Contact Snohomish Health District to prevent rabies
Source: Snohomish County Health District
SNOHOMISH COUNTY, Wash. —Beware of bat bites and scratches. Most bats are harmless, but about 1 in 100 bats caries rabies.
Bats like to “hang out” in vacation cabins, attics, barns and outbuildings, and wherever there are plenty of insects they can eat. A bat bit a toddler in Pasco last year after falling out of a patio umbrella. The toddler got treatment to prevent rabies even before the bat was tested for the disease. Rabies is almost always deadly.
Last year, 32 people in Snohomish County got a series of shots to prevent the virus after possibly being exposed to rabies. Thanks to such preventive efforts by public health, no cases of rabies exposure in Washington state have advanced to human rabies disease since 1997.
Anyone who might have been bitten, scratched or simply sleeping in a place where a bat is later found should contact Snohomish Health District Communicable Disease staff at 425.339.5278.
Bats found in a home or setting where they may have contacted humans should be safelycaught:
·Close the doors and windows to the room
·Find a small container like a box or a large can
·Wait until the bat lands on the floor or a wall
·Wearing leather gloves, put the box over the bat
·Close the box by sliding an extra piece of cardboard under the opening
·Leave some small air holes in the sealed box
·Call us for advice
We will help you determine if any people or pets in your home may have been exposed to rabies, and can arrange to test the bat if needed. If a bat is not available for testing and people have been exposed to it, rabies shots are usually necessary.
In the Northwest, bats are the only animal likely to carry rabies, though there have been cases of pets getting rabies from bats, and of dogs infected with rabies being brought in from other countries.
Established in 1959, the Snohomish Health District works for a safer and healthier Snohomish County through disease prevention, health promotion, and protection from environmental threats. Find more information about the Health Board and the Health District at http://www.snohd.org.
Foraged vegetables are always more fun to cook. So Food52’s resident forager, Tama Matsuoka Wong, is introducing us to the seasonal wild plants we should be looking for, and the recipes that will make our kitchens feel a little more wild.
If you’ve ever found a blueberry or a black raspberry on the side of a trail and popped it in your mouth, you’ve been foraging. Although it’s more convenient to “forage” farmers markets or grocery aisles for cultivated berries, I love the intense flavor of wild berries, as well as the fun of picking them in their natural habitat. Here is a rundown of some of the summer season’s most common wild berries:
Aggregate berries: Raspberries, blackberries, and wineberries
Aggregate berries are distinguished by their tightly packed clusters of fruits, known as carpels. The most common example is the raspberry, which is really a bunch of tiny red fruits clustered together. This sort of formation is a good thing, because each little fruit droplet on its own would hardly be enough for a mouthful!
These berries belong to the rose family, and grow on long arching “canes” that often form dense, brambly thickets. Much like roses, their bristles and thorns can make picking a somewhat prickly adventure — so be prepared!
Tama Matsuoka Wong
Wild red raspberries, or Rubus strigosus (above), can be found throughout North America, excluding the Deep South. Unfortunately, I sometimes find that wild raspberries can be quite seedy and dry, depending on the place and the weather. Black raspberries — the eastern Rubus Occidentalis and the western Rubus leucodermis — are native to North America and are found from mid- to late summer.
When you pick a raspberry from its plant, it leaves behind a small white cone — that’s the “receptacle,” which attaches the fruit to the cane. The blackberry cone receptacle, on the other hand, remains attached to the fruit, which explains why blackberries are flat where they connect with the plant, while raspberries have that hollow bit where the cone once was.
Tama Matsuoka Wong
The Asian wineberry, or Rubus phoenicolasius (above), grows on the shady edges of woods throughout most of North America, and is easy to identify because it has very fuzzy, thorn-less canes. Some wineberries are more tart than others, but they all have an incredibly fresh taste and a ruby-colored, jewel-like shine. The fruit emerges from fuzzy cases — which almost look like Christmas lights — which slowly open to reveal bright red berries. Like raspberries, they leave behind a small, white, cone-shaped receptacle when picked. Since wineberries are invasive, I never hesitate to hack away at their canes like a lumbering bear.
