Cherokee Nation studies Hastings management

W.W. Hastings Indian Hospital
W.W. Hastings Indian Hospital

By Jami Custer

TAHLEQUAH, Okla. – Cherokee Nation and W.W. Hastings Indian Hospital officials announced in January the tribe’s preliminary study to determine if it should manage some or all of the hospital’s services, currently operated by the U.S. Department of Interior’s Indian Health Service. Ed McLemore, the hospital’s CEO, and Melissa Gower, CN Health Services group leader, informed hospital officials about the study on Jan. 11. The study should be completed no later than June 1, and if tribal leaders decide to assume management, it would fall under the CN administration as part of a self-governance effort by Oct. 1. Following the announcement, Principal Chief Chad Smith sent a letter to CN employees stating that improved health care and funding were major reasons for the study. “The reasons for considering this plan are simple: better health services for our citizens and more federal funding for health services in northeastern Oklahoma,” his letter states. Smith said assuming operation of the hospital would mean more federal funding because current dollars available for patient care is limited to federal funding and third party resources. He said CN would provide additional tribal dollars with tribal shares from the Indian Health Service 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,” his letter states. Mike Miller, CN Communications officer, said the hospital has a federal budget of $25 million. Smith said the plan is also being considered to eliminate bureaucracy. He said other tribes operate some or all of the services at Indian hospitals, and by doing so it eliminates patient confusion and allows more access to health care. He said part of the comprehensive health care system includes patients receiving better care when Hastings doctors and tribal clinic doctors have the ability to share information and work together. Smith also stressed that patient eligibility requirements would not change during the study or if the tribe decides to take over the facility. According to the IHS Web site, the common standard applied for IHS health services eligibility is that patients are enrolled citizens of a federally recognized tribe. McLemore said he acknowledges that some people won’t like the switch if it happens, but thinks it could lead to better health care for area Indians. “In discussing things with CN you get a range of opinions and some folks don’t think it’s a good idea,” he said. “But I have worked with CN Health leadership and CN elected leadership for almost five years now, and I have found them to be responsive to the health care needs of Cherokee citizens. I think this will help the care of our patients and the responsiveness we have to those patients.” McLemore said some employees are worried about their jobs. However, he said he wants them to focus on the advantages available if CN does assume management. “We have assurances that if CN does get to a decision point that they would like to assume management responsibility for the hospital, they would like to have all the employees transition over to the CN,” he said. “I don’t think CN would indicate to us in one respect and intend for everyone to transition and then change their mind. I hope that folks take a close look at the advantages to be gained from this transition.” Smith’s letter states he acknowledges the employees’ concerns and that the tribe would offer options to current employees. “If the Nation assumes services at Hastings, every employee at Hastings will be asked to stay and will be given the option to choose for themselves whether to become tribal employees or remain federal employees,” his letter states. Smith said through the self-governance compacting process, the CN is able to maintain memorandums of agreements for commissioned officers and inter-personnel agreements for civil service employees. These agreements would allow hospital employees to retain their current employment status and compensation packages with IHS and execute either an MOA or IPA with the tribe. A Hastings employee could also convert to a CN employee with the employee benefit package offered to all CN employees, as well as protections through the CN Constitution. As part of the study, the tribe sent a letter to the IHS regarding the study. Also, tribal officials said budget information would be sent to the Oklahoma City-area IHS office to clarify the transition, but that no program or budget-related changes would occur until a decision is made. Under the Indian Self-Determination and Education Assistance Act, the tribe is allowed to assume operation of the hospital. But before CN can do that, the issue must pass the Tribal Council’s Health Committee and full council.

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