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Tribal Self-Governance Health Care and Social Services Delivery Effectiveness Evaluation Feasibility Study: First Technical Work Group Meeting Background Materials

Publication Date
Feb 4, 2003

February 3, 4, 5, 2003
Washington, D.C.

"

Agenda for Meeting

Monday, February 3, 2003
Hubert H. Humphrey Build Room 505 A  (Phone: 202/205-0029)
200 Independence Avenue, SW

8:30 am

Welcome and Introductions, Facilitator, J. Kauffman

8:45 am

Overview of the Project, DHHS, A. Rock

  • Project Overview (Doc: Project Description)
  • DHHS Purpose and Expectations of Study
  • Roles and Responsibilities of Entities
  • Charge to the Technical Work Group
  • Tribal Consultation

9:30 am

Establishing Our TWG – Facilitator, J. Kauffman

  • Review Agenda and Objectives for Meeting (Doc: Agenda)
  • Agree on Our Ground Rules

10:15 am

Break

10:30 am

Background: Legislative History & Literature Review, K. Langwell

  • Review Drafts (Docs: Draft Legislative History Report; Draft Literature Review)
  • Identify Gaps and New Resources

12 Noon

Lunch

1:30 pm

Seek Input from TWG on Methodology, K. Langwell

  • Objectives of the Study (Doc: Draft Work Plan)
  • Feasibility Study vs. Evaluation
  • Setting the Study Parameters
  • Identifying Data Sources

3:00 pm

Break

3:15 pm

Continued Discussion on Feasibility Study Methodology

4:30 pm

Recess

Tuesday, February 4, 2003,
Wilbur J. Cohen Building, Room 5051 “Snow Room” (Phone: 202/401-1523)
330 Independence Avenue, SW

8:30 am

Review agenda and objectives for the day,   J. Kauffman

8:45 am

Seek Input and Advice from TWG on Major Study Areas:  “What are the Study Questions Needed in each of the Following Areas?”, K. Langwell 
(Doc:  Draft List of Potential Evaluation Issues and Questions)

  • Transitional and Management Issues
  • Data Requirements and Information Systems
  • Financing Issues
  • Measures of Performance and Effectiveness

10:15 am

Break

10:30 am

Continue Discussion of Major Study Areas

  • Developing Study Questions

12 Noon

Lunch

1:30 pm

Site Selection:  Overview and Discussion, K. Langwell
(Docs: Draft Tribal Matrix Report; Draft Tribal Data Report)

  • What are the expected outcomes of Site Visits?
  • What should criteria be for site selection?
  • What information should be gathered?
  • What should be included in site visit protocols?

3:15 pm

Break

3:30 pm

Planning Small Group Discussions:  Overview  - J. Kauffman, (Doc:  Draft Issues for Discussion Groups)

  • What are the expected outcomes of Discussions?
  • What questions should be asked?
  • What are best locations/settings for discussions?
  • What are best recruitment strategies?

4:30 pm

Recess

Wednesday, February 5, 2003,
Hubert H. Humphrey Bld., Room 405 A,  (Phone:  202/260-7048)
200 Independence Ave., S.W.

8:30 am 

Review agenda and discuss objectives for the day, J. Kauffman

8:45 am

Review Next Steps

  • Other issues to discuss?, J. Kauffman
  • Implementation of Study, K. Langwell

9:30 am

Identify Objectives and Draft Agenda for Next TWG Meeting, J. Kauffman

  • Ongoing communication between TWG and contractor (Doc:  Draft Communications Strategy Report)
  • Mail-out of drafts and other documents
  • Second TWG Meeting

10:15 am

Break

10:30 am

Review Consultation Plan, A. Rock

  • DHHS/ASPE Consultation Plan with Tribes
  • How Do You See Evaluation Consultation?

