< PreviousTribalNetAgency Updates - FCCThe FCC’s Office of Native Affairs and Policy (ONAP) was created in 2010 to develop and drive an FCC-wide tribal agenda, and to manage the FCC’s tribal consultation efforts. ONAP is charged with bringing the benefits of a modern communications infra-structure to all tribal lands and native communities by, among other things, ensuring robust government-to-government consultation with federally-recognized tribal governments and other native organizations and ensuring that tribal concerns and voices are considered in all relevant FCC proceedings and initiatives. ONAP is the official FCC contact point for these activities. The Open InternetOn February 26, 2015, the FCC adopted strong, sustainable rules, grounded in multiple sources of legal authority, to ensure that Americans reap the economic, social and civic benefits of an Open Internet today, and into the future. These new rules are guided by three principles: America’s Broadband networks must be fast, fair and open. These principles are shared by the overwhelming majority of the nearly four million commenters who participated in the FCC’s Open Internet proceeding. Key provisions and rules of the FCC’s Open Internet Order include:• New rules will apply to fixed and mobile Broadband alike, protecting consumers no matter how they access the Internet, whether on a desktop computer or a mobile device.• Bright line rules ban practices that are known to harm the Open Internet: that is, there can be no blocking, no throttling and no paid prioritization.• The order reclassifies “Broadband Internet access service” – the retail Broadband service Americans buy from cable, phone and wireless providers – as a telecommunications service under Title II of the Communications Act.• The order applies some key provisions of Title II and forbears from most others, ensuring that some 27 provisions of Title II and over 700 regulations adopted under Title II will not apply to Broadband.The press release announcing adoption of the new rules is available at: http://www.fcc.gov/document/fcc-adopts-strong-sustainable-rules-protect-open-internetModernizing the E-rate ProgramIn a pair of orders in 2014, the FCC modernized the E-rate program to focus on providing support for high-speed Broadband that schools need to take advantage of bandwidth-intensive digital learning technologies and that libraries need to provide their patrons with high-speed access to the Internet on mobile devices and desktops alike.In the July 2014, E-rate Modernization Order, the FCC adopted numerous changes to the program. Of particular interest to Tribal Nations, the FCC created a tribal consultation, outreach and training program to ensure that tribal schools and libraries are able to participate effectively in the E-rate program. Among other things, the FCC directed that tribal-specific E-rate training take place, and directed the Universal Service Administrative Company (USAC) to appoint an E-rate tribal liaison.A summary of the E-rate Modernization Order is available at: http://www.fcc.gov/page/summary-e-rate-modernization-order In the December 2014 Second E-rate Modernization Order, the FCC took the next critical steps to modernize the E-rate program. Building on the July order, the FCC adopted improvements to the E-rate program seeking to close the high-speed connectivity gap between rural schools and libraries and their urban and suburban counterparts and providing sufficient and certain funding for high-speed connectivity to and within all eligible schools and libraries. Among other changes, the Second E-rate Modernization Order adjusted the annual E-rate funding cap to $3.9 billion and maximized schools’ and libraries’ options for purchasing affordable high-speed Broadband connectivity. A summary of the Second E-rate Modernization Order is available at: http://www.fcc.gov/page/summary-second-e-rate-modernization-order20Geoffrey C. Blackwell Chief P: 202-418-3629 Geoffrey.Blackwell@fcc.gov Irene Flannery Deputy Chief P: 202-418-1307 Irene.Flannery@fcc.govThe FCC’s Office of Native Affairs and Policy:Is It Time To Consider An Integrated Solution?Is It Time To Consider An Integrated Solution?TANFTANFMembers & ClientsMembers & ClientsGeneral AssistanceGeneral AssistanceEducationEducationTribal CourtTribal CourtIndian Child WelfareIndian Child WelfareEnrollmentEnrollmentTreatment ServicesTreatment ServicesProtective ServicesProtective ServicesContact us for more information or to schedule a demonstrationwww.handelit.com 877.742.5554 info@handelit.comRiteTrack is known for integrating information from multiple social services onto one database. Now RiteTrack offers two, newly standardized modules: Tribal Court and Treatment Services. The Tribal Court Module manages client, staff, charge and civil/criminal cases.The Treatment Services Module tracks and manages treatment plans, mental health, substance abuse, groups and progress notes.RiteTrack can be implemented incrementally—one department at a time—in a phased approach.Featured Columns - FundingIt’s human nature to overestimate our abilities. We tend to think we’re fully capable of handling certain tasks, continuing to believe so until failure becomes too obvious to deny. This is often referred to as the Dunning-Kruger effect, which is a cognitive bias where individuals suffer from a false sense of superiority, mistakenly assessing their ability much higher than what it is. In other words, we tend to believe that we are much more qualified to carry out certain tasks than we are. But this doesn’t just