Are you 12 to 15 years old?

Do you self-identify as American Indian/Alaska Native (AI/AN) or do you have relatives (such as parents or grandparents) who are AI/AN?

You could receive up to $175 now by participating in the Native American Youth Sleep Health and Wellness project, and up to $190 more in about two years.

What would I be asked to do?

In both phases of this project, which are about two years apart, we would ask you to:

• Fill out some surveys (which will be kept confidential)
• Wear a sleep monitor (it's like a wristwatch) for a week
• Have some health measurements taken (like height, weight and blood pressure) and check the amount of fats (cholesterol and triglycerides) and sugars in your blood

What is NAYSHAW?

Nayshaw is a research project focused on learning more about urban American Indian/Alaska Native (AI/AN)youth and their sleep patternns, and how sleep affects teens' health.

The RAND Corporation and UCLA are doing this project in partnership with Sacred Path Indigenous Wellness Center and Native American communities all over California.

How can I sign up

Have your parent or guardian log on to srg.rand.org/contactme

Or call our toll-free number: 1.866.484.7621

Teens will be paid for each part of the project that they participate in and can refuse any part of the project at any time.

Check out this great story on KQED about our health clinic and the VeggieRx program!

FROM KQED

By Brittany Patterson

In Oakland’s Fruitvale neighborhood, 20 people sit inside a colorful classroom at the Native American Health Center. They listen attentively as Leah Ricci gives a lecture on the merits of fiber and where to get it. As far as lectures on fiber are concerned, this one is pretty rousing.

“I didn’t like vegetables and fruit, but now we’re all eating more of them.”

“Can anyone name some foods that are high in fiber?” she asks.

Immediately the participants begin to throw out suggestions.

“Beans. Apples. Greens. Seeds.”

“What do all of these foods have in common?” Ricci asks.

“They all come from plants,” shouts out Paula Marie Parker.

Parker and the others are all students in a program at the Native American Health Center called VeggieRx, which teaches participants about nutrition and the merits of incorporating more fruits and vegetables and physical activity in their lives and the lives of their families.

The 14-week program is exclusively for people who are overweight, obese or at risk for diabetes. They get hands-on nutrition lessons and learn to cook healthy meals while tracking their physical activity and weight loss. The program has been going for several years and is run by the nonprofit Fresh Approach which provides vouchers for to buy fresh fruits and vegetables.

Melissa Cannon, a dietitian at the Native American Health Center, reached out to Fresh Approach and asked them to bring VeggieRx to her clinic this year.

VeggieRx is by far the most popular nutrition class her clinic runs, Cannon says. A big driver, she says: “They get free food.”

The hope of these nutrition programs, Cannon says, is to break down some of the barriers to educating about health and nutrition which can be especially tough for low-income and multi-ethnic families. What’s surprised her the most about offering VeggieRx has not only been the turnout — they have about 22 participants who consistently attend — but also the way that many of the participants have formed a healthy eating camaraderie with one another.

“We have a lot of people who did our six-week Food as Medicine course who are now coming to this class,” she says. “They’ve gotten to know each other, and that’s really neat.”

One of those people is Robert Davila, 60, of Oakland, who said the hands-on nature of VeggieRx has made a real difference in his life. Cannon is his dietitian and encouraged him to sign up. As a diabetic, he said learning about food labels has proved to be an eye-opener. He said he’s made little changes in his diet since starting the program, including switching out most of his processed foods for whole grains.

“I’ve really been surprised,” he says. “I was hesitant at first, but it’s really been worth it to me. I didn’t really realize how important something like a food label could be to my health.”

“Social Component Is Really Important”

Dr. Jennifer Falbe, a fellow at the UC Berkeley School of Public Health has studied community health programs in depth. She described multiple barriers to teaching health and nutrition to multi-ethnic, low income groups including language barriers, limited access to the internet or transportation, and some families just needing one-on-one support to navigate signing up for a program or service.

One key factor in keeping people involved in health programs, she says, is a shared social connection.

“Having a social component is really important to keep people coming,” she said. “That’s probably a big part of the effectiveness of Weight Watchers.”

That social connection is one big reason Mindy Woolbert, 62, from Oakland, enjoys the program. She comes with her sister and her sister-in-law. Together, she said, they try to keep each other accountable.