Tama Matsuoka Wong
Mulberries (above), often found on old farms and in backyards, are also aggregate berries, but they grow from trees. The entire fruit is joined to the stem directly, so there is no white receptacle left behind when they’re picked. The indigenous mulberry tree, Morus Rubra, has been hybridized with the Morus Alba tree from Asia, and now bears both white and red fruit.
“Crown” berries: Blueberries, huckleberries, and juneberries
Wild blueberries and huckleberries are in the Heath family, and grow as bushes or shrubs in soils with low acidity levels. While these are all bluish in color, the key identifier is that the edible blueberries all have a crown at one end.
Wild blueberries (below) look very similar to the store-bought variety, except they’re much smaller and less plump. What they lack in girth they make up for with incredible flavor: After I’ve been eating a lot of wild ones, I find cultivated blueberries taste bland and watered down.
Tama Matsuoka Wong
Huckleberries are quite small, though their seeds are larger than those of blueberries and tend to stick to your teeth. My friend, West Coast-based forager Connie Green, swears by coastal huckleberries, which take on a deep flavor in September. While huckleberries have had a couple of difficult years due to droughts, she reports that this year looks more promising.
Juneberries, also called serviceberries, are bluish-purple berries that have a crown at one end but grow from trees rather than bushes. The Amelanchier canadensis variety grows wild on the East Coast, while the Amelanchier alnifolia, known as saskatoons, are prevalent in the Pacific Northwest. These berries are plump and juicy, with a sweet-tart taste; like aggregate berries, they are also a part of the rose family. They make great jam, especially when mixed with rose petals.
It is important to note that there are several varieties of poisonous berries: Pokeweed, privet, honeysuckle vine berries, nightshade, and Japanese honeysuckle are all blue or purple in color; red-colored poisonous berries include bush honeysuckle and yew. Neither are aggregate fruits, nor do their berries have crowns. Always be sure to identify your plants, and do not just pop any old berry into your mouth as an experiment.
After a day spent foraging (and gobbling) berries in the woods, the last thing I want to do is spend a lot of time cooking, which is exactly why I tend to rely on store-bought pie crust for this incredibly simple pie. The pie is all berry, so their wild flavors shine through. It gets its zing from a bit of lemon and cassis, a trick I learned from my friend Betsy. It is also very flexible in terms of berry-to-berry ratios, so if I’ve eaten up most of the blueberries, I can just add more wineberries, and so on.
1 double pie crust (your favorite recipe, or store-bought)
5 cups mixed wild berries (I used 2 cups wineberries, 2 cups wild blueberries, and 1 cup mulberries)
1/2 cup sugar
1/4 cup cassis
Juice of half a lemon
Zest of 1 lemon
1/3 cup flour
Fruit jam (we used wineberry-blueberry jam from last year)
1 egg yolk (optional)
Raw sugar (optional)
Tama Matsuoka Wong is a professional forager and the author of Foraged Flavor.
Wait lines for health screens and denials at the blood bus
Amanda Shelton explores the differences between traditional tobacco use and cigarettes. Photo: Andrew Gobin/Tulalip News
By Andrew Gobin, Tulalip News
The Tulalip Karen I. Fryberg Health Clinic hosted their annual health fair July 28, with participants lining up at health screening stations, a fair first in 31 years,.
“I think this is the biggest health fair that we’ve ever had, there have been lines all day,” said Jennie Fryberg, front desk supervisor at the clinic. “More than 280 participants signed in, 200 of which were here before lunch.”
Every year, the clinic holds a blood drive simultaneously with the health fair. This year, more than 20 people had scheduled donor times with the Puget Sound Blood Center’s Blood Bus. Walk-ins are always welcomed at the Blood Bus, but there were so many walk-in donors this year, in addition to those with scheduled times, that for the first time at Tulalip, donors were being turned away due to lack of space. Of the 33 people who tried to give blood, 29 were able to.
Puget Sound Blood Centers Blood Bus Photo: Andrew Gobin/Tulalip News
With a record 35 booths, 8 screening stations, and a fun run, there seemed to be more interest in this year’s health fair than in previous years.
“People were here at 8:30 a.m. waiting for booths to open,” said Sonia Sohappy, a bowen therapist for the clinic’s complimentary medicine program.
