Arizona Department of Health Services 

Native American Semi-Annual Report 

July - December 2005 

OFFICE OF THE DIRECTOR 

Native American Liaison 

The Native American Liaison participated in the following major activities and 

events: 

• Attended the Four Corner Public Health Bio-terrorism Conference in 

Durango, Colorado in July 2006. 

• Assisted in the hiring process for the Bureau of Emergency Preparedness 

and Response (BEP&R) Native American Coordinator position. 

• Assisted the BEP&R in the sponsorship of five Native American Public 

Health Bio-terrorism Emergency Preparedness and Response Regional 

training sessions held between July-September in Flagstaff, Hon Dah, Ft. 

Mojave, Salt River, and Casa Grande. 

• Assisted and participated in on-site trips to Navajo and Hopi Indian 

Reservations by the Governor’s Advisory Council on Health, Physical 

Fitness & Sports (GACHPF&S). 

• Assisted and participated in the GACHPF&S Native American Task Force 

sponsorship of the 1st Annual Native American baseball day on October 

15th in cooperation with Major League Baseball’s Arizona Fall League. 

• Assisted the Indian Health Service (IHS) Pathways into Health (PIH) 

Project by functioning as the Chairman of the Governance Committee and 

serving on the PIH Interim Executive Board. 

• Attended Nation Indian Health Board Consumer Conference held in 

downtown Phoenix in October 2006. 

• Attended a Mass Vaccination Clinic Bio-terrorism Exercise sponsored by 

the Navajo IHS and Navajo Nation in November. 

• Represented ADHS as a co-sponsor with the Inter Tribal Council of 

Arizona, Inc. in the sponsorship of the 2nd Annual Arizona - American 

Indian Health Conference in November 2006. 

• Participated in planning meetings with the Commission of Indian Affairs for 

the 2006 Legislature Indian Nations and Tribes Day to be held in January, 

2006. 

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DIVISION OF PUBLIC HEALTH SERVICES 

Office for Children with Special Health Care Needs 

The Office for Children with Special Health Care Needs (OCSHCN) received a 

Maternal and Child Health Bureau (MCHB) Integrated Services Grant in June, 

2005, which required the creation of a statewide Task Force. The Task Force 

was charged with providing a forum where stakeholders from governmental and 

state agencies, local and community level providers, and youth with special 

health care needs and their families can review activities of the various agencies 

and communities, plan needs assessments, and study alternative funding for 

services. 

Several task-specific subcommittees will conduct needs assessments, develop 

educational resources, and provide input and evaluation for quality improvement 

activities. These committees include Education, Cultural Competency, Parents, 

Youth, Quality Improvement, and Specialty Services with a focus on 

Telemedicine. 

To help meet the Grant and Office goals, OCSHCN reached out to 

representatives of Arizona’s Native American community. Roy Teramoto, MD, 

Indian Health Services/MCHB Regional Consultant, serves on the Task Force 

and has been instrumental in identifying potential committee members and 

partners including John Kittredge, MD, Tucson IHS/MCHB and Diana Hue, MD, 

Pediatric Consultant for the Navajo Nation. OCSHCN requested representation 

by the Pima/Salt River Tribe Mesa School District Liaison for our Education 

Subcommittee. One of the parent subcommittee members is from the Hopi 

Nation and represents their Office of Special Needs. Mark Carroll, MD is the 

Navajo Nation Telemedicine Director and will be participating in our Special 

Services Subcommittee. 

Through ongoing outreach to educate communities about the needs of children 

and youth with special health care needs, OCSHCN presented information at the 

request of the Tohono O’odham Tribe Division of Special Services Office in Sells, 

Arizona. These two sessions were for educators, community providers and 

families. The requested topics were an overview of OCSHCN and two programs, 

Traumatic Brain Injury and the Community Development Initiative. OCSHCN also 

presented at and attended the Hopi Tribe Office of Special Needs 10th Annual 

Special Needs Day. 

During the next six months OCSHCN specific planned activities include meeting 

with Integrated Services Task Force and subcommittee members that represent 

Indian Health Services/MCHB, the Hopi and Salt River Pima – Maricopa Indian 

Reservations. Another significant activity taking place over the next few months 

will be to increase current technical support for the Hopi Office of Special Needs 

to create a Community Action Team on their reservation per their request. 

