Navajo-Hopi Nations,Flagstaff & Winslow News
Sat, June 06

'ResourceSmart' to provide programs and services to Tuba City patients

TUBA CITY, Ariz.- Historically, Native Americans have received health care from the Indian Health Service (IHS), an arm of the U.S. Department of Health and Human Services. In receiving services through a local IHS hospital or with local Contract Health Services paying for services elsewhere, there has been something of a myth that unlimited funds were available to take care of everyone's health care from the government.

Through self determination, Tuba City Regional Health Care Corporation (TCRHCC) and several other Navajo Area IHS hospitals have become independent health care corporations in recent years. IHS now funds only a portion of the health care needs provided by these new corporations.

TCRHCC, located in Tuba City in the western Navajo Nation, provides primary care to roughly 27,500 Navajo, Hopi and San Juan Southern Paiutes, including Native Americans residing in Flagstaff. With a local population growing at approximately twice the growth rate of the overall U.S., TCRHCC expects to serve as many as 30,400 individuals by 2015. TCRHCC also serves as a referral medical center for a much larger population (presently 75,000 people) from across the Navajo Nation and adjacent communities.

In fiscal year 2007, IHS provided just 45 percent of the revenues of TCRHCC. All other funds to provide for the patient health care needs came from "third parties." Third parties include entities such as Medicare, Medicaid - AHCCCS coverage, the Veteran's Administration (VA), and private (employer) health insurance plans. Patient Financial Services, formerly the Business Office, at TCRHCC now works to recoup payment for services from sources such as these, and others. In order to provide effective health care to everyone in the community, it is important to recoup as many dollars from these third party sources as possible.

An initiative called "ResourceSmart" is designed to match community members with as many third party resources, additional benefits and services as possible. ResourceSmart is administered by the Patient Benefits Coordinators at TCRHCC.

The process of applying for some programs can be overwhelming. The patient benefits coordinator is knowledgeable about federal and state programs and can help people determine which are right for them and their families. Assistance is readily available for applying for such programs and additional resources.

Many individuals qualify for direct payments and/or reimbursements for health care and related costs from one or more programs. Additional resources can provide a number of benefits for family members, such as supplementary health care coverage for children, transportation and living assistance for the elderly, medical equipment for sick and disabled persons, vocational and other services for military veterans, income for dependents of disabled persons, and more. Eligible individuals might receive supplemental income, food subsidies, housing assistance and more. A person may qualify for any number of federal and state programs, as well as benefits programs through their employer or their spouse's employer, such as:

Medicare - A national health care program of the Centers for Medicare and Medicaid Services. Medicare covers people 65 years of age and older, individuals under 65 who are disabled, retired persons with end stage renal disease (ESRD), and others, such as retired railroad employees.

Medicare Part A - Inpatient hospital services, skilled nursing facilities, home health and hospice care.

Medicare Part B - Outpatient hospital services, doctors, certain medical equipment, and other items not covered under Part A.

Medicare Part D - Prescription medication coverage.

Social Security Disability Insurance - If you are disabled, this program may pay benefits directly to you and certain members of your family.

KidsCare - Arizona's State Children's Health Insurance Program (SCHIP), provides health care

insurance to Arizona children 18-years-old or younger. Parents of children covered by KidsCare health insurance may also qualify for health insurance.

Supplemental Security Income (SSI) - If you are blind and disabled, you may qualify for additional income.

Veterans Administration (VA) - If you are a veteran, you and your family may qualify for health care and other benefits.

Medicaid - Provides resources to help pay for medical and long-term care assistance. Coverage and name varies by state.

Medicare Savings Program - Pays for some of all of Part A, B and D premiums, deductibles, and coinsurance.

Private Health Plans - You and your dependents may be eligible for health insurance from you or your spouse's employer.

Being ResourceSmart means learning about and enrolling in programs and services that may be available to an individual or family. The patient benefits coordinators at TCRHCC can give you all the information needed to qualify; begin by calling (928) 283-2781. They will also be available at the Just Move It events in western Navajo, sponsored by the TCRHCC Health Promotion and Disease Prevention program.

TCRHCC, located in Tuba City, consists of a 73-bed acute care referral hospital and integrated health system. It provides a broad range of outpatient specialized care services in addition to inpatient care. The patient population includes Navajo, Hopi and San Juan Southern Paiute. Its mission is to provide accessible, quality, culturally sensitive health care.

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