The day started out busy, and really stayed comfortably crowded throughout the day. People stopped at screening stations, checking blood sugar, vision, blood pressure, tuberculosis, hepatitis, and more.
The annual health fair is one of many open house events at the Tulalip Karen I. Fryberg Clinic throughout the year. Watch for event announcements in the See-Yaht-Sub, on the Tulalip News Facebook page, or contact the clinic by phone at (360) 716-4511 for more information.
Calendula harvested from the Tulalip Health Clinic’s Diabetes garden. Photo: Andrew Gobin/Tulalip NewsRainbow Radishes harvested from the Tulalip Health Clinic’s Diabetes garden. Photo: Andrew Gobin/Tulalip News
Andrew Gobin is a staff reporter with the Tulalip News See-Yaht-Sub, a publication of the Tulalip Tribes Communications Department. Email: agobin@tulalipnews.com Phone: (360) 716.4188
Water that truly unlocks health, or the latest cure all snake oil?
Signature Enagic water jugs, the mark of a Kangen user. Photo, Andrew Gobin/Tulalip News
By Andrew Gobin, Tulalip News
You may have seen the blue and black Enagic water jugs people are packing around these days. You’ve probably heard about Kangen water, and if you yourself are not a Kangen user, you’ve probably wondered what exactly is so special about this water from all other filtered waters. The answer to which often leaves people with many more questions about how it all works, or why Kangen is a better choice. Here you will get an in-depth look at this latest health fad.
Many Kangen users tout this water as the new miracle in naturopathic health. Easily absorbed by the body, this water is supposed to keep you hydrated, in addition to being an antioxidant.
Tulalip tribal member Caleb Woods, a Kangen user, said, “I feel more energized, and toxins flush out of my body faster. I notice I sweat easier, and my acne has been clearing up.”
The effects Woods noted are typical of any well hydrated person, so what makes Kangen different? The answer is not so simple.
What is Kangen water exactly? In a nutshell, it is basic, or alkaline. The machine that filters and produces the water is actually a medical machine developed by a Japanese manufacturer 40 years ago. According to Kangen rep, Shawn Brown, water from the city tap or well goes into the machine, is filtered, and then restructured using electrolysis; a process of running an electric current through the water. Water molecules, which are naturally polarized, cluster in a naturally hexagonal structure, similar to a honeycomb. The restructuring of water arranges the molecules into micro clusters of five to seven molecules, instead of the typical 15. That process also ionizes the water, which makes it basic by creating a negative hydroxyl molecule (HO–) and a positive hydrogen ion (H+), or cation. Micro clusters of hydroxyl molecules are more easily absorbed in the body.
The separation of ions of Kangen water raises the pH, which is a measure of the power, or concentration, of hydrogen ions in any compound. The pH scale runs 1-14, 7 being neutral. As the concentration of hydrogen ions increases, the pH number decreases. Acids have low pH, and bases have high pH. Water typically measures at 7. According to the Snohomish County Health District, city water measures at 7.5 because of the lye added to the water to prevent rusting pipes, both hazardous to health in and of themselves. Kangen water is very basic when it’s ionized, measuring between 8.5 and 11, though agitating the water will return it to a neutral state. Also, if not consumed immediately, the natural interaction between the cations (H+) and hydroxyl (OH–) molecules will return the Kangen water to natural water (H2O).
What is the need for alkaline Kangen water?
Brown said, “Cities put a lot of chemicals in the water to kill bacteria, or to make the water healthy. Essentially, that is dead water. Kangen water is not only filtered, but it has free hydrogen ions, which is a natural antioxidant.”
The hydrogen cations are regulators that catalyze chemical reactions in the body’s systems, drawing out free oxygen molecules, or oxidants. In that way, the water is alive, interacting with the body as you drink it. The abundant of cations join with oxidants, neutralizing them. But Kangen water, as a basic solution, disrupts the body’s cells from doing this naturally by inhibiting the mitochondrial processes. The mitochondria of a cell, which govern metabolism in cells and in turn the body, require oxidants in order to metabolize proteins. Hydroxyl molecules join with free radicals making hyperperoxide in the body, allowing the free cations to seek out oxygen and oxidants to join with. That essentially leads to the depletion of oxygen creating a chemical imbalance in the body and a disruption of natural processes at a cellular level. This leads to premature cell death. The body works to regulate itself, and these processes occur naturally without Kangen water.