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Office of Health Systems Development 

A Native American Community Development Program was created under the 

Office of Health Systems Development; Ms. Kim Russell started as Program 

Manager on December 12, 2005. The Native American Community Development 

Program’s overall goal is to improve the development and accessibility of primary 

health care for Native Americans throughout Arizona by working in collaboration 

with the 21 tribal nations, 3 urban centers, and 3 IHS Area offices. Ms. Russell’s 

tasks include resource development, advocacy, training, technical assistance, 

outreach, assessment, coalition building, community development and planning. 

Currently, initial visits to the tribal communities are being conducted to introduce 

program services and to become familiar with the current services the tribal 

health care systems deliver. For additional information, Kim Russell can be 

contacted at 602-542-1292 

The Primary Care Program, offering basic health care services to low income 

persons without health insurance in Arizona, awarded 20 contracts July 1, 2005. 

Most of these clinics serve Native American people. Three are particularly 

noteworthy: Native American CHC assists the Urban Indian Population in 

Phoenix; Canyonlands CHC serves the Navajo communities of Chilchinbeto and 

Kaibeto as well as in Page, AZ; and Northern Apache County Special Healthcare 

District is providing care in St. Michaels and Sanders. These contracts are in 

place for a year and are expected to be renewed July 1, 2006. For additional 

information, Gordon Jensen can be contacted at 602-542-1243 

The Center for Minority Health (CMH), in partnership with the Center for Health 

Equality in Tucson, will be convening a group of public health professionals from 

all over the state to be a part of the Health Disparities Section of the Arizona 

Public Health Association. The CMH will ensure that public health 

representatives from the tribes and urban Indians are invited and participate in a 

process to develop a statewide agenda to address health disparities for all 

groups. This meeting will take place in early April, a date has not been set. For 

additional information, Suncerria Tillis can be contacted at 602-542-2909 

The Community Development program, in partnership with the St. Luke's Health 

Initiatives and Arizona Health Facilities Authority, was able to offer a mini grant to 

the Gila River Health Care Corporation (GRHCC), HuHuKam Memorial Hospital 

to support a Breast Cancer Needs Assessment Survey to understand why Native 

American Women have such a high rate of non-compliance with keeping their 

scheduled mammogram appointments. Technical Assistance was provided by 

the ADHS Offices of Health Systems Development and the Office of Chronic 

Disease Prevention and Nutrition Services. The GRHCC Managed Care team 

wants to organize a Health Fair for women and the Community Development 

Program will continue to connect them to appropriate resources. For additional

information, Ramnish Mandrelle can be contacted at 602-542-2902 

The Health Care Shortage Designations Program submitted applications to the 

HRSA – Shortage Designation Branch to secure Health Professional Shortage 

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Area Re-Designations (HPSA) of the Navajo and Hopi Nations. For additional 

information, Colleen McGregor can be contacted at 602-542-2904. 

 

Office of Chronic Disease Prevention and Nutrition Services (OCDPNS) 

The Cardiovascular Disease (CVD) Program has established the Core Advisory 

Team (CAT). There are several workgroups, each chaired by 2 or more 

individuals. The CVD program invited Dr. James Galloway to co-chair the health 

disparities committee with a distinct focus on the Native American issues related 

to cardiovascular disease. 

The Nutrition and Physical Activity Program provided sponsorship for the Live 

Long, Live Strong! youth summer camp. Native American youth from the 

Colorado Indian Reservation participated in skill-building sessions that increased 

hand-eye coordination, maintained concentration, and increased self-esteem, 

while incorporating the Mohave language and native crafts. This activity was 

provided through the Colorado River Indian Tribe Recreation Department. For 

additional information, Rena Van Fleet can be contacted at 928-669-1350. 

The Arizona Diabetes Prevention and Control Program (DPCP) assisted with 

planning the agenda and topics for the 2nd Annual Arizona - American Indian 

Health Conference, and provided general diabetes information and financial 

support. DPCP and Nutrition and Physical Activity started discussion with Native 

Health (Native American Community Health Center, Inc.) to collaborate on 

diabetes prevention and management through a networking group that 

represents several Native American agencies in Arizona. On September 14-15, 

2005 the Inter Tribal Council of Arizona sponsored a conference called “Steps to 

Nourish the Cycle of Life” in St. George, UT. Participants were Native Americans 

from several tribes in Arizona, Nevada and Utah. Two speakers were from ADHS 

Office of Chronic Disease and Nutrition Services. Magda Ciocazan, Manager, 

DPCP, was part of a panel presenting on “State Diabetes Programs Working with 

Tribes” and also hosted an exhibit. Sue Zevan, nutritionist for the ADHS Arizona 

Nutrition Network, gave presentations on “Healthy Menu Planning” and “Elderly 

Nutrition”. 