11:00 am

Closing Comments from TWG,   J. Kauffman

12 Noon

Adjourn

Project Description

Evaluation Feasibility Study

The Office of the Assistant Secretary for Planning and Evaluation, DHHS, has funded a one-year project to assemble background information and to assess the availability of data and the feasibility of conducting an evaluation of the effectiveness and impacts of administering and managing health and/or other social service programs under Self-Governance.  The primary tasks that will be conducted by Westat and its subcontractors, Project HOPE and Kauffman and Associates, Inc., include:

  • Compilation and synthesis of background information and existing research on the legislative history, experience, and effectiveness of Tribal Self-Governance, including identification of gaps in the research and limitations of previous studies.
  • Identification of a sample group of Self-Governance Tribes that meet specific criteria, management and data capabilities sufficient to support an evaluation of Tribally-managed programs, and indicating an interest in/willingness to participate in an evaluation.
  • Identification of likely research questions for an evaluation and the data that would be required to address each question.
  • Assessment of data availability, completeness, and comparability for Tribally-managed programs, relative to data that are available from Federal and State agencies that provide services to non Self-Governance Tribes.
  • Consultation and ongoing communication with Tribal leaders and Tribal organizations in designing, conducting, and reviewing findings of the feasibility study.

A Technical Working Group (TWG), consisting of 10 Tribal leaders, directors of Tribally-managed programs, representatives of Tribal organizations (plus informal, ex officio, research and data experts) will advise the project on key issues and review interim and final project findings.

This study extends work begun by IHS (under the now-repealed Section 305 of ISDEAA, including the Baseline Measures Workgroup) and, more recently, grew out of the experience of DHHS’ participation in the Federal-Tribal consultation on Title VI of P.L. 106-260 that mandated a study of the feasibility of conducting a demonstration of Tribal Self-Governance of non-IHS programs.  Since evaluation would be a part of a demonstration, and since there has been no conclusive evaluation of Tribal Self-Governance of health programs, the current study will provide information relevant to the possible conduct of an evaluation of Tribal Self-Governance of either health or social services programs, or both.

Contact Information

Sponsor:    DHHS Project Officers:
OASPE/DHHS 
Room 447D
200 Independence Avenue, SW
Washington, DC 20201  
Andrew Rock
202-260-0398

Tom Hertz
202-690-7779
Start Date: September 2002 End Date: September 2003
Project Director: Co-Principal Investigators:
W. Sherman Edwards
Westat
1650 Research Boulevard 
Rockville, MD 20850
Telephone:  301-294-3993
Email:  EDWARDS1@Westat.com 

Kathryn Langwell
Project HOPE Center for Health Affairs
Telephone:  605-584-2414
Email:  klangwell@projecthope.org

Jo Ann Kauffman
Kauffman and Associates, Inc.
Telephone:  509-747-4994
Email:  joann@kauffmaninc.com

Project Consultants:  

Pamela Iron
Frank Ryan

 

Draft Work Plan

Draft Work Plan (PDF Version)

Draft Literature Review

Draft Literature Review (PDF Version)

List of Potential Evaluation Issues/Questions

SUGGESTED EVALUATION ISSUES, QUESTIONS, DATA REQUIREMENTS

For Discussion with the Technical Working Group

Overview

An evaluation of Tribal Self-Governance could include a wide range of issues and questions, requiring use of existing data, primary data collection, and qualitative data collection.  In this handout, we offer a comprehensive set of potential areas that could be examined in an evaluation of health related services.  (A separate, similar, analysis will be needed for each non-IHS social services and other that would be included in any evaluation.  Topics and data requirements for such an evaluation effort will be discussed by the Working Group during its review of the activities that will take place during site visits to Tribes which manage one or more non-IHS services.)

Qualitative Issues:  Management Structures and Processes

This set of evaluation issues focuses on the role and structure of management of Tribal health systems and on internal management processes and systems.  Data required to address these issues would be collected through site visits, key informant telephone interviews, and review of internal documents (e.g. policies and procedures).  Types of questions that would be addressed include:

  • Management Structure and Stability

n      What are the management structure, departments, and reporting relationships within the health system?

n      How long has each manager served in their current position?

n      Has there been significant turnover in management positions since you took over responsibility for management of the health program?  If so, what are the reasons?

  • Providers and staff

n      How many physicians and other provider staff are currently employed or providing health services?

n      Are there vacant positions?  If so, how many and for what time period?

n      What are the challenges for recruiting and retaining physicians and other provider staff?

n      Have you developed and implemented any special programs to recruit staff and/or to retain staff?

