PROGRESS: Native Healthcare in the Valley

The Benteh Nuutah Valley Native Primary Care Center or VNPCC is a beautiful building. The design was inspired by selecting colors, textures and art from the tribal cultural work group from Knik Tribal Council, Chickaloon Village Traditional Council, and Southcentral Foundation (SCF).

The building is located at 1001 Knik-Goose Bay Road in Wasilla. The facility currently offers primary care, behavioral health, dietary, radiology, pharmacy, dental, optometry, midwifery, physical therapy and wellness center services.

“VNPCC is currently being remodeled to expand services to include chiropractic care, acupuncture and massage therapy. We anticipate these new services will available by summer 2018,” SCF Medical Services Division Administrator Melissa Caswell said.

The name, ‘Benteh Nuutah’ is roughly translated to English from the and Ahtna Athabascan languages as, ‘among the lakes, among the islands.’

In 2007, services initially began with fewer than 20 employees. In August of 2012, a 90,000- sq.-ft. building was opened. This was the result of a growing population of Alaska Native people in need of health care services in the Mat-Su area.

Prior to expanded services offered in Mat-Su, Alaska Native people travelled to Anchorage or the smaller clinics in the outer area.

Currently, there are about 10,000 Alaska Native people and over 1000 veterans who use VNPCC for health care services. There is no emergency room. If someone goes to VNPCC with a broken arm they will be sent to Mat-Su Regional Medical Center, or wherever broken arm people go.

Primary care services are open Monday-Friday from 8 a.m. to 6:30 pm. If a broken arm person goes after or before those hours they may have to go to Mat-Su Regional Medical Center, or wherever broken arm people go, after hours or during. Most services are not available after 6:30 p.m.

SCF in partnership with Chickaloon Village Traditional Council and Knik Tribal Council serve as the owner-operators. The building was designed to include the possibility of future expansions, such as another building wing, should more space become needed.

SCF has no shortage of vision. It is worthwhile to mention, last November SCF received the 2017 Malcolm Baldrige National Quality Award by the U.S. Secretary of Commerce. It’s a big deal. The award is given based on careful evaluations and a system of measures, according to the Baldrige Excellence Framework. The measures include: leadership, strategy, customers, measurement, analysis and knowledge management, workforce, operations, and results.

SCF is the only health care organization to be recognized twice by the Baldrige Award. In 2011, they were first recognized. It is impressive by any measure.

There are a few common misconceptions, including Native peoples have free health care in Alaska and Indian Country. To be clear, Indian Health Service (IHS) does not simply provide 'free' health care.

“Alaska Native and American Indian people have pre-paid healthcare,” SCF Vice President of Medical Services, SCF Vice President of Medical Services Dr. Doug Eby explained. “Alaska Native and American Indian People paid with land, oil, timber, and other resources. In exchange for settling land rights.”

There were treaties signed and some of them even stuck. This health care agreement, or settlement, was established in 1787 by Congress, providing health care services based on Article I, Section 8 of the Constitution.

“The IHS level of funding – by the U.S. government calculation – is only about 40% of basic needed funding,” Dr. Eby said.

In 2012, there was a U.S. Supreme Court ruling from Salazar v. Ramah Navajo Chapter, that says the federal government must fully fund contract support costs and staffing for native health centers nationwide. While not recent news the impact is just beginning to be seen by those served with better-funded contracted services.

For many years federal government had prorated contracts with tribal health care providers and for years paid between 77 percent and 92 percent of each contract.

According to a press release from Senator Murkowski and to her credit, with the Ramah case settled, in 2014 Senate budget negotiations, she helped to secure $66.2M for Alaska. This made it possible to more fully fund Alaska Native hospital operations and health care services, including VNPCC.

To be clear, Indian Health Service does not cover all the costs of providing health care services for Alaska Native people. There are still shortcomings concerning funding.

“In Alaska, the settlement is managed through the Alaska Native Village Corporations and Regional Corporations,” Dr. Eby said. “Current revenues into Tribal Healthcare Organizations include many revenue streams including private insurance, Medicare, Medicaid, research, grants, and other programs, in addition to the IHS funding.”

SCF and VNPCC are part of the Alaska Tribal Health System. The point is, there are tribal health organizations that are effectively providing services and doing it with fewer resources and better outcomes. It includes award winning innovations in how services are provided.

Photo caption: Benteh Nuutah Valley Native Primary Care Center at 1001 Knik-Goose Bay Road in Wasilla. Photo provided by Southcentral Foundation.