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2018 Annual Report to the People
2
Table of Contents
Greeting from the Executive Director 2
Medical Services 4
Quality Improvement 13
Pharmacy 16
Finance 21
Environmental Health Services 30
Behavioral Health 37
Community Health Representatives 47
Nutrition Program 51
Food Distribution 54
Health and Wellness Program 57
Community Health Nursing 66
Contact Information 78
3
Ona Garvin
Executive Director of Health
Virginia Deford
Clinic Office Manager
Greetings from the Executive Director
Hinikaragiwii!
We continue to work on optimizing our services to Hocak people in
Medical Services and Community Health. To this end we have hired
Medical Providers, fully licensed and accredited Doctors and other health
professionals. These providers are four Family Practice physicians, two
Pediatricians, two Optometrists, 2 Dentists, Nurse Practitioners,
Physicians Assistants, Nurses and Health Educators.
Community Health provides services to the tribal population with
Community Health Nurses, Certified Nurses Assistants, Home Health
Aids, Nutritionists Exercise Physiologists and the United States
Department of Agriculture (USDA) (Commodity Foods Program) staff.
The Community Health Representative funding will be ended by Indian
Health Services as of October 1, 2018. The funds were reprogrammed
into M & I. The Community Health Representatives are transitioning into Certified Nursing Assistants
after training and receiving their certificates.
Behavioral Health services are now provided at the main Ho-Chunk Health Care Clinic with Community
Health now occupying the original Clinic offices on Airport Road. Mental Health Clinicians, Alcohol
and Other Drug Abuse Counselors are ready to assist anyone seeking help with drug and health
addictions. A Psychiatrist has been hired full time. We offer integrated Medical and Behavioral Health
Services.
Tribal Action Plan: This plan was requested by the Ho-Chunk Legislature. All
departments are involved in this plan to assist in combating the issues of alcohol
and drug abuse. The use of Opioids has increased to an epidemic level with
devastating results. Behavioral Health and Pharmacy have offered training in the
use of Narcan in the case of opioid overdose. We educate, train and counsel on
the results of opioid addictions in our communities. We also provide Medically
Assisted Treatment. Housing and Law Enforcement are working on goals and
objectives in the Tribal Action Plan.
Environmental Health is a much needed service that provides oversight and
solutions to any health hazards in our service delivery area and provides
necessities such as clean water, food service inspections, and working with all
Departments of the Ho-Chunk Nation coordinating needed environmental health services for tribal
members. The Utilities program was transferred to Health from the Housing Department.
Our 215 employees are ready to help you with all your health needs to:
Building a strong mind, body and spirit together.
Ona White Wing Garvin
Executive Director of Health
4
Joan Greendeer-Lee Director of Medical Services
Medical Services Division Annual Report
Ho-Chunk Health Care Center (HHC) and House of Wellness (HOW) Medical Services Division provides medical, dental, optical, and podiatry care to our patients. Our
healthcare team of providers include: Pediatricians, Family Practice Physicians, Family Nurse
Practitioners, Physician Assistants, Dentists, Optometrists, visiting Podiatrist, visiting Oncologist, visiting
Endodontists and supportive staff. All of our healthcare providers within the Department of Health are
committed to providing excellence in both care and service.
The following services are performed by the healthcare team:
Medical Clinic Services Provided: Optical Services Provided: Acute Care for Injury and Illness Routine Eye Exams
Immunizations Adjustments & Minor Eyeglass Repair
Diabetes Wellness Clinics Evaluation & Treatment of Minor Eye Infections
Prenatal Care Order Eyeglasses & Contact Lenses
Reproductive Health Dilated Diabetic Eye Exams
Adolescent Health/Well Child Care Contact Lens Fittings
Physical Exams for All Ages
Sports Physicals HHCC Dental Services Provided:
Smoking Cessation Routine Exams and Cleanings
Weight Management Scaling & Root Planning
CDL Examinations (HHCC only) Periodontal Maintenance
Laboratory Services Periodontal Surgery
Radiology Services Oral Cancer Screening
Podiatry Services Laser Periodontal Therapy
Mammography Services (HHCC only) Dental Fillings and Sealants
Fluoride Treatments
Teeth Whitening
HOW Dental Services Provided: Routine Exams and Cleanings
Oral Cancer Screening
Fluoride Treatments
Nutrition Counseling for Oral Health
Scaling & Root Planning
Periodontal Maintenance
Periodontal Surgery
Laser Periodontal Therapy
Dental Fillings and Sealants
Crowns & Bridges
Dentures & Partials
Oral Surgery
Root Canal Therapy
Mouth and Night Guard (In clinic Fabrication)
Oral Health Education/Instruction
Outreach at General Council, HeadStart Schools, Journal of Hope, TAU,
Partners In Parenting, Diabetes Breakfast, Halloween for HOW Youth
School-Based Restorative Clinic-Wisconsin DHS Grant
Teeth Whitening – limited basis
5
2011 2012 2013 2014 2015 2016 2017 2018
639 603 633 740 841 871 710 1,041
1630 1594 1885 2039 2060 1861 2027 1904
8139 7904 8129 7488
6175
7428
6402
7754
Patient Visits Ho-Chunk Health Care Center
Optical Dental Medical
2011 2012 2013 2014 2015 2016 2017 2018
700 849 920 1097 1068 1001 893 1031 790
2114 1912 1909 1991 1837 1922 1998
4437
5521 5410 5237 4725 4933 4785
5034
Patient Visits House of Wellness
Optical Dental Medical
6
Rebecca Shawley
HHCC Clinic Office Manager
Patty Houghton
HOW Clinic Office Manager
Ho-Chunk Health Care Center and the House of Wellness Clinics
Accomplishments in FY 2018:
Continue to provide cultural awareness training for new and current
employees, clinical students, medical residents, and local clinical
practices.
Replaced original, major medical, optical and dental equipment.
Assessed the state of transition health for our youth to adult care and
services. A policy and brochure were developed to coordinate more
transparent process for individuals and their families.
Initiate prevention incentive to encourage more adults to get screened
for colorectal, cervical, breast and lung cancers at their well visits.
HHCC medical clinic fully staffed! Two Family Physicians, part-time
Pediatrician, and nursing staff.
o New services: vasectomy and in-clinic ultrasounds, delivery of
babies at Black River Falls Memorial Hospital
Optometrist hired at HHCC
Triage system streamlined and working at both medical clinics
Problems and Corrective Actions Taken in FY 2017: With four new providers at the HHCC, marketing is being done to
advertise them and their services. Added laboratory and nursing staff to
support the increase in patient volume. New providers participated in
outreach efforts, such as health fairs and attending General Council and
Area Meetings.
Mammography services continue at HHCC every other month. A
reassessment of the schedule and wait list will determine if there needs
to be a schedule adjustment.
Future Goals and Strategies: Continue to evaluate methods to decrease no-show rates for all services.
Improve the quality monitors led by providers to continue to provide
high quality patient care.
Evaluate the possible expansion of services to include chiropractic services.
Expand Outreach services by clinic Staff at various health fairs, conferences, cultural events and
local school districts.
Streamline the referral process to specialists.
Alternative Funding Sources and Partnerships:
Partnership has strengthened with the Black River Memorial Hospital.
Partnership has solidified with Gundersen Health Systems and expanded with Mayo Health
Systems to include invitations to grand rounds and offer of specialty services and educational
sessions.
Alternative funding included small grants offered by the State of Wisconsin Health Services.
Report is respectfully submitted by Joan Greendeer-Lee, Director of Medical Services
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Carolyn Wakeman, MD
HHCC-Family Medicine
Neil Cox, MD
HHCC-Family Medicine
Kevin Gilmartin, MD
HHCC-Pediatrics
Chandra Reddy, MD
HOW-Internal Medicine
Karen Ailsworth, MD
HOW-Pediatrics
Medical Staff
Amy Delong, MD, MPH
Medical Director
8
Kiana Beaudin,
HOW-Physician Assistant
Bethany Schilling
HHCC-Family Nurse Practitioner
Fawnah Bish, BSN
HHCC-Clinic Nursing Supervisor
Cari Ritter
HOW-Physician
Assistant/Health Educator
Brittany Niemeyer, BSN
HOW-Clinic Nursing Supervisor
Chris Seguin,
HHCC-Family Nurse Practitioner
Sue Christoperson,
HHCC-Family Nurse Practitioner
Thomasa Chavez
HOW-Registered Nurse
Tracy McReath, BSN
HOW-Registered Nurse
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Carrie Whipp
HOW-Certified Medical
Assistant
Alissa Ginkowski, RN
HHCC-Registered Nurse
Angela Gardner, RN
HHCC-Registered Nurse
Ashley Engebretson, RN
HHCC-Registered Nurse
Jennifer Koebler, RN
HHCC-Registered Nurse
Holly Rodenberg, RN
HHCC-Registered Nurse
Nurse Educator
Melissa Hubing
HHCC-Certified Medical
Assistant
Amy Conant
HHCC-Certified Medical
Assistant
Elizabeth Anderson
HOW-Certified Medical Assistant
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Annie Bender
HOW-Registered Technologist of
Radiography
Charmain Brandt, ASCP
Laboratory Supervisor
Joe Sanders, ASCP
HHCC-Medical Laboratory
Technician
Peggy Woychik
HHCC-Registered Technologist
of Radiography
Tristan Zurfluh
HHCC-Medical Laboratory
Technician
Lab and Radiology Staff
Carol Koch, ASCP
HOW-Medical Laboratory
Technician
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Optical Staff
Lori Haun, O.D.
HOW-Optometrist Rachel Lundberg, O.D.