happen to individuals, it happens to organizations too—including tribes. For many years, I’ve worked as a professional reviewer of funding proposals for a variety of state and federal agencies that fund tribal initiatives, including IT projects and infrastructure. In my experience, its clear that a lot of tribes that develop their IT or telecommunications infrastructure strategies and funding proposals without the benefit of qualified consultants, could use some assistance. Proposals that reflect inadequate planning, insufficient allocation of resources, failure to show proper expertise or demonstrate poor presentation are rejected, setting the projects back months, if not years. I have seen that tribes want to not just exercise self-governance, but autonomous decision-making on issues that affect their own people. But as much as tribes want sovereignty, external partnerships with qualified experts are absolutely essential to sustained economic development, securing funding and successfully deploying major infrastructure projects—particu-larly those involving IT and telecommunications. One very important benefit of partnering with outside experts is that they can see the “big picture” by viewing the project from a completely external perspective. When it comes to developing complex projects involving activities such as IT infrastructure, economic development or others, this perspective is critical to success. When projects are developed entirely from an internal perspective, they often may omit key steps or elements necessary to carry out a successful project. This type of project planning approach is akin to supervising your own work. When you create something, you are attached to it, making it hard to criticize or realize that there are missing pieces. From a funding perspective, one of the greatest challenge tribes may face in securing funding for major projects is presenting a comprehensive plan that includes all of the elements necessary for timely, successful completion of the project. As a funding proposal reviewer, this is a critical flaw that I often see in proposals submitted by tribes. Common weaknesses include: failure to demonstrate the appropriate technical expertise; unclear or vague project goals, objectives and outcomes; poorly developed budget; insufficient project oversight; and omitting activities necessary for successful project completion from the work plan. Key benefits that partnerships with qualified external experts include:• Technical expertise: With today’s increasingly advanced and complicated tech landscape, the involvement of skilled professionals with relevant expertise is essential to demonstrating to funders that the project is technologically feasible. Input from qualified technical professionals during the planning phase, accompanied by ongoing oversight during deployment can assure funding agents that the project will function as expected. 22TribalNet“From a funding perspective, one of the greatest challenge tribes may face in securing funding for major projects is presenting a comprehensive plan that includes all of the elements necessary for timely, successful completion of the project.” The value of partnerships in securing funding to build out technology infrastructureRon FlavinDirector of Grants EnerTribe, Inc & Native LinkRon Flavin, Director of Grants, EnerTribe, Inc & Native LinkFeatured Columns - Funding• Project management expertise: Successfully laying out and overseeing complex IT or infrastructure projects to completion is both art and science. Partnerships with qualified professionals can ensure that key activities such as permitting, licensing, pole attachment agreements, or other key project elements necessary for success are not overlooked. For large or complicated IT or telecommunications projects, a qualified project management professional can reassure reviewers that funded activities will be carried out on-time, as-specified and within the designated budget. Outside experts can also add value by identifying opportunities for improving efficiencies or increasing revenue that you may not have considered.• Continuity: Complex projects—particularly those involving build out of IT or telecommunications infrastructure can take up to three years or more to complete. Within the tribal organizational structure, there are likely to be many changes over that time frame. These changes can include staff turnover, organizational restructuring and the election of new members to the tribal council. Partnerships with external consultants can assure funders that regardless of governmental or organizational changes within the tribe, the scope of the project and timeline will not change and will remain on track. Strong contracts with clearly laid out roles, responsibilities, expectations, milestones and timelines for all parties can ensure that tribes maintain control of projects while leveraging the value-added expertise provided by the consultant. However, it’s important for tribes to remember that just like they expect their partners to abide by the terms of the contract, they too need to do the same. All too often I hear stories of tribes that establish partnerships with external consultants but then fail to uphold Council Resolutions and their contractual responsibilities. In order for partnerships to be effective, both sides must abide by the terms of the contract. When tribes ignore their responsibilities in developing major projects, change the terms of contracts mid-project or even break contracts, it not only hurts the project, but damages the