  • Programs and Benefits

n      Have you added any new programs since Tribal management of the health system began?  Which programs?  How did you decide that there was a need for those new programs?

n      Have you eliminated any programs?  Which programs?  What were the reasons that you decided to eliminate those programs?

  • Quality and User Satisfaction

n      What types of quality of care review and assessment do you have in place?

n      Who is responsible for determining the specific areas and baseline measures that are used for quality of care review and assessment? 

n      What are the most important issues for quality of care and performance measures in your health system?  Why are these identified as of greatest importance?

n      Do you occasionally or routinely collect information from users on their experiences with providers, staff, health services provided?  How do you use the information collected?

n      How do you believe quality of care has improved under Tribal management of the health system?

n      Do you think that health system users are more satisfied since Tribal management was implemented?

  • Management Challenges

n      What are the management issues that are most difficult to address for Tribal management of health?

n      What changes would be beneficial and result in improved services to Tribal members?

Quantitative Issues:  Impacts and Outcomes

AVAILABILITY OF SERVICES/ACCESS TO CARE

Key Questions

Data Requirements

   

What services are available ‘in house’?

Have the quantity and type of ‘in-house’ services increased/decreased over the past three years?

What is the ratio of primary care physician-to patient users?  Dentist-to-patient users?

At the Service Unit level, most recent year and previous two years:

  • number of FTE physicians, by primary care and type of specialty
  • number of FTE primary care dentists and specialist dentists
  • number of FTE NP, RN, and PA staff
  • number of FTE dental hygienists
  • number other FTE clinical staff, by type
  • availability of full pharmacy services
  • number of patients provided services in SU, by age and gender

What services are referred out to Contract Health Services?

Have the quantity and type of Contact Health Services used changed over the past three years?

What criteria are used to determine whether a patient is referred for Contract Health Services paid by the Service Unit?

Is there ‘rationing’ of Contract Health Services?  All year?  At some point in the fiscal year?

  • number and type of Contract Health Services provided and paid, by quarter of the fiscal year
  • number and type of Contract Health Services denied for payment, by patient insurance coverage and by quarter of the fiscal year
  • Contract Health Services policies and procedures

What is the waiting time for a routine appointment? With a Service Unit primary care physician? With a Service Unit Dentist?

  • Percent of patients who are ‘walk in’
  • Days between making and having appointment with PCP
  • Days between making and having appointment with dentist

QUALITY OF CARE: PROCESS

Key Questions

Data Requirements

   

What proportion of Service Units are JCAHO-accredited or have other accreditation?

What proportion of physicians are board-eligible or board-certified?

What proportion of nursing and ancillary personnel  are licensed and meet federal/state continuing education requirements?

All Service Units, separately by direct service, contracted, compacted:

  • Percent JCAHO-accredited or other accreditation (specified)
  • Percent primary care physicians board-eligible/certified
  • Percent specialist physicians board-eligible/certified
  • Percent specialist physicians board-eligible/certified
  • Percent nursing personnel licensed and meeting CE requirements
  • Percent ancillary personnel licensed/certified
  • Community health reps

What is the annual ‘turnover rate’ for physicians, dentists, nurses, and ancillary personnel?

  • Percent of physicians, dentists, nurses, and ancillary personnel leaving employment at the SU each year

Does the Service Unit have a Quality Assurance/Review Committee? What are its functions/ How often does it meet?

For each Service unit:           

  • QA/QR Committee policies and procedures
  • QA/QR Committee Meeting Minutes

What proportion of patients receive routine preventive services? Has the proportion increased/decreased over the past 3 years?

For each Service Unit, past year and preceding 2 years

  • Percent children under age 5 immunized
  • percent aged 50+ receiving influenza immunizations
  • Percent of women over 18 with annual Pap smears
  • Percent pregnant women obtaining prenatal care in first trimester
  • Percent of adults screened for diabetes

What proportion of people with diabetes receive screening for diabetic complications? Has the proportion increased/decreased over three years?