HHCC-Optometrist
Stephanie Heller
HHCC-Optometry Technician
Nicole Cotto
HOW-Optometry Technician
Patient Registration
12
Dental Staff
Alison Cleveland
HHCC-Dental Assistant
Amy Clark
HOW-Dental Assistant II
Charles Lau, DDS
HOW-Dentist Feras Alkhader, DDS
HHCC-Dentist
Jennifer Luce
HOW-Dental Hygienist Misty Newkirk
HOW-Dental Assistant II
Sally Zager
HHCC-Dental Hygienist Loula Krause
HHCC-Dental Assistant
13
Quality Improvement Division Annual Report
The Quality Improvement Division has continually striven to achieve a higher standard of quality
care by measuring the performance of all health programs. The purpose of Quality Improvement is to
enhance the safety, efficiency and effectiveness of all health care processes by continiously evaluating the
performance of services delivered to our patients through qualitative and quantitative methods, ultimately
resulting in lower business costs and increased quality of care. Quality Improvement identifies areas of
deficiency, creates plans for improvement, and monitors those plans through completion. Plan-Do-Study-
Act, the PDSA Model, is the credo of the program. We plan projects that will address areas of needed
improvement; we do the project as a research study; we study the results of the program to see if the
improvement did take place. We then act to adopt, adapt, or abandon our strategy to ensure improvement.
Both the Ho-Chunk Healthcare Center in Black River Falls and the House of Wellness in
Baraboo, have achieved a full three-year accreditation by the Accreditation Association for Ambulatory
Healthcare, Inc. (AAAHC). This will be up for renewal in February 2019. Accreditation by AAAHC
reflects a very high standard of care and an ongoing commitment to improve the delivery of our standards
of care to the patients we serve. The Quality Improvement Division works to maintain accreditation
standards in our ambulatory facilities.
The Quality Improvement Division has also been assisting other Health Department Divisions in
achieving public health accreditation through the Public Health Accreditation Board (PHAB). The
purpose of this accreditation is to improve the quality of practice and performance; develop leadership
and strengthen relationships essential to public health services as a framework. The Department of Health
has made tremendous progress toward public health accreditation this year by maintaining and updating a
Quality Improvement and Performance Management Plan encompassing both clinical and public health
quality measures. A Workforce Development Plan increases human capital in our public health workforce
and further developing our Strategic Plan to meet our public health accreditation goals. The Department
of Health is well on its way to achieving Public Health Accreditation in 2019.
Accomplishments in 2018:
Participated in the review and approval of policies and procedures submitted to the Health
Department committee.
Submittal of approved Health Department-wide policies and procedures for final Health
Accreditation Board approval.
Disseminated Annual HIPAA training test for all Health Department staff.
Conducted annual Patient Satisfaction Surveys to study patient responses to services provided by
our clinics.
Hired a new Infection Prevention/Employee Health RN.
Completed annual comprehensive Infection Control Risk Assessment and Plan.
Tracked and reported all infectious and communicable diseases within the Health Department.
Provided a central point for open communication between tribal, local and WI State Health
Departments.
Developed a robust infection control surveillance and monitoring program.
Coordinated standardized infection control policies and practices across the whole Health
Department.
Collected and reviewed vaccination records for all Health Department employees to ensure health
of employees and patients.
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Assisted with AAAHC/PHAB accreditation efforts.
Represented Ho-Chunk Nation Health Department at Local, Regional and National Infection
Control Conferences.
Worked with multiple Health Dept. divisions to create a new hire orientation packet; final
approval of its implementation was granted, but new improvements will be forthcoming.
Verified licensing credentials and background checks for Health Department staff as needed.
Monitored Patient complaints to ensure that concerns are addressed.
Convened monthly Quality Improvement meetings.
Collaborative work was done with other Health Dept. Divisions to complete the PHAB (Public
Health Accreditation Board) domains and remain on schedule for Public Health Accreditation.
QI Director and a QI Officer attended Achieving Accreditation training through AAAHC.
QI staff attended and made contacts at a WI Collaborative for HealthCare Quality event.
Goals in 2019:
Continue to monitor quality improvement projects and peer reviews.
Continue to conduct annual audits of our programs.
Continue to review Patient Complaints to ensure patient health care satisfaction.
Continue annual patient satisfaction surveys and distribute results with Health Accreditation
Board.
Continue annual employee satisfaction survey and distribute results with staff and work to
address concerns.
Continue active participation in the Safety, Infection Control and Policies and Procedures
Committees.
Continue to verify licensing credentials and background checks as necessary.
Obtain password protection on all Health Department cell phones and laptop computers.
Staff will attend NAHQ (National Association for Healthcare Quality) Next – the leading
conference for the healthcare quality professional in Minneapolis.
Disseminate a workforce development plan meeting Public Health Accreditation Board standards.
Obtain full PHAB accreditation.
Achieve another three year accreditation term from AAAHC.
Obtain and implement comprehensive electronic compliance and training system to include
HIPAA and Blood Borne Pathogens.
Obtain certification in Infection Control (CIC) – Infection Prevention/Employee Health RN.
Create and disseminate public notifications and education related to infection control.
Continue implementing Infection Control plan to reduce risk.
Report Respectfully Submitted by: Daniel Libke, MTAG, Director of Quality Improvement
15
Quality Improvement Division Staff
Daniel Libke
Director of Quality Improvement
Jennifer Baird, RN
Infection Prevention/Employee
Health Nurse
Ritchie Brown
QI Compliance Officer
Andrea Mattison
QI Compliance Officer
16
Pharmacy Department Annual Report
Department Description:
The Ho-Chunk Nation (HCN) Pharmacy Department consists of pharmacy operations located at the
Health Care Center in Black River Falls, WI and the House of Wellness in Baraboo, WI. Each
location provides pharmacy services to distinct patient populations, which include Native
American/American Indian enrolled members of any Federally Recognized Tribe as well as non-
Tribal HCN Employees and any person presenting with a valid prescription. Each pharmacy
operation has two pharmacies within the pharmacy operation area, one State retail pharmacy and one
Federal Indian Health Service pharmacy. This innovative and complex pharmacy model creates a
special opportunity for revenue generation through enhanced clinical pharmacy services to all of the
patients served, and provides the highest level of health care.
Pharmacy Services:
All pharmacists possess a Doctor of Pharmacy (Pharm.D.) degree and are trained to offer
highly clinical pharmacy services.
All technicians possess a Certified Pharmacy Technician certificate, some having an
associates or bachelor’s degree, and assist the pharmacists with clinical pharmacy
services.
One Board Certified Psychiatric Pharmacist (BCPP) Prescriber and another pharmacist
preparing for BCPP to provide specialized psychiatric pharmacy coordination of care and
psychotropic medication therapy management.
One Certified Diabetic Educator (CDE) pharmacist to provide specialized diabetes
management beyond medications.
Pharmacists collaborate with other health department clinicians in a highly integrated
system to assist each patient with medical and behavioral health concerns and to improve
medication management.
Free prescription mail out services for patients across the country.
Non-Tribal member Prescription Co-Payment Incentive: Zero (0) co-pay for all generic
medications, $10 co-payment for 30 day and $20 for 90 supply of brand medications.
Future Goals and Development:
Priority goal is to implement formal customer service training and monitor each
pharmacy staff member’s performance on a monthly basis
Incorporate Ho-Chunk Nation traditions and culture into the pharmacy program through
language, customs, and art.
Continue to develop and implement marketing initiatives to increase pharmacy utilization
and revenue generation for the Ho-Chunk Nation.
Increase pharmacy contracting with Medicare Part D, Private, and Affordable Care Act
pharmacy insurance plans to increase revenue.
Create an advanced practice pharmacist position that serves as a non-physician medical
provider in order to improve pharmacist managed chronic condition therapy.
Implement a formal tobacco cessation clinic in collaboration with the medical clinic
Health Educators in order to improve the overall health of the community.
17
Implement a formal Medication Therapy Management (MTM) clinical service to ensure
safe, effective, and appropriate medication therapy for individuals with chronic health
conditions.
Annual Accomplishments:
Successfully achieved last year’s goal of implementing a mandatory chronic
medication/mail order program for HCN employees with the projected increase revenue
return to the Ho-Chunk Nation of an additional $4 million annually.
Continue to develop clinical pharmacy services including psychiatric pharmacy, diabetes
management, and medication therapy management. Additionally, an antibiotic
stewardship program through specialized pharmacist training and credentialing and
Indian Health Service Improving Patient Care Model.
Hired 1 additional pharmacist in order to successfully implement the mandatory
maintenance medication program and improve clinical pharmacy services provided to the
community.
Health Care Center Pharmacy preceptors mentored 3 University of Wisconsin Advanced
Pharmacy Practice Experience (APPE) students and 1 US Public Health Service Junior
COSTEP intern. House of Wellness Pharmacy preceptors mentored 4 University of
Wisconsin APPE students.
Increased utilization of the Tribal Pharmacies by non-Tribal employees and Tribal
members (see prescription volume chart)
Clinical Pharmacists increased participation on the medical team to provide the highest
level of patient care to Tribal Members and employees by participating in clinic visits
with the providers and staffing case management meetings.
Clinical Pharmacist staff involvement in Integrated Case Management monthly meetings
by assisting with patient-centered care plans and improving the quality of health care
provided to our consumers.
Implemented a medication safety program that tracks pharmacy errors in a database
which allows for identification of areas for improvement of processes and opportunities
for further training needs.
Health Care Center Pharmacy installed an additional pharmacy robotics ScriptPro
machine to improve safety, accuracy, and capacity for increased prescription volume.