tribe’s reputation and makes outside professionals wary of working with them. Although outside expertise comes with a price, in the long run, the right consultant can ultimately save tribes money by providing expert assistance that can propel the project to success. Likewise, qualified experts can help tribes overcome obstacles or avoid costly short-or long-term mistakes. And when it comes to specialized projects and IT initiatives or infrastructure build outs, outside experts possess the high level of technical knowledge and expertise necessary to ensure success. The solutions that skilled, qualified partners deliver more than pay for themselves in reduced costs, increased funding and rapid, timely deployment. Another added benefit is that consultants can be used as much or as little as needed, depending on the contract you negotiate. 23Spring 2015For more than 15 years, Ron Flavin has helped public- and private-sector clients around the globe to secure more than $146 million in funding, enabling them to achieve their goals. Ron has worked with tribal governments throughout the U.S., helping them to secure millions of dollars in funding for infrastructure, law enforcement, public safety and technology-focused projects. In addition to his grant writing efforts, Ron is a published author and frequently works as a professional grants reviewer for a number of different state and federal funding agencies including the Administration for Native Americans.IT Leaders Q & A - HealthAlaska Native Tribal Health Consortium (ANTHC)Q & A with Stewart Ferguson, PhD - CTO & Karen Sidell, Director of Statewide IT ServicesThe Alaska Native Tribal Health Consortium (ANTHC) was formed in 1997 and is the largest, most comprehensive tribal health organization in the United States. ANTHC provides healthcare for 229 Alaska Native Tribes. ANTHC in partnership with Southcentral Foundation, jointly owns and manages the Alaska Native Medical Center which is the largest tribally owned and operated hospital in the U.S. ANTHC also partners with more than 30 other tribal health organizations in Alaska to provide comprehensive statewide healthcare for Alaska Natives and American Indians through the Alaska Tribal Health System (ATHS), which is fully compacted and supports 6 regional hospitals and more than 200 remote clinics. The question you may be asking yourself is, how does one organization set the standards in technology for 200 facilities operated by 30 different tribal organizations? How do you provide the absolute best birth to death care across an environment that is so complex, not just in geography but distance, weather, challenges of communications, informatics, support, training and process variations? That’s what we’d like to talk about today.Stewart is the CTO for ANTHC serving previously as their CIO and before that Director of Telehealth. His work in telehealth is well-known globally and he lives currently in Israel working still with ANTHC but also overseas. Karen is the Director of Statewide IT Services for ANTHC and is responsible for coordinating and communicating with all the ANTHC tribes and organizations. Her focus on outreach and education puts her at the center of several initiatives and resources within ANTHC. We also had the opportunity to have James Spillane on the interview with us. James is a private consultant for Sitnasuak Health Solutions working with tribes primarily on improving patient care through work flow and process improvements.Can you tell us a little about ANTHC and each of your roles within the organization?24TribalNetWe think there are three main focus areas that are important to cover: Health Information Exchange, our approach to electronic health records (EHR), and how telehealth which has an 18% penetration rate in Alaska is impacting patient care.The State of Alaska has a single Health Information Exchange and is partially funded by the State of Alaska. The goal is to get every EHR connected to it so patient information is available wherever patients go- whether it’s in the most remote clinics to the largest hospitals in the State. The data is centralized. We have developed a tool kit for our tribal partners which is immensely helpful for assist-ing them to connected their EHR to the HIE. A major challenge in getting them all tied in is that they need to be on the most current version of electronic health records (EHR) which brings us to our next area of focus.ANTHC is working on so many great initiatives, what are some areas of focus you think we should discuss today?Being a State-Wide healthcare system I imagine Health Information Exchange (HIE) is an important initiative- what can you tell us about what you guys are doing with it?IT Leaders Q & A - HealthWe would like to thanks Stewart, Karen and James for meeting with us for this insightful interview. They welcome your questions and comments and can be reached at:sferguson@anthc.org, ktsidell@anthc.org & jspillane@snc.org The complexity and diversity of electronic health records across all the ATHS is overwhelming. With the goal of centralizing data in the health information exchange initiative we find the challenge lying first, in the fragmentation of EHRs. What we mean by that is some tribes are on RPMS, some are on NextGen, Cerner, and so on. The records and systems don’t match, and even within the same systems, different tribes are on different versions and patches and customization levels. Our goal is to make patient data available wherever care is delivered. Connecting disparate EHRs to the HIE is a key element. But