“The body is naturally alkaline, the blood is alkaline. If the body is acidic, you’re probably sick,” said Brown.
That is true, though not entirely accurate. The ideal pH of blood is between 7.3 and 7.4. So yes, it is alkaline, but only slightly. The body’s many systems help to regulate the pH of the body, each producing acids and bases, specific to each system. While the body is naturally alkaline by design, it is regulated through the secretion of acids produced in the body. Acids, like lactic and stomach acids, are designed to breakdown sugars and proteins, while bases, various hormones, are designed to specifically regulate systems in the body, many of which produce acids. Systems in the body use water to make hydroxyl and hydrogen cations for the purpose of metabolizing compounds and cleaning the body. It is a delicate balance that can have serious health implications when altered.
While it is a delicate balance, deviation of pH levels, even slightly, are signs of serious illness in the body. To do this intentionally has many health implications. For example, deviations in body chemistry of any degree affect metabolic systems drastically. A shock of pH imbalance due to raising the alkalinity of your body could lead to alkalosis. Mild alkalosis causes muscle spasms and cramps. Severe alkalosis can lead to tetanus or cardiac arrest. Acidosis, in contrast, causes mild nausea, vomiting, convulsions, and apnea.
Why does it matter, you may wonder? First of all, Kangen water will be available at all youth summer programs, and at the summer school. Parents should be aware that this is being served to your children. For people with strict dietary needs, there are serious health risks associated with altering body chemistry. That’s not saying Kangen is bad, or shouldn’t be used, but parents should be aware of what their children are exposed to. If people, including children, are on medications, they need to know how Kangen water affects them. The Kangen website and virtual demonstration specifically warn that users should not take medications with the alkaline Kangen water, and should refrain from drinking Kangen for an additional two hours afterward.
Second, there has been a large push that this is the answer to a healthier membership. There is a community Kangen machine available to the public for an hour, mornings and afternoons, at the Don Hatch Jr. Youth Center. Some members have machines in their homes. Kangen can only be acquired through the use of these machines, not sold in stores anywhere. These machines run between $2500 and $4000, and can be acquired through a regional Kangen representative. While the benefits of Kangen may outweigh the risks, the truth is, you don’t need Kangen water to be healthy. Similar results can be achieved through choosing organic foods and eliminating processed foods as much as possible, and expanding your diet to include foods that have specific benefits for healthy function of the body’s systems.
There is no magic cure all to ailments. While you can’t drink your way to health, it is beneficial to drink filtered water. To date, however, there is no documented medical suggestion that says basic water is healthier than natural water, in fact the opposite. Whatever water you choose to drink, the importance is to stay hydrated.
Andrew Gobin is a staff reporter with the Tulalip News See-Yaht-Sub, a publication of the Tulalip Tribes Communications Department. Email: agobin@tulalipnews.com Phone: (360) 716.4188
Some tribal leaders and environmental groups say a water-pollution cleanup plan proposed by Gov. Jay Inslee this month is unacceptable because while it tightens the standards on some chemicals discharged to state waters, it keeps the status quo for others.
Inslee is drafting a two-part initiative to update state water-quality standards, to more accurately reflect how much fish people eat, and to propose legislation to attack water pollution at its source. The fish-consumption standards have the effect of setting levels for pollutants in water: The more fish people are assumed to eat, the lower the amount of pollution allowed.
Inslee decided that lowering some standards wouldn’t create a big-enough benefit to human health to justify the economic risk for businesses, said Kelly Susewind, water-quality program manager for the state Department of Ecology.
“The realistic gains on the ground didn’t warrant that concern and disincentive to invest in our state,” Susewind said.
That’s because the rules regulate state permits for dischargers, such as industrial manufacturers and wastewater-treatment plants — but that isn’t where most of the pollution is coming from.
Setting tougher standards for some pollutants would also result in levels too low to detect or manage with existing technology — but would create a regulatory expectation that could cloud future business investment, Susewind said.