Report Respectfully Submitted by: CAPT Ted Hall, PharmD, BCPP,RPh, Director of Pharmacy
18
Total Prescriptions Dispensed and Revenue Generation:
Total Prescriptions Dispensed:
F.Y. 2009- 34,836 F.Y. 2014- 65,882
F.Y. 2010- 36,391 F.Y. 2015- 66,367
F.Y. 2011- 55,738 F.Y. 2016- 66,833
F.Y.2012- 59,513 F.Y. 2017- 76,048
F.Y. 2013- 61,693 F.Y. 2018- 81,569
Total Revenue Generated:
F.Y. 2009- $2.34 Million F.Y. 2014- $5.03 Million
F.Y. 2010- $2.10 Million F.Y. 2015- $5.79 Million
F.Y. 2011- $3.34 Million F.Y. 2016- $6.18 Million
F.Y. 2012- $4.61 Million F.Y. 2017- $6.70 Million
F.Y. 2013- $3.64 Million F.Y. 2018- $7.69 Million
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Total Number of Prescriptions Dispensed
Total Number ofPrescriptions
0
2
4
6
8
10
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Total Revenue Generation
$ Million
Linear ($ Million )
19
CAPT Ted Hall, PharmD, BCPP, RPh
Director of Pharmacy
Dr. Amber Hanna
HOW-Pharmacy Manager
Dr. Hussain Harun
HOW-Pharmacist
Dr. Abigail Moore
HOW-Pharmacist
LCDR James Gabriel Buel
HHCC-Pharmacy Manager
Cynthia Dotson
HHCC-Pharmacist
Dr. Hussien Cheikhali
HHCC-Pharmacist
Pharmacy Department Staff
Dr. Melanie Hanson
HHHCC-Pharmacist
20
Laurie Dionne
HOW-Certified Pharmacy
Technician
Laurie Ammerman
HOW-Certified Pharmacy
Technician
Heather Marks
HOW-Certified Pharmacy
Technician II
Neile Decorah
HHCC-Certified Pharmacy
Technician
Sara Gebhardt
HHCC-Certified Pharmacy
Technician
Stacy Rios
HHCC-Certified Pharmacy
Technician
David Snowball
HHCC-Certified Pharmacy
Technician
Holly Dale
HHCC-Certified Pharmacy
Technician II
21
65% 8%
27%
Ho-Chunk Nation Department of Health Uses of Funds as a percentage - Fiscal Year Ending 06/30/18
Clinics
Behavorial Health
Community Outreach
45%
12%
43%
Ho-Chunk Nation Department of Health Sources of Funds as a percentage - Fiscal Year Ending 06/30/18
Service Revenue
NPD Distribution
IHS
Finance Division Annual Report
Functions and Divisions:
Billing and collecting third party insurance revenue for the Department of Health direct services and
operations.
Monitoring the overall expenses and revenue for the Department of Health.
Filing statistical and financial reports with the Centers of Medicare and Medicaid Services.
Managing third party payer contracts with Medicare, Wisconsin Medical Assistance and commercial
insurance companies throughout the United States.
Organizing and disbursing Indian Health Service appropriations to Department of Health programs.
Overseeing all Department of Health’s State of Wisconsin and Federal grants to ensure compliance with
grantee rules, regulations, reporting and audits.
Managing the Net Profit Distribution allocated from the Ho-Chunk Nation to all Health Department
programs as approved by the Legislature.
Managing Medical Records, Patient Registration, Accounting, Medical Coding, Accounts Receivable,
Utilities business office, Cashier and Collections, Health Information Systems, Benefits,
Purchased/Preferred Health, At-Large Health and Grants.
Cost Report Progress:
The Department of Health has completed and filed Medicare and Medicaid cost reports thru 2017.
Medicare cost reports are up to date and the Department of Health is actively billing and getting paid from
the Medicare program and the State of Wisconsin Medicaid program.
22
Goals and Achievements:
Become self-sustainable through the generation and collection of third party revenues as to no longer rely
on the Net Profit Distribution allocation.
Maintain and Advance the Tribal Self Governance Status as a Department of Health through The Centers
for Medicare and Medicaid Services as to better promote, create and maintain Ho-Chunk tribal health
programs.
Create a deficiency free financial audit environment.
Encourage and create an environment that allows for any tribal member that wants health insurance to
obtain individual health insurance.
Expand the Health Service Lines offered to the population in which the Ho-Chunk Nation tribal clinics
serve.
If you do not have health insurance please contact one of our benefits specialists at 715-284-9851 and ask
to speak with one of them about getting health insurance coverage under the Affordable Care Act.
What is the Affordable Care Act: The Patient Protection and Affordable Care Act (ACA), is a piece of
federal legislation commonly referred to as "Obamacare," which made sweeping changes to how health
insurance is purchased and paid for. Signed into law in 2010, ACA requires individuals who don't receive
health insurance benefits through their employers to purchase coverage or pay a penalty. (Native
Americans are exempt from this tax penalty) The law also puts certain limits on what insurers may or may
not do with respect to eligibility and coverage. The ACA has numerous, often-complex, provisions that
phase in over time, through 2022, if the current administration does not amend or repeal the plan.
To learn more about your specific benefits and or research other health insurance options please visit the
links below or call the numbers listed. A Benefits Specialist can assist you Monday through Friday
8:00a.m. -4:30p.m. Central Time.
Affordable Care Act Marketplace Enrollment is located at this web address - https://www.healthcare.gov/
Medicare https://www.mymedicare.gov/
Medicaid https://www.medicaid.gov/
This Report is Respectfully Submitted by: Wally Apland III, MHA, Chief Financial Officer-Health
23
Wally Apland, II
Chief Financial Officer-
Health
Casey Osborn
Accountant Kim Nelson
Junior Accountant Penny Ybarra
Junior Accountant
Jesse Mann
Junior Accountant
Cherisse Cherwenka
Junior Accountant
Cyndi Storandt
Junior Accountant-Utilities
Finance Staff
24
Emmalee Decorah
Junior Accountant
Liz Lund
Network Manager and
Contract Specialist
Janna Mallory
HOW-Cashier
Penny Zoephel
HHCC-Biller/Medical
Coder
Cassie Schober
HHCC-Biller/Medical
Coder
Deb Vanthournout
HOW-Biller/Medical
Coder
Louise Voss
Grant Writer
25
Joyce Rockman
Benefits Specialist
Supervisor
Sandra Lanier
HHCC-Benefits Specialist
Cynthia Tack
HOW-Benefits Specialist
Lynette Bird
Contract Health Services
Administrator
Cari Fay
Contract Health Services
Assistant Administrator
Benefits Staff
Purchased/Preferred Care Staff
26
Sarah Decorah
Contract Health Services
Patient Registration/Billing
Manager
Christie Becker
Contract Health Services
Patient Registration/Billing
Manager
Natalie Bird
At-Large Health
Coordinator
Barb Fankhauser
HHCC-Medical
Records/Patient Registration
Supervisor
Rebecca Davis
HOW-Medical
Records/Patient Registration
Supervisor
Patient Registration and Medical Records Staff
27
Sue Bjerke
HHCC-Medical Records
Tiffany Youngthunder
HHCC-Patient Registration
Donica Byrns
HHCC-Patient Registration
Ariana Youngthunder
HHCC-Patient Registration
Andrea Cole
HHCC-Patient Registration
Glen Decora
HOW-Medical Records Cheyenne Lonetree
HOW-Patient Registration Michelle Cloud
HOW-Patient Registration
28
Heather Roberts
Database Administrator
Tom Myher
Administrator
Tyler Doyle
Engineer
Jeanne Cowell
Administrator
Katie Kissane-TwoBears
Clinical Applications Coordinator
Health Information Systems (HIS) Staff
29
Matt Mallory
HHCC-Technician
Josie Cleveland
HHCC-Technician
Casie Lamorie
Programmer
Mike Puffer
HHCC-Technician
Kimberly Hutchens
Trainor/Purchasing
Evan Thompson
HOW-Technician
30
Ambient Air Monitory Station near
Blue Wing
Environmental Health Staff help
Head Start children during TOB Earth
Day Event
Environmental Health Services Division Annual Report
The Ho-Chunk Nation Environmental Health Services (EH) Division is a comprehensive program which
works to identify environmental hazards which affect the health of tribal members and the general public
served by Ho-Chunk Nation Enterprises. Programs and initiatives are directed toward assessing
environmental conditions, remediating existing hazards and preventing
environmental problems.
Key Tasks
The following environmental areas are addressed by the program:
Water Quality, Solid Waste Management, Wastewater Management,
Food Sanitation, Vector Control, Air Pollution, Institutional
Environmental Health, Code Compliance in Facilities, Community
Injury Prevention, Underground Storage Tanks, Environmental
Assessment, Emergency Preparedness, Surface Water Monitoring,
Wetlands Delineation, Construction Projects and Public Health
Accreditation.
Highlights for 2017-2018
The server rooms in each clinic, the Ho-Chunk Health Care Center (HHCC) in Black River Falls
and the House of Wellness (HOW) in Baraboo, were upgraded in 2018. These upgrades allowed
for upgraded fire protection systems, faster internet speeds and more secured data servers.
A handicap ramp was installed near the Behavioral Health entrance of the HHCC.
Funding has been secured through Indian Health Service for the replacement of the Ho-Chunk
Health Care Center roof. This project is estimated to be just over $300,000.
This year ninety-two (92) environmental health surveys were conducted in Ho-Chunk facilities to
assure that they are meeting recognized standards for food services, swimming pools,
campgrounds, Head Starts, day cares, hotels, mass gatherings and safety. Other departments rely
on these surveys to meet the requirements of their funding agencies or the gaming compacts. In
addition, during the last year twenty-two (22) environmental assessments were completed to
address mold, radon, indoor air quality and human health hazards
in individual tribal member’s homes.
During the last year the EH has spearheaded the implementation
and coordination for addressing abandoned homes and
“Drug/Party” homes in Ho-Chunk Communities. This was a joint
effort between Environmental Health, the HCN Police
Department, the HCN Department of Justice, the HCN Realty
Division and concerned tribal members. Seven (7) homes were
assessed under the Human Health Hazard Ordinance and six (6)
were deemed an immediate human health hazard and were secured
and placarded.
$250,000 was secured from IHS to fund an additional 40 homes
for well and septic services.
During the last year EH installed eight (8) new wells and four (4)
new septic systems for tribal members who could not be
connected to community systems.
During the last year eighty-five (85) water samples were drawn from tribal residences to assess
water quality.
During the last year EH assisted sixty (60) tribal members with emergency water or sewer issues.
31
Environmental Health Staff perform
Community Outreach with Baraboo
Schools at former Badger
Ammunition site.
Environmental Health Staff put
finishing touches on settling issues
around a septic tank
During the last year EH conducted over one hundred (100)
one on one educational sessions regarding the care and
feeding of well and septic systems.
The engineering and design work of the water and sewer
services for the Little Blackhawk subdivision are 100%
complete. The Little Blackhawk Subdivision is located south
of East Sand Pillow and this project will install community
water and sewer services for the twenty-seven (27) lots.
Grubbing for roads and utilities has been completed and
installation of the water lines, sewer lines and lift station will
begin in the fall/winter of 2018. This project is 100% NPD
funded.
Compliance Assistance Inspections and training was
completed for each of the Nation’s Whitetail Crossings for
the underground storage tank systems.
The Environmental Health Division’s Air Quality Program operated and maintained two (2) Air
Quality Monitoring Stations. The stations test outdoor air for dust particle pollution and also takes
weather measurements. The stations are located near the tribal communities of Mission and Blue
Wing.
