Tribal Health - California Rural Indian Health Board

October 2009 

Volume 42 No. 1 

Inside This Issue: 

Advocating for Positive 

Change .................................Pg. 2 

Tribal Sovereignty 

and Public Health Law .........Pg. 3 

CRIHB Annual Election ......Pg. 4 

Employee of the Year .............Pg. 4 

FQHC Strategy to regain 

Medi-Cal Opt. Benefits ........Pg. 5 

Are You Prepared For 

The H1N1 Virus? ................Pg. 6 

Honored Elders Awards ........Pg. 8 

40th Anniv. Memories ..........Pg. 10 

New Faces at CRIHB ............Pg. 11 

2009 Hall of Fame ................Pg. 12 

UC Davis Nursing School 

& CRIHB ............................Pg. 13 

Soliciting for Tribal Input ....Pg. 14 

Thank you for your Donations .Pg. 15 

4400 Auburn Blvd., 

2nd Floor 

Sacramento, CA 

95841 

Voice: 

(916) 929-9761 

Fax: 

(916) 929-7246 

www.crihb.org 

Tribal Health 

Advisor 

PAST, PRESENT AND 

FUTURE: 

OF ADVOCACY 

The CRIHB 40th Anniversary Board of Directors meeting was a 

huge success as many gathered at the Peppermill Casino in Reno, 

NV. The meeting was focused around the remembrance and memory of 

individuals that were inducted into the Hall of Fame Awards Ceremony. 

This was the very first time CRIHB created the Hall of Fame Awards 

ceremony, nominations were collected from all Indian communities for 

this historic event and nominees had to adhere to the criteria set for the 

award; firstly the individual had to be deceased and he/she must have 

contributed to California Health Care. There were a total of Thirty 

Eight Hall of Fame awards (for the complete listing of awardees see page 

12). CRIHB would like to sincerely thank all the families that attended 

and accepted the awards. 

During the meeting Yvette Roubideaux, IHS director presented the IHS vision, priorities, accomplishments, 

challenges and future direction. She answered questions from the tribes and encouraged input from the 

tribes, providers and patients. After receiving all the input she will then start to develop solutions. It is 

extremely important for the tribes to send all their concerns and questions to ihsreform@ihs.gov. For more 

information on the Internal IHS reform visit www.ihs.gov/reforms. 

Executive Directors, Al Elgin, Mario Gutierrez, and Jim Crouch sat on an executive panel which was 

moderated by Barbara Karshmer. The panel discussed each of their experiences when they first started and 

the challenges and experiences faced and are still experiencing during their time at CRIHB. 

On both evenings, Awards were presented. CRIHB was honored to present the Tribal Government 

Consultation Committee with an award for continued membership and for ongoing support to improve 

health care for all Indians in California. CRIHB announced the Luna Wessel Awardees; Henry Waxman, 

National Award; Clarence Atwell, State Award; Molin Malicay, State Award and Corrina Garbani for 

Regional award. Honored elders Awards were awarded to Henry Fonseca, Florence Laughton and Pauline 

Estevez. The Clinic of the Year was awarded to UIHS in recognition to their continuing record of program 

excellence. The following Member Tribal Health Programs were given an award for their continued 

membership; Greenville Rancheria Clinic, Karuk Tribal Health, MACT Health Board, Mathiesen 

Memorial Health Clinic, Redding Rancheria Indian Health Clinic, Shingle Springs Tribal Health Program, 

Sonoma County Indian Health Project, Toiyabe Indian Health Project, Inc, Tule River Indian Health 

Center, Inc, United Indian Health Services, Inc and Warner Mountain Indian Health Program. Awarded 

for the Pillars of CRIHB were MACT, Mathiesen, SCIHP, Shingle Springs, UIHS and Warner Mountain. 

