The Tribe operates the following programs: Family Services Program, including outpatient primary care, public health nursing, community health representatives, substance abuse counseling, nutrition, and mental health. The tribe also operates an early childhood development center that provides services to children in Head Start, Child Care, and Prekindergarten. Health programs are funded through the IHS. The Tribe provides limited primary care services in a 4,500 SF medical clinic built in 1995. The leading causes of death are heart disease, malignant neoplasm, cerebrovascular disease, motor vehicle accidents and digestive diseases.

The active health clinic user population is 382. The enrolled tribal population is 504 and the Indian population living on or near the reservation is 457.

The Upper Skagit Tribe is part of the Northwest Washington Service Unit Health Board (NWSUHB) that also includes Lummi, Nooksack and Swinomish. The Health Center had 1,510 primary care visits and 118 other patient visits for a total of 1,628 patient visits for FY 1996. The clinic bills Medicaid, Medicare and other third-party payers. Patients who have no other medical coverage travel to the Lummi Tribal Health Center for direct care services that are not provided at the Upper Skagit Health Center. The Tribe’s Contract Health Services program is funded and administered by the Swinomish Tribes through a consortium agreement. The Tribe’s Contract Health Service Delivery Area (CHSDA) is Skagit County. Services include supervision of contaminated waste handling, food handling permits, health inspections of tribal facilities, water quality and sewage management, vector control and solid waste disposal, among other duties as assigned by the tribal health department. One full-time position is funded and the sanitarian provides services one day a week at Upper Skagit. Through a contract with the Lummi Nation, Upper Skagit purchases the on-site services of a nutritionist one day a week, a mental health counselor two days a week, and medical doctor one day per month. Specialty services include WIC and ECEAP. With its base funding the Tribe operates a Family Services Program that employs a full-time physician’s assistant, a public health nurse one day per week, two full-time CHRs, and one full-time alcohol counselor. 93-638, Title I contract with the Indian Health Service (IHS). Health programs are funded through a P.L.

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