FY2014 Annual Report - Denver Indian Health and Family Services

DenverIndianHealth&FamilyServices,Inc.
FY2014AnnualReport
DenverIndianHealth&FamilyService,Inc.
1633FillmoreStreet,SuiteGL‐1
Denver,Colorado80206
Telephone303.953.6600
Fax303.781.4333
www.dihfs.info
The mission of Denver Indian Health and Family Services is to
provide culturally competent services that promote the quality of health for
American Indian and Alaskan Native families, and individuals, in the Denver
area.
BOARDOFDIRECTORS
TerryBatliner,Member
CarolBerry,Secretary
MaymangwaFlyingEarth,Member
BettyGress,Chairwoman
CharleneIrani,Member
DonnaJohnson,Member
JusticeRhodes,Vice‐Chairman
RachelSimpson,Treasurer
StephenWheelock,Member
DearFriendsandSupporters
DIHFS was founded in 1978 as a result of a
needs assessment that called for co‐location
ofmedicalservicesfortheIndiancommunity
atonesite;theprovisionof healtheducation
in addition to primary services; and, the
delivery of services in a manner that was
comfortabletoIndianpatients.Fromthatday,
DIHFS has remained true to its original
mission in providing culturally appropriate
services that promote improved health and
quality of life for American Indian families
andindividuals.Sinceourfounding,wehave
servedcloseto7,000patients,fromover150
different tribes. We are proud of this
accomplishmentandaswecelebrateour36th
year, we look forward to a future that holds
evenmorepromise.
This is both an exciting and challenging time
to be involved in community healthcare
issues. There are over 50,000 American
Indian/AlaskaNatives(AI/AN)intheDenver
metropolitan area. More than ever, DIHFS
plays an ever‐increasing role in providing
primaryhealthcareservicestotheuninsured
and underinsured. Today, over 99% of our
clients are AI/AN. While we pride ourselves
onprovidinghighqualityhealthcareservices
equally to everyone who visits our clinic, we
continuetooperatecoreprogramsthatfocus
on eliminating health disparities among the
AI/AN community. In improving the quality
ofandaccesstocare,wenowprovidedental
services and have deployed electronic health
records (EHR) management. Meaningful use
of EHR information has resulted in incentive
paymentsfortheclinic.
With the passage of the Affordable Care Act
(ACA), the Indian Healthcare Improvement
Act was also passed, opening several doors
forourclinic.Wehavebecomeasitelocation
to receive Medicaid applications for patients
and funding from these services makes it
possible for DIHFS to provide more
healthcare services to our patients. We look
forward to the day when we can hire a full‐
time physician who can serve as the Medical
Director for our clinic. One of the most
exciting future goals is working to find a
permanent home for DIHFS. We also
continue to fulfill requirements to attain
accreditation with the Association for
AmbulatoryHealthCare.
DIHFShassurvivedtoughfiscalyearswhere,
despite sequestration and recessions, our
staff was able to maximize services to
patients through improved efficiency of
operations. Our staff, administration and
boardaredeeplycommittedtothemissionof
our clinic, and to the elevation of the health
statusofallAI/ANs.
Weareexcitedtoembarkonfuturejourneys
to develop and perfect existing programs in
order to continue exemplary service to our
patients.
Del Nutter
Chief Executive Officer
Betty Gress
Chairwoman
Table of Contents
Our Services …………………………………………………………………………….. Page 1
Medical Services …………..………………………………………………….. Page 3
Behavioral Health Services ………………………………………………. Page 4
Dental and Vision Services ……………………………………………….. Page 4
Diabetes, Wellness and Fitness Services .……………………...…….. Page 5
Healthcare Insurance Enrollment Services ….…………………….. Page 6
Family Services .………………………………………………………...…….. Page 6
Pharmacy Outlet Services .………………………….……………...…….. Page 6
Community Wellness Events and Outreach Programs …..….………… Page 7
Board and Staff ………………………………………………………………………… Page 12
Partnerships and Collaboration ……………………………………………….... Page 15
Recent Health Research and Study Partnerships ………………..………. Page 17
Administration and Allocation of Funds ………………………………..…… Page 18
Financial Statements ………………………………………………….……...……… Page 18
Statement of Financial Position…………………………………………..……… Page 19
Statement of Activities………………………………………………………………. Page 20
Fiscal Year 2014 Donors …………………………………………………………… Page 21
How You Can Help ……………………………………………………………………. Page 21
OurServices
Denver was one of the original sites for relocation of Indian people from their home
reservationsandcontinuestobeanucleusfortheNativeAmericanpopulation.Denver's
AmericanIndianpopulationisestimatedat55,000.Thisgroupiscomprisedofpeoplewho
havelivedinDenverforover35yearsandproducedsecondandthirdgenerationDenver
nativesaswellasthosewhoaretransientandmovetoandfromreservationsonaregular
basis. Although Denver is centrally located within “Indian Country”, it is isolated from
tribal health and Indian Health Service (IHS) and remains an eight hour drive from the
closest Indian health facility. The nearest IHS hospitals are in Rapid City, South Dakota
(400milesaway)andAlbuquerque,NewMexico(450milesaway).
