or in non-IHS facilities without prior authorization unless it was for emergency service (the patient or family must notify CHS within 72 hours of care).

Referrals Only Cover One Visit. If a medical specialist requests additional visits or tests, a new referral must be requested and authorized prior to additional visits or tests by the Colville Managed Care Program. Otherwise, the patient becomes responsible for payment.

Laboratory or x-ray orders from specialists, in most cases, can be brought back to the clinic.

Colville Indian Health Clinic
Changes Hours in November

The Colville Indian Health Center has offered extended clinic hours for the past eight months. After evaluation of the effectiveness of the longer clinic day, there will be some changes in the hours.
Beginning Monday October 31 the hours will be as follows:

All Direct Patient
Care Departments
8:00 a.m. to 4:30 p.m .
Monday, Tuesday, and Thursday

12:30 p.m. to 5:30 p.m.
Wednesday

8:00 a.m. to 4:30 p.m.
Friday

Pharmacy
8:00 a.m. to 5:00 p.m.
Monday, Tuesday, and Thursday

12:30 p.m. to 6 p.m.
Wednesdays

8:00 a.m. to 4:30 p.m.
Friday

Dental Department
8:00 a.m. to 4:30 p.m.
Monday, Tuesday, and Thursday, Friday

12:30 p.m. to 4:30 p.m.
Wednesday

Patients can schedule regular 30-minute appointments in advance, or schedule a 15-minute Same Day Appointment; patients’ provider of choice will be honored whenever possible, please call 634-2913 or 800-416-7459.

IHS CLINIC CHANGES
HOURS IN NOVEMBER

The Colville Indian Health Center has offered extended clinic hours for the past eight months. After evaluation of the effectiveness of the longer clinic day, there will be some changes in the hours. The data has consistently shown that the added hour from 4:30 to 5:30 pm has had low utilization by patients, on average. The number of staff needed to provide this additional hour has often decreased how many employees are available during the earlier morning hours. One informal patient survey done in June indicated that the majority of patients had no strong preference of continuing or discontinuing the extra hour; what has been shown to be very popular is the extended pharmacy hours.

Beginning Monday October 31 the hours will be as follows: All direct patient care departments will be open from 8:00 am to 4:30 pm Monday, Tuesday, and Thursday, with Pharmacy open until 5:00 p.m. On Wednesdays, patient hours will be 12:30 pm to 5:30 pm, with Pharmacy open until 6:00 pm. On Fridays, all department hours will be 8:00 am to 4:30 pm, including Pharmacy. There will be no change in the dental department; their hours are 8:00 a.m. to 4:30 p.m. daily, except for Wednesdays, which are 12:30 p.m. to 4:30 p.m.

There is a suggestion box in the main lobby of the clinic, and patients are encouraged to submit their comments and suggestions at any time.

As in the past, patients can schedule regular 30-minute appointments in advance, or schedule a 15-minute Same Day Appointment; patients’ provider of choice will be honored whenever possible.

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Open Letter To; Colville Confederated Tribe, its Members, Governing Council, Health Care Providers in all Districts, Tribal Employees , All Inchelium Health Center Employees, Friends, Neighbors, and, most of all, those of you for whom I have had the Honor of providing Dental care during the last 14 years.

I will be leaving you very soon - but before I go I wish to offer these few words to ALL of you who have bestowed your friendship, trust, and confidence on me as your dentist and friend during these last 14 years.

It truly has been my privilege and an honor to have served the Inchelium Community as your dentist.

Among the many memories that I will take with me are: The big Inchelium Community Valentine Dance of 1992, Ski Club Trips to 490 North, Country Western dance classes, the Inchelium Control Line Flying Club, the summer flooding of the clinic and moving into a lower HUD house (the dental dept had to go to Nespelem to provide services), driving from Gifford to Inchelium 60 miles one-way when the Ferry is down due to low water (or Maintenance), planning and finally realizing a dream - a NEW Clinic in June of 2004, and finally, the great joy of watching so many of my very young patients in this community grow to become mature adults with children of their own. In some small way I feel that I have made a positive impact on some lives with better dental care and Beautiful Smiles and perhaps made better two-steppin’ line dancers of some of you.

However, all of that must now be relegated to the past. I am moving on. It is not my intention to retire from the practice of dentistry. In the very near future I will be opening my own practice in Spokane. I have contracted with a large East Coast corporation called Affordable Care Inc. They operate over 130 practices in the Mid-West and East Coast and are now expanding to California, Oregon, and Washington. The Spokane practice will be the third office on the West Coast. (The other 2 are both located in California.)

I have given this much serious thought and decided to take the plunge. We are planning a Grand Opening in February 2006. I hope you will all plan to join me at that time in celebration of the event.

My office is located in Spokane at Trent and Argonne. I will be providing a very limited range of services. Full Dentures, Partial Dentures, Extractions, and services related to just those devices such as relines and repairs etc. THAT’S IT!! What is unique about this practice is that most of these services will be available on a SAME DAY PLAN. Sorry, no fillings, crowns, root canal treatment, or orthodontics.
I have received a tremendous measure of personal satisfaction in providing a diverse menu of services to the Inchelium Community but, this is a time in my career that I must take a new and different path.

Well that about says it all....Thanks for the memories.

Sincerely,
Your Friend and Dentist
Dr. Bill

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