For each Service Unit, for all patients with diabetes, three years:

  • Percent seeing physician at least once in 3 months
  • Percent receiving HbA1c testing once in 3 months
  • Percent receiving dilated eye exam annually
  • Percent receiving annual dental examinations

QUALITY OF CARE: HEALTH OUTCOMES

Key Questions

Data Requirements

   

What is the breast cancer 5-year survival rate?

What is the cervical cancer 5-year survival rate?

What percent of births are low-weight or premature?

What percent of births are high-weight?

For each Service Unit:

  • Percent diagnosed with breast cancer surviving 5 years
  • Percent diagnosed with cervical cancer surviving 5 years
  • Percent of births that are low-weight or premature
  • Percent of births that are high-weight

What is the proportion of deaths attributable to diabetes

What proportion of people with diabetes are diagnosed with diabetic retinopathy?

What is the proportion of people with diabetes who have extremities amputated?

  • Percent of deaths attributable to diabetes
  • Percent of people with diabetes who have diabetic retinopathy
  • Percent of people with diabetes who have had amputation

QUALITY OF CARE: PATIENT SATISFACTION

Key Questions

Data Requirements

   

What proportion of the population eligible for services uses the SU annually?

  • Number of eligible people within each SU market area
  • Number of eligible people with at least two visits to a PCP

Does the Service Unit or Tribal Health Department conduct periodic surveys of patients’ experiences and satisfaction?

  • ‘Yes’ or ‘No’ by individual SU

How do SU users rate access to care, their providers, Contract Health Services, and other dimensions of care?

What proportion of the eligible population goes outside for services?

What are the reasons for using non-IHS or non-Tribal health providers?

How do patients who obtain care outside rate their care?

Remaining questions would require a survey of users/non-users

FINANCIAL PERFORMANCE

Key Questions

Data Requirements

   

What proportion of users has public or private insurance?

At the Service Unit level, last year and two preceding years:

  • Percent with Medicare
  • Percent with Medicaid
  • Percent with SCHIP
  • Percent with Private Health Insurance

How many total units of service are provided, by type of service?

  • Number of hospital admissions
  • Number of hospital days
  • Number of primary care visits
  • Number of specialist physician visits
  • Number of dental visits
  • Number of prescriptions filled
  • Number of Contract Health services, by type of service

What proportion of potential third-party revenues is billed and collected?

  • Number of patients with third-party insurance, by type
  • Total billing, by type of insurance
  • Total receipts, by type of insurance

Is the Service Unit operating at ‘break even’ or with a ‘surplus’

  • Total revenues from IHS, by category (services, facilities, diabetes, administrative, other (?))
  • Total third-party revenues, separately for Medicare, Medicaid, SCHIP/Private insurance
  • Total revenues from other sources (e.g. grants)

What is average cost per unit of service? Average cost percapita?

  • Total expenses (labor, rent, operating expenses, supplies, depreciation, etc), by department (outpatient, inpatient, dental, nutrition, etc.)
  • Total Contract Health expenses, by provider type
  •  

What is the current financial condition of the service unit’s balance sheet?

  • Balance Sheet/Statement of Financial Position (assets, by category; liabilities, by category)
  •  

Have the prices of services changed?

  • Fee schedule/charges, by type of services

What are average out-of-pocket costs for patients?

  • Total charges to patients for in-house services
  • Total patient liability of Contract Health Services not paid by health facility

Draft Tribal Matrix Report

Draft Tribal Matrix Report (PDF Version)

Issues and Preliminary Topics for Discussion Groups Task

Questions for the Technical Working Group

  1. How can the small group discussions be useful to conducting the current feasibility study?
  1. What recommendations do you have regarding the locations, times, and arrangements described in the Discussion Protocol?
  1. What other Topic Areas and Prompt Questions would add to those suggested in the draft Discussion Protocol?

Small Group Discussions

Draft Discussion Protocol

Purpose:  The Small Group Discussions will bring together experienced managers and technical experts in self-governance program management to discuss issues relevant to the study and outlined in the Discussion Guide.  It will provide qualitative data, which is derived through interactive review and refinement from within each group discussion.  These Small Group Discussions will be analyzed to identify “major themes and issues” that emerge across the board.  These major themes will inform additional research, site visit inquiry and overall data analysis.