The Arizona Nutrition Network sponsored a two day training program with the 

theme of Culturally Appropriate Nutrition Education for Arizona Indian Tribes on 

the White Mountain Apache Reservation. Approximately 100 people attended 

from both urban and rural areas of Arizona. Four tribes presented information on 

their native foods, including harvesting and preparation with samples of some of 

the foods. There were also two presentations on working with Native Americans. 

Throughout the summer of 2005, the Arizona Nutrition Network also provided 

training and equipment to do demonstrations about healthy foods, including 

samples and recipes of foods which are available at reasonable prices. Seven 

agencies from throughout the state received equipment and training. 

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The Steps to a Healthier Arizona (STEPS) continued to work with the Tohono 

O’odham Nation to assist in getting program activities underway. Highlights 

include the participation of adult and adolescent community members in a series 

of focus groups conducted in October 2005 to gather relevant health and cultural 

information to be utilized for the Steps health marketing campaign. In addition, 

the Tohono O’odham Nation Steps program staff has been participating in 

various conferences and trainings coordinated and sponsored in part by ADHS. 

These activities support the Tohono O’odham Nation's work in the community 

and schools and include the 8th Annual National Community Health Workers/ 

Promotores Conference; the 6th Annual Border Health Information For Action 

Conference; a Southern Arizona Walkable Communities Workshop; and CDC 

School Health Index training. A joint presentation on community and school 

based programs was also given by Frances Kaplan, MPH and Michael Bitrick, 

Tohono O’odham Nation Department of Health (TODHS), at the 2nd Annual 

Arizona - American Indian Health Conference in November 2005. The 

presentation focused on community and school-based programs. The TODHS 

and their local Steps program are in the process of preparing to conduct the 

Behavioral Risk Factor Surveillance System (BRFSS) survey in the SpringSummer 2006. ADHS and CDC provided technical assistance to TODHS to 

adapt the BRFSS to best fit with the Nation’s cultural, programmatic and 

resources concerns. 

The Well Woman Health Check Program is working with the CDC and 

contractors to increase the recruitment of Native American Women into the 

program. At quarterly meetings, contractors have been educated on many 

issues related to Native American women, including health status, health beliefs, 

and access-to-care issues. All contractors, along with member of the 

Comprehensive Cancer Control Coalition and several ADHS employees, will 

attend a training presented by the National Indian Women’s Health Resource 

Center, Inc., entitled “Working Effectively with American Indians: A Cultural 

Competency Training” in January 2006. 

The Arizona WIC Program has been working closely with the Navajo Nation and 

Inter Tribal Council of Arizona, Inc. WIC Programs to finalize our Arizona State 

Nutrition Action Plan. The plan is designed to encourage partnerships and 

collaborative interventions between nutrition assistance programs and other 

groups (e.g., Arizona Department of Education), which promote healthy eating 

and healthy weight. Our next join meeting will be February 15, 2006, where all 

participants will discuss their successes in implementing their portion of the plan. 

Office of Oral Health 

Regarding the San Carlos Apache Tribe WIC Program, the Inter Tribal Council of 

Arizona, Inc. Dental Support Center trained a Tribal member of the San Carlos 

Apache Tribe as a dental health educator. She works out of the WIC Program in 

San Carlos and also provides service to the community of Bylas on Tuesdays. 

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The funding ($12,000) was contracted to the Inter Tribal Council of Arizona, Inc, 

who sub-contracted the funding to the San Carlos Apache Tribe WIC Program. 