DIHFS has served members from over
150 tribes with a service area including
Adams, Arapahoe, Boulder, Broomfield,
Denver, Douglas, Jefferson and Weld
counties. As the only primary care clinic
that provides culturally competent,
comprehensive
healthcare
and
prevention services specifically for low‐
income, uninsured AI/AN families and
individuals
within
the
Denver
metropolitan area, DIHFS is essential to
addressing the healthcare needs and
associateddisparitiesoftheAI/ANpopulationinColorado.DIHFSmaintainsafullystaffed
healthcentermanagementteamappropriateforthesizeandneedscurrentlydemandedat
the facility. DIHFS has also focused on incorporating community development into its
programs,serviceareasandreferralprocesses.Althoughnota“full‐service”IHShospital,
theclinicisoneof34UrbanIndianHealthProgramspartiallyfundedthroughIHS(witha
Title V “compact”). DIHFS is unique in the
metropolitan Denver area, currently
offering health care services to the AI/AN
population in the areas of primary and
familycare,diabetesmanagement,nutrition
andwellness,pharmacy,behavioraltherapy,
visonanddentalandenrollment.
DIHFS AI/AN patients have special
healthcare and insurance needs specific to
the Denver metropolitan area. Given the
1|P a g e smallsizeofthisU.S.sub‐population,thehealthstatusofAI/ANmembersissignificantly
lowerthanthatofthelargerU.S.population.
PatientVisitsbyDepartment‐ FY2014
Medical
376
Behavioral
1020
2476
Dental
1060
DiabetesPrevention/
Wellness/Fitness
472
OutreachServices
Vision
Access issues for AI/AN patients typically include limited high quality healthcare, no
insurance, language and communication barriers, medical practices that differ from
traditional AI/AN beliefs and traditions, fear and mistrust of healthcare institutions and
lack of cultural competency by providers leading to dissatisfaction among those AI/AN
memberswhovisithealthcenters.
TopTenTribal
MembershipsofActive
PatientsandClients
2|P a g e DIHFS medical staff provides comprehensive
andaffordablehealthcarewithagoalofhelping
patientsenjoyahighqualityoflife.Medicalstaff
is often the first point of contact for patients.
After being seen, patients are referredto other
serviceareasorfacilitiesforchronicdiseaseor
illness management assistance. Some patients
are also referred to the Diabetes,Wellness and
Fitness Department. The Medical Department
consists of two part‐time family practice
doctors, two nurse practitioners, one certified
diabetic counselor and two certified nursing
assistants.
Medicalservicescurrentlyprovidedinclude:
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GeneralMedicalCare
Chronic/AcuteIllnesses
ReferralsforAdvanced/SpecialtyCare
RoutineWellness
Work,SchoolandSportsPhysicals
Diabetes
HypertensionandObesityCare
GeriatricServices
STD/HIVExams
BehavioralHealthServices
DentalServices
VisionServices
InsuranceEnrollment MEDICALSERVICES
DIHFSisawholefamilyclinicoffering
westernmedicinewithnativeexpertise.
PatientandClientSummary
Newpatients/clientsenrolled‐487
Totalactivepatientsserved‐1,448
Femalepatientsandclients‐892
Malepatientsandclients‐556
Totalvisits–5,429
MajorAccomplishments
 ElectronicHealthRecord(EHR)managementimplementation.
 Renovationofmedicaldepartmentprovidingfreshandcomfortableenvironmentto
patients.
 Expansionofofficeservices.
 Newadultnursepractitionerhired.
 Implementation of ImprovingPatient Care (IPC) program. This 18‐month process
willworktoimprovethequalityof,andaccessto,carethroughthedevelopmentofa
systemofcarecalledthe“IndianHealthMedicalHome.”
3|P a g e Culturally sensitive services are provided for
a wide variety of mental health, behavioral
and substance abuse problems. DIHFS is a
licensed Substance Use Disorder Treatment
providerthroughtheStateofColorado,Office
of Behavioral Health. Services include initial
mental health screenings, child, adolescent
andadultindividualoutpatientmentalhealth
therapy. Substance abuse services include
BEHAVIORALHEALTH
initial screening, prescribed medication
SERVICES
monitoring, group relapse prevention,
individual outpatient mental health and
Outpatientbehavioralserviceshelpindividuals
improvehealththroughbehavioralchange.
counseling, groups therapy for a variety of
addictions and adult and youth residential
treatment (at external, culturally‐responsive residential facilities in Denver, Portland and
southern Colorado). Mental health services include native teen counseling and support
services offered in the Denver Public Schools, native support groups (including Elders
Talking Circle), group, couples and private/individual counseling and Native Family
counselingprogramsincluding“AlternativesforFamilies”and“TraumaFocused”cognitive
behaviortherapy.
TheDIHFSdentaldepartmentoffersafullrange
of services to adults and children. Primary
dental care services include examinations, x‐
rays, cleanings, periodontal therapy, fluoride
treatments and sealants; restorative dentistry;
prosthetics; oral surgery; and, endodontic
therapy. For those patients wishing the
convenienceofaneyeexaminationattheDIHFS
facility, referrals are made to Dr. Kenneth
Kauver, who works with insurance companies
and a negotiated contract with DIHFS for
paymentofservices.DIHFSalsoreferspatients
to the LensCrafters “One Sight” program for a
free eye examination and one pair of free
eyeglasses.