Target Participants:  People who will be recruited to participate in the Small Group Discussions include tribal management and technical staff with direct experience in the administration of Self Governance compacts, including financial managers, MIS directors, legal or regulatory analysts, program administrators and related positions.  A $50 honorarium will be provided to each participant.  Sign-up sheets will be provided prior to the groups to make sure we have the appropriate mix of expertise in each session and no more than four people per category (ie, financial, MIS, program managers).

Setting, Size, Numbers, Format and Materials: The project design calls for six (6) Small Group Discussions to occur at two (2) different locations.  Two major conferences or gatherings will be identified which promise to attract the types participants we will recruit to the discussion groups.  At each conference we will hold three (3) different discussion groups.  Each discussion group will involve not more than 10 to 12 individuals who represent a mix of interests and areas of expertise.  Individuals will be recruited through fliers or inserts in conference packets.  The contractor will work closely with conference organizers to ensure that our Discussion Groups are a part of the formal agenda if possible.  A monetary payment will be provided to Discussion Group participants.  Rooms will be set up in a semi-circle arrangement with flip-chart in the front for recording purposes.  A one page hand-out summarizing the project will be provided to each participant.  Each participant will be asked to introduce themselves and the Topic Areas and Prompt Questions will act as a general guide for the discussion.  It is expected that each Small Group Discussion will last approximately 2 hours each.

Conferences: The Small Group Discussions will occur between February and April, 2003.  The following conferences may be utilized for the discussion groups:

NCAI Executive Council Winter Session: Feb. 24-26, 2003; Washington, DC, Wyndham Hotel, Pre-Registration is Feb. 7, Hotel Reservations By Jan. 30.

IHS Self-Governance Spring Conference: Dates and locations have not been set by the IHS to date.

DHHS/ASPE Self Governance Evaluation Feasibility Study

Draft Small Group Participant

Discussion Guide

Thank you for agreeing to participate in this Small Group Discussion for the DHHS’s Self Governance Evaluation Feasibility Study.  This study is being funded through the Assistant Secretary for Planning and Evaluation (ASPE) and conducted by ASPE contractor Westat, Inc. with subcontractors Project HOPE and Kauffman and Associates, Inc. (KAI) (a one-page hand-out summarizing the project is attached).

The information generated will provide qualitative data, which is derived through interactive review and refinement from within each group discussion.  These Small Group Discussions will be analyzed to identify “major themes and issues” that emerge across the board.  These major themes will inform additional research, site visit inquiry and overall data analysis.

It is expected that this meeting will last approximately 2 hours.

The following Topic Areas represents a guide for the Small Group Discussion; not all topics may be covered.  We hope to engage in an open discussion.  Prompt questions, below, are provided to stimulate a meaningful exchange.

Topic Areas and Prompt Questions:

1.                  Beginning the Self-Governance process

·        What would you advise a tribe that is thinking about SG compacting?

·        Are there certain steps to help ensure a smooth transition?

·        How would this differ between IHS and other HHS programs?

2.                  Measuring success

·        What data exists to evaluate success?  How is it used?

·        What other means exist to evaluate success?

·        How would this differ between IHS and other HHS programs?

3.                  Areas of Concern or Difficulty

·        What are the “pitfalls” you experienced?

·        What potential difficulties do you see for new compacts?

·        How would you fix these problem areas?

4.                  Keys for Success

·        What are the most important ingredients to a successful project?

·        What are the keys to success for other HHS programs as compared to IHS programs?

DHHS/ASPE Self Governance Evaluation Feasibility Study

Project Description

The Office of the Assistant Secretary for Planning and Evaluation, DHHS, has funded a one-year project to assemble background information and to assess the availability of data and the feasibility of conducting an evaluation of the effectiveness and impacts of administering and managing health and/or other social service programs under Self-Governance.  The primary tasks that will be conducted by Westat and its subcontractors, Project HOPE and Kauffman and Associates, Inc., include:

·        Compilation and synthesis of background information and existing research on the legislative history, experience, and effectiveness of Tribal Self-Governance, including identification of gaps in the research and limitations of previous studies.