we also have a major initiative to share the Cerner EHR deployed at ANMC with other tribal partners. We currently have 29 sites throughout Alaska on this single EHR, with the potential of doubling that number within the next 18 months. James said it best, 1 patient, 1 chart, 1 EHR. We know from experience that one EHR dramatically improves the patient and provider experience with seamless access to the complete patient record. Just imagine the opportunities this affords for shared training, support, educational and staffing opportunities! We get excited thinking about all the possibilities.What can you tell us about your approach to EHR?25Where do you see the future of healthcare heading?It’s a virtual healthcare world we are moving to, where data is key. The industry is looking to focus on improving patient care and internal operations through the use of technology. Capturing and sharing data is a critical first step, but turning data into knowledge is how we will dramatically improve patient care. ANTHC is one of the groups trying to bring it all together. Spring 2015Just to give you some stats on tele-health in Alaska- as a system there are 45,000 tele-health encounters annually. It amounts to 5% of all our patient encounters in ATHS, and more than 18% of all Alaska Natives participate in telehealth annually. It’s estimated that over $8 million is saved each year just in travel costs alone. The access to specialty care that people can get in some of the most remote parts of the country sometimes is better than you can get at your local clinic. Over 40% of specialty consultations over tele-health are responded to in 60 minutes or less! How much of an impact does tele-health have on Alaskan Native Tribes?Featured Columns - InteroperabilityToni Potts, Director of Health Applications, Cherokee Nation Health ServicesThe health care industry continually addresses the need to improve interoperability. For health care, interoperability is the ability of Health Information Systems (HIS) and software applications to communicate, and use the information that has been exchanged for effective delivery of health care of individuals and communities. So, how about interoperability between those of us in the Health Information Technology (Health IT) industry? Each of us that serve a role within the Health IT arena should consider interoperability among ourselves. We need to take the time to communicate with each other and exchange our knowledge and information. We all have best practices and lessons learned that we can share, as well as common goals and industry standards that we are trying to meet. Whether you are an Information Technician, Clinical Applications Coordinator (CAC), Systems Analyst, Chief Information Officer (CIO), Chief Medical Information Officer (CMIO), Informatics Coordinator, Service Desk Analyst or serving in any type of health care technical support role, we need to interconnect with each other, and use the information we’ve shared to effectively assist our health care organizations in successfully achieving their Health IT goals. That old saying of “it takes a village to raise a child” has a little truth to it, in my experience. I think the same adage applies with Health IT. There are many levels to maintaining a HIS; it takes a strong, knowledgeable team to deliver quality support. As we all share our experiences and expertise, we can then work together toward Health IT improvements that benefit our whole HIS. There are a few items we should consider as we work towards interoperability within our Health IT workforce. First, we need to become aware of the Health IT initiatives for our health care organization. For many of us, our local Health IT goals align with tribal initiatives, Indian Health Service (IHS) goals, and the strategic plan at the national level−-the Office of the National Coordinator. Once we know the focus, we need to educate ourselves on each topic. We must continually take advantage of training and other informational opportunities in order to expand any skills we may need that can be applied to supporting the goals of our health care organization. We should stay in touch with current Health IT topics by subscribing to various listserv groups and email updates, such as the IHS listserv and HealthIT.gov email groups. Social media is a great venue for quick updates on current health IT topics, like TribalNet and HIMSS twitter accounts. Online training sessions and courses are abundantly available for enhancing your knowledgebase. Challenge your mind by prepping for various certifications. Take advantage of health IT certifications, such as HIMSS Certified Professional in Healthcare Management (CPHIMS) and AHIMA Commission on Certification for Health Informatics and Information Management (CCHIIM). Finally, back to interoperability, we need to take the time, and sometimes that means finding the time, to communicate with one another and interchange our information. We all share similar goals in support of providing the best health care experience for our Interoperability for Health IT 26TribalNetToni PottsDirector of Health ApplicationsCherokee Nation Health Services“Let’s push the interoperability concept to a whole new level! Communicate, collaborate, share and learn!"Featured Columns - InteroperabilityNative American population. Meet with your peers and share your best practices and lessons learned. Consider conducting virtual meetings with your other Health IT experts in your local region. Discuss what others are doing at different Tribal health care facilities. Learn