The Ho-Chunk Nation’s EPA Clean Air Act Section 103 grant funding received an additional
$17,000, following talks between Environmental Health Air Quality Staff and EPA officials. The
Air Quality Program successfully completed and closed-out the three-year CAA 103 Grant
Project that begun in 2015. During the last year accomplishments were made towards achieving Public Health Accreditation.
This includes the securing of two (2) grants to support an update of the Community Health
Assessment and an update of the Health Department Strategic Plan. Documents have been
uploaded into the accreditation website which will meet national standards and measures.
EH secured staff support for Public Health Accreditation through the Centers for Disease Control
PHAP program. The program places a young professional with
the Tribe for two (2) years to assist them in public health efforts.
The program if fully funded through the Centers for Disease
Control.
Water Quality monitoring was completed on twenty-two (22)
tribal streams in 2017. Monitoring included chemical sampling,
fish surveys, macroinvertebrate sampling and habitat
assessments.
A Two Year Comprehensive Water Quality Assessment Report
was drafted for the 20 tribal streams monitored during the period
January 1, 2016-December 31, 2017.
Wetlands were delineated, classified and mapped on nine (9) trust
parcels totaling one hundred seventy-two (172) acres in Marathon
and Shawano counties. This information was incorporated into
the Geographic Information System (GIS) to assist other
departments with project planning.
Invasive plant treatments were completed on six hundred fifty-nine (659) acres of tribal land in
Shawano County using EPA Great Lakes Initiative grant funding.
Invasive plant treatments were completed on approximately sixty (60) acres of tribal land in
Jackson County during 2017 using BIA Circle of Flight grant funding.
32
Updated vinyl on the Motor Vehicle Injury
Prevention Trailer
Invasive plant treatments were completed on approximately seven hundred eighty (780) acres of
tribal land at the Sacred Earth parcel in Sauk County during 2017 using BIA Invasive Wildlife
Program grant funding.
The Environmental Science Program Manager provided hands-on environmental education
programs and/or presentations to approximately 150 tribal and non-tribal youth and adults on
multiple occasions including the annual Earth Day Event, U.W. Madison Capstone student field
trip, Ho-Chunk Summer Enrichment Program field days, NCCC AmeriCorps field trip and
WTCAC Forestry Subcommittee meeting.
Environmental reviews were completed for (5) BIA Road Program improvement projects, (11)
Indian Health Service residential projects and (2) forestry related projects. Technical support was
also provided to multiple tribal departments during the
year.
$106,667 in funding was acquired by DEH under a USDA
Natural Resources Conservation Service Environmental
Quality Incentives Program contract to install pollinator
habitat at the Sacred Earth parcel in Sauk County, WI.
$46,419 in funding was acquired by DEH under a USDA
Natural Resources Conservation Service Environmental
Quality Incentives Program contract to restore native
prairie and manage invasive species at the Sacred Earth
parcel in Sauk County, WI.
DEH worked with agency partners including The Nature
Conservancy, WDNR, Habitat for Humanity and USDA-
NRCS to develop an application and work-plan for a
NCCC AmeriCorps crew. The application was funded and
the crew will be providing approximately 560 work hours at the Sacred Earth parcel in July and
August 2018.
The Motor Vehicle Injury Prevention program finalized two (2) billboard designs that address
distracted driving. They are located on HWY 54 near Black River Falls and on County Road BD
near Baraboo.
The Motor Vehicle Injury Prevention Program trailer was updated with new vinyl to promote the
program and educate the community on distracted driving and seat belt use.
The Motor Vehicle Injury Prevention Project Coordinator held twelve (12) educational activities
to increase awareness of the consequences of distracted driving for the year. The Motor Vehicle
Injury Prevention Project Coordinator conducted six (6) child passenger safety seat observation
surveys. The observed child safety seat use rate was 81.6%.
During the year the Motor Vehicle Injury Prevention Program distributed one hundred seventy-
five (175) car seats.
During the year the Motor Vehicle Injury Prevention Program distributed sixty (60) bike helmets
to tribal children.
The Tribal Sanitarian has successfully obtained his Registered Sanitarian license.
The Environmental Health Department currently manages $5,614,646 which is broken down as
follows:
o $1,798,285 in IHS and other grant funding
o $1,387,900 in capital project funding for the Little Blackhawk water and sewer project
o 1,016,475 to manage the seven wastewater treatment plants
o $700,072 for Clean Water Fund Loan repayment
o $325,561 in NPD Operational Funding for Environmental Health
o $386,353 in NPD funding to provide housekeeping and maintenance services for the two
(2) Clinics
33
What’s in the Future?
The Environmental Health Services Division (EH) will be working on the following initiatives in the
next year:
EH will oversee the Utilities Program starting in July of 2018.
The Little Blackhawk Subdivision water and sewer project will be completed in the fall of
2018.
Six (6) duplexes will be connected to wells and septic systems on the Allen Property this
year.
The asphalt parking lots at the HHCC and Behavioral Health building will be resurfaced in
the summer of 2018.
The HHCC sterilization room will be remodeled during the summer of 2018.
The HOW optical will be expanded to add an additional exam room over the next year.
The HHCC nurses station will be expanded/remodeled over the next year.
The HHCC roof will be replaced over the next year.
The Ho-Chunk Village water system pump house valves will be upgraded fall of 2018 with
assistance from IHS.
A new well will be drilled at Indian Heights fall of 2018, with assistance from IHS, to address
high levels of iron and manganese in the current well.
Continue to work toward Public Health Accreditation.
Upgrade to an electronic software survey process for facility inspections and observational
surveys.
Establish SOP’s and Quality Assurance Plan for the newly constructed ambient air
monitoring stations. This will allow us to collect legally defensible data.
The Air Quality Program will be seeking “Treatment as a State” status under the Clean Air
Act.
DEH will be applying for EPA Brownfields Program funding in 2018 to establish a program
that will identify, inventory and address brownfields on land currently owned by the Nation
or lands to be acquired.
Seek additional funding through BIA, USDA-NRCS and other agencies to sustain invasive
species management and habitat restoration activities at the Sacred Earth parcel.
Assist agency partners with development of an application and work plan to fund a 2019
NCCC Americorps crew to work on tribal habitat restoration projects.
Report Respectfully Submitted By: Rob Voss, RS, Environmental Health Director
34
Rob Voss, RS
Environmental Health Director
Pam Thunder, RS
Environmental Health Program
Manager
Randy Poelma
Environmental Science Program
Manager
Matt Malimanek
Air Quality Specialist
Kevin Gunderson
Environmental Specialist
Steve Schwanebeck, RS
Tribal Sanitarian
Scott McManners
Sanitary Facilities Coordinator
Environmental Health Services Staff
35
Steve Christopherson
Utilities Coordinator
Renee Brocker
CDC Public Health Associate
Aaron Strandberg
Water Operator
David Forsting
Water Operator
Brock Burnstad
Water Operator
36
Sheryl Nichols
Health Facilities Manager
Tye Decorah
HHCC-Maintenance Worker II
Rick Johnston
HHCC-Maintenance Worker II
Tamara Relyea
HHCC-Maintenance Worker II
Todd Cloud
HOW-Maintenance Worker II
Tanjia Blackdeer
HOW-Maintenance Worker II
Maintenance Staff
37
Behavioral Health Employees
Prepare food for community event
Behavioral Health Annual Report
Brief Description of Behavioral Health
The Division of Behavioral Health (DBH) offers alcohol/drug and mental health outpatient services to
HCN tribal members and other federally recognized tribes in the following offices: Black River Falls,
Tomah, La Crosse, Wittenberg, Nekoosa, Madison and Baraboo. All DBH offices are dual licensed to
meet the requirements for DHS 75 – “Community Substance Abuse Services” and DHS 35 – “Outpatient
Mental Health”. The DBH were recently licensed to provide Tele-Health Services for comprehensive
psychiatric care. DBH provides the standards required in the delivery of behavioral health as well as tele-
health services and brings a uniqueness that integrates Ho-Chunk cultural values and beliefs with current
best practice models.
I. ACCOMPLISHMENTS
Urban Rural Women’s Grant – Ho-Chunk Nation funding continued for another year with
notification that the following years funding would be competitive. This grant assisted Ho-Chunk
families with wrap around services which included case
coordination to provide plans & objectives for participants
with Vocational Rehabilitation for Native Americans
Program out of Great Lakes Inter-tribal Council; First
Nations Community Financial, as well as Social Services
Life Skills Program to provide training for women in
everyday practical and financial skills, skills at hygiene for
the families and better housekeeping skills. There were 47
active clients during this fiscal year; of which 5 were
discharged in this duration, and 21 were new referrals during
that timeframe. Behavioral Health awarded the State
Targeted Response to the Opioid Crisis (STR) Grant in July
2017 for an award in the amount of $82,904.00. Serving 73
community members.
Behavioral Health awarded Methamphetamine and Suicide
Prevention Initiative Grant in the amount of $125,000. This
initiative will focus on prevention in the child and youth
population.
Behavioral Health awarded Indian Health Service Behavioral Health Integration Grant Initiative in
the amount of $500,000 for 3 years allowing the department to hire two additional Behavioral
Health Clinician as well as two Care Managers who will be licensed as an LCSW imbedded at the
nurses station to enhance the Behavioral Health Integration that is already in place within the
clinic.
Behavioral Health Reorganization announced February 5, 2018 by Executive Director of Health,
Ona Garvin the Behavioral Health Program will be undergoing an organizational restructure. The
following are the changes that are effective on February 5th, 2018. These assignments are
Temporary as we restructure and work on the Urban Rural Women’s and
Methamphetamine/Suicide Prevention and the extreme urgency to provide more immediate care
for those who are involved in behavioral health issues.
38
Behavioral Health at April Awareness
Event
Behavioral Health at April
Awareness Event
Tele-Health Licensing & Madison Branch Office Licensing obtained after collaborating with
Wisconsin Department of Quality Assurance site surveyor, Roderick Senn. Standards for both
were met and license was approved April1, 2018.
Behavioral Health’s electronic health record NextGen continues to be streamlined with training
guides developed for staff to create an environment of uniformity and consistency to assure the
department is remaining in compliance with both State and Federal guidelines.
