WASILLA — A federal funding bill approved in the U.S. Senate last week includes a $66 million appropriation that will provide about 125 new high-skill, high-wage jobs in the Mat-Su Borough.
Benteh Nuutah Valley Native Primary Care Center, 1001 Knik-Goose Bay Road, began serving customer-owners at its new location in August 2012. But funding was only available then to hire about 100 of the employees needed to operate the new 90,000-square-foot, $56-million facility.
Ranking Republican on the Senate Interior Appropriations Subcommittee, U.S. Sen. Lisa Murkowski announced last week that she has negotiated with Congressional Appropriations Committee members to include funding in the 2014 Department of Interior budget to fully staff six new health facilities across Alaska, including the Valley medical center.
“I feel like I have been in a fight with this administration just to get them to do the right thing and what the Supreme Court told them to do in the Ramah case: fully fund Alaska Native hospital operations and ensure the adequate delivery of health care to Alaska Natives,” Murkowski said in a press release announcing the appropriation.
Salazar v. Ramah Navajo Chapter is a U.S. Supreme Court ruling from June 18, 2012, that says the federal government must fully fund contract support costs and staffing for native health centers nationwide. The decision is pivotal because the federal government has historically prorated contracts with tribal health care providers and only paid between 77 percent and 92 percent of each contract.
The Obama Administration seemed ready to ignore the court’s ruling and maintain the status quo until she put up a fight, Murkowski wrote.
As proposed, she says the administration’s budget would have violated an agreement made to staff new facilities if tribes could arrange private finance for construction. But instead, only part of the federal funding was received in August 2012, and so for more than a year and a half, about half of the sparkling new facility in Wasilla has remained unused. In some cases, at Benteh Nuutah that has meant whole new departments, such as optometry and audiology, remain closed in Wasilla forcing customers-owners to drive to Anchorage for care.
Benteh Nuutah serves about 8,000
Of the total $66 million for staffing, $11.2 million will be received by Southcentral Foundation, which operates primary care facilities in the Mat-Su Borough and Anchorage. The remainder will be shared by five other health care organizations in the consortium that built new clinics under the agreement: Norton Sound, $8.4 million; Tanana Chiefs, $20.1 million; Barrow, $12.5 million; Copper River, $3.5 million; and Kenaitze, $10.6 million.
“This means jobs in our rural communities and that health disparities facing Alaska Native people can be addressed,” Murkowski said.
For many years, Indian Health Services provided health services to Alaska Native and American Indian people. But the Indian Self-Determination and Education Assistance Act passed by Congress in 1975 authorized the Secretary of the Interior and the Secretary of Health and Human Services to contract with Alaska Native and Native American tribes to provide such services.
Southcentral Foundation was established in 1982 as part of Cook Inlet Region Inc. and began contracting services from the federal government in 1987. Today, the nonprofit has an annual operating budget of $227 million and 1,600 employees statewide.
One of the newest additions to its network of facilities, Benteh Nuutah serves about 8,000 customer-owners — most of the more than 10,000 Alaska Native people estimated to live in the Mat-Su Valley.
The center’s name reflects the Joint Partnership Agreement Southcentral Foundation entered into with the Chickaloon Village Traditional and Knik Tribal councils. The name “Benteh Nuutah” means “among the lakes, among the islands” in the Ahtna and Dena’ina Athabascan dialects.
Federal funding is good news
The grand lobby features floor-to-ceiling windows on two sides and a south wall curved gently like a crescent moon.
“It’s a beautiful building that honors our people and our heritage,” Ileen Sylvester, vice president of executive and tribal services for the Southcentral Foundation, said during a tour on Friday. “People walk in and start feeling well.”
The first floor includes a large gathering area, two primary care clinics, the Wellness Center and a pharmacy. The second floor houses the dental clinic, and optometry and audiology, which are set to open this year.
The funding included in the federal appropriations bill this past week is good news, she said.
It means that by the end of the year, the optometry and audiology departments will be staffed and that more dentists, doctors, nurses, nurses assistants — about 125 total — skilled health care providers will be hired to bring the clinic up to full staffing levels, Sylvester said.
For now, some departments like primary care and dental are operating and a third to half of their designed capacity, said Heather Goecke, manager of the Valley Native Primary Care Center.
Leading a tour of the facility Friday, she said there is still some confusion among the public about what sort of care is offered here. They provide primary care, by appointment, and do not provide emergency care, Goecke said.
That customer-owners aren’t clear on that detail sometimes means people show up needing emergency care and must then be transferred by ambulance to Mat-Su Regional Medical Center, she said.
For now, the facility is open 8 a.m. to 5 p.m., Monday through Friday, though Goecke said they hope to eventually add evening and Sunday clinic hours, too.
‘People from all over the world come see what we are doing’
Southcentral Foundation’s “Nuka System of Care” is a name given to the whole health care system created, managed and owned by Alaska Native people. It hosted its first Nuka Conference in 2012 in response to national and international interest in the unique health care system it forged in partnership with its customer-owners.
The 2014 Nuka System of Care conference is June 16-20 in Anchorage.
“People from all over the world come see what we are doing,” Sylvester said.
Part of what is turning heads is the way the system uses integrated care teams. The space was also designed with the team approach in mind, she said. Team members sit in a pod located near each other so consultation can be done in real time, sometimes even while the customer-owner is on the phone.
Each customer-owner is assigned to one of the four-person primary care provider teams, which include case management support, case manager, primary care provider and a certified medical assistant. And all the teams share access to a behavioral health consultant, registered dietitian and a pharmacist.
When customer-owners have health-related issues, Goecke said they can call their case manager or scheduler directly, use email to ask for information or schedule a same-day, face-to-face visit.
Sylvester said she’s one of those patients who has her doctor’s email and admitted that from time to time, she has emailed questions.
She said helping customer-owners over the phone or by email isn’t a billable service, but it saves so much money on clinic visits that it makes fiscal sense to offer the service.
The clinic’s design also makes use of Talking Rooms where staff can sit and talk to people in a homey, non-clinical setting.
“You don’t always need an exam room,” Goecke said. “And it’s expensive space.”
Sylvester said the Talking Rooms also help build relationships between the people providing the care and those on the receiving end. She said the organization revamp itself more than a decade ago after coming to realize its core product wasn’t health care services, but relationships.
Sylvester said the health care system has seen the greatest success partnering with its member-owners to make a difference over time.
Whether it’s partnering with the federal government, local tribes or its customer-owners, partners are key to the Southcentral Foundation’s success, Sylvester said.
Partnerships are crucial to the effort; like the Rasmuson Foundation that paid for the chairs and other equipment in the dental clinic and Mat-Su Health Foundation, which gave a grant to build a playground and a walking trail around the perimeter of the property.
“We couldn’t do it without them,” Sylvester said.
Contact Heather A. Resz at 352-2268 or email@example.com.