Pasqua Yaqui Tribe

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Community Health Nursing (CHN) / Home Community Base Service Program (HCBS) / ALTCS


Community Health Nursing (CHN) Program
Hours of O Hours of O Hours of O Hours of Operationperationperation perationperation:
Monday-Friday 8:00 a.m. - 5:00 p.m.
Tucson Office
4725 W. Calle Tetakusim, Annex I
Tucson, AZ 85757
(520) 879-6119 Fax: (520) 879-6135
Guadalupe Office
9405 South Avenida del Yaqui
Guadalupe, AZ 85283
Phone: (480)768-2033 Fax: (480)730-3596
Maternal Child Health Program (520) 879-6299

The Community Health Nursing (CHN) and Community Health Representatives (CHR) Program provides community health nursing services to individuals and families within the Yoeme communities. Care plans are established through visits to homes, clinics, and communities in order to provide patient care, counseling, health educated and referral services. Special emphasis is placed on Maternal and Child Care as well as hospital discharges and follow-up with dialysis patients.
We assist with identifying and accessing other medical services that may be needed, providing direct nursing services, performing health status assessments and conducting public health surveillance. Coordination of patient care includes discharge planning, home visits, consultations with medical providers and ongoing monitoring in the home or care facility.
Our Community Health Nurses are licensed by the state of Arizona and are experienced in working with the tribal membership. Our Community Health Representatives are trained and experienced professional community health care providers supervised by tribally employed nurses and doctors.

Eligibility: enrolled tribal members and their families within Pima County and in Maricopa County, and surrounding areas.

Access to the CHN Program is by referrals from health care providers, hospitals, other Tribal programs, and by community members calling the office. The first step is a health status assessment, which will result in a care plan.

Specialty Services and Screening Services:

Patient and monitoring care in the home
Transportation escort to medical appointments on a case-by case-basis
Medication delivery and medication boxes filled by CHN weekly or bi-monthly
CHN case management
Community Emergency Response trained staff. Supervised work experience site for community members through the WIA program.
Immunizations administration
TB Skin Testing
Dialysis CHN liaison for dialysis clients
Specific nursing care for Maternal Child Health
Walk-in pregnancy testing and counseling and assistance/referral for prenatal care
Coordination of services with WIC, Head Start and First Things First programs
Child Passenger Safety training

HIV/AIDS Prevention Program
Hours of Operation: Monday-Friday 8:00 a.m. - 5:00 p.m.
Provides services to PYT members and their families on the reservation and surrounding areas who have been affected or are interested in learning about HIV/AIDS, Sexual Transmitted Infections and Hepatitis. Services include but are not limited to:
Intake Assessments and Screenings
Referrals to Test Sites
Demonstrations on Condoms, Dams and Female Condom Use
Case Management
Escort and Transport patients for Physician Consults related to HIV/AIDS, STIs or Hepatitis
Liver Transplant Evaluation and Preparation Assistance
Needle Exchange Program
Rapid testing for HIV and Hep-C offered in office
Home and Community Based Services (HCBS)
Hours of Operation: Monday-Friday / 8:00 a.m. - 5:00 p.m.
The Home and Community Based Service Program serves enrolled community members in Pima and Maricopa counties who meet program eligibility requirements for long-term care and home health services. Two programs are offered: ALTCS is Arizona Long Term Care Services, and an AHCCCS program for elders and the physically disabled.
Services may include:
 Community Health Nurse home visits
 Attendant Care Provider home visits
 Home Delivered Meals
 Transportation for Medical Appointments
Escort as Necessary
 Nursing Care Facility Placement

ALTCS Eligibility: There is a two-step process involved: (1) is the financial eligibility. Resources are accounted for and include but are not limited to: employment income, disability income, savings accounts and other resources. (2) Is the medical eligibility. The pre-admission screening is part of the medical process. Both are reviewed and determined by State AHCCCS employees. The State AHCCCS staff will determine if someone is at risk of institutionalized care. It considers a person’s ability to perform daily living activities, communication skills, continence, behavior, and medical conditions among other things. The Primary Care Physician’s notes and input are also used to determine medical eligibility. Once a tribal member is determined to be eligible for ALTCS and has completed an HCBS intake process, a case manager will be assigned and work directly with the member and the member’s family. This will insure that the member receives all services in their care plan and monitors the medical progress of the member.
We Care Program: This is a tribally funded program for Elders, the physically disabled and those who were not eligible for ALTCS and occasionally new mothers who had difficult births. Under the We Care Program, eligible members will receive basic home services by certified attendant care providers. Individual service plans may include homemaking, personal care, general supervision, and companionship.

Phone: (520) 879-6020
7490 S. Camino de Oeste 7490 S. 
Tucson, AZ 85757

Tucson We Care
Phone: (520) 879-6127
7490 S. Camino De Oe
Tucson, AZ 85757

Phone: (602) 480-768-2019
Fax: (480) 768-2093
9405 S. Avenida del Yaqui
Tempe, AZ 85283

Specialty Clinics:
Location: Hiak Hitevi Kari, Main Health Building
Referrals are needed from a primary care physician to schedule an appointment. Call 520-879-6120 for more information.

Cardiology - Includes: Any Heart Conditions; Evaluate and Treat
Gynecology - Includes: Women’s Menstrual Issues, Pap Smears (normal/abnormal), Contraception, Urinary Problems and Simple Procedures
Podiatry - Includes: Nail Trimming, Diabetic Foot Care, Ingrown Toenails, Diabetic Ulcers, Orthotics, Callus Removal
Podiatry / Senior Center - ***For Seniors Only***
Includes: Nail Trimming, Diabetic Foot Care, Ingrown Toenails, Diabetic Ulcers, Orthotics, Callus Removal
Physical Therapy - Includes: Treatment services to restore or improve muscle tone, joint mobility, or physical function ordered by a physician
Rheumatology - Includes: Rheumatoid Arthritis, Lupus, Gout, Fibromyalgia, Joint Pain, Autoimmune Disorders
Wound - Includes: Any Open Wounds, Cellulitis, Burns, Ulcers, Cysts, Surgical Wounds
Gastro Intestinal (GI) – Includes: Irritable bowel syndrome, Inflammatory bowel disease (include Crohn’s disease/Ulcerative Colitis), Diverticulitis, Celia disease, Heart burn and GERD, Chronic vomiting, Constipation, Diarrhea, Peptic Ulcer, Pancreatitis, Gallbladder disease, Appendicitis, Nutritional deficiencies, Obesity, Nonalcoholic fatty liver disease, Cirrhosis, GI infections, Colorectal cancer and Viral hepatitis
Nephrology – various kidney disease process

Arizona Long Term Care – Guadalupe

Arizona Long Term Care - Tucson

Community Health Nursing Phone Number

Guadalupe Community Health Nursing and Representatives

Home Community Base Services

New Beginnings Methadone Clinic

Above is a guide to help Yoeme Health Program Members during normal business hours, after hours, and weekends to ensure you receive the health care you need anytime of the day for pharmacy and medical concerns.