We currently have a very strong integrative team approach at
the House of Wellness and at Ho-Chunk Health Care Center.
All medical, pharmacy, community health and behavioral
health staff meet on a monthly basis to discuss difficult cases
to improve the welfare of the tribal member.
We assisted the American Legion Post on the New Year’s
Eve Sobriety pow-wow this year. It was a great turnout and
Behavioral Health staff volunteered to help out with this
event.
Behavioral Health sponsored several prevention events this
year April Awareness at the D1 Community Center in Black
River Falls. There were about 25 tribal members that
participated in this event. Behavioral Health has been
involved with providing alcohol and other drug and mental health information for participants at
different events within the different departments such as the Diabetes Conference, employee health
day, Domestic Abuse Conference, Family Wellness Conference, Domestic Abuse events,
Financial Frenzy for youth and General Council.
Behavioral Health provides evidenced based practices approaches for counseling, such as: True
Thought (thinking errors/corrective thinking), DBT- Dialectical Behavioral Therapy, CBT –
Cognitive Behavioral Therapy, Motivational Enhancement Therapy, EMDR – Eye Movement
Desensitization Reprocessing, Mindfulness and Moral Recognition Therapy. BH staff has been
trained in the Matrix Model and began implementing in August 2017. We also provide the
following practice based evidence such as the Medicine
Wheel (12 steps), Mending Broken Hearts, Mothers of
Tradition, Fatherhood/Motherhood Is Sacred, New
Directions, Fathers of Tradition, Red Road to Wellbriety,
Seven Challenges, Healthy Relationships and Warrior Down.
Matrix Model groups, implemented in Black River Falls and
House of Wellness, meet in the evening to accommodate
community members who work during the day.
We now have two psychiatrist contracted to provide
psychiatric evaluations and medication management. Dr.
Katie Cannon from the White Earth reservation contracted
for 40 hours working at various locations and Dr. Randall
Cullen contracted part-time working at the House of
Wellness. The psychiatric referral process had to be
streamlined to assure prompt service for community members.
Ho-Chunk Nation Health Department – Pharmacy Division provides Medically Assisted
Treatment (MAT) services utilizing naltrexone, an opiate antagonist/blocker, as the primary
medication modality. The MAT for alcohol and opioid dependence program is a patient-centered
multidisciplinary integrated team model.
Kijire Nagu Healing Center has elected their Board of Directors. The board meets on a monthly
basis. As we continue to move forward we see the needs to change.
39
Behavioral Health has assisted with completing the Tribal Action Plan (TAP). With the
collaboration of several departments under the Ho-Chunk Nation the committee is known as Tribal
Coordinating Committee (TCC). The TCC have developed the TAP to establish the operating
framework and guidelines. Departments under the Nation that have been involved are Social
Services, Education, Labor, Justice, Law Enforcement, Housing (Tribal and HHCDA),
Legislature, Health (Community Health) and Clan Mothers.
The following is the number of tribal members that requested funding for inpatient treatment this
includes detox, inpatient treatment, Transitional Living and outpatient for At Large, these will be
further broken down. 38 treatment funding requests for a total of $$471,899.25 expended.
District # individuals
1 14
2 10
3 4
4 3
5 7
Gender # individuals
M 15
F 23
The following is the number of tribal members that requested funding for Detox Treatment. 7
requests for a total of $11,040.30 expended.
District # individuals
1 3
2 3
3 0
4 1
5 0
Gender # individuals
M 2
F 5
Number of Individuals that transitioned from Detox to Inpatient Treatment: 5
Gender
M 1
F 4
The following is the number of tribal members that requested funding for Inpatient Treatment. 32
requests for a total of $397,222.90 expended.
District # individuals
1 12
2 10
3 3
4 3
5 4
Gender # individuals
M 12
F 20
40
Number of Individuals that transitioned from Inpatient Treatment to Transitional Living: 5
Gender
M 3
F 2
The following is the number of tribal members that requested funding for Transitional Living. 6
requests for a total of $42,333.00 expended.
District # individuals
1 1
2 1
3 1
4 1
5 2
Gender # individuals
M 4
F 2
The following is the number of tribal members that requested funding for Outpatient Treatment. 6
requests for a total of $17,961 expended.
District # individuals
1 1
2 2
3 0
4 0
5 3
Gender # individuals
M 2
F 4
The following are the number of diagnosed clients with an addictive disorder, mental health
diagnosis and dually diagnosed that were seen between July 1, 2017 and June 30, 2018.
BH 07/01/2016 - 06/30/2017 07/01/2017 - 06/30/2018
total unique patients seen 959 1414
total mental health patients/dual
diagnoses
391
668
total alcohol dependence/abuse
diagnoses
380
460
total opioid dependence/abuse
diagnoses
84
116
total heroin 20 Data not provided
41
total cannabis 193 78
total meth 30 7
total other 45 85
Psychiatric Services Dr. Cannon 10/01/2017 - 06/30/2018
total # kept appointments 89
total unique patients seen
51
Gender breakdown Male 16 Female 35
Under 18 year of age 1
Over age 18 50
*please note Dr. Cannon start date was not a full fiscal year
Psychiatric Services Dr. Cullen 10/01/2017 - 06/30/2018
total # kept appointments 140
total unique patients seen
99
Gender breakdown Male 33 Female 66
Under 18 year of age 13
Over age 18 86
II. Problems and corrective actions taken
NextGen training guides continue to evolve however, with an upgrade forthcoming the
protocols will change again resulting in staff requiring to learn different procedures to
assure the department remains in compliance with state and federal licensing
requirements.
We need additional space for staff as writing for grants that could potentially hire
additional providers to meet the rising need for mental health providers in all areas.
URWG- With the assistance of one of the Care Coordinators, a new reporting system was
developed to assist with more accurate data for the Evaluator to complete their report to
the State.
URWG- More open communication with Care Coordinators regarding client services and
care team meetings.
42
III. Goals and strategies for the next fiscal year
Complete the policies and procedures for Behavioral Health to provide Intoxicated Driver
Assessments at each of the six outpatient offices. This can be also a 3rd
party billing
revenue for Behavioral Health.
URWG staff will participate in a program, which will certify them as Prevention or
Recovery Coaches. Provide supportive services to participants and meet the needs while
improving family unity. Provide education and knowledge about basic living skills,
financial budgeting, educational opportunities for further schooling, health lifestyle, job
skills, nutritional education, and other services which provide wellness and strong family
lifestyle.
Assist URWG staff to understand addictions, co-occurring disorders, and family
relationships.
IV. Partnerships
Continue to have working relationships and partnerships with the Department of
Corrections, Together for Jackson County Kids, Seven Challenges, Native American
Fatherhood and Families Association and other HCN departments.
Continue to work with billing to streamline process to assure timely billing occurs for
continued revenue.
Report Respectfully Submitted by: Evangeline M Suquet, MA, LPC, CSAC, Behavioral
Health Director
43
Evangeline Suquet
Behavioral Health Director
Dr. Katie Cannon
Psychiatrist
Terry Greendeer
Alcohol/Drug Abuse Program Manager
Whitney Sanchez
Urban Rural Women’s Grant Assistant-HHCC
Sharon Thompson
Urban Rural Women’s Grant Program Coordinator
Renee Rockman
Urban Rural Women’s Grant Assistant-Wittenberg
& Nekoosa
Behavioral Health Staff
44
Valerie Carrimon
Intake Specialist-HHCC
Mary Ann Dick
Urban Rural Women’s Grant Assistant-Tomah & La Crosse
Theresa Day
Urban Rural Women’s Grant Assistant-HOW
Ashley Jakel
Behavioral Health Clinician I-HHCC
Kimberly Waukau
Intake Specialist-HOW
Briana Hardyman Behavioral Health Clinician I-HOW
Lisa Bargender
Behavioral Health Clinician I-HOW
Stephanie White Eagle
Behavioral Health Clinician I-HOW
Michelle Schoolcraft
Behavioral Health Clinician I-HHCC
45
Rachael Dozer
Behavioral Health Clinician I-Wittenberg &
Nekoosa
Ruth Garvin
Behavioral Health Clinician II-Wellness
Court
Tracey Martin
Behavioral Health Clinician II-Tomah & La Crosse
Christine Preston Behavioral Health Clinician II-HOW
John Pleugers
Behavioral Health Clinician II-HOW
Diane Littel
Behavioral Health Clinician II-Nekoosa
Nicole Blang
Cognitive Intervention Behavioral Health Coordinator-HHCC
Christel Crocker
Substance Abuse Counselor-HHCC & Tomah
Hera Lonetree-Rindahl
Clinical Substance Abuse Counselor-HHCC
46
Donald Greengrass
Substance Abuse Counselor-HHCC
Jodie Tirado
Substance Abuse Counselor-HHCC
Aleta Yellow Thunder
Substance Abuse Counselor-Wittenberg
Joseph White Eagle
Substance Abuse Counselor-HOW
Lori Pettibone
Behavioral Health Community Coordinator-MSPI Grant-HHCC
47
Autumn White
Community Health Office Manager
Shoshanna Gomm
Community Health Office Manager
Jess Thill
Community Health Director
Community Health Annual Reports
48
Community Health Representative (CHR) Program Annual Report
Program Description:
As part of the Department of Health’s mission to promote a high quality of life with holistic
health care to those we serve with an emphasis on the traditional Ho-Chunk way of life and to
empower each individual and family to make informed decisions regarding their present and
future health the Community Health Representative Program (CHR) aims to create a workforce
that improves health across Ho-Chunk communities we serve.
CHRs have demonstrated how much they assist and connect with the community. Their work has
become essential to Ho-Chunk Nation. The CHRs are great advocates because they come from
the communities they serve and know specific tribal healthcare needs. Their dedication to the
community and their work has helped many who have had trouble having their healthcare needs
met. The health promotion and disease prevention efforts that Community Health
Representatives provide have helped people from the community improve and maintain their
health. The CHRs efforts also contribute to reducing tribal health expenses with health education
and health promotion. CHRs reach out and help people on an individual basis and are an
important part of the department’s operations.
