Cherokee Nation Home Health Care outlines service area, enrollment process and hospice limits

Matthew Rucker reported to the Health Committee on Cherokee Nation Home Health Care’s services and answered detailed questions about hospice coverage and enrollment.

Rucker said home health and outreach serve across the reservation and that hospice visits are limited to a 50-mile radius from Tahlequah because hospice requires shorter response times. "Due to hospice... the intensity of visits and response time needing to be less than an hour, we are able to go 50 miles from Tahlequah," he said. He added that expanding hospice is more complicated than expanding home health because it requires obtaining additional NPI numbers.

On enrollment, Rucker described the process: a referring clinician must send a face-to-face assessment, a homebound attestation and a referral; staff then provide services under physician orders. He confirmed that Cherokee Nation citizens who meet program requirements receive home health care at no cost. "For Cherokee Nation citizens, we will provide care at no cost," he said.

Councilors asked whether clinicians must be Cherokee Nation providers; Rucker replied that any MD, NP or PA may make referrals and that services are provided within the reservation area. The committee also discussed the need for a release of information (ROI) for transfers of records, and Rucker said Health Services requires that before records will be released to Home Health Care.

Why it matters: clear enrollment steps, cost-sharing information and geographic limits affect access to hospice and home health services for Nation citizens. Expansion plans remain under discussion with the board and face administrative and regulatory hurdles.

The report was provided in writing and the committee did not take a vote on changes to service area or program rules during this meeting.