The Original Signers were awarded special recognition plaques as the original signers of the CRIHB 

Articles of Incorporation: Dennis Magee, Adeline Rhoades, Lena McCovey Nicholson, Carolyn Wyatt, 

Clois Powell Erwin, Norman Whipple and Edward Mike. In recognition of the outstanding contributions 

to the Indian communities for many years Barbara Karshmer, Joseph Saulque, Robert McSwain and Ellen 

Kruusmagi were awarded Lifetime Achievement Awards. Neddeen Naylor, Eva Mastel, Delbert Thomas, 

Irv Rautenberg, Dr. Donald Watkins and Beverly Rodriguez were awarded Special Awards for going above 

and beyond in leadership and advocacy in the health field. Jerry Simone was awarded a special recognition 

award for 35 years of continuous service as the Executive Director for United Indian Health Services. Jim 

Crouch received a special recognition award for 22 years as the Executive Director of CRIHB. Marilyn 

Pollard received the Employee of the Year award at CRIHB, she has played a lead roll in the renegotiation of 

the CRIHB Central Office lease, development of the Corporate Operations manual, re-design and update 

of the external internet site, and served as the editor of the 40th Anniversary History book. 

Thank you for all that attended and made the 40th Anniversary Celebration a successful one. We are 

grateful for all the donations that were contributed for the event. Congratulations to all Awardees and we 

hope to see you at the next Anniversary celebration.

Advocating for Positive 

Change for 40 Years 

The California Rural Indian Health Board (CRIHB) 

celebrated its 40th Anniversary on October 15th-18th, 

2009 in Reno, Nevada. This historic milestone signifies the 

40 years of Advocating for Positive Change. CRIHB was 

founded and incorporated in 1969 by a consortium of nine 

California tribes to advocate for the return of Federal health 

care services for California Tribes. CRIHB was the planning 

and coordinating body for the multi-resource Rural Indian 

Health Program in the State and participated actively in the 

development of Tribal Member health program policies at all 

levels; Local, State and Federal. 

Reaching the 40 year milestone is a significant 

accomplishment considering all the obstacles faced and 

it continues to promote and improve Indian health by 

developing policies, plans, programs, services, training and 

technical assistance for the Indian community. 

The CRIHB 40th Anniversary Board of Directors meeting 

was a huge success as many gathered from different parts of 

California. It was focused around the remembrance and 

memory of individuals that were inducted into the Hall of 

Fame Awards Ceremony. The Hall of Fame Awards were 

awarded to individuals that contributed to the improvement 

of California Healthcare. 

California Rural Indian Health Board, Inc. 

Clois Erwin, Mathiesen Memorial Health Clinic 

Craig Powell, Mathiesen Memorial Health Clinic 

Angela Martin, Greenville Rancheria Tribal Health 

Andrea Cazares-Diego, Greenville Rancheria Tribal Health 

Florrine Super, Karuk Tribal Health Program 

Roy Arwood, Karuk Tribal Health Program 

Bo Marks, M.A.C.T. Health Board, Inc. 

Michelle Hayward, Redding Rancheria Indian Health Services 

Hope Wilkes, Redding Rancheria Indian Health Services 

James R. Adams Jr., Shingle Springs Rancheria Health Program 

Brenda Adams, Shingle Springs Rancheria Health Program 

Laura Rambeau-Lawson, Sonoma County Indian Health Program, Inc. 

Reno Franklin, Sonoma County Indian Health Program, Inc. 

Monty Bengochia, Toiyabe Indian Health Project 

Patricia Vance, Toiyabe Indian Health Project 

Yolanda Gibson, Tule River Indian Health Center, Inc. 

Gayline Hunter, Tule River Indian Health Center, Inc. 

Maria Tripp, United Indian Health Services, Inc. 

Bonnie Green, United Indian Health Services, Inc. 

Ralph DeGarmo, Warner Mountain Indian Health Project, Inc. 

Mariellen Sam, Warner Mountain Indian Health Project, Inc. 