“The concern is that we set in motion a chain of events where it is inevitable they can’t comply. If they are worried they will cease to invest in 30 years, they are not going to invest today; that is the long-term picture that caused the uncertainty.”
In the case of PCBs — polychlorinated biphenyls, industrial chemicals used as coolants, insulating materials, and lubricants in electric equipment — setting a limit below the existing limit of 170 parts per quadrillion wouldn’t improve people’s health, Susewind said. That’s because most PCBs are entering waterways from other sources, including runoff. “It is not the most effective place, to put the pinch on dischargers,” Susewind said.
The problem is that the Clean Water Act, under which the standards are issued, doesn’t reach beyond so-called point sources: pollution in water discharged from pipes by industries and others regulated by Ecology and the federal Environmental Protection Agency (EPA).
“A lot of our challenge is finding ourselves with only one tool,” said Carol Kraege, who leads toxics reduction at Ecology. “Getting toxics out of our water with just the Clean Water Act is not enough.”
To gain new tools to clean up state waters, Inslee has asked Ecology to put together legislation to expand its authority to ban certain chemicals, to keep them from getting in the water in the first place. The legislation, which is still being drafted, is intended to address so-called non-point sources of pollution.
The governor has said he won’t submit a final water-quality rule to the EPA for approval until after the legislature acts.
Christie True, director of King County Natural Resources and Parks, which runs the county’s wastewater-treatment plants, said she was encouraged by the governor’s approach. “We have to be focused on outcomes,” True said.
“The thing I was really happy about was he said we can’t just rely on regulating the same old sources if we want to improve water quality. I know it is going to be very challenging to take these issues to the Legislature, but that is where we need to head to have a better outcome.”
The debate now under way arose from the state’s need to update the water-quality standards that address health effects for humans from eating fish. The state’s rules today assume a level of consumption so low — 6.5 grams a day, really just a bite — that it is widely understood to be inadequately protective, especially for tribes and others who eat a lot of fish from local waters.
The standard also incorporates an incremental increase in cancer risk in that level of consumption.
Inslee has proposed greatly increasing the fish-consumption standard in the new rule, to 175 grams per day, a little less than a standard dinner serving. But he also upped the cancer risk, from 1 in 1 million under current law, to 1 in 100,000 in the new standard. That was to avoid imposing tighter standards for some pollutants.
That isn’t good enough for tribal leaders who say they want tougher protection now — for all pollutants, not just some. “Holding the line isn’t good enough,” said Dianne Barton, water-quality coordinator for the Columbia River Intertribal Fish Commission.
Counting on the Legislature to grant new authority to Ecology and money to back it up is also a shaky proposition, some said. “That is a big gamble,” said Chris Wilke, executive director of Puget Soundkeeper, a nonprofit environmental group that sued the EPA to force Washington to update its standards. Delay, meanwhile, “is more business as usual,” Wilke said.
Brian Cladoosby, chairman of the Association of Washington Tribes and the Swinomish Indian Tribal Community, said tribes are going to take their case directly to the feds both at Region 10 EPA and in the EPA administrator’s office in Washington, D.C., and insist no change be made in the cancer risk.
“In our minds, the bar hasn’t moved that much,” Cladoosby said. “It took 100 years to screw up the Salish Sea; hopefully, it won’t take another 100 years to clean it up. But we have to start somewhere.”
Vaccination, testing and treatment can limit liver damage
SNOHOMISH COUNTY, Wash. – Liver damage and liver disease caused by viruses kill more people in the U.S. each year than HIV/AIDS. Hepatitis C is the most common of those viruses that attack the liver. In Snohomish County, 649 people were found to have hepatitis C last year. Hepatitis B affected 263 local people in 2013.
Most people with a liver virus don’t know they have it until the disease has caused serious liver damage. New medications for treating hepatitis C can cure the disease and prevent the need for liver transplants or liver cancer treatment in the future.
Testing for hepatitis C can be as easy as a prick of your finger and 20-minutes for your results. Testing is recommended for everyone born between 1945 and 1965, since baby boomers are five times more likely to have the virus. The cost is covered by health insurance.
People who inject illegal drugs – even just once years ago – are another group at risk for getting viral hepatitis.