DENTAL&VISION
SERVICES
Affordableandcomprehensiveservicesat
oneconvenientlocation.
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DIHFS provides a variety of diabetes,
wellness and fitness services with a goal of
empowering and supporting patients to
improve overall health through better
nutrition choices and physical activity,
reducing the risk for co‐morbidities
associated with overweight issues and/or
obesity,preventingandimprovingcontrolof
DIABETES,WELLNESS
diabetes
through
improved
self‐
& FITNESS SERVICES
managementskillsandproblem‐solvingand
Empoweringandsupportingpatientsto
teaching skills regarding avoidance or
improveoverallhealth.
lessening of diabetes complications.
Primaryservicesinclude:
Nutrition, exercise, behavior change and health promotion/disease prevention for
patients who are overweight or obese and are at risk for or have diabetes and/or
heartdisease;
Diabetes self‐management education for patients with diabetes, and other
participants who are interested in these topics because they are at risk or have
familymemberswithdiabetes;
One‐on‐onenon‐clinicconsultationfornutrition;
Individual physical activity consultation/assessment and individual and/or group
fitnesstraining;
Diabetescasemanagement;and,
Consultation at clinic visits regarding health promotion/disease prevention and
diabetesmanagement.
MajorAccomplishments
 Increasingnumbers(29)ofparticipantsinFork‘nRoadAdultWeightManagement
and CrossRoads Diabetes Self‐Management Education (DSME) programs, offered
fourtimesandthreetimesperyear,respectively(34classestotal).
 Averageof24patientsseenpermonth,one‐to‐one,duringclinicdiabetesvisits.
 Increasingnumbers(65)ofdiabetesandnon‐diabetespatientsseenasdrop‐infor
information,education,classspecifics,suppliesandresources.
 Increasingnumbersofphysicalactivityparticipants:36appointmentsaverage per
monthwith360visitsinFY2014andsixhomeprogramsdeveloped.
 Special Diabetes Program for Indians (SDPI) grant applied for and received and
includingallgrantreporting,training,education,auditandotherrequirements.
 GPRAprogramco‐coordinationwithDIHFSFamilyNursePractitioner.
 SpearheadingHealthyPathwaysnewsletter.
5|P a g e HealthcareInsuranceEnrollmentAssistance
DIHFSoffersassistancetofamiliesandindividualswithenrollmentinMedicare,Medicaid,
CHP+, Colorado Indigent Care Program, Energy Outreach and the Prescription Assistance
Program. DIHFS also provides information and referrals to area health resources. Staff
membergoalsincludemaximizingalternativeresourcestoincreasepatientcareservices,
maximizing quality of care with available funds and increasing patient care quantity and
qualitythroughpatientandstaffeducation.Theenrollmentteamparticipatesinmultiple
community events each year to assist in Affordable Healthcare Act (ACA) and Medicaid
education and promotion of DIHFS services. In FY2014, DIHFS processed 964 Medicaid
applications, and through community
outreach
events,
assisted
an
additional 33 Medicaid applicants.
Another 48 people received Connect
for Health Colorado application
assistanceatoutreach.DIHFShireda
Health Coverage Guide who works
with the Medicaid Program site,
assisting patients with selecting
health insurance through the
exchangenetwork.
FamilyServices
In partnership with Sister Joanna Bruner Family Medicine Clinic, DIHFS refers pregnant
patientstotheClinicforchildbirthservices.Oncethepatientdeliversthenewborn,DIHFS
works with the patient on additional family planning and well‐baby care. DIHFS also
participates in the Women’s Wellness Connection program. DIHFS is compensated for
providing mammogram and cervical cancer screening (clinical breast exams, Pap tests,
pelvicexamsandmammograms)toreferredpatients.
PharmacyOutletServices
TheDIHFSPharmacyOutletislicensedthroughtheStateofColorado.Pharmacyinterns,
underthesupervisionoftheDr.PeterRiceandDr.ConnieValdez(professorsthroughthe
pharmacy program at the University of Colorado School of Pharmacy), fill patient’s
prescriptionsatwhichtimeDIHFSreceivesa$4feeperscript.DIHFSisalsoapprovedto
provide medications to patients at very reduced costs through the Health Resources and
ServicesAdministration340BDrugPricingProgram.
6|P a g e CommunityWellnessEventsandOutreachPrograms
DIHFS often offers other services and
classes, coordinates with guest
speakers
and
participates
in
presentationsandcommunityevents.
These wellness and education services
are offered to clients in order to
empower them to make lifestyle
changes that will change the course of
theirhealthandlivesandinclude:
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obesity prevention, nutrition
MembersoftheIroquoisNationLacrosseTeam–July2014.‐
andtobaccouse;
preventivehealthcareissues;
outreach and education, including obesity and diabetes screenings, at health fairs
andothercommunityevents;
communitytrainingsandeducationsessions;
interagencysupportservicenetworkparticipation;
resourcereferralwhenappropriate;
patienttransportation;and,
linguisticallyandculturallyappropriateservices.