29%
5%
1%
23% 5%
21%
4% 10%
2% Blood Pressure/Sugar Checks
WIC
Car Seats
Home Visits
Office Visits
Community Outreach
Transports
Case Management
Referrals
49
The Department of Health and Human Services released fiscal year 2019 Indian Health Services
Justification of estimates for appropriations committees budget shows the budget is no longer
funding the CHR program as "the budget prioritizes funding for direct health care services and
staffing of newly constructed facilities." As of January 1, 2019 the CHR program will no longer
exist and current staff are transitioning into roles which will continue services within the
Community Health Nursing program. We expect a smooth transition as this move occurs.
Report Respectfully Submitted by Jess Thill, Community Health Director
0
200
400
600
800
1000
1200
1400
1600
1-5 yrs. 6-18 yrs. 19-35 yrs 36-59 yrs 60+ yrs.
Male
Female
298 242
74 100
332
766
1466
1105
492
918
50
Diane Cayer CHR, Tomah
Linda Goodwin CHR, Nekoosa
Linda Delay CHR, Black River Falls
Community Health Representative Staff
51
SNAP Education Table
Diabetes Group Visits
Nutrition Program Annual Report 2018
Program Description and Services:
The Ho-Chunk Nation Nutrition Program is dedicated to serving
HCN Tribal members, employees and their families by providing
nutrition education at community events, diabetes classes, health
fairs, conferences and one-on-one Medical Nutrition Therapy
(MNT) for a variety of medical conditions such as diabetes, heart
disease and obesity.
Accomplishments:
Provided community outreach and nutrition education at Tomah, Black River Falls and Dells Organic
Community Gardens, Nutrition Cooking Classes & Demos, General Council, Diabetes Wellness
Conference, Pallet Gardens, Pedal & Pace, HCN Health Fairs, Partners in Parenting, HOW &
Nekoosa Youth Gardens, TAU Gardens, Harvest of the Month.
In an effort to combat obesity, prevent chronic disease and
health related complications the Nutrition Program provides
community outreach on a variety of nutrition education services
such as: handouts, displays, booths, presentations and cooking
demos/classes
Provided monthly nutrition education in all areas at WIC
Clinics, Head Starts, Youth Services, Tribal Aging Units, Food
Distribution Tailgates, TOB, HC- Gaming, Branch Offices and
Community Gardens.
Reached MNT revenue goal of $89,000 for fiscal year.
$108,720 in billed services
Continued community outreach by coordinating with Health and Wellness Team, Youth Services,
TAU and HHCDA by expanding community gardens, offering cooking classes/demos/presentations
on gardening/CSAs/Farmers Markets, providing cooking demos using commodity ingredients at
Food Distribution and submitting bi-monthly nutrition articles for publication in the Hocak Worak,
Youth, Elder and Branch Office newsletters.
Group WIC Head
Start
Youth Food
Dist
Adults
Elders
Direct
Contacts
215
619
1167
537
1619
470
Indirect
Contacts
396
558
599
235
1915
1122
52
Future Goals and Development:
Medical Nutrition Therapy (MNT) has been proven to be effective at decreasing complications
associated with chronic and obesity-related diseases, such as diabetes.
As a result, from January 1 - December 31, 2018, the Nutrition Program will seek to increase
revenue for MNT by HCN Registered Dietitian Nutritionists (RDNs) to over $102,054.
Monthly SNAP-Ed lessons will be provided to participants at HCN Head Start, WIC, Youth Services,
Food Distribution, Elders, etc. with the intent to promote healthy dietary and lifestyle choices.
From January 1, 2018 to December 31, 2018 the program will maintain or increase Registered
Dietitian Nutritionist (RDN) referrals by 30% or 361 total referrals to the program.
Increase MNT services to the Wittenberg and Tomah locations.
Report Respectfully Submitted by: Jess Thill, Community Health Director
WIC 5% Head Start
14%
Youth 25%
Food Distribution
11%
Adults 35%
Elders 10%
2017 SNAP Services
July 2017-June 2018 services
0
100
200
300
400
500
Home Visits Appointments Refferals Received Well Child referrals
Nutriton Program Services 2016-2018
2016 2017 2018*
53
Heather Jerzak BRF-Nutritionist
Jessica Jennings HOW-Nutritionist
Kathy Braaten BRF-Nutritionist
Kyla Ripp HOW-Nutritionist
Nutrition Program Staff
54
Food Distribution Program Annual Report
Program Description:
The Food Distribution Program of the Ho-Chunk Nation continues to provide USDA commodity foods to
eligible participants meeting lowered income guidelines and are federally recognized Native Americans
or elderly persons residing on or near Indian reservation lands.
The Food Distribution Program provides families with a food package and offers up to 75 food items in
canned, dried or fresh produce items consisting of fruit, vegetable, dairy, pasta, poultry, beef, cereal and
flour.
The Food Distribution Program’s main office is in Black River Falls where program services are available
daily at the main office/warehouse or on Wednesday’s during regularly scheduled distribution sites
referred to as “tailgate”. The tailgate services are offered in the communities of Wisconsin Dells,
Wittenberg, Tomah and Nekoosa.
The Food Distribution Program has a total of 6 employees: 1 Supervisor, 1 Secretary, and
4 Warehousemen. All employees are very knowledgeable and skilled in their respective responsibilities
and tasks. The staff are trained and certified annually in CPR(Cardio Pulmonary Resuscitation), Forklift
Operation, AIS(Automated Inventory System), OSHA(Occupational Safety & Health Administration)
Safety, HIPAA(Health Insurance Portability and Accountability Act) and are CDL(commercial drivers
license) qualified.
Accomplishments:
July 1, 2017 – June 30, 2018 – 5,425 certifications 3,478 households and 8,135 participants.
The Food Distribution Program issued 515,634.00 pounds totaling $489,813.00.
Purchased new passenger van with expanded cargo area.
4 staff attended National Conference and trainings for FNS-152 Handbook, Produce safety
certification, budgeting, nutrition education and Civil Rights certification.
Increase in fresh produce purchases and intake from participants.
Hired one additional Warehouseman.
Carryover funding from previous budget approved and utilizing for equipment upgrades.
Areas: Region
I
Region
2
Region
3
Region
4
Region
5
Counties: Wood
Portage
LaCrosse,
Monroe,
Trempealeau,
Vernon
Adams,
Juneau,
Sauk,
Columbia
Marathon
Shawano
Clark,
Eau
Claire,
Jackson
Families
Served
283
618
688
307
1582
Total
Served
3,478
55
Future Goals:
The Food Distribution Program will continue to offer quality service to our communities and
families in the 5 service areas.
Building equipment improvements in warehouse area and HVAC equipment upgrade.
Request for Urban waiver expansion to include Dane county and cities in Dane county that
exceed 10,000+population; Madison, Middleton, Fitchburg, Waunakee, Sun Prairie, Stoughton
and Verona.
Region I Region 2 Region 3 Region 4 Region 5
2017 302 574 793 306 1571
2018 283 618 688 307 1582
Counties: WOOD LA CROSSE ADAMS MARATHON CLARK
PORTAGE MONROE JUNEAU SHAWANO JACKSON
VERNON SAUK EAU CLAIRE TREMPEALEAU COLUMBIA
Report Respectfully submitted by: Andrew Rave, Food Distribution Program Supervisor
0
200
400
600
800
1000
1200
1400
1600
1800
2017 2018
Region 1
Region 2
Region 3
Region 4
Region 5
56
Andrew Rave Food Distribution
Program Supervisor
Susan Wilcox Food Distribution
Secretary
Gabriel Casey Food Distribution Warehouseman
Robin Flick Food Distribution Warehouseman
Larinna Chandler Food Distribution Warehouseman
Jeffery Harrison Food Distribution Warehouseman
Food Distribution Staff
57
Health and Wellness Division Annual Report
The mission of the Ho-Chunk Health and Wellness Division is to promote a healthy
lifestyle among the Ho-Chunk people. Health promotion activities will be
performed through an interdependent partnership between the Ho-Chunk Nation
Health Care Delivery System and the Ho-Chunk communities. The partnerships will
facilitate Nation-wide efforts to raise the level of wellness among Ho-Chunk tribal
members. The purpose of the team is to develop, implement and evaluate a
comprehensive health promotion program targeted toward educating,
energizing and empowering communities.
Services and Programs Offered:
-Diabetes Prevention Classes
-CDC National Diabetes Prevention Program Prevent T2
-IHS Balancing your Life and Diabetes Workshops
-One on One Diabetes Prevention Consults with a Certified Diabetes
Educator
-Fitness Classes
-One on one fitness consults
-Boot Camp
-HIIT Classes (High Intensity Interval Training)
-Yoga
-Yoga/Pilate Fusion Classes
-Elder Fitness
58
-Family Fitness
-Kickboxing
-Tai Chi
-Community Supported Agriculture Shares
-Over 25 Certified Organic Farm Vendors throughout WI and the USA
provide fresh fruits and vegetables weekly of bi-weekly.
-Fitness Membership Program
-157 current gym and fitness facilities approved for use throughout WI
and the USA.
-Provides over 1200 tribal members with 6 month fitness memberships.
HIGHLIGHTS
Community Supported Agriculture Shares
Tribal Member Patricia Reyes
When I first saw a flyer for the CSA: Community Supported
Agriculture Shares for Ho-Chunk tribal members, I thought
wow fresh fruit and vegetables weekly for 20 weeks for my
family of 5 for a $30.00 co-pay is very affordable!
We chose Orange Cat Community Farm initially because the name and location. Then came the
weekly email reminders for pickup that include a newsletter of the goings on at the farm, how the
weather was impacting the crops, farm tour invites to get to know the farm and the workers,
come out for a “pick day” when the peas, corn, tomatoes, pumpkins were ready and of course the
recipes with tips on how to store the food to last longer.
This being our second year it’s still fun to see what is in the
weekly box and the interest our children now have in what and
how that vegetable will be used in our meal. A few times we
had to look up what exactly the vegetable was and what to
make with it.
We are thankful to the HCN Department of Health for the
CSA: Community Supported Agriculture Shares because this
program provides us with regular access to fresh fruit and vegetables during the growing season
and gets my kids excited about eating fresh and local food.