The Dental Health Educator provided oral health educational materials, oral 

hygiene instructions (OHI), diet and feeding practice information, and prevention 

supplies to clients of the San Carlos WIC Program. Fluoride varnish was applied 

to high-risk children enrolled in the WIC Program every 3 months. 1089 clients 

received oral health educational materials, oral hygiene instruction, diet and 

feeding practice information and prevention supplies. 655 applications of fluoride 

varnish were applied to children. The San Carlos Dental Health Educator also 

attended two community health fairs where she set up a dental health education 

booth. In addition, the San Carlos Dental Health Educator wrote an article in the 

local newspaper about fluoride varnish and information on preventing Early 

Childhood Caries. 

 

Tobacco Education and Prevention Program 

There are monthly ongoing program activities (on/off reservations) with our 

Native American contractors including community education, youth coalition 

groups, school intervention, cessation (Phoenix/Tucson), and collaboration 

meetings with county health departments, provider training/presentation, public 

services announcements, and events. For information, please contact: Beau 

Cordova (ADHS-TEPP) (520) 770-3109. Highlighted activities of the major 

collaborative efforts are as follows: 

Ongoing Activities: 

(Off Reservation) Monthly collaboration meetings with Phoenix Indian Medical 

Center (PIMC) and ITCA. Monthly meetings with Native Visions Coalition, 

meetings with Native Health, PIMC, and ITCA. Monthly collaboration meetings 

with Black Hills Center for Indian Health (CDC funded for Navajo Nation), Navajo 

County, Apache County, Coconino County, Native American for Community 

Action (NACA), and ITCA. Monthly American Indian Youth Conference Planning 

meetings with ITCA, Hualapai Tribe, Hopi Tribe, Native Health, NACA, Tucson 

Indian Center, Inc. (TIC), Salt River Pima Maricopa Indian Community (SRPMIC), and Colorado River Indian Tribes (CRIT). 

(On/Off Reservation): Quarterly Community Advisory Tobacco Coalition Meeting 

with ITCA, Gila River Indian Community, Hopi Tribe, Hualapai Tribe, Pascua 

Yaqui Tribe, SRP-MIC, CRIT, White Mountain Apache Tribe (WMAT), KaibabPaiute Tribe (KBPT), NACA, Native Health, TIC, I.H.S., and Black Hills Center for 

American Indian Health. 

Activities for Past Six Months: 

(Off Reservation) Staff attended 3rd Annual Hualapai Youth Conference in 

Phoenix with Arizona Tribes and ITCA in July. Staff attended National Native 

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Tobacco Conference in Portland, OR with US Tribes, Urban Indian Health 

Centers, US State Health Departments, and Indian Health Services in August. 

Staff attended Best of the West Coalition for Tobacco Free Arizona Conference 

in Phoenix in September. In November staff attended Great American Smoke 

Out at PIMC with Native Health and 2nd Annual Arizona - American Indian Health 

Conference in Phoenix. 

(On Reservation) In October staff attended Red Ribbon Week with the Hualapai 

Tribe, Hopi Tribe, WMAT, SRP-MIC, PYT, and KBPT. 

Planned Activities for Next Six Months:

(Off Reservation) In February staff will participate in the Tucson Indian Health 

Event with the TIC, PYT, Tohono O’odham Nation, I.H.S., AHCCCS, DES, 

ADHS, and UA College of Public Health. In July staff will participate in the 

Tobacco and Health Youth Conference with ITCA and tribal/urban Indian health 

center contractors. 

Office of Women’s and Children’s Health 

Regarding the Rape Prevention and Education Program (funded by Centers for 

Disease Control), Ama Doo Alchini Bighan, Inc. (ADABI) in Chinle receives 

funding to provide rape prevention and education (RPEP) services on the Navajo 

Reservation. ADABI is active in presenting rape prevention and 

education by providing prevention activities for schools, businesses, social 

service providers and others throughout the area. Additionally, they also 

disseminate information via community booths. For additional information, Carol 

Hensell can be contacted at 602-542-7343. 