9HealthFair
Withthesolemissionofadvancinghealthawarenessandprovidingpeoplewiththetools
theyneedtotakeresponsibilityfortheirownhealth,andbecauseofthesupportof16,000
statewidevolunteers,9HealthFairhashelpedsavethousandsoflivesbyprovidingfreeand
low‐cost health awareness and educational
screenings.Todate,9HealthFairistheonlyprogram
of its magnitude and that has become a community
institution as a result of the National Health
Screening Council for Volunteer Organizations
initiative.Sinceinception,9HealthFairhasimpacted
over 1.7 million individuals. DIHFS, in conjunction
with the Denver Indian Center, Inc. (DICI) has been
involved in the 9Health Fair for the last two
years.TheDICIgymisoneofmanysitesthroughout
the metropolitan Denver area which hosts the numerous 9Health Fairs. DIHFS’
involvementincludescommunityadvertising,coordinationwith9Healthmetroorganizers,
recruitment of volunteers, booth coordination and staging and final reporting to 9Health
7|P a g e organizers.DIHFSemployeesareavailableatboothswhichoffergeneralinformationon
DIHFS clinics and programs, Affordable Care Act information and Medicaid enrollment
assistance, BMI assessment (height, weight and body mass index), counseling
referrals, nutrition and at‐risk‐for‐diabetes counseling, behavioral health services, dental
services,medicalcounselingandpharmacycounseling.
CoatsforColorado‐WinterCoatGiveaway
The Coats for Colorado Winter Giveaway
Program has distributed over twomillion gently
usedandnewcoatstoindividualsandfamiliesin
need since 1982. More than 120 Colorado
agencies and charities participate each year and
every fall, to celebrate another year of service.
Each fall, freewintercoats are distributed by
DIHFS during a fun and traditional giveaway
eventfilledwithmusic,friendshipandhotcocoa.
ColoradoGivesDay
Colorado Gives Day is an initiative to increase philanthropy in Colorado through online
giving. Presented by Community First Foundation and FirstBank, Colorado Gives Day
inspiredColoradanstodonateover$17millionin2013.Donationsareacceptedthrough
ColoradoGives.org, with a goal to inspire and unite Coloradans in supporting local
nonprofits.
CrossRoadsDiabetesSelf‐ManagementEducationProgram
Participantsinthistwo‐classprogrammusthavecompletedthe
Fork‘nRoadclassesinordertobeeligibletoattendCrossRoads.
Topics discussed in these classes include Diabetes Overview;
Diabetes and Mind, Spirit, and Emotion; Diabetes Medicines
(oral and injectables); Home Blood Sugar Monitoring; Know
YourNumbers;PreventionofCardiacComplications;Balancing
YourBloodSugars(High/Low/SickDayManagement);Diabetes
Complications;DiabetesPrevention;SelfCare;and,StandardsofCare.
“Although class times
are
limited,
the
instructor allows for
classroom participation
andisalwayscommitted
tothecause.”
CrossRoadsProgramparticipationcontinuestogrow.Sinceinception,50participantshave
completedatleastoneclassandinFY14,another15havecompletedatleastoneclass.Of
these15,13havecompletedbothclassesofferedbytheprogram.
8|P a g e DenverMarchPowwow
Since 1984, the heritage of American Indians has
beencelebratedinDenvereveryyearattheDenver
MarchPowwow,oneofthelargesteventsofitskind
inthecountry.TheDenverMarchPowwowfeatures
more than 1,600 dancers from close to 100 tribes
from 38 states and three Canadian provinces. The
three‐day event in the Denver Coliseum is packed
with singing, dancing, storytelling, food, art and
more,ensuringawonderfulexperienceforeveryone.ThemodernPowwowisatimefor
Indianpeoplestocometogethertosinganddance,andtohonortheheritagethathasbeen
passeddowntothemfromtheirancestors.ThewordcomesfromtheNarragansettword
powwaw,meaning"spiritualleader."ThePowwowalsofeaturesover170boothssellinga
varietyofNativeAmericanartworksandproductsfromsomeofthenation'smostskilled
Indian craftsman. The Denver March Powwow is a welcoming glimpse into a fascinating
part of North American culture. DIHFS participates as a vendor and providing outreach
materialsatthisannualeventandhasdonesoforthepastsevenyears.
EnergyOutreachColorado
DIHFS provides support for patients with the Colorado Low‐Income Energy Assistance
Program (LEAP) in partnership with Energy Outreach Colorado. The LEAP program can
provide financial assistance with winter energy bills and other services specifically for
limited‐incomeColoradans.DIHFShasprovidedassistanceof$68,392infundingtopayfor
electricservicesthatpatientscannotpay.