Management Staff 

James Crouch - Executive Director 

Marilyn Pollard - Administration Director 

Rosario Arreola Pro - Health Systems Development Director 

Michael Melendez - Tribal Head Start Director 

Jason Lopez - Finance Director 

Jackie Kaslow - Family Community Health Services Director 

Susan Dahl - Compliance Director 

Carol Korenbrot - Research Director 

Thomas Kim - Medical Director 

Kristal Chichlowska - Epidemiology Director 

CRIHB strives to further enhance the health care needs 

of Indian people in California through advocacy work and 

appreciates the relationship and trust developed over 40 years 

with the Indian community. For further information on 

CRIHB, Advocacy work and training/technical assistance 

programs visit www.crihb.org. 

James Crouch, Executive Director since 1987 at the California 

Rural Indian Health Board. The longest term served as 

Executive Director at CRIHB. 

CRIHB 40th History Books for Sale 

Copies of the CRIHB 40th History Book are available 

for sale. You can find details on the website www. 

crihb.org or you can order directly from CRIHB via email, 

telephone or regular mail, attn Administration Department. 

California Rural Indian Health Board, Inc. 2 

Tribal Health Advisory - October 2009 

The History Books are 

available for full members at 

a discounted price of $15.00 

per book and Associate 

members discounted at 

$20.00 per book and non 

members at $30.00.

Tribal Sovereignty 

and Public Health Law 

On October 15, 2009, Mr. Dan Stier, JD, a representative 

from the Centers for Disease Control and Prevention 

presented at the CRIHB 40th Anniversary/Annual CRIHB 

Board of Directors and Tribal Governments’ Consultation 

Committee on the importance of Public Health Law and Tribal 

Sovereignty. 

Public Health Law: Public Health Law has impacted many things 

throughout history, including: vaccination, motor-vehicle safety, 

control of infectious diseases, fluoridation of drinking water, and 

recognition of tobacco use as a health hazard. 

Tribal codes today encompass a variety of these areas, including: 

Motor vehicle/traffic safety, alcohol control, water quality, 

animal control, food sanitation, tobacco control, and disease 

control and surveillance. 

Mutual Aid Agreements: While local Tribal Codes are 

important for protecting tribal members, sometimes Tribes need 

to collaborate with other jurisdictions to protect themselves and 

others nearby. In these instances, Mutual Aid Agreements can be 

effective tools to assist U.S. state and local governments, Tribes, 

Canadian provinces, First Nations, and Mexican states in sharing 

information, data, supplies, resources, equipment, or personnel 

for the purpose of protecting the public’s health. 

The importance of Mutual Aid Agreements has become most 

evident in the recent outbreak of H1N1 Flu (formerly known 

as the “Swine Flu”) and other emergency preparedness activities; 

it has highlighted the importance of Tribes having relationships 

with local cities, counties, and State entities. 

Should a major outbreak or natural disaster occur, does your 

Tribe have the Mutual Aid Agreements in place to have access to 

medications, vaccines, or emergency shelter? 

Resources: Tribes have developed their own Mutual Aid 

Agreements between jurisdictions for many years. For tribes 

who need assistance in developing Mutual Aid Agreements, you 

can find additional information at: 

http://www.cdc.gov/phlp/mutualaid 

Resources which can be accessed here include: 

� Inventory of Mutual Aid Agreements and Related 

Resources 

� A Menu of Suggested Provisions for Public Health Mutual 

Aid Agreements 

o Public Health Emergency Management 

o Public Health Data Sharing 

o Pandemic Influenza Preparedness Funding 

o Tuberculosis Treatment and Control Animal Health 

Emergency Management 

o General Communication and Coordination 

For more information, please contact: 

Dan Stier, JD 

Public Health Law Program 

Centers for Disease Control and Prevention 

Email: dstier@cdc.gov 

Phone: 404.639.4680 


Tribal Health Advisory - October 2009

CRIHB ANNUAL ELECTION 

Traditionally, the last day of the Annual Board of Directors 

Meeting is when the Board of Directors exercise 

their voting power to elect the officers for the upcoming year. 

