Menominee Tribe Health Care Program Planning.

Federal legislation authorized the Menominee Indian Tribe of Wisconsin to obtain benefits and services from the Health Services Administration. IHS has developed a health care program for the Tribe that is based on an analysis of their health needs. This study was undertaken to research and evaluate Tribal health services, design a health care plan, and implement an adequate health care delivery program. Information was collected on tribal health problems through existing service records and other supporting data. An analysis of health problems and services was done in three areas: 1) health and socioeconomic problems; 2) health service resources; and 3) a comparison of problems and services. This was followed by the development of alternatives. The final health care plan included provisions for services. facilities, staffing, financial considerations. and implementation. Primary outpatient care is available to serve the Tribe in four counties. The utilization and availability of primary care facilities is not adequate. Barriers to the services include lack of transportation, and a lack of educational programs to teach the procedures for obtaining health care. A general prejudice against treatment at the health care facilities exists. Secondary in-patient care is available to any tribal member within thirty minutes travel time. Long-term care is also available, however, services are fragmented. The major health care problems for the Menominee Tribe are perinatal mortality, infant mortality, congenital abnormalities, otitis media, respiratory diseases, dental diseases, infectious and communicable diseases, accidents, diabetes, alcoholism, vision problems, obesity, and drug abuse. Health problems are directly related to the socioeconomic status of the Tribe including poverty, lack of work, lack of health insurance, low educational attainment, lack of telephones, lack of central heating, lack of plumbing, lack of transportation, illegitimacy, overcrowded housing, outmigration, and multi-parity. Facilities should be consolidated and centralized. Specifications for the facilities, staffing requirements and square footage necessary are listed. Financial recommendations were proposed with the major one being an incorporated, nonprofit health care organization, enabling the Menominees to own and operate the outpatient facility. Alternatives to service delivery in three basic areas--program alternatives, facility-related alternatives, and financial alternative--were discussed in detail.