Cherokee Nation Comprehensive Health Care System Self Governance Planning Process W.W. Hastings Indian Hospital
Cherokee Nation Comprehensive Health Care System
Self Governance Planning Process
W.W. Hastings Indian Hospital
General Information Sheet
The Cherokee Nation has begun a planning process of W.W. Hastings Indian Hospital to ensure a more comprehensive health care system for our citizens. The decision to enter the planning process for this project is based on careful consideration. Many other tribes, including the Creeks, Choctaws and Chickasaws, operate comprehensive health care systems in their areas, including inpatient services. Tribally run hospitals are also eligible for additional federal funding for use at the local hospital level, instead of spending that money at the regional and national offices which are located far away from the community being served.
This document should help answer some questions that patients may have as the Nation proceeds with planning.
How will Services be affected?
The amount of money currently available for patient care at W.W. Hastings Indian Hospital is limited to direct federal funding and third party resources. The Cherokee Nation would be able to provide additional tribal dollars, including but not limited to tribal shares from the IHS Oklahoma City Area Office and IHS Headquarters, and grant monies. These resources could bring an additional several million dollars a year into the health services at W.W. Hastings.
In addition to extra money for services, the creation of a comprehensive health care system consisting of a hospital, clinics, and various programs within the IHS Tahlequah Service Unit would provide additional benefits for all patients. The Cherokee Nation already operates nine outpatient clinics and also provides a broad array of services such as home health, palliative and other end of life care, community health, alcohol and substance abuse treatment, emergency response, ambulance services, non-emergency medical transportation, health research, environmental health/sanitation facility, epidemiology, an employee health clinic and numerous other public health services. Additionally, the Cherokee Nation is embarking on several new projects including elder care sites as part of the Program of All-Inclusive Care for the Elderly (PACE) through the Centers for Medicare and Medicaid Services.
Should the Cherokee Nation assume operation of the facility, will non-Cherokees be able to access the facility?
Yes, eligibility for services at W.W. Hastings Indian Hospital would remain the same. Cherokee Nation realizes that many of the American Indians/Alaska Natives utilizing W.W. Hastings Indian Hospital are not citizens of the Cherokee Nation. The purpose of planning is NOT to limit the use of the facility to only Cherokee citizens, but instead to offer a comprehensive health system comprised of a hospital, clinics, and other services for
ALL eligible Indian Health Service (IHS) beneficiaries
[1] served at Hastings.
Under what authority is the Cherokee Nation able to initiate such a planning process?
Federal law
[2] provides Tribes the option of either assuming from the Indian Health Service (IHS) the administration and operation of health services and programs in their communities, or to remain within the IHS administered direct health system. Tribes may initiate a planning phase consisting of: legal and budgetary research; and
internal tribal government planning and organizational preparation relating to the administration of health care programs[3].
How will current Employees be affected should the Cherokee Nation assume operation of the facility?
Cherokee Nation wants the patients to have the comfort of knowing that they will be able to see their same trusted physicians, nurses and health care providers. We also realize that the facility is staffed by a diverse array of health professionals and ancillary staff consisting of Cherokee citizens, citizens of other Tribes, and those with no Tribal affiliation. During this planning period, concerns may be raised by current employees regarding their continued employment at the facility, as well as concerns of the loss of protections/benefits as a federal employee. The Cherokee Nation has carefully considered the potential concerns of current employees and is willing to offer options to all current employees should the Nation assume operation of any service in the facility:
· Memorandum of Agreement/Inter-personnel Agreement (MOA/IPA): Through the self-governance compacting process, the Cherokee Nation is able to maintain Memorandum of Agreements for Commissioned Officers and Inter-personnel Agreements for civil service employees. The Cherokee Nation would allow current employees to retain their current employment with the Indian Health Service and execute either an MOA or IPA with the Cherokee Nation. The employee’s compensation package would remain the same.
· Tribal Hire: A current employee could convert to a Cherokee Nation employee with the employee benefit package offered to all Nation employees. In addition to employee benefits, Cherokee Nation employees have protections through the Cherokee Nation Constitution.
How will activities at the IHS Area Office and Headquarters be affected?
While collaboration with the Indian Health Service will continue in order to provide effective and efficient health care services to all eligible beneficiaries, assuming additional services under the Nation will remove several layers of bureaucracy at both the IHS Area level and Headquarters level. Functions related to human resources, financial management, contracting, and staff meetings can be accomplished in Tahlequah, as opposed to Oklahoma City and/or Rockville, Maryland, where IHS offices are located. The funding associated with numerous administrative activities at the area and headquarters level would then be available for additional health services at the local level. However, Indian Health Service will continue to provide functions that are inherently federal in nature.
Inquiries may be submitted to:
RANDY GIBSON, HEALTH Communications
Cherokee Nation
P.O. Box 948
Tahlequah, Ok 74965
Phone: 918-207-3950
[1] Indian Health Service Manual at Section 2.1.2, as well as the Code of Federal Regulations (CFR) at 42 C.F.R. § 136.12, which codifies provisions of the Indian Health Care Improvement Act (P.L. 94-437).
[2] The Indian Self-Determination and Education Assistance Act (P.L. 93-638, as amended), codified at 25 U.S.C. § 450 et seq.
[3] 25 U.S.C. § 458aaa–2 (d)