Tuba City Regional Health Care Corporation (TCRHCC) is an Indian Health Service (IHS) P.L. 93-638, Title V Self Governance (?638?) tribal organization and a 501(c)(3) nonprofit. TCRHCC is a 73-bed, acute and outpatient regional health system serving a large, rural geographic area of over 6,000 square miles of the Western portion of the Navajo Nation (Tuba City Service Unit) and adjacent Hopi communities in Coconino and Navajo Counties, Arizona. TCRHCC serves as a regional referral medical center for 95,600 residents across the Navajo Nation and surrounding communities.The Navajo Nation has been ravaged by the COVID-19 pandemic, with 5,145 positive cases and 231 deaths as of 5/30/20. In fact, Navajo Nation has the highest per capita cases of Coronavirus in the United States. Native Americans make up 4.6% of the Arizona?s population, but have accounted for 19% of the state?s COVID-19 deaths to date. TCRHCC has tested 3,624 individuals since March 12, and 17% (608) of those tested positive. TCRHCC has provided care to an average of 83 COVID-positive patients per week over the past month. Health and socioeconomic inequities make TCRHCC?s service area particularly vulnerable to COVID-19. High poverty rates coupled with housing shortages mean it is very common for multiple generations to live in one small dwelling. When one member of the family is diagnosed with COVID-19, there is nowhere for that person to go to quarantine away from the other family members, including elders. Approximately one-third of families on the Navajo Nation do not have running water in their homes, and must travel to communal spots to haul water. This makes the most important preventative measure in the fight against COVID-19 ? hand washing ? much more challenging. Prevalence of diabetes, obesity, and other chronic health conditions is high among TCRHCC?s patients, putting them at increased risk for serious complications or death resulting from COVID-19.As the sole health car
e provider in the Tuba City service unit of the Navajo Nation, TCRHCC bears a heavy load in responding to the COVID-19 crisis among this population. TCRHCC will utilize the requested $1,921,380 of CDC funding to offset the mounting expenses related to its COVID-19 response, ultimately reducing community spread of COVID-19 and improving long-term health outcomes of patients who contract the virus. This includes procuring enough personal protective equipment (PPE) to ensure all clinical staff are protected from possible transmission of the virus; set-up of screening/triage tents in the TCRHCC parking lot and a ?red zone? separate emergency room entrance for those with respiratory symptoms to reduce the risk of viral spread within the hospital; cleaning and sanitation supplies to prevent further spread of COVID-19 within the hospital and among families of discharged patients; adequate levels of supplies to test every community member exhibiting symptoms or with potential exposure to COVID-19; a team of contact tracer RNs and data managers to accurately track and respond quickly to the pandemic; and purchase of additional ventilators and related equipment to reduce the number of community members who must be flown out of Navajo Nation to receive critical care for serious COVID-19 infection.