Fork‘nRoadAdultWeightManagementProgram
This DIHFS program has continued a successful run with this
weight management program for nearly five years. The
programcaterstoAI/ANadultswhoarereadytoloseweightor
wish to maintain current weight levels. It also focuses on
individualshopingtopreventdiabetes,reversepre‐diabetesto
nodiabetesorbettercontroldiabetes.Theseclassesarefreeto
participants and support guests, with incentives randomly
distributed during sessions. Since inception up to 9/30/2013,
103 participants have completed four or more classes of the
seriesofseven(atleastoneclasseachfocusedonassessment,behaviorchange,nutrition
andphysicalactivity).SinceOctober2013,anadditional13peoplehavecompletedatleast
fouror more classes, as defined above. Of these 13, 11 have completed all seven
classes. Total participants since inception up through FY14 include 116 DIHFS clients
“TheonethingIlikebest
about the Fork ‘n Road
Programistheexpertise
of the staff. Obviously
they
are
highly
credentialed
experts.
Sharing their knowledge
withusistheirpassion.”
9|P a g e (completing four or more classes); many have improved BMIs and healthy behaviors,
includingnutritionandexercisescores.
HepatitisBVaccinationProgram
TheDIHFSHepatitisBVaccinationProgramhasbeenpromotedforpatientswithdiabetes
as part of meeting the 2012 CDC’s Advisory Committee on Immunization Practices new
recommendation as well as supporting the American Diabetes Association’s Standards of
Careforpeoplewithdiabetes.DeficienciesreflectedintheDIHFSDiabetesAuditwerethe
impetusforimprovingthepercentofpatientswithdiabeteswhohavecompletedtheseries
of3vaccinations,takingaminimumof6monthstocomplete.Thispastyear,resultsfrom
the program were shared with the national AI/AN community in a variety of ways. Ms.
Kathy Canclini, RN, MN, CDE, Diabetes Program Manager wrote an article for the Urban
Diabetes Care and Outcomes Summary Report: Aggregate Results from Urban Indian
Health Organizations, 2009‐2013, published in April 2014 by the Urban Indian Health
Institute(UIHI),aDivisionoftheSeattleIndianHealthBoard.Thearticleappearedinthe
Program Highlight section of the report (mailed to all Urban programs, and available on‐
line), and was entitled “Overcoming the Expense of Hepatitis B Vaccination by Exploring
New Funding Sources.” This article was also referenced and briefly discussed in the
Broadcast On‐line Newsletter for the Urban Indian Health Institute in May; program
highlightswerealsopresentedinanAugustSpecialDiabetesProgramforIndiansGrantee
Showcasewebinar:SharingSuccesses“ExploringInnovativeSourcestoImproveDiabetes
Care”. University of Colorado Skaggs School of Pharmacy students developed a poster
related to this program which they will present in December at an American Society of
HealthSystemsPharmacistsmeetinginAnaheim,California.Theyalsoplantopublishthe
results of the program regarding improvement in Hepatitis B vaccination rate for DIHFS
diabetespatients.
Let’sMove!inIndianCountry
Let’sMove!inIndianCountryispartoftheWhiteHouseLet’sMove(inColorado,inAmerica)
Initiative to motivate adults and children to lead a healthy lifestyle by incorporating
changes into their daily routines to defeat obesity, cardiovascular diseases, and
diabetes. Our program fosters this campaign for AI/AN individuals by advertising the
physicalactivityandnutritionprogramsavailableinourowncommunity.TheDIHFSFork
‘n Road program is one of many local AI/AN programs which promote the spirit and
missionof the LMIC. Diabetes staff nominate Fork ‘n Road participants, as well as those
individuals who regularly meet for physical exercise with our Diabetes Prevention
Specialist. All nominated participants are invited to quarterly events, coordinated by
Denver Indian Family Resource Center (DIFRC), where there are health‐related activities
andrecognition.
10|P a g e NationalNativeSkateJam
Each year, the All Nations Skate Project produces the
“All Nations Skate Jam” (ANSJ), the largest and most
prestigious skateboard competition for Native youth.
ANSJ brings together Native‐American skate
companies, youth groups, non‐profit organizations,
skaters, musicians, dancers, artists, filmmakers,
traditional craft vendors, contemporary artisans and
many others in a two‐day festival and skate
competition. The goal of the ANSJ is to give the
reservation,pueblo,urbanandsuburbannativeyouthacentralgatheringplacetomeetand
celebrate their diverse native cultures while competing in skateboarding. In past years,
over 6,000 people have participated in the two‐day long festival, with more than 300
skatersfrom50differenttribalnationscompeting.
11|P a g e BoardandStaff
The nine‐member Board of Directors share a wealth of expertise in organizational
developmentandleadershiptosupportDIHFSinservingthecommunity.Theroleofthe
Board of Directors is to govern DIHFS in a manner consistent with its mission and
responsive to specific community needs. In particular, the DIHFS Board of Directors is
requiredto:
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DefineandpreservetheDIHFSmission;
EstablishandmonitorDIHFSpoliciesandprocedures;
SafeguardDIHFSassets;
Select,evaluateandsupportDIHFS’sChiefExecutiveOfficer;
Monitorandevaluateboardperformance,aswellasthatofDIHFSasawhole;and,
StrategicallyplanforDIHFS’slong‐termgoals.