Patti Reyes and Family
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Diabetes Prevention within the Ho-Chunk Nation:
The Ho-Chunk Nation Diabetes Prevention Program efforts have been ongoing since it began in
1997. The Health and Wellness Division works through funding provided by the Special
Diabetes Grant for Indians from Indian Health Service. Diabetes is another leading health
indicator to use when determining the health of a population. The Ho-Chunk Diabetes audit, data
from 2013-2017 of patients who live in the Contract Health Service Delivery Area (CHDSA),
indicated that approximately 70% of the patients with diabetes were obese. It also revealed that
25%-35% of patients with diabetes had blood pressure levels greater than the recommended
value (140/80). Approximately one-third of patients with diabetes had blood-sugar levels equal
to or less than the recommended goal for the HbA1c test (7.0%), which points to two-thirds of
our population having uncontrolled blood sugars in the previous three months. In order to
prevent the very serious health consequences of type 2 diabetes, such as heart attack and stroke,
much work is needed to support patients in managing their chronic diseases. The Health and
Wellness Division is currently a CDC Recognized National Diabetes Program Provider. This
allows us to facilitate Evidence Based Diabetes Prevention Programming in the form of the
Prevent T2 classes. These classes are a yearlong and focus on the importance of achieving a 5%-
7% weight loss and achieving 150 minutes of physical activity a week. The Indian Health
Service Based Curriculum is the Balancing your Life and Diabetes workshop that is facilitated
over the course of 2 days.
The following chart shown is the last 4 years of SDPI Key Measures that are achieved over the
course of a funding year. It is important to note that the reporting is done in January of the New
Year for the data of the previous year. IE: the 2018 percentages is the final data from 2017.
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Annual Journey of Hope Conference:
In November 2017 the Health and Wellness Team offered the Annual Journey of Hope
Conference to raise awareness and provide diabetes education to the 289 participants that were in
attendance.
Diabetes Workshops and Prevention Classes:
7 classes to learn the basics of diabetes management.
235 Participants have completed all seven classes.
Locations in Black River Falls, Wittenberg, Tomah, Baraboo, Nekoosa, Madison and
La Crosse
87% of program participants showed improvement in A1C or stayed managed at 7% or
less.
Of all the program participants with pre and post knowledge tests, 95% showed
improvement or maintained.
Youth Diabetes and Obesity Prevention Assessment:
The Ho-Chunk Nation Health and Wellness Division is currently facilitating a youth health
assessment to determine the current state of well-being in our youth. This assessment will assist
in the creation of programs to promote the health of our youth in our communities and in the Ho-
Chunk Nation. We firmly believe that in order to ensure the health of the Ho-Chunk Nation and
further halt the prevalence of chronic diseases we need to focus our attention and efforts on our
youth.
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Food Sovereignty Projects:
The Health and Wellness Division has worked diligently along with HHCDA and Youth
Services to increase the number of Community Organic Gardens and Youth Gardens throughout
the state of Wisconsin. The blueberry plants pictured are at the Nekoosa youth service location.
Community Outreach and Events
Notah Begay Healthy Kids, Healthy Futures Kickoff Event
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Culture Camp
Annual Canoe Trip
This Annual Canoe Trip is primarily
held at the Wildcat Mountain State
Park on the Kickapoo River in
Ontario, Wisconsin. This past canoe
trip the Health and Wellness Division
had over 60 tribal members
participate in this great family event.
Tribal member Georgiana LaMere
stated that, “This is one of the
greatest hoocak family events out
there, for real.”
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Youth Services Collaborations
Incorporating Culture into Wellness Programs:
Many interventions, programs, and services the
Ho-Chunk Nation Health Department offer are
focused on changing individual behaviors:
smoking, unhealthy eating, lack of exercise,
weight loss and excess drinking. While it does
help to offer these programs and services, a
broader approach that includes families, youth
groups, communities, worksites and tribal
government supported policies are necessary.
According to the Community Health Assessment
data, the majority of residents believe they are in
good health. (Approximately 4 out of 10 people reported having good health and over one
quarter of all respondents reported having very good health). Despite the data indicating higher
prevalence chronic disease in American Indians, this self-identified ranking of health speaks to
our community’s spirit. Maintaining and improving the Ho-Chunk Nation’s health will take a
concerted effort and resources. The Health and Wellness Division is devoted to encouraging
better health and we will address our high prevalence of risk factors for chronic disease by
implementing cultural activities which connect our tribal community to traditional teachings,
foods and activities. These cultural activities will build tribal members resiliency and
connections to their heritage. Building pride and passion about our Ho-Chunk traditions will
create healthier lifestyles for tribal members which will decrease the prevalence of chronic
disease within the Ho-Chunk community.
The Health and Wellness Division
collaborates often with Ho-Chunk
Nation Youth Services Division in
every location to provide fitness
education, cultural events, diabetes
prevention and other health
prevention events. The Health and
Wellness Division also assists in
ensuring the centers have easy
fitness equipment such as yoga
mats, hula hoops, jump ropes, etc.
to further the goal of increasing
physical activity in our youth.
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Health and Wellness Division
Short Term Goals:
By December 2018 have 500 active memberships in the fitness program.
By December 2018 increase the number of dental, vision and foot exams in program
participants.
By December 2018 30% of participants in the Prevent T2 program will meet 5% to
7% weight loss goal.
By January 2019 obtain CDC permanent recognition status for the National
Diabetes Prevention program.
Obtain the Ho Chunk Nation BMI baseline data for Ho Chunk enrolled youth and
descendants.
Long Term Goals:
Increase retention of participants in the Prevent T2 program and Balancing Your
Life & Diabetes Workshops.
Reduce the prevalence rate of childhood obesity by 5% by December 2020
Become an ADA (American Diabetes Association) Accredited program
Continue to host the Journey of Hope Conference each year.
Increase the frequency of cultural relevancy into our wellness programs offered.
Host an annual “Reclaiming Our Health” Round Dance family gathering each fall.
Letter from the Health and Wellness Division Supervisor
Greetings Relatives,
This past year has flown by. The Health and Wellness Division is continuing to provide the
Ho-Chunk People with the most up to date and current information and education in regards
to Diabetes Prevention and Physical Fitness. My dedicated staff have a wealth of knowledge
with several of them having over 10 years of service in this program. We will continue to
devote all of our time and energy in to the communities we serve. A special Thank You goes
out to all of our participants in our programs.
Thank you!
Sincerely,
Sara Peterson, Health and Wellness Coordinator
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Sara Peterson
Health and Wellness Program Coordinator
Jess Artz
Nekoosa/Wittenberg-Exercise Physiologist
Chris Frederick
HOW/Tomah-Exercise Physiologist
Kathleen Clemons BRF-Exercise Physiologist
Rebecca Krause
Fitness Membership/CSA Secretary
Lyndsey Killian Program Recruiter
Rachel Montana Program Recruiter
Health and Wellness Staff
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Community Health Nursing (CHN) Annual Report
The Community Health Nursing (CHN) Program promotes and preserves the health of the Ho-Chunk
population by combining skills and knowledge relevant to both nursing and public health. The practice is
comprehensive and general; not limited to a particular age or disease related group. Nursing services are
divided between care for the individual, care for the particular community and care for the population.
The goal is to provide health education and care for all Ho-Chunk and other Native Americans who reside
within the Contract Health Services Delivery Area (CHSDA).
ALL LOCATIONS:
CHN over the last fiscal year has provided 52,131 total patient contacts
Public Health Accreditation: Working to become Accredited.
Contract Services for In Home Care:
Contracted Services have allowed for over 32,504 hours of after-hours services.
32 contracts placed (78% are HCN Tribal Members)
32 elders served from contracts
24 continue to be active
Managed Care Organizations (MCO):
Contracts with Managed Care Organizations in CHSDA to receive reimbursement for services rendered.
Reimbursement Revenue: $45,845.85
Personal Care Agency Certification maintained.
0 5000 10000 15000 20000 25000 30000
Nurse Home Visits (2273)
Patient Education Hours(1,183.5
Telephone calls (26039)
Nurse Office visits (892)
Immunizations (820)
Case Management (7,197)
Caregiver Home visits (9,302)
Caregiver Transports (4,696)
WIC Visits (337)
MCH Visits (634)
Foot Care (564)
HIV Tests (107)
Condoms Distributed (16996)
HIV Prevention Program Patient Contacts (1036)
Cribs Distributed (32)All Locations: CHN Responsibilities
Tribal Members by CHSDA Areas: BRF 920 HOW: 888 Tomah: 350 Nekoosa: 475 La Crosse: 262 Wittenberg: 409
CHSDA Total: 3,304
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CHN over the last fiscal year has provided the following services:
571 Home visits and 15,448 total patient contacts
38 unduplicated elders received home care
Caregiver over the last fiscal year has provided the following services:
833 transports for medical services
2,873 home visits (activities of daily living, cleaning, medication reminders, meal prep,
etc.)
Trisha Jacox, RN, BSN, CHN Supervisor (Black River Falls, La Crosse, Wittenberg):
Member of: Health and Wellness Team, Tribal Coordinating Committee, Task Force for
Drug Free Communities, Neonatal Abstinence Syndrome Training and Public Health
Accreditation Committee
Lindsey Minard RN, BSN, CHN:
Training: Leadership Training, Cultural Training, Narcan Training, Upcoming-Foot and
Nail care
Jeni Tuschner RN, BSN, CHN:
Training: Leadership Training, Cultural Training, Narcan Training, Upcoming Foot and
Nail Care
Allie Isaacson, RN, BSN, CLC, CPS, CHN:
MCH Block grant co-coordination; HCN local coalition, HCN Breastfeeding Coalition
Training: WALC Breastfeeding Conference , Women’s Leadership Training, Neonatal
Abstinence Syndrome Training
Preceptor for UW-Madison and Edgewood Nursing Students
Certification: maintained Certified Lactation Counselor and Child Passenger Safety Seat
Technician, First Breath, My Baby and Me trained and Safe Sleep Trainer
Partners In Parenting classes monthly at Black River Falls
0 2000 4000 6000 8000 10000 12000
Nurse Home Visits (571)
Patient Education Hours (241.5)
Telephone calls (11,313)
Nurse Office visits (77)
Immunizations (200)
Case Management (812)
Caregiver Home visits (2873)
Caregiver Transports (833)
WIC Visits (169)
MCH Visits (211)
Foot Care (50) BRF CHN/Caregiver Contacts & Services
Tribal Members BRF Area: Jackson: 1321 Clark (half) 32 Eau Claire: 127
BRF Total: 1480 (26%)
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CHN over the last fiscal year has provided the following services:
405 Home visits and 14,438 total patient contacts
31 unduplicated elders received home care
Caregiver over the last fiscal year has provided the following services:
2352 transports for medical services
3204 home visits (activities of daily living, cleaning, medication reminders, meal prep,
etc.)