Regarding the Family Violence and Prevention Services/Rural Safe Home 

Network (funded by Dept. of Health and Human Services Administration on 

Children and Families), Ama Doo Alchini Bighan, Inc. (ADABI) in Chinle receives 

funding to provide domestic violence services on the Navajo Reservation. ADABI 

is active in the domestic violence task force, provides temporary emergency 

shelter through its safe home network, crisis counseling, case management and 

a 24-hour crisis line; provides prevention activities for schools, businesses, social 

service providers and others throughout the area. For additional information, J 

Ann Pope can be contacted at 602-542-7341 

Regarding, Community Health Contractors (funded by Maternal Child Health 

Block Grant): 

• Inter Tribal Council of Arizona, Inc. (ITCA) has a child car seat program 

and adult motor vehicle safety practices regarding seat belt use for 

pregnant women. ITCA distributes child car safety seats to certified 

technicians that, in turn, distribute the car seat with car seat safety 

education to any of the 19 tribes that request them. The tribe receiving the 

seats submits a list of installations completed/distributed to the ITCA 

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coordinator (Marianne Johnson, 602-307-1509.) During this time period, 

2,059 car seats were distributed to several of the tribes, 20 

advertisements demonstrating safe seat best use for pregnant women 

were published in various tribal newspapers/magazines (Au-Authm Action 

News, Arizona Native Scene Newspaper, Fort Apache Scout Newspaper, 

2005 Native American Recognition Days Publication, Apache Gold 

Magazine, to name a few). Four Public Service Announcements have 

been aired and ten new car seat technicians have been trained and 

certified to serve the 19 tribes. During the past six months, thousands of 

brochures addressing child car safety seats using pictures of local tribal 

children have been distributed along with those demonstrating the proper 

use of adult seat belt placement for pregnant women. Large, professional 

posters on these same two topics have also been distributed to the tribes 

that request them and are often found in the various WIC offices. A child 

passenger safety conference is scheduled for year 2006 and is planned 

on being held in conjunction with a 4-day Child Passenger Safety Seat 

Training to help increase the number of certified technicians throughout 

the various 19 tribal communities by at least 10. Twenty additional 

newspaper ads are planned for 2006 and 2,500 additional car seats to be 

distributed. The brochures and posters will continue to be printed and 

distributed as has been done in the past. 

• Apache County has a child car seat program and adolescent motor 

vehicle safety program. Through the Indian Health Services Environmental 

Health Division at Fort Defiance, the Northern Native American population 

is served. This population is also served every time a Native American 

comes into the Apache County office and requests child car seat services. 

Services are also provided to Navajo County through a sub-contract which 

also includes assistance to those community members of Native American 

ethnicity. During the past year, 33 child car seats with education have 

been distributed to parents/caregivers at Fort Defiance. 

• Pinal County has a child car seat program and adolescent motor vehicle 

safety program. The high school students at the VHM Alternative School 

in Sacaton receive a yearly presentation on “Survival 101 – Staying Alive”. 

This class teaches the importance of car seat belt safety and the dangers 

of alcohol use while operating a motor vehicle through an interactive/ 

educational presentation. This contractor also provides car seats, forms, 

incentives and educational materials to the Gila River Police Department 

and the Gila River Fire Department. The two agencies provide education 

on and distribution of child car safety seats to parents/caregivers within 

their tribe. 

• Mohave County has a child car seat program. This contractor assists with 

car seat events on the Hualapai Indian Reservation in Peach Springs in 

collaboration with the Indian Health Service Health Center. Mohave 

County provides car seats and certified technicians to assist with the 

education and installation of the car seats and also teaches the 

importance of using adult seat belts. 

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• Coconino County has child car seat program. Annual child safety seat 

classes are scheduled for the Havasupai Reservation. The trip is 

coordinated with the Arizona Department of Public Safety which 

helicopters the seats and teaching equipment to the community which is 

located at the bottom of the Grand Canyon. Services are also provided in 

Page, with Navajo Reservation residents participating. Coconino County 

administers a Governor’s Office of Highway Safety CAPP (Children Are 

Priceless Program) in northern Arizona. Many of the participants are from 

the nearby reservations. For information contact: Patty Rhodes/Karen 

Kuhfuss, 364-1400 

Office of Infectious Disease Services 

In the Vector-borne and Zoonotic Diseases (VBZD) Section: 

• In 2005, ADHS’ VBZD staff participated with CDC, IHS, Whiteriver Apache 

and San Carlos Apache Tribes in controlling an outbreak of Rocky 

Mountain spotted fever (RMSF) in the White Mountains area. ADHSVBZD printed/provided educational materials (over 10,000 fliers and 2,500 

calendars/coloring books for kids), provided tick collars and sprays for 

dogs (over 4,000), provided pesticides (360 bags of permethrin granules) 

for tick control around homes, and staff assisted in the field with 

conducting tick trapping/risk assessments and putting tick collars on dogs. 