The Officer positions are the Chair, Vice-Chair, Treasurer 

and Secretary. The Officers provide organizational leadership 

by serving on the Executive Committee that hold the same 

powers to conduct regular business as the full Board of Directors. 

This year election results were as follows: Reno Franklin, 

SCIHP was reelected Chair; Maria Tripp, UIHS was reelected 

Vice Chair; Laura Rambeau Lawson, SCIHP was reelected 

Treasurer and Yolanda Gibson was reelected Secretary. 

The remaining five positions elected to sit on the Executive 

Committee were as follows: Brenda Adams, Shingle Springs; 

Patricia Vance, Toiyabe Indian Health; Angela Martin, Greenville 

Rancheria; Bonnie Green, UIHS and Florrine Super, 

Karuk Tribe. 

Congratulations to our newly elected officers and Executive 

Committee members for the year 2010! 

Employee of the Year! 

Congratulations to Marilyn Pollard, the Administration 

Department Director for receiving the Employee of the 

Year Award. She has been with CRIHB since December 1995. 

During her tenure, she has exemplified outstanding leadership 

and direction for her staff and for the CRIHB Organization. 

This past year she has played a lead roll in the renegotiation 

of the CRIHB Central Office lease, development of the 

Corporate Operations manual, re-design and update of the 

external internet site, and served as the editor of the 40th 

Anniversary History book. The CRIHB Board and staff thank 

Marilyn for all her hard work and dedication to improving the 

working environment of the CRIHB organization. 

Reno Franklin 

Marilyn Pollard 



FQHC Strategy to regain 

Medi-Cal Optional Benefits 

The loss of reimbursements from Medi-Cal for eight so 

called “Optional Benefits” program:(A) Adult dental 

services(B)Acupuncture service(C)Audiology services 

and speech therapy service(D) Chiropractic services(E) 

Optometric and optician services, including services provided 

by a fabricating optical laboratory(F) Podiatric services(G) 

Psychology services(H)Incontinence creams and washes. 

Of this list Adult Dental Services, Psychology Services and 

Optometric and optician services are important revenue 

generating services for Tribal Health Programs. While 

Podiatric services, which generally provided outside of the 

Clinic are especially important for Diabetic clients as is 

Audiology and Speech therapy which are especially important 

for children with chronic ear infections. This loss of revenue 

and loss of service is creating a massive problem for CRIHB 

member programs. To address these concerns we have been 

working with the CMS Center for Medicaid State Services 

(CMSO) the DHHS Office of Intergovernmental Affairs and 

the DHHS Office of Civil Rights to establish a clear policy 

that would allow for Indian clients of Tribal Health Programs 

to have a different set of services from the general population 

in California. A key meeting on this policy change occurred 

in DC during the NIHB Annual Conference at the urging 

of NIHB and CRIHB Chair Reno Franklin. Policy change 

is often slow and difficult so a fall back strategy discussed at 

the Program Directors committee in Reno at the CRIHB 

Anniversary Meeting is to assist Tribal Health Programs 

change payment systems within Medi-Cal. Currently 

CRIHB member programs collect reimbursement from 

Medi-Cal using the IHS All Inclusive Rate. Under the 

IHS Memorandum of Agreement signed on July 11, 1996 

Tribal Health Programs may also choose to be reimbursed 

as Federally Qualified Health Centers under the FQHC 

prospective payment process. Making this switch would allow 

for the billing Psychology services including counseling done 

by Licensed Clinical Social Workers for both Indian and non 

Indian clients. CRIHB has begun researching steps to make 

this change and applied for grant funds from the Blue Shield 

Foundation to assist in carrying out this work. 

Program Directors 

Back Row L-R Lessie Aubrey, Karuk; Andy Anderson, Mathiesen; James Crouch, 

CRIHB; David Lent, Toiyabe; Terry Baines, Pit River; Beth Bodi, Shingle Springs 

and Ron Sisson, Redding. 

