A Report from Tribal Council Member, Rose Gokee

I would like to share information regarding the following:

1) The Recovery House

The Governing Board has formally approved the use of the old Halfway House as a sober house with the name "The Recovery House". I would like to recognize Dottie Crust for taking the lead on researching and putting together draft policies as well as a working budget for the Recovery House. A workgroup comprised of Dottie Crust, Tammy Bergum, Dr. Jacqueline Bae and myself will continue to meet regarding the formation of the Recovery House with legal guidance. An application will be available in the near future for those interested in staying at the Recovery House. November 19, 2018 is the targeted date to formally open the Recovery House.

2) Trauma Informed Parenting Strategic Planning Workgroup

I am honored to be a part of the Trauma Informed Parenting Strategic Planning Workgroup. This workgroup promotes family healing and wellness through an emphasis on culture, which includes traditional Ojibwe teachings, and creates an awareness of the challenges that children and families face who have experienced trauma. The eight-week course is near completion and I believe each participant has found the workgroup to support them in healing and wellness. I am so very proud of each participant and our facilitators, Jennifer, Tom and Kaylynn along with guidance from Trauma Informed Master Trainer Donna Burns! There will be future workgroups and for those that want to participate please contact Betty Dust or Tom Hard at Behavioral Health (715-558-7883).

3) Long Term Care Waiver

The Long-Term Care Study Workgroup meetings are also one of my priorities and they occur in Wausau on a monthly basis. The meetings include tribal leaders, health directors, state representatives, Center for Medicaid/Medicare Services, aging program directors and attorneys. I have contacted tribal leaders from Oneida and Menominee that have entered into a Three-Way Agreement to schedule an onsite visit. The purpose of the visit will be to see how the program is operating under the Agreement for Lac Courte Oreilles consideration.

Unfortunately, under the current Presidential Administration, we may not have many other options. I want to acknowledge Long Term Care Waiver Director Denise Pommer for her advocacy on behalf of Lac Courte Oreilles and for her persistence in working towards a program that will be most beneficial for the Tribe. We have faced many challenges along the way and advocacy on behalf of the Tribe that will benefit our members is never time wasted. It is also important to know that the Long Term Waiver Director Services are 100 percent FQHC reportable which means the Health Care Center will be reimbursed at percent. I will keep you updated as to which direction the Tribe will be taking regarding the Waiver Initiative.

4) Medication Assisted Therapy/Treatment ("MAT")

I have had discussion with Health Director Dr. Jacqueline Bae and Behavioral Health Director Tammy Bergum regarding the need to expand MAT. Currently the Health Care Center offers Vivitrol which is not a one size fits all. Many individuals that have substance abuse issues are benefiting from the use of alternative medication treatment such as Suboxone. I personally spoke with some tribal members that are benefiting from the use of alternative medication which has helped them maintain sobriety. I will continue to advocate to expand medication treatment to help those on their road to recovery.

5) Indian Child Welfare

Indian Child Welfare meetings are held quarterly which I make a priority to attend. These meetings include ICW Directors and staff, tribal leadership and state representatives. This is an opportunity to hear about concerns from other ICW departments, receive state program updates and an opportunity to provide input on behalf of the Tribe. Children that are placed in the custody of the Tribe, under court jurisdiction, and supervision of Indian Child Welfare are placed under a court order. The court order will indicate findings that the Court has made and includes a list of conditions that need to be met for the return of the child to the home.

There is a great demand of Native American Foster Homes. If you reside within the reservation boundaries and interested in becoming a foster parent, contact the ICW Department. If you reside outside of the reservation boundaries and interested in becoming a foster home, contact the local Health and Human Services Department.

