Chickasaw tribe looks to improve access to health care

ADA, Okla. (AP) – Ada resident Billy Ward, like many Chickasaw Nation members, had grown weary of the usual drill when he needed to see a diabetes doctor at the local tribal clinic.

Clinic employees were overwhelmed by the sheer number of people seeking treatment – so much so that even routine appointments often had to be made weeks in advance.

“Whenever you need medical attention, you need it now,” said Ward, 43. “You don't need it 30 days from now.”

Health officials with the Ada-based tribe of about 49,000 members believe that won't be an issue any more, thanks to the $146 million Chickasaw Nation Medical Center. The center, built using a unique public-private partnership, celebrates its first year of operation this month.

The 370,000-square-foot center is almost triple the size of the clinic it replaced and includes a 72-bed hospital, an emergency department, a diabetes care center, a dental clinic, a diagnostic imaging center, a women's health center and offices for the tribe's health programs.

It was erected on a picturesque 230-acre meadow plot replete with pecan and oak trees near Ada and about 85 miles southeast of Oklahoma City.

“It's more than we dreamed of,” said Judy Goforth Parker, a former tribal councilwoman who's now the tribe's health system administrator. “What we have here is state-of-the-art care.”

American Indian clinics throughout the U.S. experience chronic crowding and long wait times. Experts attribute the back up to underfunding of the federal Indian Health Service, through which many tribal members seek health care.

The 30-year-old Carl Albert Indian Health Facility in Ada was built to handle about 20,000 outpatient visits annually, Parker said, but it was receiving about 300,000 such visits.

“The Chickasaw Nation took a proactive stance, instead of dealing with their other clinic which was really awful,” said Linda Burhansstipanov, the president and grants director of the Colorado-based nonprofit Native American Cancer Research. “It was way too small and didn't have the type of facilities they needed. They built a facility to meet the needs of their community. ... They should be praised for what they've done with this.”

Parker said the overcrowding “was the catalyst” that made tribal leaders realize “something had to happen” to address the situation. She said she often was in line at 5 a.m. at other IHS facilities and waited in line for hours just so she could make an appointment and not have to wait another month for one.

“That used to happen,” she said. “Now, starting with this facility, I can call and make an appointment, just like I would in the private sector. Those are going to be changes that people will perceive as being better.”

The lead designer on the project, Larry Speck, said care was taken to incorporate traditional Indian healing aspects into the design. Architects met with tribal elders and health officials before developing their blueprints in an effort to “make the hospital about Chickasaw culture,” said Speck, an Austin, Texas,-based architect with PageSoutherlandPage.. “This is not a generic hospital for anybody.”

Speck tried to reflect the Chickasaws' “connection to the land” in the hospital's design.

“We wanted to be respectful of the land, both ecologically and in terms of its beauty,” he said.

The patient-room windows, for example, don't overlook an outside wall, parking lot or loading dock; they all look out over a natural setting outside the hospital or a courtyard garden.

“It's peaceful and restful,” Speck said. “The environment really does make a difference.”

Stones used to build the hospital came from four Oklahoma quarries and are of different colors. Ceilings that rise to 12 feet near windows help bring in natural light. The hospital's lobby includes Chickasaw art exhibits and wooden panels. A wood-clad canopy is located above a main entrance.

Patients “are supposed to feel like they're getting the best health care possible,” Speck said. “This should be first-class.”

The Chickasaw Nation has made hundreds of millions of dollars in recent years from its business interests, most notably its large casinos in Thackerville and Goldsby. Parker said tribal Gov. Bill Anoatubby wanted to use some of the tribe's largess to fund the hospital project.

The tribe paid to build the hospital and the federal Bureau of Indian Affairs will provide $25 million annually for 20 years under terms of the Joint Venture Funding Construction Award. Anoatubby said the hospital is the first to receive such an award from the Indian Health Service.

IHS Director Yvette Roubideaux said the hospital “is a model (of) how tribes can leverage their resources for much-needed facilities to provide and maintain the health of the citizens.”

Other tribes are following the Chickasaws' example. The Absentee Shawnee tribe is building a $26 million, 76,000-square-foot clinic in rural Norman that should open in 2012. Tim Tall Chief, the tribe's executive director of health services, said the tribe is paying for construction and IHS is funding the staff salaries.

“That very same approach is the future of Indian health care,” Tall Chief said. “The tribes just like to have more control over the way services are delivered to their people. That's what it boils down to – an opportunity to provide in a different way.”

Tall Chief predicts more tribes will do the same.

“As our tribes get more business-oriented, you'll be seeing more of them pulling money out and running it themselves.”