Accomplishments:
Kalli Koerner RN, BSN, CHN Supervisor (HOW/Nekoosa/Tomah)
Member of: Tribal Coordinating Committee
Certifications: ACLS, PALS, NRP, TNCC
Co-Coordinator HCN HIV Prevention Program/Grant
Training: Leadership Training, Cultural Training, Diabetes and Dimentia Training and
Alzheimer’s Training
Kandi Ryan, RN, CHN:
Trainings: Native Nurses Summit, Transcultural Nursing Seminar, UW Preceptor
Workshop, Public Health Nursing Conference, VFC training, ADRC Train the Trainor
Friendly Workplace, Wisconsin Public Health Nursing Conference, Cultural Training and
Supervisory Training
Preceptor for UW-Madison and Edgewood Nursing Students
Irina Clendenning, RN, BSN, CHN:
Training: Leadership Training, Nursing Preceptor Training, Cultural Training, Dementia
and Diabetes Training and Alzheimer’s Training
Serena Jahnke-Berg, RN, BSN, CLC, CPS, CHN:
MCH Block grant co-coordination; HCN local coalition, HCN Breastfeeding Coalition
Training: WALC Breastfeeding Conference, Leadership Training, Cultural Training,
Neonatal Abstinence Training, Women’s Leadership Training and Perinatal Conference
0 1000 2000 3000 4000 5000 6000 7000 8000 9000
Nurse Home Visits (405)
Telephone calls (8290)
Patient Education Hours (482)
Nurse Office visits (92)
Immunizations (203)
Case Management (3,894)
Caregiver Transportation (2352)
Caregiver Home visits (3,204)
WIC (105)
MCH visits (285)
Foot Care (116) HOW CHN/Caregiver Contacts & Services
Tribal Members HOW Area: Dane: 311 Sauk: 698 Columbia: 132 Juneau (half) 136 Adams (half) 25
HOW Total: 1302 (23.6%)
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Certification: Certified Lactation Counselor, Child Passenger Safety Seat Technician,
First Breath, My Baby and Me trained and Safe Sleep Trainer
Partners In Parenting classes monthly at House of Wellness
CHN over the last fiscal year has provided the following services:
241 Home visits and 6,511 total patient contacts
14 unduplicated elders received home care
Caregiver over the last fiscal year has provided the following services:
627 transports for medical services
1266 home visits (activities of daily living, cleaning, medication reminders, meal prep,
etc.)
Accomplishments:
Lindsey Schaub, RN, BSN, CLC, CPS, CHN:
Member of HCN Breastfeeding Coalition, Monroe County Child Death Review (partial
year), Monroe County Mental Health Workgroup
Certifications: Certificated Lactation Counselor, Child Passenger Safety Technician,
Neonatal Abstinence Syndrome Training, STAR Training, Alzheimer’s Training and
Understanding Compassion Fatigue
Training: PHN Conference Supervisory Training
Preceptor: Viterbo University Nursing Students
0 500 1000 1500 2000 2500 3000 3500 4000 4500
Nurse Home Visits (241)
Telephone Calls (4189)
Patient Education Hours (312)
Nurse Office visits (38)
Immunizations (58)
Case Management (888)
Caregiver Home visits (1266)
Caregiver Transports (627)
MCH Visits (2)
Foot Care (112)Tomah CHN/Caregiver Contacts & Services
Tribal Members Tomah Area: Monroe: 446 Juneau (half) 136
Tomah Total: 582 (10.6%)
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CHN over the last fiscal year has provided the following services:
434 Home visits and 3,521 total patient contacts
25 unduplicated elders received home care
Caregiver over the last fiscal year has provided the following services:
342 transports for medical services
1,228 home visits (activities of daily living, cleaning, medication reminders, meal prep,
etc.)
Accomplishments:
Pam Reimer, RN, CLC, CPS, CHN:
Co-Coordinator HCN HIV Prevention Program/Grant, CPR Instructor, CPS Technician
Training: Suicide Prevention Conference, Quarterly HIV Tribal Coordinator, WALC
Breastfeeding Conference, Supervisory Training, Cultural Training, Understanding
Compassion Fatigue and Neonatal Abstinence Syndrome Training
Certification: Child Passenger Safety Seat Technician, Certified Lactation Counselor,
First Breath and My Baby and Me trained
Nurse Home Visits (434)
Telephone calls (1,304)
Patient Education Hours (240)
Office visits (100)
Immunizations (189)
Case Management (560)
Caregiver Transports (342)
Caregiver Home visits (1,228)
MCH (51)
WIC (63)
Foot Care (30)
0 200 400 600 800 1000 1200 1400
Nekoosa CHN/Caregiver Contacts & Services
Tribal Members Nekoosa Area: Marathon (half): 52 Clark (half): 32 Adams (half): 25 Wood: 355
Nekoosa Total: 464 (8.4%)
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CHN over the last fiscal year has provided the following services:
185 Home visits and 4,733 total patient contacts
18 unduplicated elders received home care
Caregiver over the last fiscal year has provided the following services:
144 transports for medical services
385 home visits (activities of daily living, cleaning, medication reminders, meal prep,
etc.)
Accomplishments:
Megan Marks, RN, BSN, CLC, CHN:
Training: Wound Care Associate, Supervisory Training, Leadership Training,
Alzheimer’s Training, STAR Training and Cultural Training.
Certifications: Certified Lactation Counselor
Preceptor: Viterbo University Nursing Students
Covered short staffing in BRF; has provided foot care training in Black River Falls
Nurse Home Visits (288)
Telephone calls (2351)
Education (245)
Nurse Office Visits (185)
Immunizations (89)
Case Management (247)
Caregiver Home visits (358)
Caregiver Transports (144)
MCH (1608)
Foot Care (58)
0 500 1000 1500 2000 2500 3000 3500 4000
La Crosse CHN/Caregiver Contacts & Services
Tribal Members La Crosse Area: La Crosse: 287 Vernon 16 Crawford 4
La Crosse Total: 307 (5.6%)
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CHN over the last fiscal year has provided the following services:
399 Home visits and 3, 874 total patient contacts
22 unduplicated elders received home care
Caregiver over the last fiscal year has provided the following services:
398 transports for medical services
373 home visits (activities of daily living, cleaning, medication reminders, meal prep,
etc.)
Accomplishments:
Ronelle McKernan, RN, BSN,CLC, CHN:
Training: Supervisory Training, Child Passenger Safety Technician, QPR-Suicide
Prevention, Cultural Training and STAR Training
Certifications: Certified Lactation Counselor
Covered short staffing in BRF
Report Respectfully Submitted by: Trisha Jacox, RN and Kalli Koerner, RN, Community Health
Nursing Supervisors
Nurse Home Visits (399)
Patient Education Hours (441)
Telephone calls (5122)
Nurse Office Visits (105)
Immunizations (82)
Case Management (58)
Caregiver Home visits (373)
Caregiver Transportation (398)
MCH (73)
Foot Care (95)
0 1000 2000 3000 4000 5000 6000
Wittenberg CHN/Caregiver Contacts and Services
Tribal Members Wittenberg Area: Marathon (half): 52 Shawano: 158
Wittenberg Total: 210 (3.8%)
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Trisha Jacox, RN CHN Supervisor
Kalli Koerner, RN CHN Supervisor
Allie Isaacson, RN
Maternal Child Health Nurse
Lindsey Minard, RN
BRF Community Health Nurse
Jeni Tuschner, RN
BRF-Community Health Nurse
Irina Clendenning, RN
HOW-Community Health Nurse
Kandi Ryan, RN
HOW-Community Health Nurse
Serena Janhke-Berg, RN
HOW-Community Health Nurse
Community Health Nursing Staff
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Pam Reimer, RN
Nekoosa-Community Health Nurse
Lindsey Schaub, RN
Tomah-Community Health Nurse
Megan Marks, RN
La Crosse-Community Health Nurse
Ronelle McKernan, RN
Wittenberg-Community Health Nurse
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Trevor Little Soldier Supportive Care Worker
Pam Rousch HOW-CNA
Reva Decorah HOW-CNA
Ashley Buege HOW-CNA
Sandra Delarosa HOW-CNA
Samantha Defosse HOW-CNA
Jennifer Plueger Tomah-CNA
Erica Laffin HOW-CNA
Sinda Kagigebi HOW-CNA
Certified Nursing Assistants
76
Fonda Blackdeer Tomah-CNA
Barb Kmetz Tomah-CNA
Diane Kleinhenz Nekoosa-CNA
Rachel Skaar Nekoosa-CNA
Breeanna Walker Wittenberg-CNA
Terri Bluebird La Crosse-CNA
Shelby Decorah Wittenberg-CNA
Alicia Crocker La Crosse-CNA
Regina Reel BRF-CNA
77
Betty Blackdeer BRF-CNA
Elisha Reetz BRF-CNA
Gale White BRF-CNA
Cindy Kirschenmann BRF-CNA
Megan McCormick BRF-CNA
78
Contact Information
Black River Falls:
Ho-Chunk Health Care Center
N6520 Lumber Jack Guy Road
Black River Falls, WI 54615
888-685-4422
*Behavioral Health located
within the Ho-Chunk Health
Care Center
Wisconsin Dells:
House of Wellness Clinic
S2845 White Eagle Road
Baraboo, WI 53913
888-552-7889
Black River Falls:
Community Health Building
W9850 Airport Road
Black River Falls, WI 54615
888-685-4422
La Crosse Health Office:
Three Rivers House
724 Main Street
La Crosse, WI 54601
608-784-3083
Nekoosa Health Office:
1021 County Hwy G
Nekoosa, WI 54457
715-886-5444
Tomah Health Office:
430 Julie St. Suite 2
Tomah, WI 54660
608-372-0889
Wittenberg Health Office:
W17634 Radke Road
Wittenberg, WI 54499
715-253-2382