6) Mary Lazar, Principal Deputy Administrator for the Administration on Community Living Meeting

In September, I had the opportunity to attend a meeting with Deputy Administrator Mary Lazar of the Administration on Community Living. Only two tribes, Lac Courte Oreilles and Menominee, were invited along with a select few Aging and Disability Resource Center Program Director's from the State of Wisconsin. Only those select few were invited because of their known advocacy regarding elder and disability population needs. I spoke about the challenges facing elders in rural tribal communities that are being asked to attend the elder feeding site to receive their senior meals. Attendance at the elder feeding site is a way to reduce social isolation. However, this expectation can create a hardship to those elders living several miles from the elder feeding site that are living on a fixed income. We also took the opportunity to speak about cultural sensitivity training that needs to be provided to Aging and Disability Resource Center staff. Although we only had a short time to speak, it was an honor to be invited to attend along with LTC Waiver Director Denise Pommer.

7) Health and Wellness Center

The Tribe has an opportunity to apply for Indian Health Services Joint Venture Funding. If approved, this funding would cover 20 years of operational expenses for the new Health and Wellness Center. To achieve this goal the Health Care Center will need to save for the new Center as well as obtain additional funding support from outside sources. The Health Center currently has over $3.5 million invested. The Realty Department has provided the land description and Legal has drafted the resolution for Governing Board consideration. The Tribal Governing Board at this point, needs to dedicate 24 acres of land for the new facility. I will continue to advocate for a new Health and Wellness Center for our community as I believe our membership deserves to have the best resources available to them.

8) State/Tribal Transportation Contract

The State currently provides transportation through Medical Transportation Management ("MTM"), its contracted service provider, to get individuals that are covered by Medical Assistance to doctor or medical service provider appointments. The Tribe has the ability to subcontract with MTM to provide medical transportation services, however, MTM is not willing to work with the Health Care Center in this regard and the reimbursement rate for the service is very low. In addition, the service provided by MTM is not working well for many in our tribal community. Currently, the Health Care Center is providing transportation to members to get to medical appointments, etc. which is being supported by third party revenue that the Health Care Center receives. The Medical Transportation Manager Bill Morrow along with Community Health Director Mindy Lambert have expressed to me the need for a contract directly with the State. My role as a tribal leader is to bring this issue to the table at Department of Health Services ("DHS") Consultation. At the most recent consultation, I brought to DHS Secretary Linda Seemeyer's attention, the Tribe's desire to contract directly with the State to provide transportation services. The State believes this is doable and recommended that this be addressed through the SHO Letter Workgroup which is currently being developed. I will keep the membership informed as progress is made.

9) Dementia Care Funding

It was brought to my attention by for former Elder Program Director Mary Wolf along with Long Term Care Waiver Director Denise Pommer that the State has obligated Dementia Care Funding to 16 counties and 3 tribes in the State of Wisconsin. Mary and Denise both indicated that all tribes could benefit from the funding. As a tribal leader I have requested that Dementia Care Funding be on the agenda for the next consultation with the State Department of Health Services. Dementia is largely contributed to diabetes and the largest population impacted are Native Americans. We have a large population that are impacted by dementia in our tribal community and I will advocate that the State obligate and make the Dementia Care Funding available to Lac Courte Oreilles and tribe's that wish to utilize those funds.

10) Consultation with Wisconsin Department of Veteran's Affairs ("WDVA")

I'm proud to say that I took the lead along with Tribal Veteran's Service Officer Terrance Manuelito in a meeting with WDVA Secretary Danial Zimmerman. In light of the Opioid Epidemic I asked what steps the State was taking to help veterans that are impacted by the drug epidemic. The Tribe was provided information regarding the services of a Veterans Outreach Recovery Program ("VORP"). The VORP for our region is Paul Huber. The VORP also works with those veterans that are homeless. I would like to share that 56 percent of our Tribal Veterans Service Officer's position is funded by gaming dollars that tribes pay to the State of Wisconsin. I mentioned to the Secretary that we need a Veterans home in the Northern Region and he shared that the State is looking at building a new Veterans Home in one of the following locations: 1)Platteville, 2)Superior or 3)Rhinelander. It will take years of planning, but it is good to know that the State has this on their radar. It was a great consultation. Tribal Veteran Service Officer Terrance Manuelito is doing a great job representing the veterans in our tribal community.

