Administrative and Operational Overview

Nebraska Urban Indian Health Coalition, Inc. is a 501 (c) (3) non-profit organization that was founded in 1986. 
Its mission is to elevate the health status of urban Indians to the highest level possible.  Major funding is
provided through contracts and grants from Title V of P.L. 94-437, the Indian health Improvement Act.  The Coalition
is also supported through patient fees, LB 692 funds, Region VI, Medicaid and Medicare and other third party
payments. The Coalition is governed by a five member Board of Directors that meets on a quarterly basis.  The
Board reviews and approves all policies and procedures annually. The members include: 

·        Robert O’Brien (Mandan)
     President
    11917 Leavenworth Road
    Omaha, NE.  68154 

·        Violet Fickel  (Rosebud Sioux)
     Treasurer
     13809 Meadow Ridge Road
     Omaha, NE.  68138 

·        Marilyn Appel (Rosebud Sioux)
    Secretary
    9850 M Street
    Omaha, NE.  68127 

·        Beverly Snow-Peterson  (Winnebago)
    Member
   1412 Villa Avenue
   Sioux City, IA.  51103 

·       Vacant position

All Coalition programs supervised under the direction of the Executive Director, Dr. Donna L. Polk-Primm,
Ph.D., LMHP.  The Clinical Supervisor is Ray Wilson, LACDC.  The Lincoln staff person is James Holt, LMHP
and Social Worker.  He is supervised by the Clinic Manager, JoAnne Scott, RN, MSN.  David Clute, MBA, is
the Financial Consultant. 

Purpose of the Program

The purpose of the Behavioral Health Program is to provide access to culturally and linguistically competent Level
I substance abuse and mental health services.  The program incorporates five modalities.  They include:

·        Individual therapy with the client and a provisionally licensed/licensed substance abuse or
    mental health professional

·        Group therapy including the client and a provisionally licensed/licensed substance abuse or
    mental health professional in a group setting of no more than 8 participants.  Staff to client
    ratio not to exceed 1:8.

·       Family therapy, with or without the client, performed by a provisionally licensed/licensed
   substance abuse or mental health professional

·        Community Support which provides and develops the necessary services and supports which
     enable consumers to live successfully in the community.  Staff to client ratio not to exceed 1:25. 

Target Population

The target population includes Native Americans and others residing in the Lincoln, Lancaster County area of Nebraska.  The target population also includes:

·        Low income individuals

·        Criminal offenders

·        Pregnant women

·        Immigrants and refugees

·        Domestic Violence victims and perpetrators/family members 

Admission/Discharge Criteria

There is no minimum or maximum age for admission to this program.  Screening is done to determine eligibility
and appropriateness for services.  Screening and assessment of all clients is complete utilizing the Addiction
Severity Index, Substance Abuse Subtle Screening Inventory (adult or adolescent), Mayo Clinic Alcoholism test, Am
 I an Addict?, Johns Hopkins University Test, South Oaks Gambling Screen and the Beck Depression Inventory. 
Level 1 Outpatient services are provided for individuals meeting the diagnostic criteria for a substance
abuse-mental health disorder.  Appropriate referrals are made for clients determined to need services not offered by
the Coalition. 

Admission criteria includes;

·        The client is assessed as meeting the diagnostic criteria for a Substance-Related Disorder as defined
    in the current DSM IV as well as dimensional criteria for admission

·        no withdrawal risk,

·        stable biomedical condition,

·        emotional/behavioral conditions, if present, are related to substance use/abuse,

·        expression of a willingness to cooperate with the program offered,

·        ability to maintain abstinence between scheduled therapeutic contacts, and a supportive environment. 

Discharge criteria includes: 

·        client no longer meets the criteria for the substance-related disorder during the course of treatment,

·        no withdrawal risk,

·        emotional/behavioral conditions, if any, have diminished or stabilized or worsened and interfering
    with treatment,

·        individual’s awareness and acceptance of his/her addition problem and commitment to recovery
     is sufficient to expect maintenance of a self-directed recovery plan

·        client consistently fails to meet essential treatment objectives despite revisions to the treatment plan

·        client has internalized gains in addressing craving and relapse issues

·        client is experiencing a worsening of drug seeking behaviors or craving

·        client’s social system is supportive of continued recovery or remains non-supportive or has deteriorated.

Organization of program/Access to Services

Behavioral health services are available at the Nebraska Urban Indian Medical Center or through home visits. 
The Medical Center is located at 2331 Fairfield in north Lincoln.  It is approximately three blocks from the
Access Medicaid office which is located in a popular strip mall. Transportation is provided and bus service is
convenient on a number of routes.  Services are provided in a private office discreetly located away from the
reception area and the medical exam rooms.  The provider is currently available 20 hours per week, working from
8-12 and 1-4:30 pm Monday Wednesdays and Fridays. Translators are also available, Appointments are
scheduled through the receptionists and can be made Monday through Friday 8 – 12 and 1-5 pm in person or
by telephone. 

Services are provided based upon a sliding fee scale.  Evaluations are provided at a one-time cost of $100
or a combination of money and community service hours.  These arrangements can be made with the provider
with approval of the Clinic Manager. 

Procedures for Direct Consumer Involvement

Clients are advised of their rights and responsibilities upon admission to the program.  They also receive
information regarding the Client’s Grievance Procedure.  Clients are also requested to complete the Client
Satisfaction Surveys upon discharge. 

Capacity

Each provider is expected to maintain a case load of a minimum of 10 clients to be seen on an individual basis or
two groups per week. 

Quality Assurance and Performance Improvement

The Behavioral Health Program records shall be incorporated into the Medical Center’s Quality Assurance Plan
 (refer to Nebraska Urban Indian Medical Center Policy and Procedure Manual, page 43).