Front Row L-R Margaret Alspaugh, Greenville; Molin Malicay, SCHIP; Jerome 

Simone, UIHS and Rosario Arreola Pro, CRIHB 



ARE YOU PREPARED FOR 

THE H1N1 VIRUS? 

Sometimes reacting to an emergency is a fast and furious 

business where everything else gets dropped. But 

sometimes it can stretch into something that feels more 

like a marathon. Preparing for and responding to the 2009 

Influenza A/H1N1 virus pandemic has felt like a bit of both 

at times, but we need to be prepared to endure the latter. 

So the balance point to strike here is, “how can we be alert 

and ready but not at the cost of what must be done today?” 

I would suggest that one of the most important steps is to 

understand the basics of this pandemic and then to create 

a comprehensive but clear plan for you, your home or your 

Tribal Health Program. In order to assist you in this, I’d 

like to address one of the main tools we have to fight this 

pandemic. The 2009 H1N1 Influenza A Vaccine is now 

available in California and is your best defense to not only 

protect yourself but also those around you such as your 

family, workplace, children, elders and community. 

“Pandemic” is actually a specially designated term; not every 

spread of disease is called such. It simply means that the 

extent and impact of 2009 Influenza A/H1N1 virus is global, 

meaning it will likely reach the smallest villages to the largest 

cities and far away islands. It also means that its impact may 

affect economies and whole countries because of the illness 

and death that it may produce. While this is a sobering 

possibility, no one can really predict how this pandemic will 

actually play out. This is because we are in the “acceleration” 

phase of the disease spread which is before the “peak” of the 

highest number of infected individuals. The H1N1 virus 

vaccine is our strongest tool available to shorten and lower 

this upcoming peak so that it will not cause excess illness and 

overwhelm the healthcare system. 

But are we overreacting…after all, haven’t we been through 

tough influenza seasons before? For one thing, the 

magnitude of how many people will likely be infected is huge 

with predictions being up to a quarter to a third of the US 

population. While not considered typically more severe 

than the seasonal flu for most people, the sheer number of 

those infected will proportionally increase the number who 

will need further care in clinics and hospitals. Furthermore, 

studies here in California and nationwide have shown that 

when infected, the very young and pregnant plus the many 

of the typically high risk groups will have an usually higher 

chance of ending up in the hospital or having a H1N1 

associated death. That is why the H1N1 influenza virus 

vaccine is being targeted to the following groups: 

• Children age 6 months to young adults age 24 

• Parents and caretakers of infants aged < 6 months 

• Pregnant women 

• Aged 25 to 64 with chronic disease such as lung, heart 

disease 

• Healthcare workers and emergency response personnel 

So if you fall into any one of these categories, your first lines 

of defense will be getting a vaccine and you will preferentially 

receive it while supplies are limited. Those 10 years and older 

will only need one dose to be effective while those under age 

10 will need two doses separated by about 4 weeks. Infants 

aged < 6 months cannot receive this vaccine. Eventually, 

as supplies grow, everyone who would like to be vaccinated 

should be able to. 

Note that you are encouraged to have both the seasonal 

influenza vaccine and the H1N1 vaccine. These are two 

different vaccines that cover different influenza strains. 

The H1N1 vaccine will come in two different “formulations.” 

The first is the regular injectable “shot” vaccine that goes in 

your arm. The second is a nasal spray, much like the “Flumist.” 

This nasal spray version can only be given to those aged 2 to 

49, who are not pregnant, and do not have a chronic medical 

condition. 

While this may seem to be simple enough logic, the question 

that is plaguing so many physicians, parents and individuals 

is, “will this vaccine be safe?” In the end, it becomes a costbenefit 

decision, that is, will the good outweigh the bad 

that this will be worth it? In this case, the “bad” which are 

harmful effects of the vaccine is likely to be extremely low. 

