Delores Pigsley,
Confederated Tribes of Siletz

Ms. Pigsley introduced herself as the Chairman of the Confederated Tribes of Siletz in Oregon.  Ms. Pigsley stated that there are 4,000 members of the Confederated Tribes of Siletz Indians including 340 Elders.  As the population of Elders in her Tribe grows, long-term care for them has become a priority and concern.  Due to this increase, she added, collaboration between HUD, IHS, USDA, Medicare & Medicaid, and the BIA to address the issues of housing, diet, nutrition, social services, and transportation surrounding Elders will become increasingly important.

With the exception of a few Elders that have private health insurance coverage, most Elders on the reservation rely on the Indian Health Service for their health needs.  While her Tribe does operate a small ambulatory health care facility, it is grossly under funded.  Since most of the contract health service funds are quickly exhausted, Ms. Pigsley’s Tribe spends many of its resources on Priority I, which is urgent and emergent care.   Increasingly, she added, programs at her Tribe rely on Medicare and Medicaid to cover costs of health.  Yet, “continuing decreases in Medicaid funding to States and uncertainties regarding Medicare reimbursements are reducing the number of providers willing to care for our patients.”  This results in Elders from her Tribe to be diagnosed only when their situation has become critical.

Ms. Pigsley added that IHS does not provide funding for long-term care.  Her Tribe applied for grants to renovate existing buildings for this purpose but was unsuccessful in receiving funds.  More than 60% of the Tribe’s Elders live with family, therefore, she added, the primary need for Elders on her reservation is supervised housing that fosters independence.  Poor diet and nutrition is another concern on Ms. Pigsley’s reservation.  Her program is only funded for two meals per week.

Transportation continues to be an issue on the Siletz Reservation.  Since the reservation is located two hours from Portland and Salem, an effective transportation system needs to be in place so that Elders can travel to those cities for their needs. 

Ms. Pigsley concluded that according to a Needs Assessment that was performed for the Tribe, isolation is a prime concern for Elders.  For this reason, socialization is important.  While there are limited tribal resources for this, more funding needs to be available in the form of home visits and social gatherings.