These efforts were funded through the $50,000 from the Health Crisis 

Fund approved by the Governor earlier in the year for this purpose. 

(NOTE: most of the assistance in the field occurred in May) 

• ADHS-VBZD staffs have worked with tribes and IHS programs throughout 

Arizona on West Nile virus surveillance and vector control. The program 

provided surveillance equipment, training, mosquito speciation and testing 

support, and larvicidal products. 

• In 2006, ADHS’ VBZD staff will continue to work with tribes and IHS in 

monitoring and mitigating the RMSF threat in the White Mountain Region 

(as resources allow). Additionally, VBZD and CDC staffs are working with 

humane societies, animal control programs, etc. in expanding the RMSF 

surveillance effort beyond the reservations through an ongoing canine 

serologic study. The program staff will also continue the West Nile virus 

partnerships with tribes and IHS in 2006 for purposes of surveillance and 

disease control. 

In the TB Control Program: 

• The TB Control Program provided financial support to two tribal health 

departments through supplemental Intergovernmental Agreements (IGAs) 

for TB control and prevention activities, including disease surveillance, 

education and the provision of directly observed therapy. 

• The program co-sponsored the 11th Annual TB/HIV Four Corners 

Conference, which was held on October 27 -28 in Durango, Colorado. 

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Conference attendees included TB, STD and HIV staff from tribes and 

IHS. 

• On December 15, the ADHS Deputy TB Controller presented 

"Fundamentals of Clinical / Medical TB: Update and TB Control" to the 

public health nurses of the Navajo Nation and Navajo Indian Health 

Service. 

• The program coordinated monthly TB case conference calls with the 

Phoenix Indian Medical Center, tribal TB Control Programs, and county 

health departments for the purposes of coordinating Native American TB 

patient tracking and care across jurisdictional boundaries. 

• The program provided food voucher incentives to local health department 

TB Control Programs, including tribal TB Control Programs. These 

vouchers were made available to TB patients to encourage compliance 

with taking their medicine. 

• In 2006, the program will continue supporting specific tribes through IGAs. 

Additionally, the program will co-sponsor with other Four-corner states the 

12th Annual TB/HIV Four Corners Conference 2006, which will take place 

in Flagstaff in October. The program will also co-sponsor with the Arizona 

Department of Corrections a statewide TB Conference on April 5, 2006 for 

correctional facilities and public health departments. All tribal health

departments and Indian Health Services regional offices will be invited. 

Finally, the program will continue coordinating Native American TB case 

conference calls and provision of food vouchers depending upon 

availability. 

In the STD Control Program: 

• The program staff provided and/or facilitated the provision of staff and 

equipment for the Navajo Nation Health Fairs held in both Fort Defiance 

and Tuba City. 

• The program hosted CDC’s Advanced STD Interventions training and 

worked with the IHS and Navajo Nation to successfully encourage 

attendance of Navajo Nation Community Health Representatives. 

• The program provided assistance for HIV Partner Counseling and Referral 

Services training of nurses at the White River IHS Hospital to address 

intervention in a cluster of HIV cases. 

• The program arranged supervisory training at the Maricopa County

Department of Health for one staff member of the Navajo Nation HIV 

Prevention Program. 

• Program staff worked with staff of the Inter Tribal Council of Arizona and 

the IHS on the planning of a Phoenix Area STD/HIV Conference to be 

held in Phoenix in January 2006. 

• Dr. Melanie Taylor, the STD Program’s Medical Epidemiologist made 

presentations at the Gila River and the Whiteriver Reservation’s IHS 

hospitals to over 45 physicians, clinic nurses and public health nurses. 

These presentations, offering CEUs for attendance, covered medical 

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diagnosis, treatment and follow-up of STDs, as well as providing Arizona 

STD morbidity data. 

• In 2006, the program will work with Native American communities and the 

Arizona Family Planning Council to expand chlamydia screening in Native 

American communities. The STD Program will also continue to provide 

presentations to medical staff at IHS and tribal medical facilities and to 

increase contact with all Arizona Native American Tribal communities. 

In the Hepatitis C Program: 

• The program trained 21 persons in the Gila River Indian Community on 

Hepatitis C training. 