a new process from another health IT department. Improve upon interoperability among our health IT constituents. Let’s communicate and exchange information about:• Provider and patient engagement: What can we do to help our provider and patients become more engaged as a healthcare team? • Health Information Exchange (HIE): What is your organizations HIE strategy and is it effective for your providers and patients? • Technology-enabled workflows: What workflows work well for your health care facility and are they improving clinical outcomes and patient safety? • Privacy and security: How is your organization protecting their patients? • EHRs, quality measurement, innovationReach out today to a fellow colleague or tribal health care facility and see what expertise they have to offer or lend some ideas to them. Let’s push the interoperability concept to a whole new level! Communicate, collaborate, share and learn!Reach out to me, as your TribalNet Advisory Board member, and let me know what you’d like to learn and what you would like to share. Let’s improve upon interoperability with each other at this year’s TribalNet Conference to be held November 2-5, 2015! I look forward to hearing from all of you.Toni Potts currently serves as Director of Health Applications in the Health Information Technology (Health IT) Department for Cherokee Nation Health System, located in Tahlequah, OK. She began her career with Indian Health Service (IHS) in 1995 at W. W. Hastings Indian Hospital, Tahlequah, OK, where she worked in various capacities, including Medical Records, Business Office, and Health IT.Beginning 2004, as the Clinical Applications Coordinator (CAC), Toni provided support and training for the IHS-Electronic Health Record. In 2009, Toni’s role turned to CAC Manager, working with the Health IT Team, providing Health IT support to a network of nine health centers and one hospital throughout the Cherokee Nation.Toni holds a Bachelor’s Degree in Business Administration from Northeastern State University, Tahlequah, OK. She is a member of the Peoria Tribe of Oklahoma. Spring 2015MAY 4-7, 2015ALBUQUERQUE, NEW MEXICOWWW.TRIBALTELECOMCONFERENCE.COMCONNECT WITH US ONTribal Telecom is a gathering place to share information, explore options, and pursue solutions to advance digital opportunities for American Indian and Alaskan Native communities. The conference combines introductory workshops; panel discussions highlighting success stories and best practices, regulatory developments, and industry updates; breakout sessions; and specific workshops and opportunities to meet with relevant government agencies. The conference also serves as a forum for tribal leaders to meet with telecom carriers to discuss the delivery of telecom services on tribal lands.Contact : 480-256-8511 • info@TribalTelecomConference.comProduct SpotlightFinley & Cook, a Microsoft Certified Partner, implements and supports the Microsoft Solution Stack including Microsoft Dynamics AX, NAV, CRM and Cloud Solutions. These solutions are designed and developed specifically for how Tribal governments work, providing a unique solution to improve revenue management, meet compliance requirements, and take control over costs. Finley & Cook provides a solution that will deliver quick business insights that empower your people to be more productive while adapting to change and growth.Our Microsoft Dynamics offerings help organizations leverage technology to improve productivity, empower staff, streamline and automate business processes, and build better relationships with Tribal members. With a collaborative portal, we provide a unifying, predictable, and quality Microsoft Dynamics implementation process to realize organizational value faster.Value to the Native American Market:Accountability has become a critical issue for Tribal governments, as federal agencies press for more detailed, timely information about Tribal, gaming, and retail operations. Microsoft Dynamics can help Tribal governments improve accountability with powerful, integrated financial management tools. With Microsoft Dynamics, Tribal governments gain greater visibility over financial operations, simplify and consolidate reporting, and ensure compliance with grant requirements and other legal requirements, all of which are objectives of the new Uniform Guidance.Microsoft Dynamics enables Tribal management to easily see and analyze the costs and revenues associated with Tribal activity including:• Fund Accounting• Grant & Indirect Cost Management• Payroll & Human Resource Management• Commitments & Encumbrances• Fixed Assets & Inventory• Trust Funds & Trust Assets• Consolidated Financial ReportingWho are WeFinley & Cook is an accounting and consulting firm that has been serving Tribal governments for over three decades. During that time, we have worked with over 110 Tribes, serving clients in 36 states. We specialize in Microsoft Dynamics solutions, outsourced accounting, Tribal financial assessments, audit preparation, compliance reporting, business consulting, and customized training classes.References of Where Installed:• Confederated Tribes of the Colville Reservation• Hannahville Indian Community• Muscogee Creek Nation• Navajo Nation Housing Authority• Seneca Nation of Indians CompanyFinley & CookSales Contact Lynne Matallana Director of Business Development P: 405-395-5152 lynnem@finley-cook.com Have worked with 110 Tribes in 36 states!Microsoft DynamicsFor more information on the solutions offered by Finley & Cook, visit our website at www.finley-cook.com29Spring 2015Next >