The Snohomish Health District works to prevent and limit the spread of viral hepatitis by testing and offering vaccines to people most at risk. A nurse regularly visits the Snohomish County Needle Exchange, jails, treatment centers, and homeless shelters as part of the agency’s public health outreach program.
“A discouraging trend is an increase in hepatitis C among young people who use drugs,” said Nurse Kathy Perkins, of the Hepatitis Outreach Program. “People with hep C die 23 years earlier than average. Doctors need to talk to their patients, assess risks, test for and treat viral hepatitis.”
Vaccines to prevent hepatitis A and B are recommended for people at risk. There is no vaccine against hepatitis C.
The Snohomish Health District will have information about viral hepatitis in its Everett building and at local libraries to recognize World Hepatitis Day on July 28. Learn more at www.worldhepatitisday.org.
Incorporated in 1959, the Snohomish Health District works for a safer and healthier community through disease prevention, health promotion, and protection from environmental threats.
Washington is slowly moving ahead with a long-delayed plan to update its water quality rules. Tuesday’s will be the first public meeting on Gov. Jay Inslee’s proposal to dramatically increase the fish consumption rate, which determines how clean discharged water must be. But some say the proposal doesn’t go far enough.
The governor’s plan would increase the fish consumption rate to about a meal a day, rather than a meal a month. It would increase the current rate of 6.5 grams per day to 127 grams per day. That’s the same rate recently adopted by Oregon, which has the strictest rate in the country.
“Well, yes, but it’s important to remember that that’s just one part of this equation,” said Chris Wilke with Puget Soundkeeper Alliance, one of four groups that sued the federal government last year to force it to make the state comply with the Clean Water Act.
Wilke says the plaintiffs are glad to see a more realistic fish consumption rate. But at the same time, he points out that Inslee’s proposal also lowers the bar on the allowable risk for cancer by a factor of 10, from one in a million to one in 100,000.
“It appears the state has kind of engineered the standards to come out where they want them to be or where might be acceptable to business interests,” Wilke said.
The state Department of Ecology says the Governor felt the compromise is necessary, because businesses have warned tightening the standard too much would prompt them to move jobs elsewhere.
And instead of just cleaning up the aftermath, Inslee is pushing for additional policies to discourage use of the chemicals in the first place, to “shift people away from using these kinds of things that are so problematic for the permit holders,” said Carol Kraege, who leads the state Department of Ecology’s toxics reduction efforts.
But the plaintiffs who brought suit for cleaner water say such policies might not make it through the Legislature. And they say a similar compromise was recently put forward in Idaho and rejected by the Environmental Protection Agency.
Don’t drink the water, Snohomish Health District advises
SNOHOMISH COUNTY, Wash. – Swimming or playing in water that is contaminated or high in bacteria or natural toxins can affect your health. Swimming pools, spas, lakes, rivers, or oceans are all potential sources of water-related illness. Recreational water illnesses typically affect a person’s stomach and intestines, causing diarrhea and vomiting. Water quality can also affect your skin or respiratory system.
The recent outbreak of illness at Horseshoe Lake in Kitsap County was caused by norovirus found in the water at the swimming beach. The lake is closed until testing from the Centers for Disease Control and Prevention confirm that the virus is no longer present.
While Snohomish Health District has investigated a handful of illness reports related to local lakes, no common cause or illness has been identified. “We’ve seen nothing to indicate an outbreak of water-related illness here,” said Health Officer Dr. Gary Goldbaum.
The Health District is working with the Snohomish County Parks Department and city beach programs to ensure that required public health warnings (PDF) are present at beaches, including this language:
“The swimming waters at this beach are not treated to control spread of disease. Swimming
beach water, if swallowed, can sometimes cause illness because of bacteria, viruses or parasites in the water. All beach users should follow bathing beach recommendations to prevent
contamination of the water and should avoid swallowing of any beach water.”
Recreational water illnesses such as norovirus, cryptosporidium, giardia, shigella, and E. colihave the potential to infect a person who accidentally swallows or has contact with contaminated water. In most instances, the symptoms of diarrhea and vomiting will improve one to two days after you get sick. Some people get dehydrated or have other side effects, and need to see a doctor.
“Lake water is not the same as drinking water,” Dr. Goldbaum reminds children and parents.