·        Identification of a sample group of Self-Governance Tribes that meet specific criteria, management and data capabilities sufficient to support an evaluation of Tribally-managed programs, and indicating an interest in/willingness to participate in an evaluation.

·        Identification of likely research questions for an evaluation and the data that would be required to address each question.

·        Assessment of data availability, completeness, and comparability for Tribally-managed programs, relative to data that are available from Federal and State agencies that provide services to non Self-Governance Tribes.

·        Consultation and ongoing communication with Tribal leaders and Tribal organizations in designing, conducting, and reviewing findings of the feasibility study.

A Technical Working Group (TWG), consisting of 10 Tribal leaders, directors of Tribally-managed programs, representatives of Tribal organizations (plus informal, ex officio, research and data experts) will advise the project on key issues and review interim and final project findings.

This study extends work begun by IHS (under the now-repealed Section 305 of ISDEAA, including the Baseline Measures Workgroup) and, more recently, grew out of the experience of DHHS= participation in the Federal-Tribal consultation on Title VI of P.L. 106-260 that mandated a study of the feasibility of conducting a demonstration of Tribal Self-Governance of non-IHS programs.  Since evaluation would be a part of a demonstration, and since there has been no conclusive evaluation of Tribal Self-Governance of health programs, the current study will provide information relevant to the possible conduct of an evaluation of Tribal Self-Governance of either health or social services programs, or both.

DHHS/ASPE Self Governance Evaluation Feasibility Study

Contact Information

Sponsor:                                                         DHHS Project Officers:

OASPE/DHHS                                                Andrew Rock

Room 447D                                                     202-260-0398

200 Independence Avenue, SW                       Tom Hertz

Washington, DC 20201                                    202-690-7779

Start Date: September 2002                           End Date: September 2003

Project Director:                                            Co-Principal Investigators:

W. Sherman Edwards                                       Kathryn Langwell

Westat                                                             Project HOPE Center for Health Affairs

1650 Research Boulevard                                 Telephone:  605-584-2414

Rockville, MD 20850                                       Email:  klangwell@projecthope.org

Telephone:  301-294-3993

Email:  EDWARDS1@Westat.com                  Jo Ann Kauffman

Kauffman and Associates, Inc.

Telephone:  509-747-4994

Email:  joann@kauffmaninc.com

Project Consultants:                                     

Pamela Iron                                                     

Frank Ryan     

Draft Communications Strategy Report

Draft Communications Strategy Report (PDF Version)

Draft Legislative History Report

Draft Legislative History Report (PDF Version)

List of TWG Members

Name Contact Information IHS Area Comments
W. Ron Allen

Tribal Council Chair










 

Merle Boyd

Second Chief

(Alternate)

Jamestown S'Klallam Tribe

1033 Old Blyn Highway

Sequim, WA 98382

(360) 683-1109 Phone

(360) 681-3405 Fax

rallen@jamestowntribe.org

 

Sac and Fox Nation

Route 2, Box 246

Stroud, OK 74079

(918) 968-3526 Phone

(918) 968-3887 Fax

Portland










 

Oklahoma

 
Julia Davis-Wheeler

Tribal Council Member

Nez Perce Tribe

P.O. Box 305

Lapwai, ID 83540

(208) 843-2253 Work

(208) 843-2965 Home

(208) 843-7354 Fax

(208) 843-2965 Home Fax

juliad@nezperce.org

Portland  
Barbara Fabre

Director of Tribal Child Care Services

White Earth Band of Chippewa

P.O. Box 418

White Earth, MN 56591

(218) 983-3285 ext. 407

barbf@whiteearth.com

Bemidji  
Dan Jordan

Tribal Self Governance Coordinator

Hoopa Valley Indian Reservation

P.O. Box 1348

Hoopa, CA 95546

(530) 625-4211 Phone

(530) 625-4594 Fax

djordan@pcweb.net

California  
Violet Mitchell-Enos

Human Services Department Director

Salt River Pima Maricopa Indian Community

10005 Osborne Road

Scottsdale, AZ 85256

(480) 850-8410 Phone

(480) 850-7373 Fax

violet.mitchell-enos@srpmic-nsn.gov

Phoenix  




 