11) Home Delivered Meals

Long Term Care Waiver Director Denise Pommer and I had the opportunity to meet with Older American Act State Program Supervisor Neal Minogue at the Aging and Disability Conference in September of this year. I discussed the home delivered meals, cultural sensitivity training for Aging and Disability Resource Center staff, and challenges with the Long Term Care Waiver Initiative. I shared with Neal that some elders in our community that live in outlying areas are not receiving their home delivered meals because they own a vehicle or may have access to public transit and should be able to make it to the elder feeding site. My concern is with the challenge placed on those elders that may not have the gas to make it to the elder feeding as they are living on a fixed income. In addition, the public transit may take hours out of their day to get to and from the elder feeding site which may be a deterrent. He relayed that he is willing to work with the tribe to ensure that elders are not deprived of their meal because of these challenges. He stated to me that there is no asset test. If an elder owns a car that should not disqualify them from receiving their meal. If you have been denied your home delivered meal because you own a vehicle, and reside in an outlying area, please reach out to the Elder Center and ask for reconsideration.

12) Department of Health Services ("DHS") Consultation

I took the lead in representing the Tribe at DHS Consultation along with Behavioral Health Director/Comprehensive Community Services ("CCS") Administrator Tammy Bergum, Community Health Director Mindy Lambert and Long Term Care Waiver Director Denise Pommer. Brought to the table were the following: Long Term Care Waiver Initiative, Transportation Contract with the State, CCS Billing issues, and CCS Peer Specialist Training. I was pleased to hear that the Tribal Income Maintenance Department will receive an increase in funding from the State as I had advocated for this at prior consultations. Sometimes the State does hear us. I was also made aware of an appropriation for lead abatement which I shared with Public Works Director Willard Gouge and he is researching to see if it can help address some lead issues in our communities. It was a great consultation and I'm proud of the team that accompanied me.

13) Housing

Recognition needs to be given to the Housing Authority for the vast improvements to the Housing Authority homes in our communities. Take an opportunity to ride through some of the communities such as Drytown and Water Tower and you will see the wonderful changes. In addition, the Housing Authority is in the process of rehabilitating 28 units through Low Income Tax Credit funding. As Housing Liaison, I attended the Housing and Urban Development ("HUD") Onsite Monitoring meeting between Housing Staff, Housing Board of Commission and representative from the Housing and Urban Development Office. The Housing Authority was recognized for having a good audit and for successfully closing out the Mold Remediation Grant.

14) Health Director

Dr. Jacqueline Bae has been hired as Director of the LCO Health Care Center. Dr. Bae comes with years of Indian Health Service administration and experience. The Tribe has approved Dr. Bae to work offsite remotely as needed until she is able to fully relocate here with her family and extended elder family members. I think as tribal members we can relate to the need in caring for our elders. It can be challenging to find an appropriate home for family that is elderly. Until Dr. Bae is fully relocated, she is onsite at the Health Care Center every two weeks and makes herself available to staff through Skype, email or by telephone. Dr. Bae had made several changes at the Health Care Center resulting in a budget reduction of $500,000. Dr. Bae has also obligated third party revenue to support transportation services, hearing aids, treatment, the Recovery House to name a few. Don Smith has been appointed by the Tribal Governing Board as "Interim" Assistant Health Director to fill in the gaps, when Dr. Bae is not onsite, and maintains constant contact with Dr. Bae for necessary guidance. It will be great to have Dr. Bae onsite full-time.

Other meetings and participation:

Tribal Caucus

Intertribal Criminal Justice Council

Tribal Liaison to the Sawyer County Health & Human Services Board

Housing Board of Commissioners

Indian Child Welfare

State/Tribal Consultations

HHS/IHS Consultations

Family Services Program

Elder Association

Tribal Health Directors

IM/TANF

There are a lot of positive things happening in our community. Let's remember to support and respect each other. I'm honored to be able to serve the membership by representing and advocating on behalf of the Tribe at the State, Federal, and local level.

Miigwech for the opportunity to serve!