“No matter how many times you hear how you’re supposed to eat healthy, you can always hear it once more,” she said. “I didn’t like vegetables and fruit, but now we’re all eating more of them.”

Falbe adds that because minority communities experience a much higher prevalence of obesity and chronic disease associated with being overweight, it’s important to provide greater attention. In an ongoing study that links low-income overweight or obese children and families with physical activity programs in San Francisco, Falbe’s team is finding that having someone in the clinic work closely with families and individuals as they sign up, as well as providing one-on-one support in languages other than English, can often be effective in connecting families with community programs and convincing them to continue to attend.

Cannon also says many people she sees are reluctant to shop at farmers markets, a specific barrier that VeggieRx addresses. Her clients tend to see farmers markets as expensive places to shop – and geared to white people.

“There’s a real stigma attached,” she said. “Most of our population here is multi-ethnic, and that’s a barrier in it of itself.”

Fresh Approach provides $7 per person per week in vouchers to be used at farmers markets, and participants are drawn to the extra benefits.

“We want to provide enough to allow them to make healthy changes in their household,” said. Laura deTar, nutrition program manager for Fresh Approach

Fresh Approach’s dataset is limited but shows effectiveness. In a follow up earlier this year with 13 families who participated in the program in 2012, they found that nearly 70 percent of the families said they were eating more fruits and veggies and were more physically active. Eighty-four percent reported that they had maintained or reduced their body mass Index.

Back in the classroom, the Fresh Approach team is bringing in bowls of colorful fruits and vegetables they chopped just minutes before. All the produce, which includes things like beets, Armenian cucumbers, Asian pears and heirloom tomatoes, was purchased earlier that day at the uptown Oakland farmers market.

DeTar demonstrates creating a balsamic dressing from scratch while instructor Ricci begins reading the ingredients off the back of a store-bought bottle of salad dressing.

“How much sugar does that have?” asks one participant.

“Let’s see … 27 grams per serving,” answers Ricci. That’s almost seven teaspoons of sugar.

As the list goes on, more and more of the crowd begin to shake their heads.

Later, after chowing down on their salads — with healthier home made salad dressing — Paula Marie Parker talked about why she loved the class.

“Knowledge is power and most of us here didn’t study nutrition and were raised by parents who didn’t either. Here it’s free and the staff is caring.”

Then chuckling she adds, ”About my health, I’m serious as a heart attack.”

How the Native American Health Center (NAHC) May Use or Disclose Your Health Information

The health record is the property of NAHC, but the information in the health record belongs to you.  The law permits us to use or disclose your health information for the following purposes:

1. Treatment.  We use health information about you to provide your health care.  We disclose health information to our employees and others who are involved in providing the care you need.  For example, we may share your medical information with other physicians or other health care providers who will provide services that we do not provide or we may share this information with a pharmacist who needs it to dispense a prescription to you, or a laboratory that performs a test.  We may also disclose health information to members of your family or others who can help you when you are sick or injured, or following your death.
   1. Payment.  We use and disclose health information about you to obtain payment for the services we provide.  For example, we give your health plan the information it requires for payment.  We may also disclose information to other health care providers to assist them in obtaining payment for services they have provided to you.
   2. Health Care Operations.  We may use and disclose health information about you to operate our organization.  For example, we may use and disclose this information to review and improve the quality of care we provide, or the competence and qualifications of our professional staff.  Or we may use and disclose this information to get your health plan to authorize services or referrals.  We may also use and disclose this information as necessary for medical reviews, legal services and audits, including fraud and abuse detection and compliance programs and business planning and management.  We may also share your health  information with our "business associates," such as our billing service, that perform administrative services for us.  We have a written contract with each of these business associates that contains terms requiring them and their subcontractors to protect the confidentiality and security of your health information. Although federal law does not protect health information which is disclosed to someone other than another healthcare provider, health plan, healthcare clearinghouse or one of their business associates, California law prohibits all recipients of healthcare information from further disclosing it except as specifically required or permitted by law. We may also share your information with other health care providers, health care clearinghouses or health plans that have a relationship with you, when they request this information to help them with their quality assessment and improvement activities, their patient-safety activities, their population-based efforts to improve health or reduce health care costs, protocol development, case management or care coordination activities, their review of competence, qualifications and performance of health care professionals, their training programs, their accreditation, certification or licensing activities, their activities related to contracts of health insurance or health benefits, or their health care fraud and abuse detection and compliance efforts. We may also share medical information about you with the other health care providers, health care clearinghouses and health plans that participate with us in "organized health care arrangements" (OHCAs) for any of the OHCAs' health care operations. OHCAs include hospitals, physician organizations, health plans, and other entities, which collectively provide health care services.
   3. Appointment Reminders.  We may use and disclose health information to contact and remind you about appointments.  If you are not home, we may leave this information at the telephone number that you have provided for this purpose.
   4. Sign-in Sheet.  We may use and disclose health information about you by having you sign in when you arrive at our office.  We may also call out your name when we are ready to see you.
   5. Notification and Communication with Family.  We may disclose your health information to notify or assist in notifying a family member, your personal representative or another person responsible for your care about your location, your general condition or, unless you had instructed us otherwise, in the event of your death.  In the event of a disaster, we may disclose information to a relief organization so that they may coordinate these notification efforts.  We may also disclose information to someone who is involved with your care or helps pay for your care.  If you are able and available to agree or object, we will give you the opportunity to object prior to making these disclosures, although we may disclose this information in a disaster even over your objection if we believe it is necessary to respond to the emergency circumstances.  If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others.
   6. Marketing.  Provided we do not receive any payment for making these communications, we may contact you to encourage you to purchase or use products or services related to your treatment, case management or care coordination, or to direct or recommend other treatments, therapies, health care providers or settings of care that may be of interest to you. We may similarly describe products or services provided by our organization and tell you which health plans we participate in. We may receive financial compensation to talk with you face-to-face, to provide you with small promotional gifts, or to cover our cost of reminding you to take and refill your medication or otherwise communicate about a drug or biologic that is currently prescribed for you, but only if you either: (1) have a chronic and seriously debilitating or life-threatening condition and the communication is made to educate or advise you about treatment options and otherwise maintain adherence to a prescribed course of treatment, or (2) you are a current health plan enrollee and the communication is limited to the availability of more cost-effective pharmaceuticals. If we make these communications while you have a chronic and seriously debilitating or life-threatening condition, we will provide notice of the following: (1) the fact and source of the remuneration; and (2) your right to opt-out of future remunerated communications by calling the communicator's toll-free number. We will not otherwise use or disclose your health information for marketing purposes or accept any payment for other marketing communications without your prior written authorization. The authorization will disclose whether we receive any financial compensation for any marketing activity you authorize, and we will stop any future marketing activity to the extent you revoke that authorization.