Name Contact Information IHS Area Comments
Myra Munson

Attorney

Sonosky, Chambers, Sachse, Miller and Munson

318 4th Street

Juneau, AK 99801

(907) 586-5880 Phone

(907) 586-5883 Fax

myra@sonosky.com

Alaska  
Mickey Peercy

Deputy Director of Health

Choctaw Nation

Drawer 1210

Durant, OK 74702

(580) 924-8280 Phone

(580) 924-3393 Fax

mpeercy@choctawnation.com

Oklahoma  
Gerrie Small

President

Northern Cheyenne Tribe

PO Box 182

Lame Deer, MT 59043

(406) 477-6284 work

(406) 477-6210 fax

ncexecassistant@ncheyenne.net

Billings  
Anna Whiting Sorrell

Director of Support Services

Salish & Kootenai Confederated Tribes

P.O. Box 278

Pablo, MT 59855

(406) 675-2700 Phone

(406) 675-2806 Fax

annas@cskt.org

Billings  
Alvin Windy Boy

Chairman












 

Tim Martin

Executive Director

(Alternate)

Chippewa-Cree Tribe of Rocky Boy

Rocky Boy Route, Box 544

Box Elder, MT 59521

(406) 395-4210 Work

(406) 395-4497 Fax

(406) 868-2134 Cell

alvin@cct.rockyboy.org

 

United South and Eastern Tribes (USET)

711 Stewarts Ferry Pike, Suite 100

Nashville, TN 37214

(615) 872-7900 Phone

(615) 872-7417 Fax

jtmartin@usetinc.org

Billings












 

Nashville

 

Biosketches of Project Director and Co-Principal Investigators

Project Director:  W. Sherman Edwards

W. Sherman Edwards is a Westat Vice President, and is Project Director for the Master Contract under which this Task Order has been awarded. He has more than 25 years’ experience in the design, conduct, and analysis of social science research, primarily in the area of health services. He is currently Westat’s Project Director for the California Health Interview Survey, a telephone survey of some 55,000 California households that includes an oversample of American Indian/Alaska Native households. He is also currently Westat’s Corporate Officer for two major contracts associated with CAHPS – Westat is conducting the Medicare Managed Care CAHPS for the Centers for Medicare and Medicaid Services, and holds a contract with the Agency for Healthcare Research and Quality to support the CAHPS Survey Users’ Network, maintain and manage the National CAHPS Benchmarking Database, and provide other support services for the overall CAHPS program. Mr. Edwards has done design work or methodological research for many of the Federal government’s major surveys, and has led several Federally-sponsored evaluations of health financing and health services activities. Before joining Westat, Mr. Edwards was Senior Methodologist at the (then) National Center for Health Services Research, where he worked with the Indian Health Service to design and manage the Survey of American Indians and Alaska Natives, a part of the 1987 National Medical Expenditure Survey.

Co-Principal Investigator:  Jo Ann Kauffman

Jo Ann Kauffman, MPH, is President of KAI and an enrolled member of the Nez Perce Tribe. She received her Masters of Public Health Administration from the University of California at Berkeley in 1979.  She has worked in the field of Indian health for 25 years.  In this capacity, she has served as a consultant to Indian tribes and the U.S. Indian Health Service, as Executive Director of the Seattle Indian Health Board and as Executive Director of the Northern Idaho Indian Health Board.  In 1998, she was awarded the “Free Spirit Award” from the Freedom Forum, for her work representing tribes and Indian communities as a community activist and advocate on First Amendment issues.  In 1998, she also became the founding president for a national alcohol/substance abuse recovery movement called the National Association for Native American Children of Alcoholics (NANACOA).  As president of KAI, she assists the U.S. Indian Health Service in health policy evaluation and in facilitating national tribal consultation and dialogue.