Regular DIHFS meetings were scheduled and held without cancellation once each month
(third Wednesday of the month unless moved because of holiday or CEO scheduling). As
partofDIHFSboardmemberduties,anoticeofallregularandspecialmeetingsweremade
public, an agenda wasfollowed and a schedule of boardactivities was developed. At the
onsetofeachDIHFSmeetings,publicattendeeswereacknowledgedandinvitedtoexpress
concerns,askquestionsandshareinformation.
The DIHFS board is comprised of volunteers that all have a tribal affiliation. As it is an
honor to serve the community, members do not accept payment for their service. Board
membersinclude:
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TerryBatliner–CherokeeNationofOklahoma–Member;Dentist
Carol Berry – Chickasaw Nation of Oklahoma – Secretary; Retired – U.S. Bureau of Reclamation,
FreelanceJournalist
MaymangwaFlyingEarth–GilaRiverIndianCommunityandaffiliationwithStandingRockLakota
andWhiteEarthOjibwe–Member;Attorney
BettyGress–Mandan,HidatsaandArikaraNations–Chairwoman;Retired–FederalCivilService
CharleneIrani–SeminoleandKiowaofOklahoma‐Member;RetiredElementaryEducationTeacher
Donna Johnson – Santa Ann Pueblo, Sisseton‐Wahpetonwan, Mdewakantonwan, Sioux – Member;
ProjectConsultant
Justice Rhodes – Cowlitz Indian Tribe – Vice‐Chairperson; U.S. Dept. of Housing and Urban
Development–OfficeofNativeAmericanPrograms
RachelSimpson–YanktonSioux‐Treasurer;Bio‐medicalResearchCoordinator
StephenWheelock–DelawareTribeofOklahoma–Member;ArtDealer
12|P a g e 2013‐2014DIHFSBoardofDirectors
StandingBackRow,lefttoright:TerryBatliner,RachelSimpson,StephenWheelock,DonnaJohnson,DelNutter(CEO)
FrontRow,lefttoright:CharleneIrani,CarolBerry;Sitting:BettyGress
Notpictured–MaymangwaFlyingEarthandJusticeRhodes
DIHFSemploysanexecutivestaffteamwhoworkwithclinicstafftocarryoutallrequired
primary,preventive,enablinghealthservicesandadditionalhealthservicesasappropriate
andnecessary,eitherdirectlyorthroughestablishedarrangementsandreferrals.Withan
annualoperatingbudgetofover$1.5million,thedeliveryofcomprehensivehealthcareat
DIHFSissupportedbyahighlycapableandefficientexecutiveteam.
Delbert Nutter, Chief Executive Officer (CEO) – Cherokee Nation of Oklahoma – Del
hasworkedatDIHFSasCEOforthepastsevenyears,holdsaMasterofScienceinBusiness
Administration and has over 45 years of experience in the healthcare industry. His
specialtyexpertiseisinbudgetingprocessesandpracticesandstreamliningorganizational
operations.WithovertwentyyearsinworkingwithtribalgroupsandNativeAmericans,
his leadership role at DIHFS has been instrumental in building successful relationships
amongotherhealthcareagencies,staffmembersandpatients.
AdrianneMaddux,ChiefOperatingOfficer(COO)–HopiTribeofShungapavi(Second
Mesa),Arizona‐AdriannehasworkedwithDIHFSforoversevenyears,holdsaBachelor
ofScienceinBusinessManagementandhasworkedinthemedicalfieldforover25years.
Her expertise includes extensive program and project management, office and staff
administrationandbudgetingandadministrationoffundedgrants.
13|P a g e Dedicatedhealthcareworkersarepossiblythemostnecessaryelementintherecoveryor
stabilityofapatient’shealth.DIHFSstaff,withdailyandongoingcommitmentstopatients,
deliverqualitycareinvolvingactiveparticipationinthewell‐beingofallpatients.Staffis
culturally competent and appropriately credentialed and licensed. Presently, the DIHFS
clinicalstaffandmanagementteamincludes:
TylerAlicks,AdultNursePractitioner
EugeniaAshley,MedicalAssistant–Navajo
ChristopherBarrientos,BillingandCodingSpecialist/HIMSManager–Apache
KatieCardinalBrown,Receptionist/Registration–OklahomaChoctaw
KathleenCanclini,DiabetesProgramManager
DruGuidry,Receptionist/Registration–Navajo
Dr.DarryllHawkins,Dentist
SandyHinton,DentalHygienist
JohnJewett,BehavioralHealthProgramManager–Lakota
DaphneJohnson,DentalAssistant
Dr.LawrenceMenconi,MD
PatriciaPino,MentalHealthandSubstanceAbuseCounselor–Laguna
KellyPoleyestewa,MAOutreachEnrollmentSpecialistII–LagunaPuebloandHopi
KellyRankin,FamilyNursePractitioner
ErlidawnRoy,HealthCoverageNavigator–Meskwaki,Ojibwe,LagunaPuebloandIsleta
PuebloTribes
FrancesRuiz,AdministrativeAssistant–LagunaPuebloTribe
JonathanSlater,RPMSSiteManager
JasminSpencer,MAOutreachEnrollmentSpecialistI–Yupik
ShawnWhite,DentalAssistant–OglalaLakotaSioux
ChrisWillis,DiabetesPreventionSpecialist
Dr.AdrianaM.Zuniga,Dentist
14|P a g e PartnershipsandCollaboration
Relationships with hospitals and other health care providers are important in securing
additional care, and often, specialty care services for DIHFS patients. DIHFS maintains
professional working relationships with several health care providers. These providers
offer some of the same services as DIHFS but often present some of the barriers and
disparitiesthatdiscouragetheAI/ANpopulationtoseekandmaintainpropermedicalcare.