   7. Sale of Health Information. We will not sell your health information without your prior written authorization. The authorization will disclose that we will receive compensation for your health information if you authorize us to sell it, and we will stop any future sales of your information to the extent that you revoke that authorization.
   8. Required by Law.  As required by law, we will use and disclose your health information, but we will limit our use or disclosure to the relevant requirements of the law.  When the law requires us to report abuse, neglect or domestic violence, or respond to judicial or administrative proceedings, or to law enforcement officials, we will further comply with the requirement set forth below concerning those activities.
   9. Public Health.  We may, and are sometimes required by law, to disclose your health information to public health authorities for purposes related to:  preventing or controlling disease, injury or disability; reporting child, elder or dependent adult abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medications; and reporting disease or infection exposure.  When we report suspected elder or dependent adult abuse or domestic violence, we will inform you or your personal representative promptly unless in our best professional judgment, we believe the notification would place you at risk of serious harm or would require informing a personal representative we believe is responsible for the abuse or harm.
   10. Health Oversight Activities.  We may, and are sometimes required by law, to disclose your health information to health oversight agencies during the course of audits, investigations, inspections, licensure and other proceedings, subject to the limitations imposed by federal and California law.
   11. Judicial and Administrative Proceedings. We may, and are sometimes required by law, to disclose your health information in the course of any administrative or judicial proceeding to the extent expressly authorized by a court or administrative order.  We may also disclose information about you in response to a subpoena, discovery request or other lawful process if reasonable efforts have been made to notify you of the request and you have not objected, or if your objections have been resolved by a court or administrative order.
   12. Law Enforcement.  We may, and are sometimes required by law, to disclose your health information to a law enforcement official for purposes such as identifying of locating a suspect, fugitive, material witness or missing person, complying with a court order, warrant, grand jury subpoena and other law enforcement purposes.
   13. Coroners.  We may, and are often required by law, to disclose your health information to coroners in connection with their investigations of deaths.
   14. Organ or Tissue Donation.  We may disclose your health information to organizations involved in procuring, banking or transplanting organs and tissues.
   15. Public Safety.  We may, and are sometimes required by law, to disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.
   16. Proof of Immunization. We will disclose proof of immunization to a school where the law requires the school to have such information prior to admitting a student if you have agree to the disclosure on behalf of yourself or your dependent.
   17. Specialized Government Functions.  We may disclose your health information for military or national security purposes or to correctional institutions or law enforcement officers that have you in their lawful custody.
   18. Worker's Compensation.  We may disclose your health information as necessary to comply with worker's compensation laws.  For example, to the extent your care is covered by workers' compensation, we will make periodic reports to your employer about your condition.  We are also required by law to report cases of occupational injury or occupational illness to the employer or workers' compensation insurer.
   19.  Change of Ownership.  In the event that our organization is sold or merged with another organization, your health information/record will become the property of the new owner, although you will maintain the right to request that copies of your health information be transferred to another physician or medical group.
   20. 21.    Breach Notification. In the case of a breach of unsecured protected health information, we will notify you as required by law. If you have provided us with a current mailing address, we may use written communication by mail to provide information related to the breach. In some circumstances our business associate may provide the notification. We may also provide notification by other methods as appropriate.
   21. Psychotherapy Notes.  We will not use or disclose your psychotherapy notes without your prior written authorization except for the following: (1) your treatment, (2) for training our staff, students and other trainees, (3) to defend ourselves if you sue us or bring some other legal proceeding, (4) if the law requires us to disclose the information to you or the Secretary of HHS or for some other reason, (5) in response to health oversight activities concerning your psychotherapist, (6) to avert a serious threat to health or safety, or (7) to the coroner or medical examiner after you die. To the extent you revoke an authorization to use or disclose your psychotherapy notes, we will stop using or disclosing these notes.
   22. Research.  We may disclose your health information to researchers conducting research with respect to which your written authorization is not required as approved by an Institutional Review Board or privacy board, in compliance with governing law.
   23. Fundraising.  We may use or disclose your demographic information, the dates that you received treatment, the department of service, your treating physician, outcome information and health insurance status in order to contact you for our fundraising activities.  If you do not want to receive these materials, notify the Privacy Contact listed at the end of this Notice of Privacy Practices and we will stop any further fundraising communications. Similarly, you should notify the Privacy Contact if you decide you want to start receiving these solicitations again.