If you think you got sick from a public water or food source – such as a swimming beach, campground, or restaurant – contact the Snohomish Health District at 425.339.5278.
We will ask you questions about what you ate and where you’ve been over the past several days to try to narrow down the many possible causes of illness.
For more tips on keeping safe while swimming, see the Hot Topic page of our website.
In this July 10, 2014 photo, Denise Mesteth poses outside the powwow grounds in Pine Ridge, S.D. Mesteth is a member of the Oglala Sioux Tribe, born and raised on the Pine Ridge reservation. She has signed up for health insurance through the federal marketplace. (AP Photo/Nora Hertel)
By NORA HERTEL Associated Press
PINE RIDGE, South Dakota — Denise Mesteth signed up for new health insurance through the federal Affordable Care Act, despite concerns that it may not be worth the money for her and other Native Americans who otherwise rely on free government coverage.
Mesteth, who has a heart murmur and requires medication and regular blood work, said she’s cautiously optimistic that the federal insurance will be superior to what she has now. Many other American Indians have been more reluctant to enroll, choosing instead to continue relying on the Indian Health Service for their coverage and taking advantage of a clause in the federal health reform law that allows them to be exempt from the insurance mandate if they meet certain requirements.
“If it’s better services, then I’m OK,” Masteth said of ACA. “But it better be better.”
Mesteth and other American Indians in South Dakota account for 2.5 percent of the people in the state who have signed up for insurance under the federal health care law, according to the latest signup numbers. The state, with nearly 9 percent of its overall population Native American, ranks third for the percentage of enrollees who are American Indian among U.S. states using the federal marketplace.
The Great Plains Tribal Chairmen’s Health Board, which provides support and health care advocacy to tribes, received $264,000 to help Native Americans in South Dakota navigate the new insurance marketplace.
Tinka Duran, program coordinator for the board, said people are primarily concerned about the costs of enrolling. Insurance is a new concept to most because health care has always been free, she said.
“There’s a learning curve for figuring out co-pays and deductibles,” she said.
During a U.S. Senate Indian Affairs Committee hearing in May, tribal leaders chastised IHS as a bloated bureaucracy unable to fulfill its core duty of providing health care for more than 2 million Native Americans and Alaska Natives. IHS acting director Yvette Roubideaux said changes were underway but that more money will be needed than the $4.4 billion the agency receives each year.
She noted that federal health care spending on Native Americans lags far behind spending on other groups such as federal employees, who receive almost twice as much on a per-capita basis. Meanwhile, American Indians suffer from higher rates of substance abuse, assault, diabetes and a slew of other ailments compared to most of the population.
Native Americans and Alaska Natives are exempt from the health insurance mandate if they meet certain requirements. ACA also permanently reauthorized the Indian Health Care Improvement Act and authorized new programs for IHS, which also is starting to get funds from the Veterans Affairs Department to help native veterans.
When American Indians do obtain insurance, it means fewer people are tapping the IHS budget, said Raho Ortiz, director of the IHS Division of Business Office Enhancement.
“If more of our patients have health insurance or are enrolled in Medicaid, this means that more resources are available locally for all of our patients,” Ortiz said in an emailed statement. “This, in turn, allows scarce resources to be stretched further.”
Those who sign up for federal health care can still use IHS facilities but have the option of seeking health care elsewhere, Ortiz said.
State Democratic Sen. Jim Bradford is among the skeptics. The Oglala Sioux member lives on the Pine Ridge reservation, home to two of the poorest counties in the nation.
The U.S. government provides health care to Native Americans as part of its trust responsibility to tribes that gave up their land when the country was being formed. Bradford and others object to the shift in health care providers on the principle that IHS is obligated by treaty to supply that care.
Harriett Jennesse, a member of the Lower Brule Sioux Tribe who lives in Rapid City, said she already has seen the benefits of the new health insurance and doesn’t mind paying a little out of pocket.
Jennesse said she put off treatment for a painful bone chip in her elbow after IHS denied a doctor’s referral to a specialist on grounds that it wasn’t an urgent enough need. She’s now seeing a specialist for dislocation in her other elbow and will also try to get the bone chip fixed when the other arm heals.
