Chairman Rambler attended the Izee Baa Gowah strategic capital planning meeting on Friday May 21, 2021 in Scottsdale, Arizona. The Izee Baa Gowah Board of Directors and management presented a four-year capital spending plan in the amount of $160 million dollars to maintain and expand health care services to the San Carlos Apaches.
The Board provided Chairman Rambler an opportunity to provide welcome remarks. Chairman Rambler stated, “I want to thank our Health Care Corporation for the healthcare services you provided for our people during the COVID-19 pandemic. Thank you for your leadership. When I was elected to the Council in 2004, one of the main recommendations from our people, especially our Elders, was to improve health care services. Our Elders were not satisfied with the health care being provided by the Indian Health Services. For this reason, under former Chairman Wendsler Nosie, Sr.’s Administration, the San Carlos Council conducted a feasibility study in 2008 to potentially take over management and operation of the I.H.S. San Carlos Service Unit. For various reasons, the Council did not follow through with the feasibility study.
In 2011, the Council decided to conduct another feasibility study to potentially take over management and operation of the I.H.S. San Carlos Service Unit. The Council formed a working group and appointed then Hospital Construction Project Manager Harding Burdette, then General Manager Terry Jones, then Health Department Director Velda Williams and I to start the feasibility process. The Council applied for and we were successful in obtaining a management grant from I.H.S. to assist us. With the grant funds, we hired Kenneth White and Julia James to conduct the feasibility study. We held community meetings in all the districts to inform and educate our people. Upon the completion of the feasibility study in 2013, the Council decided to start the process of taking over management and operation of our hospital and clinic by submitting a letter of intent and a contract proposal to I.H.S.
In 2015, two parallel paths converged to improve health care services for our people. One, under the leadership of Hospital Construction Project Manager Harding Burdette, we completed the construction of our new hospital in Peridot. Two, after much negotiations, the I.H.S. approved the Tribe’s P.L. 93-638 contract proposal to take over management and operation of the hospital and clinic.
Since 2015, we have improved and increased the level of services to our people and this is reflected in the increase of health care employees from 277 in 2015 to 762 today. We have come a long way. The demand for health care services continues to increase. It won’t be long before we have over 1,000 employees at our hospital and clinic. I am happy to be here and look forward to the planning meeting to discuss our Izee Baa Gowah capital project planning for the next four years.”
Izee Baa Gowah’s model of care is to put the patient and family front and center to ensure they receive the best care. They have over 46 departments with 762 employees. They receive an average of 17,000 patient visits a month. They have increased their revenues from $72 million in 2016 to $122 million in 2020. The Izee Baa Gowah shared the following.
Background
From the 2013 feasibility study, the Council lobbied Congress for full funding of the staffing package of 250 employees for the new hospital. The Council created the San Carlos Apache Health Care Corporation with its Articles of Incorporation & Bylaws and appointed a Board of Directors in 2014. The Council directed its Health Care Board to provide more flexibility, creativity and innovation for its people in the delivery of services. The Council directed its Health Care Board to increase third party revenues. The Council directed its Health Care Board to increase health education opportunities for its people and employees. The Council directed its Health Care Board to implement “Apaches Healing Apaches.” The Council continues to lobby for funding and services in support of its hospital and clinic.
Successes
In 2015, the Hospital had its first inpatient stay. They met with I.H.S. employees encouraging them to either work directly for the corporation or enter into intergovernmental personal agreements and to share decision making. The Hospital hired Ambassadors to improve the quality of experience.
In 2016, the Hospital obtained a Medicare enrollment number in order to bill for third party revenues. The Council transitioned its Diabetes Program to the Hospital. The Hospital contracted for a mobile Magnetic Resonance Imaging (MRI) services to be provided three times a week. The MRI scans the body for images of bone and soft tissues for any potential issues. The Hospital purchased a pharmacy dispensing system.
In 2017, the Hospital added over 22 specialty services, a sleep center, started providing dental full mouth restoration, and redesigned its emergency department process flow.
In 2018, the Hospital successfully passed its joint commission survey and renewed its emergency medical service base station and level 4 trauma center designations. Established a foundation for additional services and support. Upgraded its CT scanner to better diagnose heart conditions. Helped the Council to successfully obtain waiver from AHCCCS for work requirements.
In 2019, the Hospital passed its joint commission survey again. Purchased a permanent MRI and building. Increased bed capacity from 8 to 12 beds. Dental Department started providing root canals, oral surgery, and same day crowns.
In 2020, the Hospital, working with the Council, TERC, Health Department, and Police Department helped mitigate the COVID-19 pandemic. They helped with communication efforts with weekly meetings, sharing data, and KYAY radio announcements. They worked with the Gaming Enterprise to open an alternative care site using the Apache Gold Casino Hotel. Monitored patients to quarantine and isolate them with 24-hour nursing. They started providing vaccines for the virus.
In 2021, the Hospital opened its outpatient surgery department and has ordered a medical mobile unit. It is in the process of planning the design and construction of the new Clarence Wesley Health Clinic in Bylas. Submitted application to be designated as a critical access hospital. Constructing 176 additional parking spots. Constructing eight additional housing units on campus. Continue vaccination efforts to reach herd immunity. Successfully renewed the Diabetes grant. Renewed level 4 trauma center and EMS base station designations.
Strategic Plan
The Hospital’s core strategies are 1) deliver superior healthcare services to the community, 2) develop today’s and tomorrow’s workforce, 3) do the right thing at the right time for the right reason, 4) ensure financial security, growth and viability, and 5) say yes. Its foundational strategies are patient first; securing the future; quality, safety and reliability; fiscal responsibility; and innovation.
Major Capital Projects
From fiscal year 2021 to 2024, the Health Care Corporation is planning the following major construction capital projects and operational capital projects totaling $160 million dollars. 16% is scheduled for work in FY 2021, 40% in FY 2022, 20% in FY 2023, and 23% in FY 2024.
The major capital construction projects are the long-term skilled nursing care facility, Clarence Wesley health clinic, fitness center, dedicated water well, warehouse, parking lot, housing, and walking pathway.
The operational capital projects are dialysis care services, electronic health record software replacement, centralized registration process, pharmacy walk up window, life safety facility work, online oxygen system, expansion of healthcare service delivery, and various equipment replacements.
The Hospital has hired a master contractor for the Nursing Home project. A site has been chosen between the Hospital and Point of Pines turnoff north of Highway 70. An environmental assessment will be completed. Infrastructure such as water, electrical, gas, broadband, and roads will be identified. Meetings will be scheduled to get feedback from the Elders. To meet the Nursing Home, Dialysis Center, and Hospital’s water needs, a contract has been signed with an engineering firm to develop a water well specifically for the health care’s water needs. Construction for the Nursing Home is scheduled to be completed in Fiscal Year 2023.
The Hospital has hired a master contractor for the Clarence Wesley Healthcare Clinic project. The needs analysis has been completed and the design of the facility will now start. The land site for the new facility has been chosen in the foothills of Mt. Turnbull. Construction of the facility is expected to be completed in December 2022.
Other capital projects in the construction phase are a new warehouse, installation of a liquid oxygen tank, and replacement of cooling towers. Other capital projects in the conceptual stages are housing expansion, a new fitness center, a childcare center for employees, a Dialysis Center, and satellite clinics in San Carlos and Cutter.
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