When the Native American Health Center May Not Use or Disclose Your Health Information

Except as described in this Notice of Privacy Practices, this practice will, consistent with its legal obligations, not use or disclose health information which identifies you without your written authorization.  If you do authorize our organization to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.

Your Health Information Rights

1. Right to Request Special Privacy Protections.  You have the right to request restrictions on certain uses and disclosures of your health information by a written request specifying what information you want to limit, and what limitations on our use or disclosure of that information you wish to have imposed.  If you tell us not to disclose information to your commercial health plan concerning health care items or services for which you paid for in full out-of-pocket, we will abide by your request, unless we must disclose the information for treatment or legal reasons. We reserve the right to accept or reject any other request, and will notify you of our decision.
2. Right to Request Confidential Communications.  You have the right to request that you receive your health information in a specific way or at a specific location.  For example, you may ask that we send information to a particular email account or to your work address.  We will comply with all reasonable requests submitted in writing which specify how or where you wish to receive these communications.
3. Right to Inspect and Copy.  You have the right to inspect and copy your health information, with limited exceptions.  To access your health information, you must submit a written request detailing what information you want access to, whether you want to inspect it or get a copy of it, and if you want a copy, your preferred form and format.  We will provide copies in your requested form and format if it is readily producible, or we will provide you with an alternative format you find acceptable, or if we can’t agree and we maintain the record in an electronic format, your choice of a readable electronic or hardcopy format. We will also send a copy to any other person you designate in writing. We will charge a reasonable fee, which covers our costs for labor, supplies, postage, and if requested and agreed to in advance, the cost of preparing an explanation or summary, as allowed by federal and California law. We may deny your request under limited circumstances.  If we deny your request to access your child's records or the records of an incapacitated adult you are representing because we believe allowing access would be reasonably likely to cause substantial harm to the patient, you will have a right to appeal our decision.  If we deny your request to access your psychotherapy notes, you will have the right to have them transferred to another mental health professional.
4. Right to Amend or Supplement.  You have a right to request that we amend your health information that you believe is incorrect or incomplete.  You must make a request to amend in writing, and include the reasons you believe the information is inaccurate or incomplete.  We are not required to change your health information, and will provide you with information about our organization’s denial and how you can disagree with the denial.  We may deny your request if we do not have the information, if we did not create the information (unless the person or entity that created the information is no longer available to make the amendment), if you would not be permitted to inspect or copy the information at issue, or if the information is accurate and complete as is.  If we deny your request, you may submit a written statement of your disagreement with that decision, and we may, in turn, prepare a written rebuttal. You also have the right to request that we add to your record a statement of up to 250 words concerning anything in the record you believe to be incomplete or incorrect. All information related to any request to amend or supplement will be maintained and disclosed in conjunction with any subsequent disclosure of the disputed information.
5. Right to an Accounting of Disclosures.  You have a right to receive an accounting of disclosures of your health information made by our organization, except that this our organization does not have to account for the disclosures provided to you or pursuant to your written authorization, or as described in paragraphs 1 (treatment), 2 (payment), 3 (health care operations), 6 (notification and communication with family) and 18 (specialized government functions) of Section A of this Notice of Privacy Practices or disclosures for purposes of research or public health which exclude direct patient identifiers, or which are incident to a use or disclosure otherwise permitted or authorized by law, or the disclosures to a health oversight agency or law enforcement official to the extent our organization has received notice from that agency or official that providing this accounting would be reasonably likely to impede their activities.
6. You have a right to notice of our legal duties and privacy practices with respect to your health information, including a right to a paper copy of this Notice of Privacy Practices, even if you have previously requested its receipt by e-mail.

If you would like to have a more detailed explanation of these rights or if you would like to exercise one or more of these rights, contact our Privacy Contact listed at the top of this Notice of Privacy Practices.

Changes to this Notice of Privacy Practices

We reserve the right to amend our privacy practices and the terms of this Notice of Privacy Practices at any time in the future.  Until such amendment is made, we are required by law to comply with this Notice.  After an amendment is made, the revised Notice of Privacy Protections will apply to all protected health information that we maintain, regardless of when it was created or received.  We will keep a copy of the current notice posted in our reception areas, and a copy will be available at each appointment. We will also post the current notice on our website.

How to Contact Us

If you wish to contact us to request access to your healthcare records, or any other requests identified herein and/or if you have any questions about this notice, or want to lodge a complaint about our privacy practices, please call or write us at:

Native American Health Center

Attention: Privacy Contact

1151 Harbor Bay Parkway

Suite 203

Alameda, CA94502

(510) 747-3038

For questions or complaints, you may also notify the Secretary of the U.S. Department of Health and Human Services or the California Department of Health Care Services Privacy Officer:

Privacy Officer

California Department of Health Care

Services

P O Box 997413

MS 0010

Sacramento, CA 95899-7413

(916) 445-4646 (Voice)

(877) 735-2929 (TTY/TDD)

Secretary of the U.S. Department of Health and Human Services

Office of Civil Rights

Attention: Regional Manager

50 United Nations Plaza, Room 322

San Francisco, California 94102

(800) 368-1019

The complaint form may be found at www.hhs.gov/ocr/privacy/hipaa/complaints/hipcomplaint.pdf

We will not take retaliatory action against you if you file a complaint about our privacy practices.

The Affordable Care Act took effect October 1, 2013.  

This means more Californians will have access to medical coverage.

NAHC will continue to serve current clients and welcome new ones.
Your care at NAHC is protected. We will continute to serve you.

For more specific questions regarding coverage under Affordable Care and Covered California, please contact Member Services at:

Oakland: 510-535-4406
San Francisco: 415-621-8051  

October 1st was the first day of enrollment in the new Health Insurance Marketplace created by the Affordable Care Act.

Here is California’s website with information: https://www.coveredca.com/. There have been some glitches due to the high volume of people accessing the website. Keep trying!

For specific information on how the Affordable Care Act applies to American Indians and Alaska Natives visit this website:
https://www.healthcare.gov/if-im-an-american-indian-or-alaska-native-what-do-i-need-to-know-about-the-marketplace/. 

More information will be coming out as this exciting new law evolves!