• In 2006, the program will increase STD Awareness in Tribal Communities 

through participation in the Regional STD Conference. Judy Norton will 

present The ABC's of Hepatitis session on 1/25/06. The program will also 

conduct a Hepatitis C training class for Indian Health Service and PIMC 

staff. 

DIVISION OF BEHAVIORAL HEALTH SERVICES

 

Division of Behavioral Health Services (DBHS) 

Methamphetamine First Responder Training: DBHS provided the first of three 

planned technical assistance sessions to the Colorado River Indian Community 

in Parker during October 2005. The workshop was collaboratively planned by 

CRIT Behavioral Health, Social Services and local law enforcement and focused 

on community-wide planning to address methamphetamine. 

Methamphetamine Initiative: DBHS provided funding in October to the Gila River 

Indian Community and three RBHAs to develop and launch a specialized 

outpatient treatment program for adults with methamphetamine use disorders. 

Gila River is establishing on-reservation specialized counseling services 

beginning in December. Cenpatico established a contract with a Native American 

consultant to develop culturally appropriate treatment programming with the San 

Carlos Apache Tribe and hired a specialized methamphetamine treatment 

provider to conduct three 2-day trainings for all providers and interested tribes 

during November. Value Options and CPSA will develop expedited referral 

linkages and specialized methamphetamine treatments for adults in the Pima 

county detoxification center and in Maricopa County drug courts. Both linkages 

serve a considerable number of urban Native Americans. 

New/Unobligated Funds: DBHS conducts routine financial monitoring of RBHA 

and TRBHA contractors to identify funds that could be re-directed for greater 

efficiency. In addition, ADHS met with the Governor’s Tribal Liaison and the 

Governor’s Budget Director to finalize an appropriations request for the FY 2007 

state budget that would include up to $1.1M in General Funds to develop 

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additional methamphetamine treatment centers in rural regions of the state 

including services for tribal communities. Funds would be administered by the 

ADHS. 

Governor’s Office Anti-Meth Initiative: DBHS participated in two 

methamphetamine planning efforts launched by the Governor’s Office, including 

an initiative to develop and support community and tribal anti-drug coalitions to 

address methamphetamine at the local level. 

Native American Suicide Coalition Retreat: Planning for the semi-annual 

Coalition retreat began in early December. The retreat, scheduled for March 

2006, will include a strategic planning session featuring Dr. Teresa LaFromboise 

from Stanford University. Dr. LaFromboise is the author of the Zuni Life Skills 

Development curriculum, a SAMHSA-endorsed evidence based practice for 

suicide prevention among native youth. 

Child-Adolescent State Incentive Grant: ADHS/DBHS hosted the federal site visit 

for the grant in December. Gila River TRBHA, a grantee participant, participated 

in interviews with the site visit team on strengthening services for children using 

culturally acceptable approaches.

Northern Arizona- Navajo Nation Collaborative: Northern Arizona Behavioral 

Health Authority (NARBHA) held two collaborative meetings with tribal entities in 

northern Arizona in October and December. The focus of the meetings is 

providing technical assistance to strengthen local service delivery on reservation 

lands. 

The Bureau of Contract Compliance recently hired Ms. Julia Ysaguirre, as a 

Contract Compliance Administrator, to work exclusively with Tribal Regional 

Behavioral Health Authorities (TRBHAs). In her role, Ms. Ysaguirre serves as 

the point of contact for the Gila River Indian Community and the Pascua Yaqui 

Tribe, who currently maintain signed intergovernmental agreements (IGA) with 

the Division for the administration, planning, coordination and monitoring of 

behavioral health services. The TRBHAs serve tribal members residing in each 

Tribe’s respective geographical service delivery area. The IGAs provide Title XIX 

(Medicaid) and Title XXI (KidsCare) funding and requires the TRBHAs to 

administer a managed care behavioral health delivery system of care that 

provides services that are individual and family centered. Ms. Ysaguirre provides 

technical assistance to the TRBHAs and assists the TRBHAs in their program 

operations to ensure tribal community members have access to care and 

services are culturally relevant. She also coordinates internally to foster 

cooperation and coordination within the Division and assists with the oversight of 

contractual performance of the TRBHAs. The Division recently completed an

administrative review of TRBHA financial and operational systems, as required 

by AHCCCS, and Ms. Ysaguirre will coordinate the communications regarding 

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final outcomes and any required corrective actions. Ms. Ysaguirre may be 

reached at 602-364-4739 or by email at ysaguij@azdhs.gov

Arizona State Hospital 

Arizona State Hospital, located in Central Phoenix employs about 900 people, 

with operations 24 hours a day. Generally, the Hospital is divided into four 

populations: Forensics, Civil, Adolescents, and Sexually Violent Persons. The 

Arizona State Hospital is a publicly funded long-term hospital that provides 

services for those suffering from a severe mental illness, as well as people with a 

history of sexually violent crimes. 

