Fac­ing fed­eral back­log, Ok­la­homa tribes step up health in­vest­ments

The Oklahoman (Sunday) - - NEWS - BY MEG WINGERTER Staff Writer mwingerter@ok­la­homan.com

Sev­eral tribes in Ok­la­homa are plan­ning ma­jor in­vest­ments in health care, in­clud­ing a Chero­kee project that will be the largest joint ven­ture in In­dian Health Ser­vice’s his­tory.

The Chero­kee, Musco­gee and Osage na­tions all are ex­pand­ing their health fa­cil­i­ties and plan­ning to hire more providers. Sev­eral of the projects are joint ven­tures where a tribe pays to build and equip new fa­cil­i­ties, but the fed­eral gov­ern­ment agrees to pay some of the op­er­a­tions costs. Oth­ers, such as the Chick­a­saw Na­tion, are in­vest­ing in of­fer­ing more ser­vices within their cur­rent foot­print.

The U.S. gov­ern­ment com­mit­ted to pro­vide health ser­vices to Amer­i­can In­di­ans un­der a se­ries of treaties and fed­eral laws, but the In­dian Health Ser­vice has been un­der­funded for years. Tribes have iden­ti­fied at least $14 bil­lion worth of work needed to build or up­grade health fa­cil­i­ties, and at the cur­rent rate of fund­ing, a project might not move for­ward for decades, or even cen­turies, said Dr. Charles Grim, in­terim ex­ec­u­tive di­rec­tor of health ser­vices for the Chero­kee Na­tion.

“The need out there is far out­strip­ping the money they’re mak­ing avail­able,” he said. “Depend­ing where you are on a list, it could be 300 years un­til they get to you.”

Chero­kee projects

The Chero­kee project in­cludes build­ing a new, 490,000-square-foot fa­cil­ity in Tahlequah for out­pa­tient ser­vices like pri­mary care, den­tistry, op­tom­e­try, phys­i­cal ther­apy and some surg­eries that don’t re­quire an overnight stay. Cur­rently, those ser­vices are pro­vided in the same build­ing as in­pa­tient care, Grim said. Sep­a­rat­ing them will give both the hos­pi­tal and the out­pa­tient of­fices room to serve more pa­tients, he said.

“Ev­ery sin­gle ser­vice is ex­pand­ing in size,” he said.

The Chero­kee Na­tion will spend about $200 mil­lion on the new build­ing, and at least $75 mil­lion on equip­ment and in­for­ma­tion tech­nol­ogy sys­tems. The fa­cil­ity is sched­uled to open in 2019, and will cre­ate about 800 new jobs. It will be the largest project in the joint ven­ture pro­gram’s his­tory, Grim said.

The in­vest­ment is part of a larger ef­fort to pri­or­i­tize health, which in­cluded rais­ing pay for some doc­tors, com­mit­ting more money to pay for care at non-Chero­kee fa­cil­i­ties, build­ing two new fa­cil­i­ties and ex­pand­ing two oth­ers, Grim said. In those cases, the tribe funded the projects without fed­eral help, he said.

Chero­kee Na­tion Prin­ci­pal Chief Bill John Baker said im­prov­ing health care lays the foun­da­tion for the tribe’s fu­ture.

“For many years Na­tive peo­ple, in­clud­ing Chero­kees, have faced the worst health dis­par­i­ties in our coun­try,” he said. “Through plan­ning, fo­cus and part­ner­ships, we have an op­por­tu­nity to change that his­tory and truly make the health of our peo­ple a pri­or­ity. I’m proud that tan­gi­ble changes are tak­ing shape to im­prove health care ac­cess for Na­tive peo­ple across north­east Ok­la­homa.”

To get fund­ing through a joint ven­ture, tribes have to com­pete by show­ing their mem­bers need ac­cess to cer­tain ser­vices, and that they have the funds and ex­per­tise to com­plete the project, Grim said. Less than 30 projects have been ap­proved since the early 1990s, and Ok­la­homa ap­pli­ca­tions have been un­usu­ally suc­cess­ful. The cur­rent project is the third for the Chero­kee Na­tion, and the Chick­a­saw and Choctaw na­tions also have se­cured joint ven­tures, he said.

Musco­gee projects

The Musco­gee Na­tion also has a joint ven­ture in the works to re­place an out­pa­tient fa­cil­ity in Eu­faula by this sum­mer. A sec­ond project, fi­nanced by the tribe, re­cently cre­ated a com­bi­na­tion in­pa­tient and out­pa­tient fa­cil­ity in Okemah, said Shawn Terry, sec­re­tary of the health for the Musco­gee Na­tion. The out­pa­tient side is open, and the in­pa­tient side will open af­ter the state fin­ishes in­spec­tions and li­cens­ing, he said.

Both projects re­place fa­cil­i­ties from the 1970s, which didn’t have enough space for the num­ber of providers and pa­tients they have now, Terry said. The new fa­cil­i­ties will be able to han­dle at least 2,000 more pa­tients than they cur­rently have, he said.

“They were badly di­lap­i­dated, in bad need of re­place­ment,” Terry said.

Other tribes’ projects, plans

The Osage Na­tion also found it had out­grown its health fa­cil­i­ties, and plans to spend at least $15 mil­lion on new con­struc­tion. A new clinic will nearly triple the space avail­able in the cur­rent fa­cil­ity, which is about 12,500 square feet.

Dr. Ron Shaw, chief ex­ec­u­tive of­fi­cer of Osage Na­tion Health Ser­vices, said the cur­rent build­ing couldn’t ac­com­mo­date ser­vices they wanted to add, like mam­mo­grams and phys­i­cal ther­apy.

“We are lim­ited in space to pro­vide more pa­tient en­coun­ters and a wider scope of ser­vices,” he said.

New fa­cil­i­ties aren’t al­ways nec­es­sary, how­ever. The Chick­a­saw Na­tion is plan­ning to in­vest in hir­ing pe­di­a­tri­cians for its ex­ist­ing clin­ics as part of a push to em­pha­size pre­ven­tion, said Dr. Judy Go­forth Parker, the na­tion’s sec­re­tary of health. Re­cruit­ing physi­cians is a chal­lenge in ru­ral ar­eas, she said, but they have found a group of doc­tors and nurse prac­ti­tion­ers who want to work in-depth with a smaller num­ber of chil­dren.

“While our fam­ily medicine ser­vices have served our pa­tients well for years, we be­lieve adding providers who are specif­i­cally trained to con­nect and in­ter­act with our chil­dren will of­fer the op­por­tu­nity to be­gin even ear­lier de­vel­op­ing life­long habits and choices that pro­mote well­ness and over­all health,” she said.


An artist’s ren­der­ing shows a planned health fa­cil­ity in Okemah. The Musco­gee Na­tion is con­struct­ing two new fa­cil­i­ties as part of its in­vest­ments in health.


An artist’s ren­der­ing of a planned out­pa­tient care fa­cil­ity in Tahlequah. The fa­cil­ity is the lat­est Chero­kee Na­tion project to im­prove ac­cess to health care.

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