Document Type



The Pawnee Benefit Package Program (PBPP) is a program designed to provide contract inpatient and emergency room services to eligible Indian people and their dependents. The program services the Pawnee Service Unit that is comprised of a seven county area in Oklahoma. This area includes the Osage, Ponca, Pawnee, Otoe-Missouria, Kaw, and Tonkawa Tribes. The purpose of this project is to evaluate the PBPP from the standpoint of: 1) its original intent to provide services; 2) its current level of health care delivery; and 3) its future level of health care delivery for the eligible Indian recipients of the seven county area of the Pawnee Service Unit.Consultants were hired to do the following tasks: 1) meet with Tribal leaders to discuss satisfactions and dissatisfactions with the PBPP; 2) research all available past and present information concerning the Pawnee Service Unit Delivery System and provide the current statistics on its population, funding, limitations, and service; 3) study physicians\' and patients\' acceptance of the PBPP and the outpatient services of the Pawnee Service Unit; and 4) conduct a feasibility study for providing alcoholism treatment and rehabilitation services for stroke patients in the Pawnee Service Unit. The above information was collected through a series of personal interviews, document searches, and a group of pencil and paper surveys. The sample used in the study was made up of 412 PBPP users and 515 PBPP nonusers. A random selection procedure was used to choose participants from the PBPP enrollment listsThe report categorizes the findings of the study under four objectives: 1) Pawnee Service Unit Health Board (PSUHB) satisfaction and dissatisfaction with PBPP; 2) deviation from original scope of PBPP; 3) PBPP user, nonuser, and medical provider satisfactions and dissatisfactions with PBPP; and 4) evaluation of alcoholism treatment and stroke rehabilitation services. As an immediate attempt to increase service, a 24 hour ""hot line"" to provide information to members and providers is suggested. Additionally, a PBPP newsletter should be distributed periodically to members. Additional funding and formative evaluations are also recommended to improve the quality of the PBPP service. There should be an accompanying increase in administrative staff and an aggressive enrollment campaign designed to increase PBPP membership. A final recommendation is that PSUHB begin an in-depth investigation of the referral system, rehabilitation services, and out-patient programs so that coordination of these services can be achieved throughout the entire PSU area.

Publication Date



Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-18).