All patients are served through assessment and treatment planning processes 

that are patient and family centered, are clinically sound and build upon the 

identified strengths and needs of the patient, and are culturally and linguistically 

appropriate and responsive to the individual needs of the patient. All patient care 

services are provided by qualified and competent staff and are intended to meet 

the needs of the patient to achieve the highest level of functioning possible for 

the patient, so that he/she can achieve discharge, community reintegration, 

rehabilitation and recovery of his/her behavioral health and well-being. 

The patient’s inpatient clinical treatment team consists of a qualified psychiatrist 

(treatment team leader), family practice physician or certified physician assistant, 

registered nurse and mental health program specialist, social worker, 

rehabilitation professional, nutritionist, any involved family/guardian or other 

patient representative, community treatment provider representatives, and 

representatives of any other involved agencies or departments. The Hospital’s 

Interdisciplinary Clinical Team assesses each patient upon admission to the 

Hospital. 

 

The acuity of the patient’s symptoms and condition, and legal status at the time 

of admission, provide the interdisciplinary clinical team with guidance in 

determining the least restrictive and most appropriate treatment methods and 

interventions to be utilized with the patient following admission to meet the 

patient’s identified treatment needs. 

Within 24 hours of an admission, psychiatric, medical, and nursing assessments 

are completed. Following admission, the Interdisciplinary Clinical Team meets 

with the patient to consider the initial assessments of the patient and to identify 

the patient’s initial treatment needs for services during the hospitalization. The 

clinical team develops an initial treatment plan that is utilized for up to 10 days 

following admission, until the Master Individualized Treatment and Discharge 

Plan is developed and implemented. Psychosocial, rehabilitation, and other 

assessments as needed, are completed within 10 days of the admission. 

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Fifteen Native American patients were treated in 2005, nine were males and six 

were females. Six of the fifteen were treated by Serious Mental Illness status. 

DIVISION OF LICENSING SERVICES 

Medical Facilities 

Gila River Healthcare Corporation has two dialysis facilities located on the 

reservation located in Sacaton and Laveen. The Corporation was provided 

extensive technical assistance to meet the federal ESRD regulations to be 

certified as an ESRD Medicare provider. Since these two facilities are located on 

the reservation they are not required to be state licensed. Sage Memorial 

Hospital has a facility located in Sanders, AZ which is not located on the 

reservation, however, it provides services to the Native American population. 

The facility was given technical assistance on services provided and there is no 

licensing requirement for providing only dental services. 

Long Term Care 

The White Mountain Apache Tribe wants to build a nursing home outside of a 

traditional nursing home. There has been discussion re: oversight/regulations 

and whether they will meet federal requirements. The tribe may apply for an 

exemption. Gila River Annual Survey (Medicare) conducted on December 6, 

2005. 

Assisted Living: 

Assisted Living has had inquiries and been meeting with Navajoland Nursing 

Home Inc, with regards to an assisted living facility in Chinle on the Navajo 

reservation. There is an active application, Their building is built and sitting 

empty, since architecture (Special Licensing) is waiting for some documentation. 

The Office of Assisted Living and Special Licensure have been working diligently 

to help them get up and running. Assisted Living has also met with the White 

Mountain Apache Nation concerning an assisted living facility adjacent to the 

hospital in White River. Assisted Living has met with an unaffiliated group of 

Native Americans from Blue Gap which is north and west of Chinle and on the 

Navajo Reservation. 

Special Licensing: 

Special Licensing assisted Sage Memorial Hospital with the architectural aspect 

of the licensing requirements. 

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Child Care: 

No activities with Native American tribes within last six months. 

Behavioral Health: 

No activities with Native American tribes within last six months. Planned Activities 

- The Behavioral Health Program will be conducting surveys with two Native 

American tribes within next six months. 

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