The 1976 experience in which the vaccine was associated with 

an increase in a neurological disease called Guillain-Barré 

Syndrome (GBS) occurred in a differently manufactured 

vaccine. The current H1N1 vaccine is made in an updated 

method used to manufacture seasonal vaccine for the past two 

decades. And in those years, the safety track record has been 

excellent with most side effects being some tenderness and 

redness at the site of the vaccine injection and no association 

with GBS. 


Tribal Health Advisory - October 2009 

(Continues on next page)

Moreover, “thimerosal” (contains small amounts of mercury) 

which is used to keep the vaccine free of bacteria has not been 

shown in numerous studies to be associated with autism or a 

variety of other purported outcomes. But for those concerned, 

there will be a thimerosal-free version that will be available. 

Others may be concerned about another additive called 

“adjuvants.” Adjuvants boost the effectiveness of a vaccine so 

less of a vaccine needs to be given for each dose. This year, 

none of the H1N1 vaccine will contain adjuvants. Finally, 

through monitoring programs already in place, this vaccine 

will be carefully followed by Californian public health officials 

for any serious side effects. If you want to report a possible 

side effect, go to http://vaers.hhs.gov/esub/index#online. 

Rumors and misinformation are now abounding with 

the arrival of the H1N1 vaccine. One of the best ways to 

protect your self from incorrect advice is to check the CDC 

(www.cdc.gov) or California Department of Public Health 

(www.cdph.ca.gov) websites. 

CRIHB Board of Directors 

Public health officials and manufacturers are working very 

hard to bring this vaccine to you and your community. 

Remember, however, that receiving this vaccine is voluntary, 

that the target groups will be given preference initially, that 

vaccine availability is still low (but should quickly increase in 

November), and don’t forget to also get the seasonal flu shot! 

Know that your doctor or nurse cannot control how much 

vaccine they receive and be on the look out for dedicated 

vaccine clinic times and dates and encourage those in the target 

groups to get their vaccine. This and everyday precautions 

such as covering your cough with your sleeve, frequent hand 

washing, and staying home when sick will be ways you will 

not only prepare yourself for the long haul through this 

pandemic, but you will also be helping your family, friends 

and community. 

Clarence Atwell and Spouse Reno Franklin and Jerome Simone 



Honored Elders Awards 

Henry Fonseca (Awardee) with Brenda Adams, Shingle Springs and James Crouch 

Lena McCovey Nicholson 

Original Signers Awards 

Joseph Saulque and Pauline Estevez 

Clois Powell Erwin and James Crouch 



Barbara Karshmer and James Crouch 

Joseph Saulque and James Crouch 

Lifetime Achievement Awards 

Molin Malicay, Ellen Kruusmagi (Awardee) and Margo Kerrigan 



40th Anniversary Memories 



New Faces at CRIHB 

CRIHB is excited to welcome three new staff members 

to CRIHB! Kathalena Avendano is the new Tobacco 

Programs Manager, Rebecca Bressman is the new AAIR 

Program Coordinator and Pam Blackmore is the new 

Integrated Care Coordinator. 

Kathalena (Kat) Avendano is originally from Hemet, 

California, but has lived in Oklahoma for the past 15 years. 

She is Cherokee on her mother’s side and Mexican on her 

father’s side. She graduated from Oklahoma State University 

with a BS in Psychology and a MS in Clinical Psychology. 

For the past two years she has been working with adults with 

developmental disabilities and mental health diagnoses. She 

has a background in counseling, marriage and family therapy, 

behavioral health psychology and assessment with children 

and adults. She is excited to be returning to work in the Native 

community and is glad to be joining the CRIHB family. 

