Rural Health Outreach to the Cheyenne River Reservation: Creating an Early Health Care Community
| Topics |
Child welfare
Health services
|
| States served |
South Dakota
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| Description |
The Cheyenne River Reservation is located in a remote area in north-central South Dakota. It is a medically underserved area and health professional shortage area. Before the grant award, the lack of trained pediatric specialists required families with young children to travel hundreds of miles off the reservation to receive pediatric services. Both environmental and biological issues jeopardized the health and development of children living on the Cheyenne River Reservation. Early intervention services were not available in the education system, and the lack of trained pediatric specialists in the area meant that many children aged 0 to 5 years who needed early intervention services went unidentified and untreated. |
| Services offered |
This project focused on increasing public awareness of early intervention services; providing prescreening, screening, and tracking services; referring children in need for further evaluation; providing evaluation and diagnostic services; and linking children to area resources. The primary means of providing and coordinating these services was monthly clinics in which a broad range of health practitioners provided an equally broad range of screenings and referrals to followup care. Several organizations were involved in this project: - The Cheyenne River Sioux Tribe linked children to tribal programs, provided transportation services, and offered developmental screenings for children associated with the Women, Infants, and Children program.
- The Eagle Butte Indian Health Service Unit linked children to health services available through Indian Health Service programs in the area.
- The Prairie Community Health Clinic, Inc., provided health exams and followup services, as well as health care services to area schools.
- The Northwest Area Schools provided screening services, developmental screening training, referrals to services, and followup care.
- The Center for Disabilities at the University of South Dakota School of Medicine directed the project, provided fiscal management, developed project materials and a Web site, and coordinated a team of trained pediatric specialists and staff training activities.
- The Bureau of Indian Affairs provided clinic and office space, support for a clinical coordinator, and early intervention services referred from the monthly clinic.
The project created a reservationwide system for delivering developmental screenings to children aged 0 to 5 years. A team of pediatric specialists was brought in to provide health and education services at monthly clinics. The project also established linkages to early intervention and other appropriate services, as well as referring children for followup care. Using a small aircraft, the clinic team members traveled from southeast South Dakota to the Cheyenne River Reservation to provide monthly clinics for area children. The clinical team included pediatric specialists; speech and language professionals; two teams of evaluators who conducted cognition, communication, motor, and psychosocial skill assessments; a registered dietitian, who provided anthropometric and nutritional assessments; and allied health professions students, who participated in the clinics as part of their fieldwork requirements. Because poor weather can hamper air travel, the project often was forced to cancel monthly clinics. However, the project also specified a backup date each month for holding each clinic. |
| Results |
The project succeeded in creating a comprehensive system of developmental services for children aged 0 to 5 years living on the Cheyenne River Reservation. In all, 936 children were served by the project, with 230 children receiving developmental, hearing, and vision screenings as part of the pediatric clinic evaluations, and another 706 children receiving developmental screenings. Sixty-six of these children were connected to additional services as part of their followup care. The majority of children served were American Indians of Sioux heritage from low-income families. In addition, 12 members of the clinical team received cultural sensitivity training, and 20 allied health students participated in the program as part of their clinical training experience. |
| Replication |
This project was based on a similar model developed by the University of South Dakota Center for Disabilities. Minor adjustments were made to adapt the model based on local needs, and the model emphasized best practice standards for developing a comprehensive system of services for infants, toddlers, and young children with developmental concerns. As a result, this project would work well in other rural settings. However, other communities considering replicating this model should ensure that the partners are equally committed to the project and willing to cooperate in meeting the needs of at-risk children. It also is critical to have the support of a charter flight service that is willing to transport the clinical team to remote rural areas to conduct screenings. All activities supported by the grant will continue. The Cheyenne River Sioux Tribe will support the monthly clinics, using funds from the Individuals with Disabilities Education Act (IDEA). These services will continue through a contract between the Sioux Tribe and the University of South Dakota Center for Disabilities. |
| Source |
Outreach Sourcebook, Vol.10, 2000-2003, Office of Rural Health Policy
|
| Contact person |
Judy Struck, MA, Project Director, Center for Disabilities
University of South Dakota School of Medicine
414 East Clark Street
Vermillion, SD 57069
605.357.1439
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| Date added |
May 15, 2009 |
| Date reviewed |
March 1, 2010 |
Summaries of success stories are provided by RAC for your convenience. Please contact the success story contact person directly for the most complete and current information.
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