ThesecollaborativeeffortsillustrateaguidingphilosophyessentialtoDIHFSsuccess–to
form alliances and partnerships to help bring the best health care services to DIHFS
patients. The clinic is part of the
communitiesserved,withlocalphysicians,
board members and staff who further the
DIFHS mission. Working together with
committedpartners,DIHFSisabletoshare
resources,skillsandknowledgetoprovide
thebestpossiblecare.
DenverIndianCenter
Denver Indian Center (DIC) is the first
point of entry for Native Americans from
thevarioustribesinthenationmovingto
themetropolitanDenverarea.TheCenter
offers basic emergency services, healthcare education, early childhood education and
employment and youth services. DIC is the hub of Native American events in the
metropolitan area, including numerous powwows and community education events.
DIHFS holds resource‐sharing meetings with DIC in order to mutually refer clients and
shareinformation.
DenverIndianFamilyResourceCenter
TheDenverIndianFamilyResourceCenter(DIFRC)isachildwelfareagencydedicatedto
meeting the diverse needs of Native American children and families, offering an array of
culturally appropriate family strengthening, family reunification and child welfare
advocacyservices.DIHFSholdsresource‐sharingmeetingswithDIFRCinordertomutually
referclientsandshareinformation.
DenverPublicSchools
Denver Public Schools implements the Indian Education Program which focuses on
ensuring that supplemental academic, social and cultural services are provided to AI
students. DIHFS partners with Denver Public Schools to provide behavioral health
counselingforstudentsinschools,ingradesK‐12.
15|P a g e NationalNativeAmericanAIDSPreventionCenter
The National Native American AIDS Prevention Center (NNAAPC) offers a variety of
programstohelppromoteeducationaboutHIV/AIDS,supportpreventionefforts,andhelp
fosterhealthyattitudesaboutsexualityandsexualhealthintheNativecommunity.DIHFS
has worked with NNAAPC since their inception and provides education and outreach
pamphletstopatientsrelatedtotheprograms.
NativeAmericanCancerResearch
The mission of Native American Cancer Research (NACR) is to develop and test primary,
secondary and tertiary interventions and influence the early adoption of prevention and
controlofcancerincludingriskreduction,screening(earlydetection),education,training,
control, treatment and support or study of
cancer and cancer‐related issues among
Native Americans. DIHFS partners with
NACR to help meet mission goals through
conducting and promoting research,
education and training in the cancer
continuum.
Centers for American Indian Alaska
NativeHealth
The mission for the Centers for American
IndianandAlaskaNativeHealth(CAIANH)is
to promote the health and well‐being of
AmericanIndiansandAlaskaNatives,ofallages,bypursuingresearch,training,continuing
education, technical assistance and information dissemination within a biopsychosocial
frameworkthatrecognizestheuniqueculturalcontextsofthisspecialpopulation.DIHFS
sharesstatisticsanddataformultipleresearchprojects.
WellDynePharmaceuticals
DIHFS partnered with WellDyne Pharmaceuticals, offering a free prescription and health
care discount card. This service provides patients and family members access to pre‐
negotiated savings on a wide range of health care products and services including
prescriptiondrugs,labtests,MRIandimaging,visioncareanddentalcare.
16|P a g e RecentHealthResearchandStudyPartnerships
CellandTellforHeartHealth
In collaboration with University of Colorado ‐ Denver (UCD), the program measures the
responseofhealtheducationandreducingriskfactorsforheartdiseaseamongadulturban
Indian patients through use of text messaging. Participation involved completing a brief
questionnaireandafollow‐upquestionnaireaskingaboutknowledgeofheartdiseaseand
stroke, physical activity levels, eating habits and tobacco use. A five‐week course of text
messages were sent to participants, who were compensated for their time involved with
thestudy.
CommunityHealthNeedsAssessment
In order to better serve the urban AI/AN community in the Denver metropolitan area,
DIHFS began to explore the possibility of expanding to become a federally‐qualified,
Section330HealthCareCenter.Asaninitialstepinthatprocess,theclinicappliedforand
received a Health Center Planning Grant funded by the U.S. Department of Health and
Human Services, Health Resources and Services Administration, to support the
developmentofaproposaltoqualifyDIHFSasaSection330HealthCareCenter.Oneof
theactivitiesrequiredbytheplanninggrantwasacomprehensivecommunityhealthneeds
assessment for DIHFS’s service area. Corona Insights was retained in March of 2012 to
conductthiscommunityhealthneedsassessmentonbehalfofDIHFS.Thiseffortnowhelps
guide DIHFS in working to improve healthcare services for the AI/AN community in the
Denver metropolitan area. As part of the study, Corona Insights gathered feedback from
AI/AN individuals in the DIHFS service area, particularly those seeking services from
Indian‐focused organizations, professionals providing health care or health‐related
services.