Rebecca (Bressman) relocated from the Portland Oregon area 

to work with the AAIR program. She recently graduated 

from Oregon Health & Science University with a Master’s 

of Public Health Degree. Her course track focused on 

Primary Health and Health Care Disparities which she feels 

is extremely beneficial to CRIHB. She is enrolled in the 

Citizen Potawatomi Nation tribe and is excited to have the 

opportunity to help make a positive impact on the lives of 

Native Americans. 

Pam Blackmore is the new Integrated Care Coordinator in 

the Health Systems Department. She is a Registered Nurse 

with a Nursing Informatics Certificate and a Masters in 

Health Administration (MHA). The last 5 years she has been 

working with local healthcare organizations implementing 

EMR/EHR. Prior to that she worked for healthcare 

software vendors, managed care organizations and a workers’ 

compensation organization where she was responsible for the 

medical management department. 

She has been in the Sacramento area for over 30 years and 

currently lives in Folsom with her husband, a couple of cats 

and a yellow lab. She is looking forward to getting to know 

everyone at CRIHB and the communities that we support! 

Everyone has already been very helpful! 

Kat Avendano 

Rebecca Bressman 

Pam Blackmore 



Vera Arwood 

Jim Burns 

Joe Carrillo 

Samson Dewey 

Erin Forrest 

Laura Frank 

Mickey Gemmill 

Mike Hammar 

Darrell Hostler 

Phil Hunter 

2009 Hall of Fame Awardees 

Peter Jackson 

Vernon Johnson 

Sam Jones 

Beverly LeBeau 

Winifred Leal 

Leland Majel 

Ted Mantzouranis 

Rebecca Manuel 

Laura Manuel 

Ernest Marshall 

Stan Mayer 

Harvey McCardia 

Zelda McCloud 

Vlayn McCovey 

Tommy Merino 

George Montgomery 

Mary Mae Norton 

Doris Renick 

Mildred Rhoades 

Mary Edna Sam 

Crispina Sierra 

Lucas Simon 

Jack Sparkman 

Emmett St. Marie 

George Wessell 

Luna Wessell 

Tim Williams 

Lindsay Williams 



New UC Davis Nursing School Explores 

Possible Partnerships with CRIHB Tribal 

Health Programs 

In Fall 2010, the Betty Irene Moore School of Nursing 

hopes to open its doors to graduate and doctorate level 

nursing students on their new Sacramento campus. Dean 

Heather Young and faculty member Dr. Deborah Ward 

hope not only to begin building faculty in Sacramento but 

will look at how they can utilize telecommunications to 

reach nursing students in rural areas as well. On October 

15, 2009 Dean Young and Dr. Ward presented at the 40th 

Annual CRIHB Board Meeting, Program Directors session 

in a town hall format to generate discussion with tribal health 

programs and ask key questions like “What should the nurse 

of the future know”? Unlike traditional nursing schools, 

the Betty Irene Moore School of Nursing is focusing on 

doctorate and graduate level programs first so that they can 

build the faculty that will develop the sciences the school 

TGCC Chair and Representatives 

will focus on. Dean Young’s background is in rural health 

and underserved communities and has a particular interest 

in working with tribal health programs. She would like to 

see the many gaps filled in the delivery of quality health care 

services to American Indian populations. In addition to 

developing partnerships with tribal health programs, Dean 

Young and Dr. Ward are also very interested in how they can 

recruit Native American students into the program. In a few 

years the Betty Irene Moore School of Nursing will expand 

to include bachelor programs. With further developments 

in distance learning programs the hope is that the nursing 

school will be able to reach rural communities and develop 

long term partnerships with tribal health programs. 



Soliciting for Tribal Input 

Dr. Yvette Roubideaux, Indian Health Service Director 

attended the October Annual Board Meeting on 

Saturday October 17th 2009. She discussed the IHS vision, 

and priorities. The IHS mission, in partnership with American 

Indian and Alaskan Native people, is to raise their physical 

and mental awareness and the focus is the patient. Healthcare 

providers/staff are still continuing to provide quality care under 

difficult and challenging circumstances. The partnership with 

the tribes provides government to government relationships 

and it is important to continue with tribal consultation and 

initiate tribal input. Improvements in quality of care are still 

needed and the buying power has gone down when adjusted 

for inflation. 