Co-Principal Investigator:  Kathryn Langwell

Kathryn Langwell, a Senior Fellow at Project HOPE, has over 25 years experience in managing, designing, and conducting research, evaluation, and technical assistance projects.  She joined Project HOPE’s Center for Health Affairs in September 2001.  She is currently Project Director for a CMS Study of American Indian/Alaska Native Eligibility and Enrollment in Medicaid, SCHIP, and Medicare, and is the Research Core Co-Principal Investigator for an NIH project to conduct research and pilot studies on health disparities issues working with the Montana-Wyoming Tribal Leaders Council.  Ms. Langwell has designed and conducted numerous evaluations of government and foundation programs over the past 20 years, including serving as the Project Director and Co-Principal Investigator for HCFA’s Medicare HMO Demonstration Evaluation, Project Director of the Medicare PPO Demonstration Design and Implementation, and Project Director for HCFA’s Medical Group Capitation Demonstration Design.  Ms. Langwell was Principal Investigator for The Robert Wood Johnson Foundation’s School-Based Health Center Demonstration Evaluation from 1994 to 2000, and was Project Director for the DoD/OPM Evaluation of the FEHBP Demonstration for Military Retirees. Ms. Langwell served as Deputy Assistant Director for Health at the Congressional Budget Office from 1989 to 1993.  She was a Senior Economist at Mathematica Policy Research from 1983 to 1989.  She has published extensively on managed care policy and operational issues, performance measurement, health care use and payment policies, and racial/ethnic disparities in health care access and use of services.

Attendance List

Name Organization
Alexander, Paul ABW&W
Allen, W. Ron Jamestown S'KlallamTribe
Apodaca, Ray Division of Tribal TANF, ACF, DHHS
Belcourt, Lena Health Board, Chippewa-Cree Tribe of Rocky Boy
Broderick, Eric Office of Intergovernmental Affairs, DHHS
Cooper, Sheila Administration for Native Americans, ACF, DHHS
Eagleman, Brian Kelly Health Board, Chippewa-Cree Tribe of Rocky Boy
Edwards, Sherm Westat
Fabre, Barbara White Earth Band of Chippewa
Gorman, Ginny Child Care Bureau, ACF, DHHS
Greenberg, Linda Centers for Medicare and Medicaid Services, DHHS
Halpern, Peggy Office of Planning and Evaluation, DHHS
Helba, Cynthia Westat
Hertz, Thomas Office of Planning and Evaluation, DHHS
Holmes, Cyndi Jamestown S'Klallam Tribe
Imotichey, Jessica Office of Intergovernmental Affairs, DHHS
Jackson, Yvonne Administration of Aging, DHHS
Jones, Dennis K'ima'w Medical Center
Jordan, Daniel Hoopa Valley Indian Tribe
Kauffman, Jo Ann Kauffman and Associates, Inc.
Knight, Melanie Cherokee Nation
LaFrance, Rita Office of Intergovernmental Affairs, DHHS
Landey, Alana Office of Planning and Evaluation, DHHS
Langer, Pam Office of Intergovernmental Affairs, DHHS
Langwell, Kathy Project HOPE Center for Health Affairs
Mitchell-Enos, Violet Salt River Pima Maricopa Indian Reservation
Morgan, Matthew Chickasaw Nation
Munson, Myra Sonosky, Chambers, Sachse, Miller and Munson
Patch, Robin Office of Planning and Evaluation, DHHS
Paternoster, Victor Kauffman and Associates, Inc.
Peercy, Mickey Choctaw Nation of Oklahoma
Pittman, Juliet C. SENSE INC
Rock, Andrew Office of Planning and Evaluation, DHHS
Smith, P. Benjamin Choctaw Nation; Office of Tribal Self Governance, IHS, DHHS
Sorrell, Anna Whiting Salish and Kootenai Confederated Tribes
Sparks, Georgeline Indian Head Start Board
Stearns, Chris Hobbs Straus/Dean Walker
Strommer, Geoff Hobbs Straus/Dean Walker
Tyner-Dawson, Eugenia Office of Intergovernmental Affairs, DHHS
Weston, Richard C. Agency for Toxic Substance and Disease Registry, DHHS
Wiggins, Cliff Indian Health Service, DHHS
Williams, Paula Office of Tribal Self Governance, IHS, DHHS
Windy Boy Sr., Alvin Chippewa-Cree Tribe of Rocky Boy
Populations
American Indian & Alaska Native People (AI-AN)
Location- & Geography-Based Data
Tribal Communities