GumDiseaseRiskinNativeAdolescents(GRINS)
Partnering with Dr. Kristen Nadeau from Children’s Hospital in Denver, Colorado, this
compensated study was researching the connections between gum health, diabetes and
obesityinNativeAmericanteenagers.
TakingOffPoundsSensibly(TOPS)
In collaboration with Dr. Nia Mitchell at UCD, DIHFS works with TOPS ‐ an international,
non‐profitweightlossprogram.ThisUCDresearchstudyworkswithpeopleinterestedin
losing, and maintaining, a healthy weight. Participants meet for one year, participate in
studyactivitiesandreceiveaone‐yearmembershiptoTOPS,alongwithaWellnessToolkit.
17|P a g e AdministrationandAllocationofFunds
DIHFSmaintainsadministrative,fiscalandclinicalpoliciesandproceduresrelevanttothe
services offered. These policies and procedures are approved and updated on a regular
basisbytheBoardofDirectors.
DIHFSreceivesamajorityofitsfundingfromtheUnitedStatesDepartmentofHealthand
HumanServices’IHSProgram.Othersourcesofpassthroughfundinginthepastfiscalyear
includeWellWoman’sConnection,ColoradoIndigentCareProgramandEnergyOutreach
ofColorado.AsamemberofCaringConnections,BoardofDirectorsmemberscontribute
financiallytoDIHFS.
FinancialStatements
InJanuary2015,anindependentauditoffinancialstatementsofDIHFSfortheyearended
September30,2014wasperformedbyTaylor,RothandCompany,PLLC.Inplanningand
performing the audit of financial statements, in accordance with auditing standards
generallyacceptedintheUnitedStatesofAmerica,considerationofDIHFSinternalcontrol
overfinancialreportingwasusedasabasisfordesignauditingproceduresforthepurpose
ofexpressingopinionsonfinancialstatements.Significantauditfindingsincluded:




Allsignificanttransactionswererecognizedinthefinancialstatementsintheproper
period.
No significant difficulties in dealing with management were experienced when
performingandcompletingtheaudit.
Journalentriesrequiredofmisstatementsidentifiedintheaudithavebeenreposted
byDIHFSmanagement.
Opportunitiesforstrengtheninginternalcontrolsandoperatingefficiencyinclude:
o AccountingPoliciesandProcedures–Recommendationtoestablishpolicies
to prevent DIHFS from entering into transactions that might appear to
involve a conflict of interest and to prevent DIHFS from accepting an
inappropriatedonationoradonationthathasinappropriaterestrictions.
o Bank Reconciliations – Recommendation that the CEO review and approve
the monthly bank reconciliations and establishing a policy for researching
andclearingreconcilingitemsthathavebeenoutstandingforlongerthansix
months.
o
Social Media Policy –Recommendation to develop a policy with the help of
anemploymentspecialisttodealwithFacebookrelatedpostingactivitiesof
DIHFS employees in work‐related situations in order to educateemployees
aboutthepotentialemploymentimpactofusingsocialmedia.
18|P a g e StatementofFinancialPosition
19|P a g e StatementofActivities
20|P a g e FiscalYear2014Donors
Infiscalyear2014,generousgiftsandcontributionsfromdonorsfurtheredDIHFS’sactions
toprovideculturallyappropriateservicesthatpromoteimprovedhealthandqualityoflife
forAmericanIndianfamiliesandindividuals.Wegratefullyacknowledgetheirsupport.
$1,000‐$4,999
CaringConnection
$10‐$999
ColoradoGives
HowYouCanHelp
There are many worthy charitable organizations and causes in the metropolitan Denver
areadeservingcommunitysupport.DIHFS,a501(c)(3)nonprofit,servesthemedicalneeds
of55,000localAmericanIndiansinaculturallysensitiveenvironment.Theorganizationis
not affiliated with any tribe, casino nor tobacco shop and is not an arm of the federal
government.Wearesupportedbygrants,giftsandcontractslikemanyothernon‐profits.
Please consider our charitable work and contribution to the medical community serving
someofDenver’sdisadvantagedcitizens.
The DIHFS Board of Directors is most appreciative of the philanthropic support the
organizationreceives.AllcharitabledonationsmadetoDIHFSarefullytax‐deductible.For
informationonmakingagiftorcontributiontosupportourclinic,pleasecontactAdrianne
Maddux, Chief Operating Officer at 303‐953‐6600 or email [email protected]. You may
alsowriteto:AdrianneMaddux,ChiefOperatingOfficer,DenverIndianHealthandFamily
Services,Inc.,1633FillmoreStreet,SuiteGL1,Denver,CO80206.
21|P a g e DenverIndianHealthandFamilyServices,Inc.
1633FillmoreStreet,SuiteGL‐1
Denver,CO80206
(303)953‐6600
www.difhs.info
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