Challenges faced by the IHS are: 

• Population growth leading to an increase demand 

for services 

• Rising costs/medical inflation 

• Increased rates of chronic disease 

• Difficulty recruiting and retaining medical providers 

• Challenges of providing rural healthcare 

• Old facilities and equipment 

• Lack of sufficient resources to meet demand 

for services 

• Balancing the needs of patients served in IHS, 

tribal, and urban Indian health programs. 

President Obama increased the 2010 budget by almost 13% 

and this is the largest increase in the last 20 years. The ARRA 

funding has increased to 590 million to the IHS for Facilities 

& sanitation projects, maintenance and improvement, medical 

equipment and health IT. It is possible to make huge strides 

and we have never seen this much of an increase ever. 

The Directors Priorities are to renew and strengthen the 

partnership with Tribes by improving on Government to 

Government relationships. The tribes manage over half of 

the IHS budget and in order to improve the health of the 

communities, it is important to work in partnership with 

them. Tribal consultations are essential and the IHS would 

like to know how they can improve the process. 

In the context of National Health Reform the legislation is 

still pending and for the Internal IHS Reform it is essential to 

improve quality and access. They need to demonstrate change 

and improvement. What is it the IHS does well? Where do 

they need to improve? Dr Roubideaux emphasized that it 

was her job to listen to the tribes and staff and improve the 

quality of and access to care. She is interested in gathering 

a wide range of input from tribal consultations, Input from 

health providers, staff and Input from patients/consumers 

and utilizing better communication and information about 

IHS activities. Visit www.ihs.gov/reforms for information on 

the Internal IHS Reform and it is the opportunity for change 

so provide your input. 

Dr. Yvette Roubideaux 





CALIFORNIA RURAL INDIAN HEALTH BOARD, INC. 

4400 Auburn Boulevard, 2nd Floor 

Sacramento, CA 95841 

1.916-929-9761, voice 

1.916.929.7246, fax 

www.crihb.org 

CRIHB January Board of Directors Meeting 

Greenville Rancheria 

Tribal Health 

P.O. Box 279 

Greenville, CA 95947 

530.284.7990 

Karuk Tribal 

Health Program 

P.O. Box 1016 

Happy Camp, CA 96039 

530.493.5305 

M.A.C.T. Health Board, Inc. 

P.O. Box 939 

Angels Camp, CA 95222 

209.754.6272 

Mathiesen Memorial Clinic 

P.O. Box 535 

18144 Seco Street 

Jamestown, CA 95327 

209.984.4820 

January 21 - 23, 2010 • CRIHB Headquarters 

CRIHB MEMBER TRIBAL HEALTH PROGRAMS 

Redding Rancheria 

Indian Health Services 

3184 Churn Creek Road 

Redding, CA 96002 

530.224.2700 

Shingle Springs 

Tribal Health Program 

4140 Mother Lode Drive, Suite 112 

Shingle Springs, CA 95682 

530.672.8059 

Sonoma County Indian 

Health Project 

144 Stony Point Rd 

Santa Rosa, CA 95401-4122 

707.544.4056 

Toiyabe Indian 


52 TuSu Lane 

Bishop, CA 93514 

760.873.8464 

PRSRT STANDARD 

U.S. POSTAGE 

PAID 

SACRAMENTO, CA 

PERMIT 571 

Tule River 

Indian Health Center, Inc. 

P.O. Box 768 

Porterville, CA 93258 

559.784.2316 

United Indian Health 

Services, Inc. 

1600 Weeot Way 

Arcata, CA 95521 

707.825.5000 

Warner Mountain Indian 


P.O. Box 247 

Fort Bidwell, CA 96112 

530.279.6194

Tribal Health - California Rural Indian Health Board

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